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PubMed2001

Condom effectiveness in reducing heterosexual HIV transmission.

BACKGROUND: The amount of protection that condoms provide for HIV and other sexually transmitted diseases is unknown. Cohort studies of sexually active HIV serodiscordant couples with follow-up of the seronegative partner, provide a situation in which a seronegative partner has known exposure to the disease and disease incidence can be estimated. When some individuals use condoms and some do not, namely some individuals use condoms 100% of the time and some never use (0%) condoms, condom effectiveness can be estimated by comparing the two incidence rates. Condom effectiveness is the proportionate reduction in disease due to the use of condoms. OBJECTIVES: The objective of this review is to estimate condom effectiveness in reducing heterosexual transmission of HIV. SEARCH STRATEGY: Studies were located using electronic databases (AIDSLINE, CINAHL, Embase, and MEDLINE) and handsearched reference lists. SELECTION CRITERIA: For inclusion, studies had to have: (1) data concerning sexually active HIV serodiscordant heterosexual couples, (2) a longitudinal study design, (3) HIV status determined by serology, and (4) contain condom usage information on a cohort of always (100%) or never (0%) condom users. DATA COLLECTION AND ANALYSIS: Studies identified through the above search strategy that met the inclusion criteria were reviewed for inclusion in the analysis. Sample sizes, number of seroconversions, and the person-years of disease-free exposure time were recorded for each cohort. If available, the direction of transmission in the cohort (male-to-female, female-to-male), date of study enrollment, source of infection in the index case, and the presence of STDs was recorded. Duplicate reports on the same cohort and studies with incomplete or nonsepecific information were excluded. HIV incidence was estimated from the cohorts of "always" users and for the cohorts of "never" users. Effectiveness was estimated from these two incidence estimates. MAIN RESULTS: Of the 4709 references that were initially identified, 14 were included in the final analysis. There were 13 cohorts of "always" users that yielded an homogeneous HIV incidence estimate of 1.14 [95% C.I.:.56, 2.04] per 100 person-years. There were 10 cohorts of "never" users that appeared to be heterogeneous. The studies with the longest follow-up time, consisting mainly of studies of partners of hemophiliac and transfusion patients, yielded an HIV incidence estimate of 5.75 [95% C.I.: 3.16, 9.66] per 100 person-years. Overall effectiveness, the proportionate reduction in HIV seroconversion with condom use, is approximately 80%. REVIEWER'S CONCLUSIONS: This review indicates that consistent use of condoms results in 80% reduction in HIV incidence. Consistent use is defined as using a condom for all acts of penetrative vaginal intercourse. Because the studies used in this review did not report on the "correctness" of use, namely whether condoms were used correctly and perfectly for each and every act of intercourse, effectiveness and not efficacy is estimated. Also, this estimate refers in general to the male condom and not specifically to the latex condom, since studies also tended not to specify the type of condom that was used. Thus, condom effectiveness is similar to, although lower than, that for contraception.

Cohort Studies↗
PubMed2003

PROCORAD's international intercomparisons highlight the evolution of techniques used to determine uranium in urine.

Inter-laboratory tests are a means of assessing the analytical coherence of medical laboratories. In radiotoxicology, this kind of exercise makes it possible to keep up with laboratory know-how and with the evolution and relative performances of analytical techniques. The intercomparison exercises organised by PROCORAD (Association for the Promotion of Quality Controls in Radiotoxicological Bioassays) provide an opportunity to compare and contrast radiochemistry and metrology for the in vitro analysis of urine and faeces. For uranium compounds, the development of new techniques such as inductively coupled plasma-mass spectrometry (ICP-MS), alpha spectrometry, and laser spectrofluorimetry makes it possible to compare the effectiveness of these protocols with respect to radiation protection monitoring, both in routine and special situations. Detection limits, flexibility, repeatability, reproducibility and isotopic quantification are the criteria considered in this study. The authors present the evolution of performances for the analysis of uranium in urine over the years. However, the goal of the laboratories taking part in these annual exercises is not only to check the accuracy of their results but also to have analytical discussions and the opportunity to exchange experiences that will enrich the group's general competence.

France↗
PubMed2004

Polycomb complexes and silencing mechanisms.

Advances in the past couple of years have brought important new knowledge on the mechanisms by which Polycomb-group proteins regulate gene expression and on the consequences of their actions. The discovery of histone methylation imprints specific for Polycomb and Trithorax complexes has provided mechanistic insight on how this ancient epigenetic memory system acts to repress and indicates that it may share mechanistic aspects with other silencing and genome-protective processes, such as RNA interference.

Animals↗
PubMed1999

Milk consumption, smoking and lead concentration in human hair.

Trace elements in hair samples were examined in 79 medical and sports students in Vienna and 77 biology students in Rome (ages 19-31 years). Lead concentration was determined by inductively coupled plasma mass spectrometry. The effect of smoking on lead levels is confirmed. Those who consume milk and dairy products daily show a lower lead concentration than those who consume them occasionally, both overall and in smokers and non-smokers. The effects of milk consumption and smoking appear to be independent. It seems that smokers may not enjoy the protective effect of milk consumption to the same extent as non smokers.

Adult↗
PubMed2005

gamma-L-glutamyltaurine.

The discovery of the dipeptide gamma-glutamyltaurine (gamma-GT; glutaurine, Litoralon) in the parathyroid in 1980 and later in the brain of mammals gave rise to studies on intrinsic and synthetic taurine peptides of this type. It was suggested that gamma-glutamyltransferase (GGT; gamma-glutamyltranspeptidase) in the brain is responsible for the in vivo formation of this unusual dipeptide. gamma-GT has been prepared by both synthetic and enzymatic methods. The chemical syntheses included the use of protecting groups and coupling methods. A wide spectrum of analytical and spectroscopic methods was used to confirm the structure of the synthetic compounds and to elucidate the position of the peptide bond. Enzymatic preparation of gamma-GT from taurine takes advantage of the selective transpeptidation action of GGT on L-glutamine, glutathione, gamma-glutamyl-p-nitroanilide or other glutamine donors. Although the functional roles of gamma-GT in the brain are only poorly understood, many of its established CNS effects have been reported in the last 25 years. Its effect on emotional arousal and its anti-conflict potencies are synergistic with the anxiolytic drug diazepam. gamma-GT exhibits anti-conflict potency, which is exerted by reducing aversion or phobia and/or the anxiety levels. gamma-GT also acts as endogenous modulator in excitatory aminoacidergic neurotransmission. It is suggested that such acidic peptides through N-methyl-D-aspartic acid receptors could be part of the neurochemical substrate underlying self-stimulation of the medial prefrontal cortex. Other gamma-GT effects in neural systems include: effects on the monoamine concentration in the brain; effects on aggressive behavior in the cat; effects on thyroid hormones in the rat; amelioration of electroshock-induced amnesia; potent and long-lasting antiepileptic action (on intra-amygdaloid injection); affect the glutamatergic system in schizophrenic disorders. Roles for gamma-GT in non-neural systems have also been reported, e.g., effects on the metamorphosis of amphibians; on plasma rennin regulation; on radiation protection; on uric acid levels; on human antibody-dependent cell-mediated cytotoxicity (ADCC) and many more.

Amphibians↗
PubMedDate not supplied

Radiation-induced neoplastic transformation in vitro: evidence for a protective effect at low doses of low LET radiation.

The study of radiation-induced transformation in vitro has long been an experimental approach to examine mechanisms underlying radiation carcinogenesis. Even though the major concern of exposure to radiation is the risk of cancer induction at low radiation doses, most laboratory mechanistic studies have focused on high dose effects. This, coupled with the fact that epidemiologic data are rarely powerful enough to accurately discriminate this risk at doses <5 cGy, has led in recent years to an increased effort to study low dose effects using the endpoint of neoplastic transformation in vitro. Since transformation frequencies at low doses are typically low (< 10(-4)), such studies are, by necessity, large and labor intensive. However, they have yielded quantitative dose-response data, as well as insights into underlying cellular and molecular mechanisms. An interesting, and potentially important, finding is that low doses of low LET radiation can suppress neoplastic transformation in vitro to levels below that seen spontaneously. Mechanistic studies have revealed that multiple mechanisms are likely to be involved, and these include both the death of a subpopulation of cells prone to spontaneous neoplastic transformation and the induction of DNA repair. The relative contribution of these mechanisms appears to be dose-dependent. The relevance of in vitro studies to carcinogenesis in vivo is discussed.

Animals↗
PubMed2002

[Emergency contraception. Characteristics of the demand].

OBJECTIVE: Define the profile of the women that ask for emergency contraception (EC).Design. Transversal descriptive investigation. SETTING: Familiar Planning Center of 4th Area of Instituto Madrileño de Salud. in Madrid. Participants. All the women that went in the year 2000 requiring EC (n=404). Measurements. Was carried out a survey with sociodemographic variables, related with the EC and with the sexual life. RESULTS: The average age was of 23.9 years (age range 14 to 49) were inquired, 9.9 were under 18. They had an average of 6.7 intercourses per month, the first intercourse when they were 18 years old on average, and 4.9 years of sexual relationships. 90.9% stated to have a couple. 75% were graduated from high school or university, and 55.7% said they had never received information about contraceptives. For 19.5% this was not the first time they asked for EC. 6.5% had interrupted on purpose pregnancy and 36% of them had used EC before. The reasons to demand EC were: condom break (69.3%), held condom (16.9%) and intercourse without any protection (12%). 7% acknowledged other risky intercourses during the same period. 33.2% had been sent by a General Practitioner, 26.1% knew the center, 19% were sent by acquaintances and 16% from Emergency Services. EC was not prescribed in 12.2% of the cases because of minimum risk to pregnancy. The evaluation was made by a nurse (52.6%), by a doctor (34.4%) and by a gynecologist (13%). CONCLUSIONS: There is a lack of information about contraceptive methods. Most of the patients are sent from other sanitary services.

Adolescent↗
PubMed2001

Protease-activated receptors: how proteases signal to cells.

Certain proteases from the circulation, mast cells and elsewhere signal directly to cells by cleaving protease-activated receptors (PARs), members of a new subfamily of G-protein-coupled receptor. Cleavage exposes a tethered ligand domain that binds to and activates the cleaved receptors. Advances in the past year have improved our understanding of the molecular mechanisms of this signaling and how it is switched off. It is now recognized that PARs play important roles in 'emergency situations' - such as trauma, when there is generation or release of proteases - and are involved in coagulation, inflammation, pain, healing and protection. Selective antagonists or agonists of these receptors may be useful therapeutic agents for the treatment of human diseases.

Animals↗
PubMed2006

Barriers to effective STI screening in a post-Soviet society: results from a qualitative study.

OBJECTIVE: This qualitative study assesses knowledge about sexually transmitted infections (STI), identifies perceived barriers to STI testing, and recommends strategies to optimise participation in a home based STI testing programme. METHODS: Five focus groups composed of 29 total participants were recruited using convenience sampling methods based on age (18-40 years), gender (male and female), and residency (Tartu region, Estonia). RESULTS: The focus groups revealed significant knowledge deficits and a widespread attitude of denial. However, participants acknowledged that STIs are a serious problem and recommended strategies for increasing participation in an STI testing and treatment programme. Successful STI prevention programmes must address a number of challenges, including disease stigmatisation and privacy protection. CONCLUSION: The fear of enforced disease control methods coupled with the current stigmatisation of STIs creates a serious challenge for Estonian STI prevention and treatment efforts. This qualitative study provides a good contextual reference for STI control programmes in eastern Europe.

Adult↗
PubMed2004

Failure to detect human immunodeficiency virus type 1 superinfection in 28 HIV-seroconcordant individuals with high risk of reexposure to the virus.

We have examined the occurrence of HIV-1 superinfection in 14 HIV-seroconcordant couples (i.e., partners were independently infected with different HIV-1 strains) with high risk of reexposure to the virus. Phylogenetic analyses based on pol and env global sequences obtained from more than 100 longitudinal plasma samples (corresponding to a period of 1-4 years) failed to detect HIV-1 superinfection in this cohort of patients. Our results suggest that despite recent reports of HIV-1 reinfection, chronic HIV infection seems to confer protection against superinfection with a second HIV-1 strain.

CD4 Lymphocyte Count↗
PubMed2005

Nanotechnology and animal health.

Nanotechnology, as a new enabling technology, has the potential to revolutionise agriculture and food systems in the United States of America and throughout the world. Examples of potential applications of nanotechnology in the science and engineering of agriculture and food systems include disease treatment delivery systems, new tools for molecular and cellular biology, the security of agricultural and food systems, new materials for pathogen detection, and protection of the environment. Existing research has clearly demonstrated the feasibility of introducing nanoshells and nanotubes into animal systems to seek out and destroy targeted cells. Nanoparticles smaller than one micron have been used to deliver drugs and genes into cells. Thus, some building blocks do exist in isolation and are expected to be integrated into systems over the next 10 to 15 years. It is reasonable to presume over the next couple of decades that nanobiotechnology industries and unique developments will revolutionise animal health and medicine.

Animal Welfare↗
PubMedDate not supplied

New vaccines for the prevention of pneumococcal infections.

Streptococcus pneumoniae is a major cause of acute otitis media, pneumonia, bacteremia, and meningitis. Because in recent years antibiotic-resistant pneumococcal strains have been emerging throughout the world, vaccination against pneumococcal infections has become more urgent. The capsular polysaccharide vaccine that has been available is neither immunogenic nor protective in young children and other immunocompromised patients. Several pneumococcal proteins have been proposed as candidate vaccines, but no human studies associated with them have been reported. Clinical trials of first-generation pneumococcal conjugate vaccines have shown that covalent coupling of pneumococcal capsular polysaccharides to protein carriers improves the immunogenicity of the polysaccharides. The protective efficacy of the conjugate vaccines against carriage, acute otitis media, and invasive infections is being studied.

Adult↗
PubMed2006

Current hospital mortality of aortic valve replacement in octogenarians.

BACKGROUND AND AIM OF THE STUDY: The increasing incidence of cardiovascular disease with age, coupled to a constant extension of life expectancy in industrialized countries, is leading to an ever-increasing number of elderly patients being referred for aortic valve replacement (AVR). In light of advances in surgical technology and cardiac protection, the operative mortality and risk factors have been updated in order to specify surgical indications. METHODS: Between January 2000 and December 2004, a total of 442 patients (203 males, 239 females) aged > or =80 years (mean age 82.7 +/- 2.3 years) underwent AVR at the authors' institution. Surgery was either isolated (n = 344) or associated with coronary revascularization (n = 86), mitral valvuloplasty (n = 5) or aortic surgery (n = 7). Seventeen patients had undergone previous cardiac surgery. The EuroScore was calculated for each patient. RESULTS: Overall operative mortality was 7.5% (n = 33). Independent predictive factors of mortality were: aortic insufficiency (30%, p <0.004), NYHA class IV (20.5%, p < 0.001), left and right heart failure (11.5% and 19.4%, p <0.02), chronic renal insufficiency (18.5%, p <0.04), emergency (37.5%, p <0.001, OR = 4.7), left ventricular ejection fraction (21.1%, p <0.004, OR = 0.9), and redo surgery (35.3%, p <0.001, OR = 6). Mortality was also increased in case of associated coronary revascularization (11.6%), mitral or tricuspid surgery (20%) and ascending aorta procedure (25%). CONCLUSION: Patient functional improvement achieved after valve replacement at the cost of a rather low operative mortality justifies considering octogenarians for surgery. However, decisions should be taken on an individual basis. An earlier referral to surgery before the onset of altered cardiac function could lead to further reductions in hospital mortality.

Aged, 80 and over↗
PubMed2002

Efficacy of a new method of family planning: the Standard Days Method.

The Standard Days Method is a fertility awareness-based method of family planning in which users avoid unprotected intercourse during cycle Days 8 through 19. A prospective multi-center efficacy trial was conducted to test, in a heterogeneous population, the contraceptive efficacy of the Standard Days Method. A total of 478 women, age 18-39 years, in Bolivia, Peru, and the Philippines, with self-reported cycles of 26-32 days, desiring to delay pregnancy at least one year were admitted to the study. A single decrement multi-censoring life table analysis of the data indicate a cumulative probability of pregnancy of 4.75% over 13 cycles of correct use of the method, and a 11.96% probability of pregnancy under typical use. This article describes the study and the results. Results suggest that despite its requirement that couples modify their sexual behavior when the woman is fertile, the Standard Days Method provides significant protection from unplanned pregnancy and is acceptable to couples in a wide range of settings.

Adolescent↗
PubMed1989

Successful management of esophageal strictures without resection or replacement.

Esophageal resection or replacement has become the standard therapy for severe esophageal strictures chiefly because less aggressive methods generally have failed. We hereby report our experience with 12 consecutive infants and children who have been managed successfully by means of Stamm gastrostomy and string-guided esophageal dilatation, coupled with endoscopically guided four-quadrant intralesional steroid injection, protected by Nissen fundoplication when gastroesophageal reflux has been demonstrated. In six patients, the stricture(s) were caused by ingestion of lye. In five, they were associated with repair of esophageal atresia. In one, the etiology was never determined. The strictures averaged 3.5 cm in length (range, 1 to 10 cm); the severity of the lesions was indicated by the fact that, in all instances, patients were completely intolerant of solids, and was confirmed fluoroscopically by demonstration of significant luminal narrowing. A mean of 4.3 steroid injections (range, 1 to 8) was required to obtain complete remission of symptoms; there have been no complications except in one lye ingestion patient who developed a tiny perforation following the initial dilatation, which responded to antibiotics alone. All patients remain symptom-free; the mean length of follow-up is 6.2 years (range, 1 to 11 years). We conclude that string-guided esophageal dilatation, when coupled with endoscopically guided steroid injection, is a safe and reliable method for treatment of severe esophageal strictures, which should obviate the need for esophageal resection or replacement in most patients. Moreover, even if treatment should ultimately fail, a procedure of lesser magnitude than esophageal replacement will likely be possible.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMedDate not supplied

Caregiver and patient marital satisfaction and affect following hematopoietic stem cell transplantation: a prospective, longitudinal investigation.

The process of stem cell transplantation (SCT) is both intra and inter dependent; like patients, spousal caregivers (CGs) are affected by the experience. Few empirical investigations have focused on the needs of CGs or dyadic differences over the course of adaptation-the foci of the present study. SCT recipients and spousal CGs (n=131 dyads) completed the Profile of Mood States (POMS) and the Dyadic Adjustment Scale at three time points: pre-transplant, 6 months post-transplant and 1 year post-transplant. A separate, non-medical group completed the POMS as a normative sample. CGs reported higher levels of depression and anxiety as compared to patients and non-medical norms. With respect to marital satisfaction, couples were matched in their perceptions of the relationship prior to transplantation but grew mismatched over time. Six months and 1 year post-transplant, CGs reported lower levels of marital satisfaction relative to their patient counterparts. Counter to prediction, change in CG marital satisfaction (from pre-transplant to 1 year post-transplant) was predicted only by CG gender, not patient physical, nor psychosocial characteristics. Findings offer implications for person-specific and relationship-protective interventions.

Adaptation, Psychological↗
PubMed1990

Production of large-scale peptides in solution.

The production of large-scale peptides in solution has some advantages and some disadvantages. Advantages. (i) The layout of the synthesis can be planned in advance in respect of: main- and side-chain protection; fragment selection and methods of fragment coupling to minimize racemization. (ii) In production: purification, at best crystallization, of the intermediates; scale-up potential; analysis can be performed at each step and analytical criteria defined and different fragments can be produced at the same time. Disadvantages. There are a number of problems: solubility of the intermediates; limited scale-up potential; introduction of processes into production in an immature state; process-streamlining over several years; long-time requirement for the synthesis, which depends on the reactors that are available and the most time-consuming path of the synthesis and the demands of the market cannot be met on short notice.

Amino Acid Sequence↗
PubMed1992

Dental composites/glass ionomers: the materials.

Most commercial dental composites contain liquid dimethacrylate monomers (including BIS-GMA or variations of it) and silica-containing compositions as inorganic reinforcing filler particles coated with methacrylate-functional silane coupling agents to bond the resin to the filler. They also contain initiators, accelerators, photo-initiators, photosensitizers, polymerization inhibitors, and UV absorbers. Durability is a major problem with posterior composites. The typical life-span of posterior composites is from three to 10 years, with large fillings usually fewer than five years. Polymerization shrinkage and inadequate adhesion to cavity walls are remaining problems. Some pulp irritation can occur if deep restorations are not placed over a protective film. Some have advocated the use of glass-ionomer cement as a lining under resin composite restorations in dentin. The concept of glass-ionomer cements (GICs) was introduced to the dental profession in the early 1970's. Current GICs may contain poly(acrylic acid) or a copolymer. Higher-molecular-weight copolymers may also be used to improve the physical properties of some GICs. Stronger and less-brittle hybrid materials have been produced by the addition of water-soluble compatible polymers to form light-curing GIC formulations. The ion-leachable aluminosilicate glass powder, in an aqueous solution of a polymer or copolymer of acrylic acid, is attacked by the hydrated protons of the acid, causing the release of aluminum and calcium ions. Salt bridges are formed, and a gel matrix surrounds the unreacted glass particles. The matrix is adhesive to mineralized tissues. Provisions must be made for maintenance of the water balance of restorations for the first 24 hours.(ABSTRACT TRUNCATED AT 250 WORDS)

Bisphenol A-Glycidyl Methacrylate↗