Understanding the role of intimate partner violence on HIV transmission in Zimbabwe: Secondary data analysis of data from the Zimbabwe demographic survey 2015-2016

Background

Gender-based violence (GBV) has been shown to have significant and long-lasting impacts on women's physical and mental health. It is, therefore, important to study its occurrence in a population and its intersect with infectious diseases such as HIV to inform the wider health promotion agenda. This study aimed to determine the association between GBV and HIV status in women and adolescent girls in Zimbabwe.

Methods

A secondary data analysis of data from a cross-sectional Zimbabwe Demographic and Health Survey (ZDHS) was conducted. Statistical analysis was employed to establish the association between GBV and HIV status. Geospatial mapping was conducted using a kernel smoothing method was employed to generate a continuous kernel density surface to illustrate the local spatial variations of female HIV and GBV prevalence.

Results

Women and adolescent girls suffering emotional GBV, such as those subjected to humiliation by their husbands or partners, were 1.45 (1.14-1.84) [OR (95% CIs)] times more likely to be HIV positive than those who were never humiliated. The same was true for women and adolescent girls whose husbands or partners threatened to harm them or someone they love, 1.33 (1.04-1.68). There is a relationship between women's HIV status and intimate partner aggression, such as when their partners pushed, shook, or threw something at them or physically abused them. This was also the case for those who reported that partners kicked, dragged, or beat them, tried to choke or burn them on purpose, or threatened or attacked them with a knife, gun, or other weapons. Women who experienced forced sexual violence with threats were more likely 1.61 (1.08-2.41), to be HIV positive than those women who did not experience the same.

Conclusion

GBV is widely spread in Zimbabwe. There is a need for the government to implement creative strategies to reach out to survivors, especially those that are forced to have unprotected sex and are at increased risk of HIV acquisition. This manuscript raises issues that can be addressed by robust health promotion strategies to reduce the impact of the syndemic of GBV and HIV acquisition in Zimbabwe.

The case to scale up edutainment as an effective public health communication intervention to combat the COVID-19 pandemic in Zimbabwe

Efforts to control the coronavirus disease 2019 (COVID-19) pandemic have been negatively affected by myths, misconceptions and misinformation, fuelled by an "infodemic" spread via social media platforms. In response, The Zimbabwean COVID-19 response built on its experience with past public health communication strategies to employ edutainment strategies for COVID-19 awareness campaigns. This article discusses the different strategies and how they were employed. In this perspective piece, the authors discuss edutainment as an effective vehicle for reaching wider sectors of society. In tackling complex social issues with simple language, integrated into various entertainment formats, edutainment can bring about change in contexts where traditional strategies and actions may prove unsuccessful.

Limited syphilis testing for key populations in Zimbabwe: A silent public health threat

In this article, the authors discuss the problem of high prevalences of active syphilis amongst key populations (KPs) in Zimbabwe, in combination with low testing rates, partly because of a difficult legal and social environment for these populations. The article highlights the need to develop strategies to address the high prevalence of syphilis amongst KPs. The authors discuss requirements for addressing deficits in existing clinical services, predominantly primary care settings, in providing primary healthcare, including sexually transmitted infection (STI) management, to Zimbabwe’s KP communities and utility of point-of-care testing and self-testing and other innovations to improve testing uptake.

Risk of mortality in HIV-infected COVID-19 patients: A systematic review and meta-analysis

BACKGROUND

The relationship between HIV infection and COVID-19 clinical outcomes remains a significant public health research problem. We aimed to determine the association of HIV comorbidity with COVID-19 mortality.

METHODS

We searched PubMed, Google Scholar and World Health Organization library databases for relevant studies. All searches were conducted from 1st to 7th December 2021. Title, abstract and full text screening was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The relative risk of mortality in HIV-infected COVID-19 patients was computed using a random-effects model. All analyses were performed using Meta and Metasens statistical packages available in R version 4.2.1 software package. The quality of included studies was assessed using the GRADE approach, Egger's test was employed to determine the risk of bias.

RESULTS

A total of 16 studies were included in this review. Among the COVID-19 patients with HIV infection, the mortality rate due to COVID-19 was 7.97% (4 287/53,801), and among the COVID-19 patients without HIV infection, the mortality rate due to COVID-19 was 0.69% (127, 961/18, 513, 747). In the random effects model, we found no statistically significant relative risk of mortality in HIV-infected COVID-19 patients (RR 1.07, 95% CI 0.86-1.32). The between-studies heterogeneity was substantial (I2 = 91%, P < 0.01), while the risk of publication bias was not significant.

CONCLUSION

Findings did not link HIV infection with an increased risk of COVID-19 mortality. Our results add to the conflicting data on the relationship between COVID-19 and HIV infection.

Risk factors for COVID-19 infection among healthcare workers. A first report from a living systematic review and meta-analysis

Health care workers (HCWs) are more than ten times more likely to be infected with coronavirus infectious disease 2019 (COVID-19) than the general population, thus demonstrating the burden of COVID-19 among HCWs. Factors that expose HCWs to a differentially high-risk of COVID-19 acquisition are important to elucidate, enable appropriate public health interventions to mitigate against high risk and reduce adverse outcomes from the infection. We conducted a systematic review and meta-analysis to summarize and critically analyze the existing evidence on SARS-CoV-2 risk factors among HCWs. With no geographical limitation, we included studies, in any country, that reported (i) the PCR laboratory diagnosis of COVID-19 as an independent variable (ii) one or more COVID-19 risk factors among HCWs with risk estimates (relative risk, odds ratio, or hazard ratio) (iii) original, quantitative study design, and published in English or Mandarian. Our initial search resulted in 470 articles overall, however, only 10 studies met the inclusion criteria for this review. Out of the 10 studies included in the review, inadequate/lack of protective personal equipment, performing tracheal intubation, and gender were the most common risk factors of COVID-19. Based on the random effects adjusted pooled relative risk, HCWs who reported the use of protective personal equipment were 29% (95% CI: 16% to 41%) less likely to test positive for COVID-19. The study also revealed that HCWs who performed tracheal intubations were 34% (95% CI: 14% to 57%) more likely to test positive for COVID-19. Interestingly, this study showed that female HCWs are at 11% higher risk (RR 1.11 95% CI 1.01–1.21) of COVID-19 than their male counterparts. This article presents initial findings from a living systematic review and meta-analysis, therefore, did not yield many studies; however, it revealed a significant insight into better understanding COVID-19 risk factors among HCWs; insights important for devising preventive strategies that protect them from this infection.

PROSPERO registration number

CRD42020193508 available for public comments via the link below https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020193508).

Inappropriate Antibiotic Use in Zimbabwe in the COVID-19 Era: A Perfect Recipe for Antimicrobial Resistance

The global COVID-19 pandemic has resulted in an upsurge in antimicrobial use. The increase in use is multifactorial, and is particularly related to the empirical treatment of SARS-CoV-2 and suspected coinfections with antimicrobials and the limited quality of diagnostics to differentiate viral and bacterial pneumonia. The lack of clear clinical guidelines across a wide range of settings, and the inadequacy of public health sectors in many countries, have contributed to this pattern. The increased use of antimicrobials has the potential to increase incidences of antimicrobial resistance, especially in low-resource countries such as Zimbabwe already grappling with multidrug-resistant micro-organism strains. By adopting the antimicrobial stewardship principles of the correct prescription and optimised use of antimicrobials, as well as diagnostic stewardship, revamping regulatory oversight of antimicrobial surveillance may help limit the occurrence of antimicrobial resistance during this pandemic.

Utilization of SARS-CoV-2 Wastewater Surveillance in Africa-A Rapid Review

Wastewater-based epidemiology for SARS-CoV-2 RNA detection in wastewater is desirable for understanding COVID-19 in settings where financial resources and diagnostic facilities for mass individual testing are severely limited. We conducted a rapid review to map research evidence on the utilization of SARS-CoV-2 wastewater surveillance in Africa. We searched PubMed, Google Scholar, and the World Health Organization library databases for relevant reports, reviews, and primary observational studies. Eight studies met the inclusion criteria. Narrative synthesis of the findings from included primary studies revealed the testing methodologies utilized and that detected amount of SARS-CoV-2 viral RNA correlated with the number of new cases in the studied areas. The included reviews revealed the epidemiological significance and environmental risks of SARS-CoV-2 wastewater. Wastewater surveillance data at the community level can be leveraged for the rapid assessment of emerging threats and aid pandemic preparedness. Our rapid review revealed a glaring gap in the primary literature on SARS-CoV-2 wastewater surveillance on the continent, and accelerated and adequate investment into research is urgently needed to address this gap.

HIV status, knowledge and prevention of cervical cancer amongst adolescent girls and women: a secondary data analysis

Introduction

the objective of this manuscript was to describe the knowledge profiles and determinants of cervical cancer screening among HIV positive and negative adolescent girls and women in Zimbabwe.

Methods

we conducted secondary statistical data analysis to explore the determinants of cervical cancer screening among HIV positive and negative adolescent girls and women using Zimbabwe Demographic Health survey for 2015-16.

Results

a total of 9054 adolescent girls aged 15-19, and women aged 20-49 were included in the analysis and the majority (63%) of them resided in rural areas. More than two-thirds (65.9%) had attained secondary level of education. The majority (41.3%) of the adolescent girls and women belonged to the Apostolic sect. A number of key determinants have been identified for being ever screened for cervical cancer. The odds of being ever being screened increased by age, OR(CI) 4.38 (3.22-5.94), p<0.001 for women who are 40 years and older when compared to adolescent and young woman who are between 15-24 years.

Conclusion

our study reports significant programmatic gaps in the provision of cervical cancer screening and treatment services in the country. The nascent Zimbabwe cervical cancer screening and treatment progamme will benefit from expansion of the number of facilities offering the services and the provision of more efficient health education to adolescent women and girls.

Optimising COVID-19 Vaccination Policy to Mitigate SARS-CoV-2 Transmission within Schools in Zimbabwe

The COVID-19 pandemic has disrupted the learning of millions of children across the world. Since March 2020 when the first cases of COVID-19 were reported in Zimbabwe, the country, like many others, has gone through periods of closing and re-opening of schools as part of the national COVID-19 control and mitigation measures. Schools promote the social, mental, physical, and moral development of children. With this viewpoint, the authors argue that schools should not be closed to provide a measured and efficient response to the threats posed by the COVID-19 epidemic. Rather, infection prevention and control strategies, including vaccination of learners and teachers, and surveillance in schools should be heightened. The use of multiple prevention strategies discussed in this viewpoint has shown that when outbreaks in school settings are adequately managed, the transmission usually is low. The information presented here suggests that schools should remain open due to the preponderance of evidence indicating the overriding positive impacts of this policy on the health, development, and wellbeing of children.

Associations of diarrhea episodes and seeking medical treatment among children under five years: Insights from the Zimbabwe Demographic Health Survey (2015-2016)

Diarrhea is a significant pediatric public health concern globally and places a significant burden on healthcare systems. In resource-limited settings, the problems of diarrhea could be worse than reported. Continuously monitoring and understanding the changing epidemiology of diarrhea, including risk factors, remain an important aspect necessary to design effective public health interventions to reduce the incidence, outcomes and strain on healthcare resources caused by diarrheal illness. We, therefore, undertook this study to understand the factors associated with diarrhea as well as describe determinants for seeking medical treatment in children under-five in Zimbabwe using the Zimbabwe Demographic and Health Survey 2015-2016 Data. Children with recent diarrhea were on average younger (mean age 22 months), compared to those who did not have an episode of diarrhea (mean age 30 months) p = .001. Incidence of recent diarrhea was lower among female children compared to their male counterparts (16% vs. 19%), p = .013. Incidence of diarrhea decreased with increasing maternal education level and so was the same for increasing wealth quintile. Those with unimproved sources of drinking water had a higher incidence of diarrhea. The wealth quintile remained the only factor associated with seeking medical attention for a recent diarrhea episode among children less than 6 years, with those in the highest wealth quintile being 2.49 times likely to do so, p = .031. The results are useful in informing pediatric public health policies and strategies for them to be successful in significantly reducing the incidence, morbidity, mortality and significant healthcare costs and burden to society associated with caring for children with diarrheal illnesses.

Mothers' HIV status and their children's nutritional status: Insights from secondary analysis of the Zimbabwe Demographic and Health Survey data (2015-2016)

Infants and young children are completely dependent on others, primarily their mothers, for nutrition. This means maternal health status is one of the most important maternal characteristics that are predictors of the nutritional status of children. This study aimed to describe the association between mothers' HIV status and their children's nutritional status using data from the Zimbabwe Demographic and Health Survey (2015-16). We used statistical analysis to determine the association between mothers' HIV status and their children's nutritional status. The findings revealed that 30%, 4%, and 11% of children whose mothers were HIV positive presented with moderate-to-severe stunting, wasting, and underweight, respectively. The risk of stunting was higher for children whose mothers were HIV positive compared with children whose mothers were HIV negative (odds ratio [OR] 1.23; 95% confidence interval [CI] 1.00-1.52)). Maternal HIV-positive status is associated with an increased risk of the child being underweight (OR 1.69; 95% CI 1.24-2.30). The prevalence of being underweight, stunting, and wasting is still high among children of HIV-positive mothers several years into HIV Care and Treatment programs. This study's findings call for implementation of a robust national wide improved infant and young child feeding scheme to enhance the overall nutritional status of children in the country.

Impact of Covid-19 on farming systems in Europe through the lens of resilience thinking

CONTEXT

Resilience is the ability to deal with shocks and stresses, including the unknown and previously unimaginable, such as the Covid-19 crisis.

OBJECTIVE

This paper assesses (i) how different farming systems were exposed to the crisis, (ii) which resilience capacities were revealed and (iii) how resilience was enabled or constrained by the farming systems' social and institutional environment.

METHODS

The 11 farming systems included have been analysed since 2017. This allows a comparison of pre-Covid-19 findings and the Covid-19 crisis. Pre-Covid findings are from the SURE-Farm systematic sustainability and resilience assessment. For Covid-19 a special data collection was carried out during the early stage of lockdowns.

RESULTS AND CONCLUSIONS

Our case studies found limited impact of Covid-19 on the production and delivery of food and other agricultural products. This was due to either little exposure or the agile activation of robustness capacities of the farming systems in combination with an enabling institutional environment. Revealed capacities were mainly based on already existing connectedness among farmers and more broadly in value chains. Across cases, the experience of the crisis triggered reflexivity about the operation of the farming systems. Recurring topics were the need for shorter chains, more fairness towards farmers, and less dependence on migrant workers. However, actors in the farming systems and the enabling environment generally focused on the immediate issues and gave little real consideration to long-term implications and challenges. Hence, adaptive or transformative capacities were much less on display than coping capacities. The comparison with pre-Covid findings mostly showed similarities. If challenges, such as shortage of labour, already loomed before, they persisted during the crisis. Furthermore, the eminent role of resilience attributes was confirmed. In cases with high connectedness and diversity we found that these system characteristics contributed significantly to dealing with the crisis. Also the focus on coping capacities was already visible before the crisis. We are not sure yet whether the focus on short-term robustness just reflects the higher visibility and urgency of shocks compared to slow processes that undermine or threaten important system functions, or whether they betray an imbalance in resilience capacities at the expense of adaptability and transformability.

SIGNIFICANCE

Our analysis indicates that if transformations are required, e.g. to respond to concerns about transnational value chains and future pandemics from zoonosis, the transformative capacity of many farming systems needs to be actively enhanced through an enabling environment.

Oral administration of Lactobacillus fermentum CRL1446 improves biomarkers of metabolic syndrome in mice fed a high-fat diet supplemented with wheat bran

This work evaluated the effect of oral administration of Lactobacillus fermentum CRL1446, feruloyl esterase producing, on metabolic biomarkers and intestinal microbiota of high fat diet-induced metabolic syndrome mice and supplemented with wheat bran.

Mixed methods protocol for a realist evaluation of electronic personal health records design features and use to support medication adherence (ePHRma)

BACKGROUND

National Health Service policy suggests that increasing usage of electronic personal health records (PHR) by patients will result in cost savings and improved public health. Medication adherence means that patients take their prescribed medication as agreed with their doctors. Some of the claimed benefits of PHRs are decreasing healthcare costs and improving medication adherence and patient outcomes.

METHODS

This is a mixed methods convergent study, primarily qualitative. The qualitative and quantitative data collection and analysis will occur in parallel, and then be synthesised. We are interviewing and surveying adults with long-term conditions to identify what are the most important and useful features of their current PHR. The data collection comprises patient demographics, the Medication Adherence Questionnaire, the personality scale Big Five Inventory-2 Extra-Short Form and the WHO Quality of Life-BREF scale. Qualitative data will be analysed using the Framework method.

ETHICS

We have received a favourable ethical opinion from the Health Research Authority/Research Ethics Committee.

What are the important design features of personal health records to improve medication adherence for patients with long-term conditions? A systematic literature review

OBJECTIVES

This systematic literature review aims to identify important design features of the electronic personal health record (PHR) that may improve medication adherence in the adult population with long-term conditions.

DATA SOURCES

PubMed (including MEDLINE), CINAHL, Science Direct (including EMBASE), BioMed Central, ACM digital, Emerald Insight, Google Scholar and Research Gate.

METHODS

Studies that were published between 1 January 2002 and 31 May 2018 in English were included if the participants were adults, with at least one long-term condition, were able to self-administer their medication and were treated in primary care settings. The quality of evidence was assessed with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system and the risk of bias was appraised using the Cochrane risk of bias tool.

RESULTS

From a total of 27 studies that matched the inclusion criteria, 12 were excluded due to low quality of evidence, 10 were rated moderate and 5 were rated high quality. All the included studies had low sample size and limited follow-up duration. Thirteen of the included studies found that the use of a PHR has increased medication adherence. The identified design features are reminders, education, personalisation and tailoring, feedback and alerts, gamification, medication management, medical appointment management, diary and self-monitoring, health condition management, set goals, patient's blog and tethered. It was impossible to draw conclusions as to which feature is important to what group of patients and why. The most frequently identified conditions were HIV and diabetes. This review did not identify any papers with negative results. It was not possible to numerically aggregate the PHR effect due to high heterogeneity of the medication adherence measurement, study type, participants and PHRs used.

CONCLUSION

Although we found recurrent evidence that PHRs can improve medication adherence, there is little evidence to date to indicate which design features facilitate this process.

PROSPERO REGISTRATION NUMBER

CRD42017060542.

'Prescribing' psychotropic medication to our rivers and estuaries

SummaryThe influence of pharmaceuticals on the environment is an increasing concern among environmental toxicologists. It is known that their growing use is leading to detectable levels in wastewater, conceivably causing harm to aquatic ecosystems. Psychotropic medication is one such group of substances, particularly affecting high-income countries. While these drugs have a clear place in therapy, there is debate around the risk/benefit ratio in patients with mild mental health problems. Therefore, it is necessary to evaluate the wider implications as risks could extend beyond the individual to non-target organisms, particularly those in rivers and estuaries.Declaration of interestNone.

Provision of Bilingual Dispensing Labels to Non-Native English Speakers: An Exploratory Study

Patients with limited English proficiency living in the U.K. receive prescribed medication labels in English. These patients are at risk of worse health outcomes compared with the general population. This article describes a service evaluation of the use of bilingual dispensing labels to facilitate patient understanding of medicine administration instructions. Recruited patients answered two questionnaires to assess engagement with and understanding of their medicine labels. The first was completed at the point of dispensing, and the second within six weeks. Questionnaires were either self-completed or via facilitation over the telephone. A total of 151 participants completed the first questionnaire, and 130 completed the follow-up. Key findings highlighted the lack of engagement by participants with English-language labels and their reliance on asking for help from pharmacy staff, friends, or family to understand the information. However, when provided with information in their preferred language, they reported high levels of understanding and sought help less frequently from a third party. This study has shown that this service has improved understanding of labelling information in this target group.

Important Design Features of Personal Health Records to Improve Medication Adherence for Patients with Long-Term Conditions: Protocol for a Systematic Literature Review

Background

The National Health Service (NHS) England spent £15.5 billion on medication in 2015. More than a third of patients affected by at least one long-term condition do not adhere to their drug regime. Many interventions have been trialed to improve medication adherence. One promising innovation is the electronic personal health record.

Objective

This systematic literature review aims to identify the important design features of personal health records to improve medication adherence for patients with long-term conditions.

Methods

This protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA-P 2015) statement. The following databases will be searched for relevant articles: PubMed, Science Direct, BioMed Central, Cumulative Index to Nursing and Allied Health Literature, Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials. Studies published in the last fifteen years, in English, will be included if the participants are adults who were treated outside the hospital, have the ability to self-administer their medication, and have at least one long-term condition. The review will exclude commercial or political sources and papers without references. Papers that research pediatrics, pregnant, or terminally ill patients will also be excluded, since their medication management is typically more complex.

Results

One reviewer will screen the included studies, extract the relevant data, and assess the quality of evidence utilizing the Grading of Recommendations Assessment, Development, and Evaluation system and the risk of bias using the Cochrane RevMan tool. The second reviewer will assess the quality of 25% of the included studies to assess interrater agreement. Any disagreement will be solved by a third reviewer. Only studies of high and moderate quality will be included for narrative synthesis.

Conclusions

NHS policy assumes that increasing usage of personal health records by citizens will reduce demand on health care services. There is limited evidence, however, that the use of health apps can improve patient outcomes, and, to our knowledge, this is the first systematic literature review aiming to identify important design features of the personal health record which may improve medication adherence in the adult population with long-term conditions.

Trial Registration

PROSPERO CRD42017060542; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=60542 (Archived by WebCite at http://www.webcitation.org/6zeuWXxVh)

Registered Report Identifier

RR1-10.2196/9778

Serum and gene expression profile of tumor necrosis factor-alpha and interleukin-6 in hypertensive diabetic patients: effect of amlodipine administration

Pro-inflammatory cytokines are critical factors in type 2 diabetes-associated atherosclerosis. We aim to analyze in hypertensive type 2 diabetic patients the serum concentrations and the mRNA expression levels in peripheral blood mononuclear cells (PBMC) of the pro-inflammatory cytokine tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6), as well as to evaluate the effect of amlodipine administration. Twenty-one hypertensive diabetic patients and 10 healthy non-diabetic controls were included in the study. Serum levels of cytokines were measured by chemiluminescent immunometric assay, and mRNA expression levels by RT-PCR. The mean serum concentrations of TNF-alpha and IL-6 in diabetic patients showed a 6.1-fold and 2.9-fold increase with respect to non-diabetic control subjects, respectively (p less than 0.0001). Likewise, there was a 3.3- and a 4-fold increase in the PBMC mRNA expression level of TNF-alpha and IL-6 (p less than 0.0001) in diabetic subjects. After amlodipine administration, a significant decrease (p less than 0.01) was observed in the serum TNF-alpha and IL-6 levels. In addition, pre-treatment mRNA expression of TNF-alpha and IL-6 also decreased, with a mean percent reduction of 26 percent (p less than0.01) and 25 percent (p less than 0.001), respectively. In conclusion, serum concentrations and PBMC mRNA expression levels of TNF-alpha and IL-6 are significantly elevated in hypertensive type 2 diabetic patients. Administration of amlodipine is associated with a significant reduction of the increased levels of these inflammatory parameters, both at the protein as well as at the transcriptional level. These modulatory effects of amlodipine on proinflammatory cytokine level and expression may be related to its suggested anti-atherosclerotic actions.

Relationship between Somatotype and Blood Pressure in a Group of Institutionalized Venezuelan Elders

BACKGROUND

Somatotype, as an indirect measure of estimating body composition, provides an easy and comprehensive picture of body shape. Multiple investigations have shown the existence of an association between somatotype components and cardiovascular disease.

OBJECTIVE

The aim of the present study was to examine the association of somatotype with blood pressure during ageing.

METHODS

The Heath-Carter anthropometric somatotype and both systolic (SBP) and diastolic (DBP) blood pressures were recorded. The sample included 809 healthy institutionalized elders (370 males and 439 females) from geriatric units in Caracas, Venezuela. Ages ranged from 60 to 102 years. Product-moment correlation coefficients between somatotype components and both blood pressure readings were calculated. Principal component analysis and homogeneity analysis by means of alternative least squares tests were also performed.

RESULTS

Females were more endomorphic and mesomorphic than males. Males were more ectomorphic than females. SBP showed a downward tendency with age in males, while in females the tendency was for the SBP to increase. Correlations among variables were from low to moderate and ranged from -0.37 to +0.34 in males, and from -0.18 to +0.32 in females. Correlations tended to be stronger in the younger age group and differences between sexes were found. A negative tendency in the correlation between ectomorphy and both SBP and DBP was found, except for the oldest age group, for which the correlation was positive. Endomorphy and mesomorphy showed a stable correlation pattern with blood pressure in males, while in females this pattern was more irregular and less consistent.

CONCLUSION

Individuals with high levels of SBP and DBP had mean somatotypes, which were similar to those of other male groups characterized by myocardial infarct, coronary heart disease and the risk of hypertension, indicating that these somatotypes may be associated with cardiovascular risk factors. In particular, our results indicate that individuals who present a cardiovascular risk profile are more endomorphic and mesomorphic and less ectomorphic than those with a lower cardiovascular risk profile.

Antiandrogenic effect of new synthetic steroids

These results indicate that castration decreased the flank organ diameter and the weight of the seminal vesicles, whereas daily injection of testosterone restores them. However injections of finasteride together with testosterone inhibited the diameter of the flank organs, the weight of the seminal vesicles, and the conversion of testosterone to dihydrotestosterone. The four compounds tested inhibited flank organ diameter size and the weight of the seminal vesicles as compared to the testosterone-treated animals. On the other hand, none of these compounds suppressed the conversion of testosterone to dihydrotestosterone. These results suggest that the synthesized steroids compete with androgen receptors.

Antiandrogenic effect of 16-substituted, non-substituted and D-homopregnane derivatives

The pharmacological activities of 12 pregnane derivatives (4-15) were determined on gonadectomized male hamster flank organs and seminal vesicles as antiandrogens and as 5alpha-reductase inhibitors. The results from this study indicate that subcutaneous injection of testosterone for 3 d increased the diameter of the pigmented spot in the flank organs, whereas finasteride when injected with testosterone decreased the size of the spot significantly when steroids 4-15 were injected together with testosterone, the diameter of the flank organs of gonadectomized male hamsters, decreased significantly (p<0.005) compared to testosterone. Compound 11 was the most active steroid and reduced the diameter of the pigmented spot more than the other synthesized steroids or finasteride. Subcutaneous injections of testosterone to gonadectomized animals restore the seminal vesicle size lost upon castration. Injection of testosterone plus finasteride decreased significantly the weight of these glands (p<0.005). Steroids 5-15 when injected with testosterone decreased the weight of the seminal vesicles compared to testosterone. Finasteride is a good inhibitor of the conversion of testosterone to dihydrotestosterone (DHT) (low formation of DHT) measured as pmole of DHT/g of protein/h. Steroids 6-15 inhibited the conversion of testosterone to DHT as compared to testosterone however finasteride and 10 appeared to be the most effective compounds. Castration increases the protein content of the seminal vesicles (control) expressed as microg/mg of tissues. Testosterone tends to decrease it significantly, as did compounds 4, 5, 7, 9, and 15. We demonstrated that DHT as well as cyproterone acetate and steroids 5, 6, 8, 9, 11, and 14 at increasing non radioactive steroid concentration, inhibited the binding of [3H]DHT to cytosolic androgen receptor (AR), as indicated by its Ki values. However, 4, 7, 10, 12, and 13 did not have any inhibitory effect.

A prioritization and analysis strategy for environmental surveillance results

DOE facilities are required to conduct environmental surveillance to verify that facility operations are operated within the approved risk envelope and have not caused undue risk to the public and the environment. Given a reduced budget, a strategy for analyzing environmental surveillance data was developed to set priorities for sampling needs. The radiological and metal data collected at Sandia National Laboratories, New Mexico, were used to demonstrate the analysis strategy. Sampling locations were prioritized for further investigation and the needs for routine sampling. The process of data management, analysis, prioritization, and presentation has been automated through a custom-designed computer tool. Data collected over years can be analyzed and summarized in a short table format for prioritization and decision making.

Role of membrane potential in hypoxic inhibition of L-arginine uptake by lung endothelial cells

System y+ accounts for the majority of L-arginine transport by pulmonary artery endothelial cells (PAEC). Given that membrane potential is a driving force for transport via system y+, we examined the hypothesis that hypoxia inhibits this transport by decreasing membrane potential. Porcine PAEC or plasma membrane vesicles derived from these cells were exposed to normoxia (room air-5% CO2) or hypoxia (0% O2-95% N2-5% CO2). After exposure, L-[3H]arginine transport and/or accumulation of the lipophilic cation [3H]tetraphenylphosphonium, a quantitative sensor of changes in cell membrane potential, were measured. Hypoxia caused reversible time-dependent decrease in L-arginine transport and membrane potential in PAEC and in plasma membrane vesicles. Comparable decreases in membrane potential and L-arginine transport by PAEC were also observed after depolarization induced by KCl or ouabain. Hyperpolarization, induced by valinomycin, increased membrane potential and L-arginine transport in PAEC and plasma membrane vesicles. Valinomycin also prevented the hypoxia-mediated decreases in membrane potential and L-arginine transport in PAEC. These results indicate that hypoxia-induced plasma membrane depolarization is responsible for reduced L-arginine transport by system y+ in hypoxic porcine PAEC.

Neurobehavioral test performance among apprentice painters: baseline data

In the debate on chronic effects of solvent use, it is often difficult to find information on the cerebral health status of subjects before any exposure has occurred. The objective of this study was to obtain baseline data by examination of workers at the beginning of their occupational lives. This study compares the performance of 57 apprentice painters, mean age 16.6 +/- 1.2 years, with that of 62 apprentices, mean age 16.2 +/- years, drawn from other manual trades involving no significant exposure to solvents. Their performances were compared twice over a period of 3 years using a series of behavioral tests chosen from a translated version of the Neurobehavioral Evaluation System (NES). There were no major differences in performance between the apprentices, except for the verbal ability test, which showed lower results for painters. This can be explained by factors such as socioeconomic background, previous schooling, or mother tongue, and raises the question of whether it is appropriate to use such a test to adjust for the influence of premorbid ability in elderly exposed workers.

Hypoxia inhibits L-arginine uptake by pulmonary artery endothelial cells

Under physiological conditions, L-arginine transport by porcine pulmonary artery endothelial cells (PAEC) is mediated by system y+, a sodium-independent transport system that accounts for 60 +/- 5% of L-arginine transport, and system Bo,+, a sodium-dependent system that accounts for 40 +/- 5% of transport. Because NO production is dependent on intracellular L-arginine content and intracellular L-arginine content depends on transport of extracellular L-arginine, we examined the effect of hypoxia on L-arginine transport and intracellular L-arginine content in PAEC. Exposure of passage 3-7 PAEC in monolayer culture to 0% O2 for 4 h decreased L-arginine transport via system y+ from 120 +/- 10 to 81 +/- 23 (in pmol.mg protein-1.30 s-1) (P < 0.001), whereas 20-h exposures decreased transport from 122 +/- 17 to 84 +/- 18 (P < 0.001) in system y+ and from 104 +/- 19 to 90 +/- 26 (P < 0.05) in system Bo,+. Exposure to 5% O2 for 3-5 wk decreased L-arginine transport via system y+ from 128 +/- 15 to 73 +/- 13 (P < 0.001) and via system Bo,+, from 105 +/- 25 to 65 +/- 13 (P < 0.001). Kinetic studies revealed that hypoxia decreased the maximal transport velocity but not the apparent Michaelis constant for both system y+ and system Bo,+, and the decreases in transport were not reversible after return to normoxia for up to 24 h. Long-term exposure, i.e., 3-5 wk, to 5% O2 also resulted in decreases in intracellular L-arginine content (0.75 +/- 0.10 vs. 0.49 +/- 0.09 nmol/10(6) cells, P < 0.05) which did not reverse after return to normoxia for 24 h.(ABSTRACT TRUNCATED AT 250 WORDS)

Therapeutic tumor-specific cell cycle block induced by methionine starvation in vivo

The ability to induce a specific cell cycle block selectively in the tumor could have many uses in chemotherapy. In the present study we have achieved this goal of inducing a tumor-specific cell cycle block in vivo by depriving Yoshida sarcoma-bearing nude mice of dietary methionine. Further, we demonstrate that methionine depletion also causes the tumor to eventually regress. The antitumor effect of methionine depletion resulted in the extended survival of the tumor-bearing mice. The mice on the methionine-deprived diets maintained their body weight for the time period studied, indicating that tumor regression was not a function of body weight loss. The data reported here support future experiments utilizing methionine depletion as a target for tumor-selective cell cycle-dependent therapy.

Expression of the biochemical defect of methionine dependence in fresh patient tumors in primary histoculture

Methionine dependence is a metabolic defect that occurs in many human tumor cell lines but not normal in unestablished cell strains. Methionine-dependent tumor cell lines are unable to proliferate and arrest in the late S/G2 phase of the cell cycle when methionine is replaced by its immediate precursor homocysteine in the culture medium (MET-HCY+ medium). However, it is not known whether methionine dependence occurs in fresh patient tumors as it does in cell lines. In order to determine whether methionine dependence occurs in fresh patient tumors as well as whether methionine dependence occurs in fresh patient tumors as well as in cell lines we took advantage of the technique of sponge-gel-supported histoculture to grow tumors directly from surgery. We then measured nuclear DNA content by image analysis to determine the cell cycle position in MET-HCY+ compared to MET+HCY- medium in 21 human patient tumors. Human tumor cell lines found to be methionine dependent by cell count were used as positive controls and were found to have marked reduction of cells in G1 compared to total cells in the cell cycle in MET-HCY+ medium with respect to the G1: total cell ratio in MET+HCY- medium. Therefore late cell cycle arrest was used as a marker of methionine dependence for histocultured patient tumors. We found that 5 human tumors of 21, including tumors of the colon, breast, ovary, prostate, and a melanoma, were methionine dependent based on cell cycle analysis. These data on fresh human tumors indicate that methionine dependence may frequently occur in the cancer patient population. Implications for potential therapy based on methionine dependence are discussed.

Extensive liver metastasis from human colon cancer in nude and scid mice after orthotopic onplantation of histologically-intact human colon carcinoma tissue

Clinically-relevant animal models of human cancer are greatly needed for the study of human cancer biology and the development of new cancer therapeutics and diagnostics. We report here that by orthotopically transplanting histologically-intact human colon cancer to the colon of the immunodeficient nude and scid mouse mutants that extensive local growth and liver metastases occur consistently even after extensive in vivo orthotopic passage. We demonstrate that the liver metastases arise by hematogenous spread. The models described in this report for human colon cancer should prove useful for individual cancer patients as well as for basic and applied studies to develop improved treatment.

Occupational exposure of truck drivers to dust and polynuclear aromatic hydrocarbons: a pilot study in Geneva, Switzerland

The exposure to dust and polynuclear aromatic hydrocarbons (PAH) of 15 truck drivers from Geneva, Switzerland, was measured. The drivers were divided between "long-distance" drivers and "local" drivers and between smokers and nonsmokers and were compared with a control group of 6 office workers who were also divided into smokers and nonsmokers. Dust was measured on 1 workday both by a direct-reading instrument and by sampling. The local drivers showed higher exposure to dust (0.3 mg/m3) and PAH than the long-distance drivers (0.1 mg/m3), who showed no difference with the control group. This observation may be due to the fact that the local drivers spend more time in more polluted areas, such as streets with heavy traffic and construction sites, than do the long-distance drivers. Smoking does not influence exposure to dust and PAH of professional truck drivers, as measured in this study, probably because the ventilation rate of the truck cabins is relatively high even during cold days (11-15 r/h). The distribution of dust concentrations was shown in some cases to be quite different from the expected log-normal distribution. The contribution of diesel exhaust to these exposures could not be estimated since no specific tracer was used. However, the relatively low level of dust exposure dose not support the hypothesis that present day levels of diesel exhaust particulates play a significant role in the excess occurrence of lung cancer observed in professional truck drivers.

Secretory glycoproteins of the rat subcommissural organ are N-linked complex-type glycoproteins. Demonstration by combined use of lectins and specific glycosidases, and by the administration of Tunicamycin

Two experimental protocols were used to investigate the secretory glycoproteins of the subcommissural organ (SCO). Protocol I: Lectins, specific exoglycosidases and immunocytochemistry were sequentially applied to the same section or to adjacent semithin sections of the rat SCO fixed in Bouin's fluid and embedded in methacrylate. Lectins used: concanavalin A (con A), wheat germ agglutinin, Limulus polyphemus agglutinin, Ricinus communis agglutinin and Arachis hypogeae agglutinin. Glycosidases used: neuroaminidase, beta-galactosidase, alpha-mannosidase, alpha-glucosidase and beta-N-acetyl-glucosaminidase. For immunocytochemistry an antiserum against bovine Reissner's fiber (AFRU) was used. Lectins and glycosidases were used in sequences that allowed the cleaved sugar residue to be identified as well as that appearing exposed as a terminal residue. This approach led to the following conclusions: (1) the terminal sugar chain of the secreted glycoproteins has the sequence sialic acid-galactose-glucosamine-; (2) the con A-binding material present in the rough endoplasmic reticulum corresponds to mannose; (3) the apical secretory granules and Reissner's fibers displayed a strong con A affinity after removing sialic acid, thus indicating the presence of internal mannosyl residues in the secreted material; (4) after removing most of the sugar moieties the secretory material continued to be strongly immunoreactive with AFRU. Protocol II: Rats were injected into the lateral ventricle with Tunica-mycin and killed 12, 24, 50 and 60 h after the injection. The SCO of rats from the last two groups showed a complete absence of con A binding sites. The results from the two experiments confirm that the secretory glycoproteins of the rat SCO are N-linked complex-type glycoproteins with the conformation previously suggested (Rodríguez et al. 1986).

A general native-state method for determination of proliferation capacity of human normal and tumor tissues in vitro

An important need in cancer research and treatment is a physiological means in vitro by which to assess the proliferation capacity of human tumors and corresponding normal tissue for comparison. We have recently developed a native-state, three-dimensional, gel-supported primary culture system that allows every type of human cancer to grow in vitro at more than 90% frequency, with maintenance of tissue architecture, tumor-stromal interaction, and differentiated functions. Here we demonstrate that the native-state culture system allows proliferation indices to be determined for all solid cancer types explanted directly from surgery into long-term culture. Normal tissues also proliferate readily in this system. The degree of resolution of measurement of cell proliferation by histological autoradiography within the cultured tissues is greatly enhanced with the use of epi-illumination polarization microscopy. The histological status of the cultured tissues can be assessed simultaneously with the proliferation status. Carcinomas generally have areas of high epithelial proliferation with quiescent stromal cells. Sarcomas have high proliferation of cells of mesenchymal organ. Normal tissues can also proliferate at high rates. An image analysis system has been developed to automate proliferation determination. The high-resolution physiological means described here to measure the proliferation capacity of tissues will be important in further understanding of the deregulation of cell proliferation in cancer as well as in cancer prognosis and treatment.