Association between culture and the preference for, and perceptions of, 11 routes of medicine administration: A survey in 21 countries and regions

Medicines can be taken by various routes of administration. These can impact the effects and perceptions of medicines. The literature about individuals' preferences for and perceptions of the different routes of administration is sparse, but indicates a potential influence of culture. Our aim was to determine: (i) any association between one's culture and one's preferred route of medicine administration and (ii) individual perceptions of pain, efficacy, speed of action and acceptability when medicines are swallowed or placed in the mouth, under the tongue, in the nose, eye, ear, lungs, rectum, vagina, on the skin, or areinjected. A cross-sectional, questionnaire-based survey of adults was conducted in 21 countries and regions of the world, namely, Tunisia, Ghana, Nigeria, Turkey, Ethiopia, Lebanon, Malta, Brazil, Great Britain, United States, India, Serbia, Romania, Portugal, France, Netherlands, Japan, South Korea, Hong Kong, mainland China and Estonia, using the Inglehart-Welzel cultural map to ensure coverage across all cultures. Participants scored the pain/discomfort, efficacy, speed of onset and acceptability of the different routes of medicine administration and stated their preferred route. Demographic information was collected. A total of 4435 participants took part in the survey. Overall, the oral route was the most preferred route, followed by injection, while the rectal route was the least preferred. While the oral route was the most preferred in all cultures, the percentage of participants selecting this route varied, from 98% in Protestant Europe to 50% in the African-Islamic culture. A multinomial logistic regression model revealed a number of predictors for the preferred route. Injections were favoured in the Baltic, South Asia, Latin America and African-Islamic cultures while dermal administration was favoured in Catholic Europe, Baltic and Latin America cultures. A marked association was found between culture and the preference for, and perceptions of the different routes by which medicines are taken. This applied to even the least favoured routes (vaginal and rectal). Only women were asked about the vaginal route, and our data shows that the vaginal route was slightly more popular than the rectal one.

Alveolar macrophage membrane phospholipid methylation in sarcoidosis and hypersensitivity pneumonitis

Methylation of phospholipids seems to be an essential step in the recognition and transduction of regulatory signals by eukaryotic cells. Phosphatidylethanolamine methylation was compared in alveolar macrophage membrane from patients presenting with pulmonary sarcoidosis or hypersensitivity pneumonitis and control subjects. Phosphatidylethanolamine methyltransferase (PMT1) activity was determined by various measures of incorporation of tritiated methyl group from (3H) S-adenosyl-L-methionine in membrane phospholipids. Tritiated methyl group incorporation in macrophage membrane was higher in some patients presenting with sarcoidosis or hypersensitivity pneumonitis, than in controls. PMT1 activity was found to be higher in sarcoidosis patients with a positive gallium lung scan. As lipids play an important role during macrophage activation and cell interaction, although a wide heterogeneity was observed in PMT1 activity, increased membrane phospholipid methylation seems to be an important feature in pulmonary diseases where macrophages are involved.

Effect of microwave irradiation (2450 MHz) on murine cytotoxic lymphocyte and natural killer (NK) cells

Male Balb/c mice were exposed in an anechoic chamber to 2450 MHz CW microwaves at 5, 10, 15, and 20 mW/cm2, 4 hours daily for 4 days, under controlled environmental conditions. T-cell cytotoxicity and natural killer (NK) cell activity were compared in exposed and sham animals. A significant decrease (p less than 0.001) of cell-mediated cytotoxicity was observed only for a power density of 20 mW/cm2. A significant increase (p less than 0.01) in NK activity was demonstrated following exposures at 15 mW/cm2.