Immunohistochemical analysis of MMP-9 and COX-2 expression in carotid atherosclerotic plaques among patients undergoing carotid endarterectomy: A prospective study

BACKGROUND

Matrix metalloproteinase-9 protein (MMP-9) and cyclooxygenase-2 (COX-2) proteins may have a role in remodelling of atherosclerotic plaques. We analysed and compared the radiological, histological and immunohistochemical characteristics of carotid atherosclerotic plaques between symptomatic and asymptomatic patients who underwent carotid endarterectomy (CEA).

METHODS

This prospective single-blinded study included 31 patients (70 [64-75] years, 58% males, 42% symptomatic) who underwent CEA and a total of 155 carotid plaque sections that were analysed. Preoperative assessment and multimodality diagnostic imaging with magnetic resonance imaging (MRI) or computed tomography angiography (CTA), histological and immunohistochemical analyses of carotid plaques including the expression of MMP-9 and COX-2 proteins were performed.

RESULTS

Symptomatic and asymptomatic patients did not significantly differ in respect to preoperative characteristics. Unstable plaques were detected in 12/13 (92.3%, p = 0.020) symptomatic patients using MRI or CTA. There was no perioperative mortality and perioperative outcomes were comparable in both groups. A significantly higher expression of MMP-9 in macrophages was observed among symptomatic patients (p = 0.020). ROC curve analysis showed statistically significant associations of both the higher intensity of COX-2 staining in CD68 PG-M1 positive macrophages (area under the curve [AUC]=0.701, p = 0.014) and higher MVD (AUC=0.821, p < 0.001) within the plaque with cerebrovascular symptoms. The expression of COX-2 and the intensity of COX-2 staining in macrophages within the unstable carotid plaques detected by preoperative MRI or CTA were significantly higher (76.1% vs. 40.0%, p = 0.038; 76.2% vs. 30.0%, p = 0.01, respectively).

CONCLUSIONS

Advanced non-invasive multimodality diagnostic imaging including MRI or CTA is reliable in differentiating unstable from stable carotid plaques. High expression of MMP-9 and COX-2 in macrophages within the symptomatic plaque is associated with increased risk of cerebrovascular complications.

TRIAL REGISTRATION

This study has been registered at the ISRCTN registry (ID ISRCTN46536832), isrctn.org Identifier: https://www.isrctn.com/ISRCTN46536832.

Detection and quantitation of iron in ferritin, transferrin and labile iron pool (LIP) in cardiomyocytes using 55Fe and storage phosphorimaging

Dysregulated iron metabolism has a detrimental effect on cardiac function. The importance of iron homeostasis in cardiac health and disease warrants detailed studies of cardiomyocyte iron uptake, utilization and recycling at the molecular level. In this study, we have performed metabolic labeling of primary cultures of neonatal rat cardiomyocytes with radioactive iron coupled with separation of labeled iron-containing molecules by native electrophoresis followed by detection and quantification of incorporated radioiron by storage phosphorimaging. For the radiolabeling we used a safe and convenient beta emitter ⁵⁵Fe which enabled sensitive and simultaneous detection and quantitation of iron in cardiomyocyte ferritin, transferrin and the labile iron pool (LIP). The LIP is believed to represent potentially dangerous redox-active iron bound to uncharacterized molecules. Using size-exclusion chromatography spin micro columns, we demonstrate that iron in the LIP is bound to high molecular weight molecule(s) (≥5000 Da) in the neonatal cardiomyocytes.

An activating mutation of GNB1 is associated with resistance to tyrosine kinase inhibitors in ETV6-ABL1-positive leukemia

Leukemias harboring the ETV6-ABL1 fusion represent a rare subset of hematological malignancies with unfavorable outcomes. The constitutively active chimeric Etv6-Abl1 tyrosine kinase can be specifically inhibited by tyrosine kinase inhibitors (TKIs). Although TKIs represent an important therapeutic tool, so far, the mechanism underlying the potential TKI resistance in ETV6-ABL1-positive malignancies has not been studied in detail. To address this issue, we established a TKI-resistant ETV6-ABL1-positive leukemic cell line through long-term exposure to imatinib. ETV6-ABL1-dependent mechanisms (including fusion gene/protein mutation, amplification, enhanced expression or phosphorylation) and increased TKI efflux were excluded as potential causes of resistance. We showed that TKI effectively inhibited the Etv6-Abl1 kinase activity in resistant cells, and using short hairpin RNA (shRNA)-mediated silencing, we confirmed that the resistant cells became independent from the ETV6-ABL1 oncogene. Through analysis of the genomic and proteomic profiles of resistant cells, we identified an acquired mutation in the GNB1 gene, K89M, as the most likely cause of the resistance. We showed that cells harboring mutated GNB1 were capable of restoring signaling through the phosphoinositide-3-kinase (PI3K)/Akt/mTOR and mitogen-activated protein kinase (MAPK) pathways, whose activation is inhibited by TKI. This alternative GNB1^K89M-mediated pro-survival signaling rendered ETV6-ABL1-positive leukemic cells resistant to TKI therapy. The mechanism of TKI resistance is independent of the targeted chimeric kinase and thus is potentially relevant not only to ETV6-ABL1-positive leukemias but also to a wider spectrum of malignancies treated by kinase inhibitors.

Current state of open access to journal publications from the University of Zagreb School of Medicine

AIMS

To identify the share of open access (OA) papers in the total number of journal publications authored by the members of the University of Zagreb School of Medicine (UZSM) in 2014.

METHODS

Bibliographic data on 543 UZSM papers published in 2014 were collected using PubMed advanced search strategies and manual data collection methods. The items that had "free full text" icons were considered as gold OA papers. Their OA availability was checked using the provided link to full-text. The rest of the UZSM papers were analyzed for potential green OA through self-archiving in institutional repository. Papers published by Croatian journals were particularly analyzed.

RESULTS

Full texts of approximately 65% of all UZSM papers were freely available. Most of them were published in gold OA journals (55% of all UZSM papers or 85% of all UZSM OA papers). In the UZSM repository, there were additional 52 freely available authors' manuscripts from subscription-based journals (10% of all UZSM papers or 15% of all UZSM OA papers).

CONCLUSION

The overall proportion of OA in our study is higher than in similar studies, but only half of gold OA papers are accessible via PubMed directly. The results of our study indicate that increased quality of metadata and linking of the bibliographic records to full texts could assure better visibility. Moreover, only a quarter of papers from subscription-based journals that allow self-archiving are deposited in the UZSM repository. We believe that UZSM should consider mandating all faculty members to deposit their publications in UZSM OA repository to increase visibility and improve access to its scientific output.

Integral membrane proteins in proteomics. How to break open the black box?

Integral membrane proteins (IMPs) are coded by 20-30% of human genes and execute important functions - transmembrane transport, signal transduction, cell-cell communication, cell adhesion to the extracellular matrix, and many other processes. Due to their hydrophobicity, low expression and lack of trypsin cleavage sites in their transmembrane segments, IMPs have been generally under-represented in routine proteomic analyses. However, the field of membrane proteomics has changed markedly in the past decade, namely due to the introduction of filter assisted sample preparation (FASP), the establishment of cell surface capture (CSC) protocols, and the development of methods that enable analysis of the hydrophobic transmembrane segments. This review will summarize the recent developments in the field and outline the most successful strategies for the analysis of integral membrane proteins.

SIGNIFICANCE

Integral membrane proteins (IMPs) are attractive therapeutic targets mostly due to their many important functions. However, our knowledge of the membrane proteome is severely limited to effectively exploit their potential. This is mostly due to the lack of appropriate techniques or methods compatible with the typical features of IMPs, namely hydrophobicity, low expression and lack of trypsin cleavage sites. This review summarizes the most recent development in membrane proteomics and outlines the most successful strategies for their large-scale analysis.

Proteomic analysis of imatinib-resistant CML-T1 cells reveals calcium homeostasis as a potential therapeutic target

Chronic myeloid leukemia (CML) therapy has markedly improved patient prognosis after introduction of imatinib mesylate for clinical use. However, a subset of patients develops resistance to imatinib and other tyrosine kinase inhibitors (TKIs), mainly due to point mutations in the region encoding the kinase domain of the fused BCR-ABL oncogene. To identify potential therapeutic targets in imatinib-resistant CML cells, we derived imatinib-resistant CML-T1 human cell line clone (CML-T1/IR) by prolonged exposure to imatinib in growth media. Mutational analysis revealed that the Y235H mutation in BCR-ABL is probably the main cause of CML-T1/IR resistance to imatinib. To identify alternative therapeutic targets for selective elimination of imatinib-resistant cells, we compared the proteome profiles of CML-T1 and CML-T1/IR cells using 2-DE-MS. We identified eight differentially expressed proteins, with strongly upregulated Na⁺/H⁺ exchanger regulatory factor 1 (NHERF1) in the resistant cells, suggesting that this protein may influence cytosolic pH, Ca²⁺ concentration or signaling pathways such as Wnt in CML-T1/IR cells. We tested several compounds including drugs in clinical use that interfere with the aforementioned processes and tested their relative toxicity to CML-T1 and CML-T1/IR cells. Calcium channel blockers, calcium signaling antagonists and modulators of calcium homeostasis, namely thapsigargin, ionomycin, verapamil, carboxyamidotriazole and immunosuppressive drugs cyclosporine A and tacrolimus (FK-506) were selectively toxic to CML-T1/IR cells. The putative cellular targets of these compounds in CML-T1/IR cells are postulated in this study. We propose that Ca²⁺ homeostasis can be a potential therapeutic target in CML cells resistant to TKIs. We demonstrate that a proteomic approach may be used to characterize a TKI-resistant population of CML cells enabling future individualized treatment options for patients.

[Publications in the Croatian medical journals by doctoral candidates at University of Zagreb School of Medicine]

By searching Medline/PubMed bibliographic database we collected data on publications of two groups of PhD candidates who earned their PhD degrees at University of Zagreb Medical School in 2000 and 2010. We identifed their publications in the Croatian medical journals and separately in the Croatian language. First group of PhD candidates (y 2000) published in the Croatian journals 34% of all published papers, with a share of 29% in the Croatian language. Another group (y 2010) published in the Croatian journals 44% of all published papers in which the number of papers published in the Croatian journals in English language grow significantly (5% vs. 31%). The number of papers published in the Croatian language decreased to 13%. Our results agreed with the global decreasing trend of the number of medical papers in non-English languages. The importance of mother-tongue in the medical education and health care may have influence on preserving scientific communication in non-English medical journals.

[Online information service: the library support for evidence-based practice]

It frequently happens that physicians do not have adequate skills or enough time for searching and evaluating evidence needed in their everyday practice. Medical librarian can serve as a mediator in enabling physicians to utilize the potential offered by contemporary evidence-based medicine. The Central Medical Library (CML) at University of Zagreb, School of Medicine, designed a web-based information service aimed at the promotion of evidence-based practice in the Croatian medical community. The users can ask for a help in finding information on their clinical problems. A responsible librarian will analyse the problem, search information resources and evaluate the evidence. The answer is returned to the user by an e-mail. In the 2008-2012 period 166 questions from 12 clinical fields were received and most of them (36.1%) came from internal medicine doctors. The share of treatment-related questions was 70.5%. In the setting of underdeveloped ICT infrastructure and inadequate EBM resources availability, such information service can help in transfer of scientific evidence into the everyday clinical practice.

[Assessing research productivity in Department of Internal Medicine, University of Zagreb, School of Medicine and University Hospital Centre Zagreb]

Bibliometric analysis may give an objective information about publishing activity, citation rate and collaboration patterns of individuals, groups and institutions. The publication productivity of the present medical staff (79 with specialist degree and 22 residents) in Department of Internal Medicine, University of Zagreb School of Medicine in University Hospital Centre Zagreb was measured by the number of papers indexed by Medline, their impact was measured by the number of times these papers had subsequently been cited in the medical literature, while the collaboration pattern was estimated by the authors' addresses listed in the papers. PubMed database was a source for verifying the bibliographic data, and the citation data were searched via Thomson Web of Scence (WoS) platform. There were a total of 1182 papers, published from 1974 to date. The number of papers per author ranged from 0 to 252. Sixty of papers were published in English, and 39% in Croatian language. The roughly equal share was published in local and foreign journals. The RCT studies and practice guidelines were among the most cited papers and were at the same time published by the highly ranked journals. The collaboration analysis confirmed the extensive involment in the international multicentric clinical trials as well as in the development of international/local practice guidelines.

Fos expression in tyrosine hydroxylase containing hypothalamic neurons in CRH-KO mice: effect of immobilization stress

OBJECTIVE

Little is known about the response of tyrosine hydroxylase (TH) containing hypothalamic neurons to stress in corticoliberine deficient (CRH-KO) mice. This study was aimed to extend this issue and reveal the data leading to a better understanding of physiological/anatomical plasticity of hypothalamic TH cells in response to acute immobilization stress (IMO) as well as of possible of CRH body deficiency contribution in the regulation of TH cells during stress. We examined the topographic distribution of TH protein immunolabeled perikarya in selected hypothalamic structures including the paraventricular (PVN), supraoptic (SON), periventricular (PeVN), arcuate (ArcN), dorsomedial (DMN), and ventromedial (VMN) nuclei and extrahypothalamic zona incerta (ZI) in CRH-KO and wild type (WT) mice.

METHODS

The animals were perfused with fixative 120 min after a single IMO stress. The brains were removed, cryo-sectioned throughout the hypothalamus and Fos-TH co-localizations were processed immunohistochemically. Fos protein was visualized by diaminobenzidine (DAB) intensified with nickel ammonium sulphate, while TH cells were labeled only with DAB chromogen. The evaluation of Fos-TH co-labeled perikarya was performed with the use of computerized Leica light microscope and expressed as the percentage of total amount of TH labeled cells.

RESULTS

From the qualitative point of view, the present data indicate similar anatomical distribution of TH immunoreactive perikarya in all brain structures investigated in both WT and CRH-KO mice, while from the quantitative point of view only TH cells in the DMN of CRH-KO mice showed a trend for increased activation by IMO.

CONCLUSIONS

In several hypothalamic structures the basic population of TH neurons was not affected by the absence of endogenous CRH. Based on the data of this study it can also be assumed that despite of the presence of direct reciprocal connections between PVN and DMN neurons, PVN CRH neurons possibly are not participating in the regulation of TH neurons in the DMN during IMO stress.

KEYWORDS

Hypothalamic nuclei - Fos-immunohistochemistry - Tyrosine hydroxylase - Immobilization stress - CRH knockout mice.

Croatian Medical Journal citation score in Web of Science, Scopus, and Google Scholar

AIM

To analyze the 2007 citation count of articles published by the Croatian Medical Journal in 2005-2006 based on data from the Web of Science, Scopus, and Google Scholar.

METHODS

Web of Science and Scopus were searched for the articles published in 2005-2006. As all articles returned by Scopus were included in Web of Science, the latter list was the sample for further analysis. Total citation counts for each article on the list were retrieved from Web of Science, Scopus, and Google Scholar. The overlap and unique citations were compared and analyzed. Proportions were compared using chi(2)-test.

RESULTS

Google Scholar returned the greatest proportion of articles with citations (45%), followed by Scopus (42%), and Web of Science (38%). Almost a half (49%) of articles had no citations and 11% had an equal number of identical citations in all 3 databases. The greatest overlap was found between Web of Science and Scopus (54%), followed by Scopus and Google Scholar (51%), and Web of Science and Google Scholar (44%). The greatest number of unique citations was found by Google Scholar (n=86). The majority of these citations (64%) came from journals, followed by books and PhD theses. Approximately 55% of all citing documents were full-text resources in open access. The language of citing documents was mostly English, but as many as 25 citing documents (29%) were in Chinese.

CONCLUSION

Google Scholar shares a total of 42% citations returned by two others, more influential, bibliographic resources. The list of unique citations in Google Scholar is predominantly journal based, but these journals are mainly of local character. Citations received by internationally recognized medical journals are crucial for increasing the visibility of small medical journals but Google Scholar may serve as an alternative bibliometric tool for an orientational citation insight.

[Attitudes of health personnel in a university hospital toward evidence-based medicine]

Over the last few years the concepts and methods of the evidence-based medicine (EBM) have been increasingly recognized and applied in the Croatian medical community. Central Medical Library at Zagreb university Medical School has been developing a web-based service aimed to help practitioners find best evidence for solving specific clinical problems. Therefore, the health personnel affiliated to a teaching hospital were surveyed. The questionnaire included 18 questions evaluating attitudes towards EBM. It was displayed by the library's information desk. There were 204 respondents, 62% of them clinical specialists. Most respondents agreed that EBM is useful in clinical decision making (57.4%) as well as in improving patient care (55.4%). Lack of personal time (60.8%) and insufficient skills (60.3%) were percieved as the main barriers to practising EBM. The vast majority of respondents (96.6%) reported never having received EBM training. The study results show that medical librarians can play an expanded role in saving the practitioners' time by searching EBM resources and assessing the quality of the information.

Response of hypothalamic oxytocinergic neurons to immobilization stress is not dependent on the presence of corticotrophin releasing hormone (CRH): a CRH knock-out mouse study

This study explores the quantitative patterns of immunolabeled Fos protein incidence in the hypothalamic paraventricular (PVN) and supraoptic nuclei (SON) oxytocinergic (OXY) neurons in response to immobilization (IMO) stress in corticotrophin releasing hormone deficient (CRH-KO) mice. Adult male mice, taken directly from cages or 120 min after a single IMO, were sacrificed by intracardial perfusion with fixative. Coronal brain sections of 30 mum thickness were processed for dual Fos/OXY immunohistochemistry. In control wild type (WT) and CRH-KO mice, scattered Fos immunoreactivity was observed in hypothalamus, including the PVN where scanty Fos signal occurred in both parvocellular and magnocellular PVN subdivisions. Dual Fos/OXY immunostainings revealed higher basal Fos expression in the PVN of control CRH-KO mice. IMO evoked a marked rise in Fos expression in OXY neurons of the PVN and SON in both WT and CRH-KO groups of mice. The present data demonstrate that 1/ CRH deficiency upregulates the basal activity of hypothalamic PVN OXY cells in CRH-KO mice and 2/ IMO stress in both WT and CRH-KO mice affects distinctly the activity of OXY cells in both SON and PVN. Our data indicate that CRH deficiency does not alter the responsiveness of PVN and SON OXY cells to IMO stress.

[Identification of differentially expressed proteins using automatic meta-analysis of proteomics-related articles]

We present here a new method for automatic meta-analysis of proteomic articles using assessment of frequency of individual protein names in the text. The list of all possible human protein names including synonyms was retrieved from UniProt knowledgebase. The retrieved names were searched in full-texts of peer-reviewed publications from electronic version of "Proteomics" journal and from PubMedCentral. In the automatic mode we have confirmed the earlier list of proteins [Petrak et al., Proteomics (2008) 8, 1744] most frequently reported as differentially expressed (DEPs) in human tissues. We have also verified, that the most recurrent proteins were reported in proteomic papers regardless of tissue, experimental goals or, to some extent, experimental methods employed. Frequently reported DEPs were: annexins, peroxiredoxins, alpha-enolase, triosephosphate isomerase, and HSP60. Besides, serum albumin, cathepsin D and vimentin were observed with relatively high frequency. The DEPs were reported in papers related to oncological, cardiovascular and neuronal diseases, and were involved in such biological processes as inflammation, cell regulation, immune responce and signal transduction. We conclude that automatic meta-analysis of proteomic papers enabled extraction of frequently reported proteins that are most likely the differentially expressed ones.

For free or for fee? Dilemma of small scientific journals

Biomedical publishing is becoming increasingly dominated by multinational companies, advertising research articles at the international market, presenting them electronically through web-based services, and distributing them to readers-consumers. It seems that they will soon become the sole publishers for the majority of biomedical journals. In the past decade, however, we witnessed a quiet revolution in the whole structure of scientific communication, influenced by new technologies and initiatives such as Open Access, PubMedCentral, PLoS, and BioMedCentral. The Croatian Medical Journal (CMJ) has recently been approached by two major publishing companies and offered to become one of the journals in their group. The editorial decision was to join neither of the publishers. We felt that the decision had to be explained to our readers by defining CMJ's position in global scientific and medical journal publishing. Our experience may be similar to that of the many biomedical journals which find themselves in a dilemma whether to join major publishers or not.

Sex and relationships for HIV positive women since HAART: a quantitative study

OBJECTIVE

To investigate current levels of sexual activity, enjoyment, condom use, and other factors affecting sexual behaviour in a sample of women living with HIV.

METHOD

Participants were self selected. A cross sectional design using semi-structured questionnaires was employed. 82 HIV positive women completed questionnaires asking about demographics, relationships, sexual behaviour, and safer sex practices. The Hospital Anxiety and Depression Scale (HADS) and Golombok-Rust Inventory of Sexual Satisfaction (GRISS) were administered.

RESULTS

28% of women had had no sexual partners since diagnosis. Mean time diagnosed was 69 months, range 4-191 months. Time since diagnosis was not associated with having had a sexual partner. 59% of women had a current sexual partner, half reporting intercourse in the past month. Infrequent sex (84%), avoidance (84%), non-communication (69%), and dysfunction (60%) were among the most prevalent sexual difficulties. Endorsement of HIV impaired sexual enjoyment was associated with reduced sexual frequency (p = 0.006) and sexual dysfunction (p = 0.042). Sexual dissatisfaction was associated with infrequency of sex (p = 0.037), avoidance (p = 0.02), and non-communication (p = 0.032). Clinically significant levels of anxiety and depression were reported in 60% and 38% of cases, respectively. Depression was associated with avoidance of sex and higher total GRISS scores (p = 0.006 and p = 0.042). 60% of respondents stated that they "always" used condoms; a trend was observed between reduced condom use and higher levels of depression and anxiety (p = 0.09 and p = 0.06, respectively).

CONCLUSION

Sexual difficulties, including abstinence, were prevalent in this sample indicating the potential for interventions addressing the psychosexual needs of HIV positive women and their partners.

[Does visibility matter? International visibility of the Lijecnicki vjesnik]

From the very beginning Lijecnicki vjesnik has been fulfilling the role of the official organ of the Croatian Medical Association publishing also original reports of the Croatian authors. To identify the international visibility of the Lijecnicki vjesnik, its coverage by international indexing and abstracting services has been analysed. Lijecnicki vjesnik has been covered by Index Medicus since 1957, and more then 4200 items are accessible through PubMed service. In the ISI Web of Science database 399 papers published in Lijecnicki Vjesnik have been cited so far. The international medical community can access the papers published by Lijecnicki vjesnik and there is no need to change its mission of the most important general medical journal in the Croatian language.

"We don't really have cause to discuss these things, they don't affect us": a collaborative model for developing culturally appropriate sexual health services with the Bangladeshi community of Tower Hamlets

OBJECTIVE

To identify barriers to accessing sexual health care among the Bangladeshi community of east London and to develop a model of community participation in service development.

METHODS

Qualitative study using one to one interviews with sexual health service users plus focus groups in community settings.

RESULTS

58 people participated in the study, 12 in individual interviews and the remainder in six focus groups. All were of Bangladeshi origin. Four main themes were reported as impacting on access to services; confidentiality concerns, relevance of services to the community, problems with discussing sexual issues, and problems with previous experiences of health promotion. Community values regarding sex outside of marriage were an important underlying factor in participants' responses. Existing sexual health services were seen as culturally insensitive by patients and community groups.

CONCLUSIONS

Community based health initiatives among hard to reach ethnic minority groups should use existing networks of statutory and non-statutory groups to benefit from local expertise and relationships. Steering groups composed of members of the local communities served by the clinic can usefully inform service development.

Journal publications from Zagreb University Medical School in 1995-1999

AIM

To analyze a five-year publication output of the Zagreb University Medical School in scientific journals, especially in the journals covered by the Current Contents (CC), bibliographic database of the Institute for Scientific Information.

METHODS

Medical School of the Zagreb University is organized in 10 preclinical, 6 public health, and 17 clinical departments, with 359 faculty members. Research activity is important for the academic promotion, with the number of publications (especially in journals covered by CC) and their impact as a key element. Bibliographic data on the published papers by the authors affiliated to the Zagreb University Medical School in the 1995-1999 period were searched in the CC and Biomedicina Croatica databases, according to the official faculty name list. The collected data were classified into three groups according to the source journals: papers published in international journals covered by the CC, Croatian journals covered by the CC, and Croatian journals not covered by the CC. The publication production was measured on individual and departmental levels by using two counting schemes: a) full publication to each author/department; and b) an equal fraction of a publication (1/n) to each author/department.

RESULTS

In the 1995-1999 period, the faculty published 578 papers in the journals covered by the CC, 22.6% of them in the subset of Croatian journals. The differences among departments were considerable, with publishing activity per faculty member varying from 0.25 to 6.23 papers in CC journals and from 0.0 to 15.8 in Croatian non-CC journals. Preclinical departments published significantly less in the Croatian journals indexed in the CC then public health and clinical departments. There was a high variance in the number of publications on the individual level, with the 15.4% of the faculty in the professor rank and 45% in the assistant rank who did not publish a single paper in journals covered by the CC in the analyzed period. On the contrary, 10.1% of professors and 6.0% of assistants published more than 10 and more than 4 CC-indexed papers, respectively. A number of authors who have been very productive in international journals indexed in the CC (11 or more papers) did not publish in Croatian journals indexed in the same database, and vice versa.

CONCLUSION

Publication output of the Zagreb University Medical School shows imbalances characteristic of a small scientific community: productivity with extreme values, relatively unsatisfactory number of papers published in the international journals covered by the CC database as compared to their importance in the process of the academic promotion, and disproportional role of certain domestic journals covered by the CC.

Psychosocial predictors of HIV/STI risk behaviours in a sample of homosexual men

OBJECTIVES

To determine the prevalence of STI/HIV risk behaviours in a sample of homosexual men and investigate the psychosocial and cognitive variables associated with these behaviours.

METHOD

A sample of 123 users of a homosexual men's sexual health clinic completed a questionnaire which included demographic information, psychometric measures, history of sexual risk behaviour, and history of non-consensual sex (NCS).

RESULTS

High rates of sexual risk were found in this sample behaviour (36% of men had risky sex in the previous month) despite using a narrower definition than other recent studies. Comparable rates of non-consensual sex were found in this sample (26% of the sample had experienced NCS); however, this variable was not directly linked to increased risk behaviour. Depression and cognitions associated with controllability or predictability of risk were associated with increased HIV/STI risk behaviour.

CONCLUSIONS

Clinical measures of depression are associated with risk behaviour in this sample as are cognitions about the uncontrollability of risk and reducing chances of exposure to HIV by insertive sexual practices and fidelity. Demographic variables, a history of non-consensual sex and depression are not predictors of risk behaviour when sexual risk cognitions are used to predict unsafe sexual practices indicating that cognitions are foremost in driving risk behaviours, demographic variables, and the NCS history of the subject. Given the considerable costs of providing medical care to patients with HIV it is likely that even modest reductions in rates of HIV infection through proactive psychological interventions to modify erroneous cognitions will prove highly cost effective.

Scientific biomedical journals in Croatia

AIM

To assess the current situation in biomedical journal publishing in Croatia, according to the journals editorial and publishing characteristics.

METHOD

A survey questionnaire with 38 questions was sent to the editors-in-chief of 43 biomedical journals in Croatia. Thirty-seven journals were analyzed.

RESULTS

In 2000, there were 14 general and 23 specialized biomedical journals in Croatia. Twenty-five journals received financial support from the government. Six journals were indexed in MEDLINE, with two of them also in Current Contents, 20 in other bibliographic databases, and 11 were not indexed at all. Twelve journals published articles in English, 11 in Croatian, and 14 in either English or Croatian. Only 9 journals were available on-line: 5 offered abstracts only and 4 offered full-text articles. There were more indexed than non-indexed journals that were financially supported by the government (p=0.031) and published in English or either English or Croatian (p=0.011). Indexed journals published more pages (p=0.020) and received more articles (p=0.030) per year. Five journals provided salary for the editorial staff and 4 paid the reviewers services. Median number of subscribers was 250 (range, 0-7,000) and median circulation 650 (range, 300-7,200). Finances, number and quality of articles, and problems with the review process were perceived by editors as the most important problems.

CONCLUSION

Many journals had financial problems despite receiving governmental or other support. Low number/quality of articles received and inefficient review process could reflect the self-containment of Croatian medical community, which comprises around 11,000 physicians and dentists. Large ranges in circulation, number of subscribers, and number of pages published per year, as well as in indexing rates, might imply large differences among the journals in their target readership and editorial policies and performance.

[Bibliometric indicators for evaluation of research work. 2. Citations and their analysis]

Citations are part of publishing in science, and scientific areas differ in use of citations. Mostly, only previously published papers which had been useful in writing and publishing the new work are cited. Therefore, the number of citations points to effective presence of a paper or an author in a scientific community, and it is used in the evaluation of scientific impact of an author, institution, discipline, country etc. Sources of data for so called citation analyses are citation indexes. Results of citation analyses should be assessed with caution, in the context of other indicators of scientific impact.

[Bibliometric indicators in evaluation of research activity. 1. Publishing and evaluation of research]

Publishing of scientific results is the key phase in scientific work. Reviewing process is a common way of evaluation of published scientific papers, but bibliometric indexes (number of papers, number of citations, impact factor etc.) are used as an adjunct in the assessment of scientific performance in scientific and academic promotion. The article discusses the presence of Croatian medical journals and Croatian medical authors in international indexing, i.e. data bases.

The association between abuse in childhood and STD/HIV risk behaviours in female genitourinary (GU) clinic attendees

OBJECTIVES

To compare and contrast women with a history of child abuse with those who have no history of child abuse on STI/HIV risk behaviours and safer sex beliefs in an inner city UK sample.

DESIGN

Cross sectional sample survey.

METHODS

Routine female clinic attendees were invited to complete an anonymous self report questionnaire which included background information, sexual and drug risk behaviour, self reported sexually transmitted infections (STIs), psychological distress (Hospital and Anxiety Depression Scale; HADS), Sexual Risk Cognitions Questionnaire (SRCQ), and history of child sexual, physical, and emotional abuse.

RESULTS

137 (45%) of 303 women reported a history of child abuse; all three forms of child abuse--sexual (26%), physical (20%), and emotional (27%) abuse--overlapped. The majority of women reported one sexual partner in the past month, and the majority did not use condoms. Women reporting a history of child abuse were more likely to have had previous STIs (p = 0.007) and to have had more than one STI (p = 0.04) compared with women who had not experienced child abuse. Injecting drug use and commercial sex work were of low prevalence across the whole sample and no group differences were found. Women reporting a history of child abuse had higher HADS anxiety (p = 0.03) compared with women with no history of child abuse. Confidence in using condoms with a sexual partner was not related to child abuse. Women with a history of child abuse reported significantly higher frequency of thoughts reflecting anticipated negative reactions from partners to suggesting condom use (p = 0.02) and judging a partner's risk by their appearance (p = 0.05) compared with women with no history of child abuse.

CONCLUSIONS

Comparable rates of child sexual abuse with US studies were found in this UK inner city population of women attending sexual health services. Women who had experienced child abuse were more likely to report ever having had an STI and having had more than one STI. Complex psychological and social factors contribute to difficulties for women in negotiating safer sex including emotional distress, abuse histories, and anticipating a negative reaction from partners. Multifaceted prevention models are needed.

Rape attitudes amongst British medical students

OBJECTIVES

To examine the rape attitudes of a sample of 252 British medical students.

DESIGN

A 20-item questionnaire was used.

SETTING

A London medical school.

SUBJECTS

Fourth-year medical students.

RESULTS

In general, students were well informed on legal and factual issues regarding rape and sexual assault. However, significant differences were found in the attitudes to rape between males and females. Female students were significantly more positive in their responses to victims.

CONCLUSIONS

These results support findings from previous studies of rape attitudes in other professional groups. Better knowledge and enlightened attitudes amongst health care staff can have a significant impact on the management of sexual assault and influence the likelihood of victims presenting for treatment. In conclusion, this study emphasizes the importance of teaching about sexual violence in British medical schools.