Understanding the experience and manifestation of depression in people living with HIV/AIDS in South Africa

Understanding the experience of depression in people living with HIV/AIDS (PLWH) could aid in the detection and treatment of the disorder. Yet, there is limited knowledge of the subjective experience of depression amongst PLWH in low- and middle-income countries despite high rates of this disorder in this population. In the current study, semi-structured interviews were conducted with depressed adults living with HIV attending a primary infectious disease clinic in South Africa. Interview transcripts were thematically analyzed. The construct of depression was consistent with DSM-IV criteria; however, the symptom presentation was distinctive. Somatic symptoms were most prominent in participants' initial presentations because participants perceived them as medically relevant. Affective, cognitive, and behavioral symptoms were not readily reported as participants did not perceive these symptoms as pertinent to their medical treatment. We identified several idioms of distress that could assist in screening for depression in this population. A valid, contextually developed screener for depression in PLWH awaits further investigation. Such a measure could play a key role in formulating a logistically feasible method of detection and treatment for depression in this population.

Use of statins and risk of glioma: a nationwide case-control study in Denmark

Background:

Laboratory studies and a single case–control study have suggested a protective effect of statins on the risk of glioma. We wished to investigate the influence of statin use on the risk of glioma in a population-based setting.

Methods:

We conducted a nationwide case–control study in Denmark based on population-based medical registries. We identified all patients aged 20 to 85 years with a first diagnosis of histologically verified glioma during 2000–2009. These cases were matched on birth year and sex with population controls. Prior use of statins since 1995 was classified into short-term use (<5 years) and long-term use (5+ years). We used conditional logistic regression to compute odds ratios (ORs), with 95% confidence intervals (CIs), for glioma associated with statin use, adjusted for potential confounders.

Results:

A total of 2656 cases and 18 480 controls were included in the study. The risk of glioma was reduced among long-term statin users (OR=0.76; 95% CI: 0.59–0.98) compared with never users of statins, and was inversely related to the intensity of statin treatment among users (OR=0.71; 95% CI: 0.44–1.15 for highest intensity). The inverse association between long-term statin treatment and glioma risk was more pronounced among men aged ⩽60 years (OR=0.40; 95% CI: 0.17–0.91) compared with men aged 60+ years (OR=0.71; 95% CI: 0.49–1.03). An inverse association was also observed among women aged ⩽60 years (OR=0.28; 95% CI: 0.06–1.25), but not among women over age 60 years (OR=1.23; 95% CI: 0.82–1.85).

Conclusion:

Long-term statin use may reduce the risk of glioma.

Diseases of farmed Atlantic salmon Salmo salar associated with infections by the microsporidian Paranucleospora theridion

The microsporidian Paranucleospora theridion was discovered in Atlantic salmon Salmo salar suffering from proliferative gill disease in a marine farm in western Norway in 2008. The parasite develops in cells of the reticuloendothelial system, cells important for normal immune function. The aim of this study was to see if P. theridion could play a part in some of the diseases with unclear causes in salmon production in Norway, i.e. proliferative gill disease (PGI), pancreas disease (PD), heart and skeletal muscle inflammation (HSMI) and cardiomyopathy syndrome (CMS). P. theridion was present in all areas with salmon farming in Norway, but high prevalence and densities of the parasite in salmon and salmon lice were only seen in southern Norway. This region is also the main area for PGI and PD in Norway. Quantification of pathogens associated with PGI, PD, HSMI and CMS diagnoses showed that P. theridion levels are high in southern Norway, and may therefore play a role in susceptibility and disease development. However, among the different diagnoses, fish with PGI are particularly heavily infected with P. theridion. Therefore, P. theridion appears as a possible primary agent in cases with high mortality in connection with PGI in western Norway.

Life cycle assessment of three water systems in Copenhagen--a management tool of the future

Environmental life-cycle assessment (LCA) was applied to evaluate three different water systems of the water sector in Copenhagen, Denmark, including technologies within water supply, facilities recycling water and treatment of sewer overflow. In these three water systems LCA was used to evaluate the environmental impacts of each of the processes involved. The overall conclusion was that LCA is suitable as a decision support tool in the water sector as it provides a holistic evaluation platform of the considered alternatives categorised in environmental impact categories. The use of LCA in the water sector of this region has limitations since it does not yet consider impact categories assessing freshwater scarcity and ecological sustainability.

Effect of parenteral zinc sulfate on colon anastomosis repair in the rat

BACKGROUND AND AIMS

To prevent colonic anastomotic dehiscence, pharmaceutical interventions should inhibit degradation of existing submucosal collagen fibers and accelerate the synthesis of new collagen molecules. Zinc has multiple functions in collagen metabolism and was recently found beneficial in colonic anastomosis repair. We have investigated the effect of daily intraperitoneal zinc (2 mg/kg) injections on the development of the biomechanical integrity of left colon anastomoses.

MATERIALS AND METHODS

Sixty Sprague-Dawley male rats (median 245 g) were allocated to treatment with zinc sulfate in saline (n = 30) or with saline alone (n = 30) starting 1 h before the anastomoses were made. Serum zinc levels and anastomotic breaking strength were determined on postoperative days 3 (n = 30) and 7 (n = 30). The initial breaking strength or suture-binding capacity was determined in additional ten non-treated animals (277 g).

RESULTS

The breaking strength of the anastomoses decreased in the two groups combined (n = 30) by 50% (p < 0.001) on day 3 but was regained by postoperative day 7 compared with the initial anastomotic biomechanical strength. Serum zinc levels also increased from day 3 to day 7 in both intervention groups and correlated significantly with breaking strength (r = 0.57, p < 0.001). Although the median serum zinc level was 14% higher (p < 0.01) on day 7 in zinc-treated than in saline-treated animals, the breaking strength did not differ significantly between zinc-treated and saline-treated rats on either day 3 (p = 0.95) or day 7 (p = 0.70).

CONCLUSION

In contrast to previous report in rabbits, we failed to demonstrate the beneficial effects of parenteral zinc supplementation on colon anastomosis repair in a rat model.

Tissue tropism of salmonid alphaviruses (subtypes SAV1 and SAV3) in experimentally challenged Atlantic salmon (Salmo salar L.)

Diagnosis of SAV infections has traditionally been based upon clinical observations together with a set of histopathological findings in exocrine pancreas, heart and skeletal muscle, but recently, real-time RT-PCR assays have been developed as a supplement for the detection of SAV. The aim of this study was to determine tissue tropism of SAV1 and SAV3 in Atlantic salmon Salmo salar L. in order to identify the most suitable tissues for real-time RT-PCR diagnostic assays. The results indicated that the pseudobranch and the heart (ventricle) are the most useful tissues for such assays, regardless of disease status. The pyloric caecae with associated pancreatic tissue is unsuitable for diagnosis using this method. The use of real-time RT-PCR enabled viral RNA detection at all stages of the disease, including in surviving fish six months after infection. Considering the short production cycle of farmed salmonids, this suggests that surviving Atlantic salmon may become life-long asymptomatic carriers of SAV after an infection.

Risk factors for peptic ulcer disease: a population based prospective cohort study comprising 2416 Danish adults

BACKGROUND

No population based prospective cohort study has previously assessed the impact of multiple risk factors, including Helicobacter pylori infection, on the incidence of peptic ulcer disease (PUD).

AIMS

To identify risk factors for PUD and estimate their relative impact on ulcer incidence.

SUBJECTS

Random sample of 2416 Danish adults with no history of PU.

METHODS

Sample members were interviewed in 1982 and 1994. PUs diagnosed within the observation period were verified through medical records. Information on psychosocial factors, lifestyle practices, and medication was obtained from a questionnaire completed at study entry. H pylori infection status was determined by ELISA.

RESULTS

The main risk factors for PUD were H pylori infection (odds ratio 4.3 (95% confidence interval 2.2; 8.3)), tobacco smoking (3.8 (1.7; 9.8)), and use of minor tranquillisers (3.0 (1.4; 6.6)). Intake of non-steroid anti-inflammatory drugs did not affect the incidence of PUD (0.4 (0.1; 2.3)). In those with increased antibodies to H pylori, tobacco smoking (12.7 (2.8; 56.8)) and intake of spirits (2.4 (1.1; 5.4)) increased the risk of PUD whereas moderate leisure time physical activity (0.3 (0.2; 0.7)) protected against PUD.

CONCLUSIONS

Tobacco smoking and H pylori infection are the main risk factors for PUD in Danish adults. Physical activity may protect against PUD in those infected with H pylori.

Guidelines for the practice of anesthesia in Norway

Since the first version saw the light of day in 1991 the Guidelines have occupied a central position in the Norwegian practice of anesthesia. This document comprises part of the quality management documents held in the departments of anesthesia in Norwegian hospitals. If departments of anesthesia are unable to adhere to certain specific points in the Guidelines, it is recommended that this should be documented in writing. It has been stated by central governmental bodies and patients' insurance organizations that the Guidelines will be an important factor in medico legal cases, although it is not an obligatory legal document for hospital owners. It is our objective that the document will form the foundation for quality assurance work in the departments of anesthesia in Norway. The purpose of this document is to ensure a satisfactory standard for the practice of anesthesia in Norway. 'The Guidelines for the Practice of Anesthesia in Norway' (the Guidelines) is a series of recommended guidelines. The practice of anesthesia in this context includes general anesthesia, regional anesthesia, controlled sedation, postoperative monitoring, and other observations where anesthesia personnel are required. The Guidelines apply to all doctors, nurses, and other personnel undertaking the delegated practice of anesthesia. Deviations from the Guidelines should be explained and documented in every case. The Guidelines should be adhered to in medical emergencies as far as possible. The Guidelines must not be allowed to prevent the execution of immediate and lifesaving measures. The Guidelines should be revised at regular intervals so that it is up-to-date with current legislation and medical and technological developments and practice.

Validity and use of a non-parallel insulin assay for pharmacokinetic studies of the rapid-acting insulin analogue, insulin aspart

A radioimmunoassay (RIA) for insulin was validated for reliable measurement of the human insulin analogue, insulin aspart, by correction of non-linear measurements. Specificity was equivalent for several species of insulin, except insulin aspart. A non-linear hyperbolic model fitted insulin aspart with a correction formula for non-linearity of: z = 1,503y/ (1,398 - y), where y denotes measured concentration and z denotes true concentration. Matrix-effects were insignificant for human, porcine, and canine heparin-plasma and for human and porcine serum. The coefficient of variation was below 15% for 80-800 pmol/L human and porcine insulin and for 80-600 pmol/L insulin aspart. The limit of detection for insulin aspart was 11.5 pmol/L with a lower limit of quantification of 17.5 pmol/ L. Dilution of serum with Pharmacia dilution media introduced no significant error. In conclusion, this paper demonstrates that a non-parallel radioimmunoassay can be used to estimate accurate concentrations of insulin aspart.

Symptom recognition in advanced cancer. A comparison of nursing records against patient self-rating

The aim of the study was to investigate the extent to which the symptoms experienced by advanced cancer patients were covered by the nursing records. On the day of the first contact with our palliative care department, a nursing record was taken, and on this or the following day, 56 patients filled in the questionnaires EORTC Quality of Life Questionnaire (EORTC QLQ-C30), Edmonton Symptom Assessment System (ESAS), and Hospital Anxiety and Depression Scale (HADS). In each patient, the symptomatology reported in the patient-completed questionnaires was compared with the symptomatology mentioned by the nurse in the nursing record. The analysis revealed good concordance concerning pain and poor physical functioning, but patients reported other symptoms or problems much more often than their nurses. Reasons for these discrepancies are discussed. It is suggested that the nurse's knowledge of the patient's symptomatology might gain from more systematic screening or from transfer of information from patient self-assessment questionnaires to the nursing records.

Development of an ELISA for vitellogenin in whole body homogenate of zebrafish (Danio rerio)

The yolk protein, lipovitellin (Lv) was purified from ovaries of mature female zebrafish (Danio rerio) by gel filtration and anion exchange chromatography. Polyclonal antibodies against Lv were raised in rabbits. Anti-Lv IgG was purified by affinity chromatography. SDS-PAGE followed by Western blotting was performed to analyse the specificity of the antibody and the immunological similarities between Lv and vitellogenin (Vtg). Anti-Lv IgG was used to develop a direct non-competitive sandwich ELISA to measure Vtg concentrations of whole body homogenate (WBH) in zebrafish. The intra- and interassay variabilities were 5.8% and 10.4%, respectively. The sensitivity was 0.2 ng Vtg x ml(-1) and the practical detection limit was 40 ng Vtg x g(-1) fish (wet weight). Adult male zebrafish were exposed to a nominal water concentration of 10 ng x l(-1) of ethinylestradiol (EE2) in a semi-static exposure system for 7 days. Compared with the control group, exposure to 10 ng EE2 x l(-1) induced a 200-fold increase in Vtg levels.

A new insulin immunoassay specific for the rapid-acting insulin analog, insulin aspart, suitable for bioavailability, bioequivalence, and pharmacokinetic studies

OBJECTIVES

To validate a specific enzyme-linked immunosorbent assay for the rapid-acting human insulin analogue, insulin aspart, in human serum, human plasma, and porcine plasma.

DESIGN AND METHODS

For the enzyme-linked immunosorbent assay, two murine monoclonal antibodies were developed that bind to two different epitopes on the insulin aspart molecule. Key parameters for validation were imprecision, accuracy, matrix effects, dilution-linearity, and cross-reactivity.

RESULTS

No cross-reactivity was found with human and porcine insulin, human proinsulin, or human C-peptide. The assay is sensitive (limit of quantification = 11.5 pmol/L), accurate (95-107% recovery with human serum, human plasma, and porcine plasma in the range 16-800 pmol/L), and has a 14.7% total imprecision within the entire analytical range. Dilution of samples gave linear results with human serum as the diluent.

CONCLUSIONS

The insulin aspart-specific enzyme-linked immunosorbent assay described in this study is well suited to study the bioavailability, bioequivalence, and pharmacokinetics of this insulin analogue.

Synthesis of epimers of L-cyclopentenylglycine using enzymatic resolution

Both epimers of the naturally occurring nonproteinogenic amino acid L-cyclopentenylglycine, (2S,1'S)- and (2S, 1'R)-2-(cyclopent-2'-enyl)glycine, were obtained via a procedure involving condensation of 3-chlorocyclopentene with diethyl acetylaminomalonate, deethoxycarbonylation, chromatographic separation of the resulting two pairs of enantiomers, and enzymatic resolution of the racemates employing enantioselective hydrolysis of the ethyl ester group with alpha-chymotrypsin. The method was used for preparation of (13)C-labeled compounds of interest for biosynthetic tracer experiments. Enantiomeric purity of the products was determined by chiral HPLC on a Crownpak CR(+) column. The biologically active (2S,1'R) isomer was obtained as a pure compound and characterized for the first time. The (2R,1'R) and (2R,1'S) isomers were obtained as N-acetyl ethyl ester derivatives.