Migration and Mobility: Correlates of Recent HIV Testing Among Substance Using Female Sex Workers at the Mexico-Guatemala Border

The goal of this paper is to determine the association between traveling to engage in sex work in another country and recent access to HIV testing among substance-using female sex workers (FSWs) in the Mexico-Guatemala border region. From 2012 to 2015, through modified time-location sampling and peer referral, 255 FSWs were recruited at Mexico's southern border. Participants completed questionnaires on sociodemographics, migration and mobility experiences, work environment factors, and substance use. A conceptual framework, as depicted by a directed acyclic graph (DAG), guided our analysis. Crude and adjusted logistic regression models were used to evaluate the relationships between mobility experiences and HIV testing in the past year. Overall HIV testing was low (41%); after considering relevant covariates (i.e., interaction with health services and organizations, and sex work characteristics) traveling to engage in sex work in another country was found to be positively associated with HIV testing in the past year. Future efforts need to consider voluntary and non-stigmatizing prevention HIV services and focus on reaching out to less mobile women.

Forming Habits, Overcoming Obstacles, and Setting Realistic Goals: A Qualitative Study of Physical Activity Maintenance Among Latinas

BACKGROUND

The impact of physical activity interventions for Latina women can be enhanced by identifying and implementing strategies to achieve long-term physical activity maintenance. Physical activity promotion research has mainly focused on physical activity initiation and we know little regarding individual, interpersonal, or environmental factors that influence maintenance of physical activity. This study aimed to qualitatively explore and understand factors associated with maintenance and non-maintenance of physical activity among Latinas.

METHODS

Semi-structured individual interviews were conducted with 21 Latinas who increased their physical activity as a result of an intervention, and who completed a 3-month maintenance period without contact from research staff. Data were analyzed using thematic analysis.

RESULTS

Important facilitators of physical activity maintenance described by participants included having made physical activity a habit; the ability to proactively overcome obstacles to engaging in physical activity, and satisfaction with outcomes obtained from engaging in physical activity. Additional facilitators mentioned by both maintainers and non-maintainers included having motivation, social support, and opportunities to be active. Both maintainers and non-maintainers reported high self-efficacy for PA maintenance in the future.

CONCLUSIONS

Guiding intervention participants to form habits and to set realistic expectations could help them to independently continue engaging in physical activity upon completion of physical activity interventions. Teaching them skills to proactively overcome obstacles may also be important for physical activity maintenance.

Psychosocial Correlates of Meeting National Guidelines for Muscle-Strengthening Activities in Latinas

BACKGROUND

Performing regular muscle-strengthening activity has numerous health benefits, including improvements in blood pressure, hemoglobin A1c, and lean body mass. Despite the disproportionate prevalence of lifestyle-related chronic disease in Latinas (diabetes, hypertension, obesity), most do not report meeting the national guidelines for muscle-strengthening activity. Existing physical activity (PA) research in Latinas has focused almost exclusively on aerobic PA. Our study examined Latinas' sociodemographic and psychosocial correlates of meeting muscle-strengthening PA guidelines that can inform future PA interventions.

METHOD

A cross-sectional study of participants (N = 436) enrolled in a randomized controlled trial promoting PA and cancer screening in Latinas was conducted, and t tests examined the associations between sociodemographic and psychosocial factors with self-reported muscle-strengthening activities. Hierarchical regression was conducted in separate blocks guided by the socioecological model (sociodemographic, individual, and interpersonal factors) to examine the independent contribution of each block to the outcome of meeting national guidelines for muscle-strengthening PA.

RESULTS

Participants who met the national PA guidelines of ≥2 days/week of muscle-strengthening activities reported significantly higher social support for PA (p < .001), greater use of behavioral strategies for PA (p < .001), and lower barriers to PA (p < .03) than those who did not meet the guidelines. Hierarchical binary logistic regression indicated behavioral strategies for PA was the only significant correlate of meeting the national guidelines for muscle-strengthening PA (odds ratio = 1.39, 95% confidence interval [1.18, 1.65], p < .001).

DISCUSSION/CONCLUSION

Results support a hypothesis that instructing Latinas to use behavior change strategies could help them increase muscle-strengthening PA.

Intercepted journeys: Associations between migration and mobility experiences and depressive symptoms among substance using migrants at the Mexico-Guatemala border

Substance use and depressive psychiatric symptoms have been associated with migration and mobility. The Mexico-Guatemala border is a key transit point for internal, regional, and international migration flows. However, there is limited knowledge of the role of substance use, migration, and mobility on mental health among migrants at this border. Our paper explores the association of migration and mobility patterns with possible major depressive symptoms among migrants at this key geographic region. We recruited 392 substance-using migrants using modified time-location sampling. Crude and adjusted logistic regression models were developed. We found that 12% of the sample had possible major depressive symptoms. After adjusting for relevant covariates, including gender, income, and perceived homelessness, we found that recent rural-urban and short-term migrants had higher odds of possible major depressive symptoms, whereas international migrants had lower odds. Findings of this paper suggest that although migrants experience hardship and uncertainty, they may respond with complex and nuanced forms of coping and planning.

Lapse, Relapse, and Recovery in Physical Activity Interventions for Latinas: a Survival Analysis

BACKGROUND

Physical activity (PA) research extensively focuses on initiation of PA, yet lapse and relapse among PA intervention participants are less well understood, particularly among minority populations such as Latinas in the USA. This study aimed to (1) determine the probability of lapse during two PA interventions for Latinas; (2) assess demographic, psychosocial, and environmental predictors of the amount of time until first lapse; and (3) identify factors predictive of lapse recovery.

METHODS

Data from 176 Latina intervention participants were pooled. Survival functions and Kaplan-Meier curves were used to illustrate probability of lapse. Cox proportional hazard models assessed predictors of time to lapse. Logistic regressions identified predictors of lapse recovery.

RESULTS

The probability of lapse after 1 month of starting to exercise was 18%, escalating to 34% after 4 months. Predictors of earlier lapse included various psychosocial constructs (i.e., self-efficacy and various processes of change), but none of the measured environmental factors, and only one demographic factor (≥ 2 children under 18). Increased use of consciousness raising at 2 months was associated with lower likelihood of lapse recovery, yet use of behavioral processes of change at 6 months was associated with higher likelihood of recovery.

CONCLUSIONS

Lapsing may not be pre-determined by demographic and environmental characteristics. On the other hand, skills that can be learned through interventions, such as skills to improve self-efficacy, seem important in the delay or prevention of lapses. Results pertaining to lapse recovery are less clear.

Crystallization of ApoA1 and ApoE4 nanolipoprotein particles and initial XFEL-based structural studies

Nanolipoprotein particles (NLPs), also called “nanodiscs”, are discoidal particles with a patch of lipid bilayer corralled by apolipoproteins. NLPs have long been of interest due to both their utility as membrane-model systems into which membrane proteins can be inserted and solubilized and their physiological role in lipid and cholesterol transport via HDL and LDL maturation, which are important for human health. Serial femtosecond crystallography (SFX) at X-ray free electron lasers (XFELs) is a powerful approach for structural biology of membrane proteins, which are traditionally difficult to crystallize as large single crystals capable of producing high-quality diffraction suitable for structure determination. To facilitate understanding of the specific role of two apolipoprotein/lipid complexes, ApoA1 and ApoE4, in lipid binding and HDL/LDL particle maturation dynamics and develop new SFX methods involving NLP membrane protein encapsulation, we have prepared and crystallized homogeneous populations of ApoA1 and ApoE4 NLPs. Crystallization of empty NLPs yields semi-ordered objects that appear crystalline and give highly anisotropic and diffuse X-ray diffraction, similar in characteristics to fiber diffraction. Several unit cell parameters were approximately determined for both NLPs from these measurements. Thus, low-background, sample conservative methods of delivery are critical. Here we implemented a fixed target sample delivery scheme utilizing the Roadrunner fast-scanning system and ultra-thin polymer/graphene support films, providing a low-volume, low-background approach to membrane protein SFX. This study represents initial steps in obtaining structural information for ApoA1 and ApoE4 NLPs and developing this system as a supporting scaffold for future structural studies of membrane proteins crystalized in a native lipid environment.

Abstract C060: Does the border play a role? Cancer-related disparities by neighborhood proximity to the US-MX border

Background Disparities in cancer outcomes have been documented among populations along the United States (US)-Mexico border. However, the drivers of these disparities have not been well characterized. We sought to identify differences in cancer-related knowledge, attitudes, and behaviors at a granular level, within the 5th largest US county. Methods The University of California, San Diego Moores Cancer Center and San Diego State University Institute for Public Health administered a county-wide assessment to a random sample of 4,000 residents with an additional random sample of 1,000 households in border-adjacent ZIP codes. Mailed in English and Spanish, the survey assessed access to care, health and cancer screening history, cancer beliefs, HPV vaccination, precision medicine knowledge, and socio-demographics. Data collection is ongoing; 494 completed surveys were included in this analysis comparing those residing in border-adjacent ZIP codes (BA; n=72) to the remainder of the county (RC; n=422) using t-tests and chi-square tests. Results Respondents from BA were demographically similar to those from those from RC in mean age and percent female (65 and 59 years; 66% and 63%, respectively). No significant differences were observed between BA and RC respondents in proportion earning &lt;$35,000 per year (26% versus 16% in RC; p=0.05) or the proportion finding it difficult or very difficult on their present income (19% versus 13% in RC; p=0.186). Although slight differences were observed in health care coverage (90% versus 97% in RC; p=0.022), there were no significant differences in access to a usual source of care or age-appropriate colorectal, breast, or cervical cancer screening. Participants from BA were less likely to rate their overall health as excellent or very good (34% versus 54% in RC; p=0.003). Agreement with fatalistic cancer statements was higher among BA respondents: 73% agreed that it seems like everything causes cancer (50% RC; p=0.001) and 36% agreed that there is not much you can do to lower your chances of getting cancer (19% RC; p=0.002). There were more HPV vaccine misperceptions among BA with significantly higher agreement with statements such as: the HPV vaccine was not properly tested (36% versus 16% in RC; p=0.001), the HPV vaccine encourages promiscuity (31% versus 12% in RC; p=0.001), and the HPV vaccine can give you HPV and cause cancer (24% versus 8% in RC; p=0.001). BA residents were less likely to have heard about physician-ordered genetic tests (56% versus 78% in RC; p&lt;0.001) and were less familiar with 9 of 13 precision medicine terms assessed (p&lt;0.05). Conclusions Despite relatively similar levels of health coverage, access to care, and screening adherence, there were significant differences between BA and RC in cancer-related misperceptions, mistrust, and knowledge. Interventions from trusted community organizations that target these areas may begin to reduce cancer disparities among border populations.

Citation Format: Corinne McDaniels-Davidson, Harvey Vu, Priscila Chagolla, Sandip Patel, Samir Gupta, Noe Crespo, Jesse Nodora, M Elena Martinez. Does the border play a role? Cancer-related disparities by neighborhood proximity to the US-MX border [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C060.

The role of physical exercise and rehabilitation in delirium

PURPOSE

This article aims to analyze the intersections between delirium, physical exercise and rehabilitation, to better understand their interrelation and to visualize future lines of research.

METHODS

In this narrative review, after an overview of brain neurophysiology and function, as common substrates to understand the relationship between delirium and physical function, we explore the scientific evidence in: (1) physical dysfunction as a risk factor for delirium; (2) physical dysfunction as a symptom of delirium and (3) functional consequences related to delirium. Later, we analyze the physical therapy as one of the main strategies in multicomponent interventions to prevent delirium, by examining intervention studies including rehabilitation, which have shown to be effective in managing delirium. Finally, we analyze how frailty, delirium and physical exercise interact with each other.

RESULTS

This review confirms the close relationship between delirium and physical dysfunction; therefore, it is not surprising that physical exercise is widely used in delirium preventive strategies. Although delirium is catalogued as a neurocognitive disorder, scientific evidence shows that it is also a motor disorder, which is to be expected, since a vast body of literature already supports an interaction between motor and cognitive function.

CONCLUSION

The motor component of delirium should be taken into account when designing interventions or strategies to address delirium. These interventions may have a special importance in frail older adults.

2'-Deoxyribosyltransferase from Leishmania mexicana, an efficient biocatalyst for one-pot, one-step synthesis of nucleosides from poorly soluble purine bases

Processes catalyzed by enzymes offer numerous advantages over chemical methods although in many occasions the stability of the biocatalysts becomes a serious concern. Traditionally, synthesis of nucleosides using poorly water-soluble purine bases, such as guanine, xanthine, or hypoxanthine, requires alkaline pH and/or high temperatures in order to solubilize the substrate. In this work, we demonstrate that the 2'-deoxyribosyltransferase from Leishmania mexicana (LmPDT) exhibits an unusually high activity and stability under alkaline conditions (pH 8-10) across a broad range of temperatures (30-70 °C) and ionic strengths (0-500 mM NaCl). Conversely, analysis of the crystal structure of LmPDT together with comparisons with hexameric, bacterial homologues revealed the importance of the relationships between the oligomeric state and the active site architecture within this family of enzymes. Moreover, molecular dynamics and docking approaches provided structural insights into the substrate-binding mode. Biochemical characterization of LmPDT identifies the enzyme as a type I NDT (PDT), exhibiting excellent activity, with specific activity values 100- and 4000-fold higher than the ones reported for other PDTs. Interestingly, LmPDT remained stable during 36 h at different pH values at 40 °C. In order to explore the potential of LmPDT as an industrial biocatalyst, enzymatic production of several natural and non-natural therapeutic nucleosides, such as vidarabine (ara A), didanosine (ddI), ddG, or 2'-fluoro-2'-deoxyguanosine, was carried out using poorly water-soluble purines. Noteworthy, this is the first time that the enzymatic synthesis of 2'-fluoro-2'-deoxyguanosine, ara G, and ara H by a 2'-deoxyribosyltransferase is reported.

Urinary phthalate metabolite concentrations among pregnant women in Northern Puerto Rico: distribution, temporal variability, and predictors

BACKGROUND

Phthalate contamination exists in the North Coast karst aquifer system in Puerto Rico. In light of potential health impacts associated with phthalate exposure, targeted action for elimination of exposure sources may be warranted, especially for sensitive populations such as pregnant women. However, information on exposure to phthalates from a variety of sources in Puerto Rico is lacking. The objective of this study was to determine concentrations and predictors of urinary phthalate biomarkers measured at multiple times during pregnancy among women living in the Northern karst area of Puerto Rico.

METHODS

We recruited 139 pregnant women in Northern Puerto Rico and collected urine samples and questionnaire data at three separate visits (18 ± 2 weeks, 22 ± 2 weeks, and 26 ± 2 weeks of gestation). Urine samples were analyzed for eleven phthalate metabolites: mono-2-ethylhexyl phthalate (MEHP), mono-2-ethyl-5-hydroxyhexyl phthalate, mono-2-ethyl-5-oxohexyl phthalate, mono-2-ethyl-5-carboxypentyl phthalate, mono-ethyl phthalate (MEP), mono-n-butyl phthalate, mono-benzyl phthalate, mono-isobutyl phthalate, mono-3-carboxypropyl phthalate (MCPP), mono carboxyisononyl phthalate (MCNP), and mono carboxyisooctyl phthalate (MCOP).

RESULTS

Detectable concentrations of phthalate metabolites among pregnant women living in Puerto Rico was prevalent, and metabolite concentrations tended to be higher than or similar to those measured in women of reproductive age from the general US population. Intraclass correlation coefficients ranged from very weak (MCNP; 0.05) to moderate (MEP; 0.44) reproducibility among all phthalate metabolites. We observed significant or suggestive positive associations between urinary phthalate metabolite concentrations and water usage/storage habits (MEP, MCNP, MCOP), use of personal care products (MEP), and consumption of certain food items (MCPP, MCNP, and MCOP).

CONCLUSIONS

To our knowledge this is the first study to report concentrations, temporal variability, and predictors of phthalate biomarkers among pregnant women in Puerto Rico. Preliminary results suggest several potentially important exposure sources to phthalates in this population and future analysis from this ongoing prospective cohort will help to inform targeted approaches to reduce exposure.

Pilot study to introduce a notification card for partner notification of sexually transmitted infections in Catalonia, Spain, June 2010 to June 2011

We conducted a cross-sectional study in 10 primary care centres in Catalonia, to determine applicability, acceptability and effectiveness of partner notification cards used by patients diagnosed of a sexually transmitted infection (STI) and to characterise these and their sexual partners. Statutorily notifiable STIs included Chlamydia infection, gonorrhoea, syphilis, human immunodeficiency virus (HIV) infection or other STIs as deemed necessary by the treating physician. Between June 2010 and June 2011, 219 index cases were enrolled, of whom 130 were men (59.4%), 71 of them men who have sex with men (54.6%). Chlamydia infection (41.1%), gonorrhoea (17.8%) and syphilis (16.0%) were the STIs most frequently diagnosed. HIV infection accounted for 4% of cases. A total of 687 sexual partners were reported, and 300 of these were traceable through the notification card (45.7%). Those who did not report traceable contacts were older (mean age: 34 years versus 31 years, p=0.03). The main reason for not distributing the card was anonymous sexual intercourse (38%). Patient referral notification cards can reach a high percentage of sexual partners at risk. However, only few notified sexual partners attended participating health centres. Internet-based partner notification may be considered in order to reach those partners not otherwise traceable.

[Attention deficit and understanding of non-literal meanings: the interpretation of indirect speech acts and idioms]

AIM

To report on the oral comprehension of the non-literal meanings of indirect speech acts and idioms in everyday speech by children with attention deficit hyperactivity disorder (ADHD).

SUBJECTS AND METHODS

The subjects in this study consisted of a sample of 29 Chilean schoolchildren aged between 6 and 13 with ADHD and a control group of children without ADHD sharing similar socio-demographic characteristics. A quantitative method was utilised: comprehension was measured individually by means of an interactive instrument. The children listened to a dialogue taken from a cartoon series that included indirect speech acts and idioms and they had to choose one of the three options they were given: literal, non-literal or distracter.

RESULTS

The children without ADHD identified the non-literal meaning more often, especially in idioms. Likewise, it should be pointed out that whereas the children without ADHD increased their scores as their ages went up, those with ADHD remained at the same point.

CONCLUSIONS

ADHD not only interferes in the inferential comprehension of non-literal meanings but also inhibits the development of this skill in subjects affected by it.

Polyunsaturated fatty acids reduce insulin and very low density lipoprotein levels in broiler chickens

An experiment was conducted to study the effect of different dietary fatty acid profiles on plasma levels of insulin, very low density lipoproteins (VLDL), cholesterol, and glucose. Diets with four types of fat (tallow, olive, sunflower, and linseed oils) at an inclusion level of 10% and a basal diet without additional fat were administered to female broiler chickens. Serum insulin, cholesterol, and plasma VLDL were affected by the different treatments; however, glucose concentrations were similar among treatments. In the fasted state, broilers fed diets with sunflower or linseed oil presented lower levels of insulin and cholesterol with respect to those fed tallow or olive oil (P < 0.05). VLDL in the fasted state was reduced in broilers fed sunflower and linseed oils (P < 0.05) with respect to those fed tallow, olive oil, or the basal diet. Plasma levels of VLDL were only significantly correlated with abdominal fat in birds fed the basal diet, in the fed and in the fasted state, and in those fed linseed oil in the fed state (P < 0.05). Results of this experiment suggest that higher insulin levels in broilers fed diets rich in saturated fatty acids could be related to higher fat deposition. Fat deposition in birds fed high fat diets was not correlated with circulating VLDL, which suggested direct dietary fat deposition, except for birds fed linseed oil diets. Although birds fed linseed oil diets presented lower levels of VLDL than those fed tallow, olive oil, or the basal diet, the higher correlation with abdominal fat suggests that in these birds, fat deposition is more dependent on hepatic VLDL secretion, despite the high dietary fat level.

Nutrient and fatty acid deposition in broilers fed different dietary fatty acid profiles

The aim of this study was to determine the effect of different dietary fatty acid profiles on efficiency of energy, fat, nitrogen, and fatty acid deposition in broiler chickens. Sixty female broiler chickens were fed a basal diet without additional fat or with 4 other diets with different fats (tallow, olive, sunflower, and linseed oils) at 10% from 28 to 48 d of age. Among broilers fed diets with added fat, those fed linseed oil had less abdominal fat (in grams and percentage) than those fed tallow (P < 0.05). Absorbed fat losses were slightly higher for birds fed linseed oil, and nitrogen efficiency was lower in those fed tallow (P < 0.05). However, there were not significant differences in energy deposition among broilers fed diets with added fat. Fatty acid balance showed the highest values of fatty acid oxidation during the experimental period in broilers fed linseed oil (48.2 g), followed by those fed sunflower oil (23.2 g). Contribution of endogenous fat synthesis to total body fat deposition was minimal in birds fed diets with added fat accounting for 3, 1.2, 8.5, and 7.5 g for broilers fed tallow, olive, sunflower, and linseed oils, respectively. This reflects lipogenesis inhibition by dietary fat addition. Interestingly, between broilers fed diets with added fat, higher values of fatty acids from endogenous synthesis were found in broilers fed diets rich in polyunsaturated fatty acids (PUFA). Results suggest that reduction of abdominal fat in broilers fed linseed oil seems to be a consequence of higher lipid oxidation despite the higher synthesis of endogenous fatty acids.

Dietary linseed oil produces lower abdominal fat deposition but higher de novo fatty acid synthesis in broiler chickens

Previous experiments have shown lower abdominal and body fat deposition in broilers fed polyunsaturated fatty acids (PUFA) compared with those fed saturated fatty acids (SFA) or monounsaturated fatty acids (MUFA). These changes in fat deposition may be related to different rates of lipid synthesis or lipid oxidation. In Experiment 1, in vivo lipogenesis of broilers fed different dietary fatty acid profiles (tallow, sunflower oil, or linseed oil) was investigated. In Experiment 2, liver fatty acid deposition of broilers fed a basal diet (without additional fat) or diets with added tallow, olive oil, sunflower oil, or linseed oil was studied. Results from Experiment 1 showed higher rates of de novo fatty acid synthesis in broilers fed the diet with added linseed oil (P < 0.05), compared with those fed tallow or sunflower oil. In Experiment 2, values of liver-to-dietary-fatty-acid ratios of fatty acids from endogenous synthesis (SFA, n-7 and n-9 fatty acids) were higher in broilers fed linseed oil and the basal diet. Results obtained in both experiments suggest that lower abdominal and body fat deposition of broilers fed PUFA compared with those fed SFA or monounsaturated fatty acids is mainly due to differences in lipid oxidation rates and that the higher in vivo lipogenesis found in broilers fed linseed oil would be another mechanism to dissipate energy, contributing to the lower fat deposition in these birds.

Dietary polyunsaturated fatty acids decrease fat deposition in separable fat depots but not in the remainder carcass

Two experiments were conducted in order to determine the effect of dietary fatty acid profile on deposition of body fat, carcass fat, and separable fat depots. Diets with four types of fat (tallow, olive, sunflower, and linseed oils) at an inclusion level of 10% were administered to female broiler chickens. In Experiment 1, total body fat, carcass fat (total body fat minus abdominal fat), and abdominal fat (AF) were determined. In Experiment 2, several separable fat depots (abdominal, neck, sartorial, and mesenteric fat) were removed and weighed. In general, the analyzed separable fat depots were reduced in broilers fed sunflower or linseed oils with respect to those fed tallow or olive oil (P < 0.05). Percentages of body and carcass fat were also slightly reduced in birds fed sunflower or linseed oil, with respect to those fed tallow; however, the differences were not statistically significant. Regression analysis showed that body fat, carcass fat, and fat depots variability were closely correlated with AF (R2 = 0.69, 0.56, and 0.81, respectively), except for birds fed tallow, in which abdominal and mesenteric fat showed a different growth pattern with respect to the other treatments and to the other fat depots. These results suggest that polyunsaturated fatty acids reduce fat deposition in separable fat depots with respect to monounsaturated and saturated fats but not in the rest of the body fat depots. The growth pattern of fat depots can be modified by dietary fatty acid profile. Broilers fed saturated fat tend to deposit more fat in abdominal and mesenteric depots.

[Developmental amnesias]

OBJECTIVE

The literature on clinical and physiophatologic characteristics of the spectrum of memory disorders in childhood is reviewed in this article.

DEVELOPMENT

There are only a few detailed reports of permanent specific memory disorders in children. Early anoxo ischaemic bihippocampal injuries can cause a selective permanent impairment of episodic daily life memory with preservation of semantic learning and general intelligence; this dissociation has been related to partial hippocampal damage whilst the entorhinal, parahippocampal and prefrontal cortices, which are critical to systematized memorizing and work memory, keep normal. Biological psychiatry research has shown that early childhood amnesias after psychological maltreatment or abuse could be related to damage in neuronal systems which support memory, caused by glutamatergic cascade. Both severe bilateral hippocampal sclerosis (also mediated by toxic neurotransmitters) in early malignant epilepsies, and massive bilateral damage of mesial temporal lobes due to herpex virus encephalitis or Reye's syndrome, cause severe amnesic deficits, frequently accompanied by absence of any language development and autism with features of Klüver-Bucy syndrome. There are also on record some examples of Korsakoff's syndrome in children with midfossa tumors.

CONCLUSIONS

All types of classical amnesias described in adults have been observed in children. Developmental amnesias are probably more frequent than currently presumed. It must be paid special attention to selective autobiographical memory impairments in individuals who underwent a partial bihippocampal damage in perinatal or early postnatal periods; they are to be distinguished from, although it may coexist with, other clinical situations such as attention deficit disorder or semantic pragmatic disorder.

Comparative study of the efficacy and tolerability of policosanol and lovastatin in patients with hypercholesterolemia and noninsulin dependent diabetes mellitus

This randomized, double-blind study was undertaken to compare the efficacy and tolerability of policosanol (10 mg/day) and lovastatin (20 mg/day) in patients with hypercholesterolemia and noninsulin dependent diabetes mellitus. After 6 weeks on a lipid lowering diet, 53 patients were randomized to receive either policosanol or lovastatin tablets that were taken o.i.d. for 12 weeks under double-blind conditions. Both groups were similar at randomization. Policosanol significantly (p < 0.001) lowered low-density lipoprotein (LDL)-cholesterol (20.4%), total cholesterol (14.2%) and the ratio of LDL-cholesterol to high-density lipoprotein (HDL)-cholesterol (23.7%). Lovastatin significantly (p < 0.01) lowered LDL-cholesterol (16.8%), total cholesterol (14.0%) and the ratio (p < 0.05) of LDL-cholesterol to HDL-cholesterol (14.9%). Triglyceride levels did not significantly change after therapy. Policosanol, but not lovastatin, significantly increased (p < 0.01) levels of HDL-cholesterol (7.5%). Comparison between groups showed that changes in HDL-cholesterol induced by policosanol were significantly greater (p < 0.01) than those induced by lovastatin. Both treatments were safe and well tolerated. Lovastatin moderately but significantly (p < 0.05) increased levels of aspartate aminotransferase, creatine phosphokinase and alkaline phosphatase. Adverse reactions were more frequent in the lovastatin group (p < 0.01) than in the policosanol group. In conclusion, policosanol administered at 10 mg/day produces more advantageous changes in HDL-cholesterol and has a better safety and tolerability profile than lovastatin 20 mg/day.

Dietary fatty acid profile modifies abdominal fat deposition in broiler chickens

An experiment was conducted to study the effect of different dietary fatty acid profiles on abdominal fat deposition in broilers. Diets with four types of fats (tallow, olive oil, sunflower oil, and linseed oil), at two levels of fat inclusion (either 6 or 10%), were administered to males from 21 to 42 d and to females from 21 to 49 d of age. The sexes were studied separately. Performance parameters, abdominal fat, muscle fat and cholesterol, and fatty acid profile of thigh, breast, and abdominal fat were determined. Broilers fed sunflower and linseed oils presented better values of feed efficiency. Abdominal fat and cholesterol content of thigh muscle were significantly lower in animals fed sunflower and linseed oils than in those fed tallow or olive oil (P < 0.001). In females, abdominal fat increased with level of fat inclusion only in birds fed tallow or olive oil, whereas it remained constant in birds fed sunflower or linseed oil. Muscle fat content was lower for birds fed tallow or olive oil but not significantly. The fatty acid profile of the different tissues reflected dietary fatty acid profile. Monounsaturated fatty acids were higher in abdominal fat, whereas polyunsaturated fatty acids were higher in muscle fat. These results suggest that polyunsaturated fatty acids produce lower abdominal fat deposition than saturated or monounsaturated fatty acids.

Incorporation of different polyunsaturated fatty acids into eggs

An experiment was carried out to examine thoroughly the relationships among different n-3 and n-6 polyunsaturated fatty acids (PUFA) in the diet, their deposition into the eggs' fat, and their effect on hens' laying performance. A diet enriched with 4% fish oil (FO) was fed to the birds throughout the 14-wk laying period (Treatment 1; T1); this was the same oil source that was replaced in proportions of 25, 50, 75, or 100% with four different fat sources, resulting in 17 isocaloric dietary treatments: linseed oil (LO; T2 to T5), rapeseed oil (RO; T6 to T9), sunflower oil (SO; T10 to T13), and tallow (T; T14 to T17). Performance parameters were recorded weekly and analyzed on the basis of the replacing fat source. At the end of the 14-wk experimental period, eggs were collected, and their fatty acid (FA) profile was determined. Performance parameters were not significantly different among grouped treatments. Smaller proportions of FO in diets resulted in lower values of saturated and higher values of n-6 FA contents, regardless of the fat source used when replacing FO. The n-6 content increased mostly because of the rise in linoleic acid (LA), although the level of arachidonic acid (AA) was always higher when FO was completely suppressed. The amount of the different n-3 long-chain PUFA was lower (P < 0.001) when FO was present in lesser proportions in the diet. However, the slope of the decline of these FA changed according to the included fat. Replacing FO with LO resulted in the lowest decline of its derivatives by elongation and desaturation and an increase in the total n-3 FA in the form of linolenic acid (LNA).

Expression of adhesion molecules in 113 patients with B-cell chronic lymphocytic leukemia: relationship with clinico-prognostic features

The B-cell chronic lymphocytic leukemia (B-CLL) is a heterogeneous disease, its clinical and biological behavior possibly being influenced by surface molecules expressed in B-lymphocytes. These molecules mediate cell adhesion, mobility and homing. Expression of surface adhesion molecules of the integrin family (CD11a/CD18 or LFA-1, CD11c/CD18), of the immunoglobulin-related family (CD54), of the selectin family (CD62L or LAM-1) and the lymphocyte homing receptor (CD44) were analyzed in peripheral cells from 113 B-CLL patients. The association with three prognosis-related parameters (Rai stage, bone marrow pattern and doubling time) was determined. The study included only patients with B-CLL lymphocytes of typical morphology, which always expressed CD5 and CD23. Low expression of integrins, particularly CD18, was associated with advanced disease (Rai stages III-IV) and diffuse bone marrow pattern, even after adjusting for other prognosis-related variables. Expression of CD54 was associated independently with rapid doubling time (less than 12 months). The association persisted after adjusting for stage and bone marrow pattern; CD44 was expressed in all patients. No correlations were found between expression of CD62L and the prognostic variables analyzed. In conclusion, CD54 expression and low CD18 expression are both significantly associated with poor prognostic features.

Incidence and characteristics of lymphoid malignancies in untreated myelodysplastic syndromes

We have analyzed 1,198 patients with untreated myelodysplastic syndromes (MDS) with two main objectives: (1) to determine the prevalence of lymphoid malignancies (LM) in MDS patients; and (2) to ascertain whether there is some relationship between the MDS subtype and the LM type. In fourteen of 1,198 primary MDS patients (1%) (4 with refractory anemia, 3 with refractory anemia with ring sideroblasts, 2 with refractory anemia with excess of blasts and 5 with chronic myelomonocytic leukemia) a LM was detected. In all cases, the LM was of the B-cell type: 6 cases of chronic lymphocytic leukemia, 5 cases of lymphoplasmacytoid lymphoma, and 3 cases of multiple myeloma. B-cell malignancy did not prevail in any MDS subtype and no correlation was observed between the different varieties of both diseases. In conclusion, in this large series, 1% of the untreated patients with MDS had B-cell malignancy, an association that in most cases is likely to be merely coincidental.

Oligoblastic leukaemia with (8;21) translocation and haemophagocytic syndrome and granulocytic cannibalism

We report a 47-year-old man with oligoblastic leukaemia (8;21) translocation, phenomenon of cannibalism by granulocytic cells and haemophagocytic syndrome. The patient responded to intensive chemotherapy with disappearance of haemophagocytosis, granulocytic and histiocytic. We conclude that: (1) granulocytic cannibalism and haemophagocytic syndrome can be unusual myelodysplastic features; (2) the oligoblastic leukaemia with presence of cytogenetic abnormalities related to AML in young patients are probably more close to acute leukaemia than to myelodysplastic syndrome.

Hairy cell leukemia and autoimmune hemolytic anemia

A case of hairy cell leukemia (HCL) presenting as autoimmune hemolytic anemia (AHA) is described. A 40-year-old woman presented with severe hemolytic anemia. The morphological and immunological studies of bone marrow and spleen revealed a hairy cell leukemia. Although autoimmune diseases are a well known complication of HCL this is the first description of AHA as a complication of HCL.

Simultaneous occurrence of cutaneous T cell lymphoma and low-grade B cell lymphoproliferative diseases. A report of two cases

Two previously unreported patients with cutaneous T cell lymphoma associated with systemic low-grade B cell proliferations are presented. The first patient had Waldenström's macroglobulinemia and the second had simultaneous chronic lymphocytic leukemia. The use of immunosuppressive drugs or a genetic predisposition may have contributed to the second malignancy. However, the possibility that malignant helper/inducer T lymphocytes were a factor in the promotion of the proliferation of B cells cannot be excluded.