Calcium dynamics and associated temporal patterns of milk constituents in early-lactation multiparous Holsteins

At the onset of lactation, calcium (Ca) homeostasis is challenged. For the transitioning dairy cow, inadequate responses to this challenge may result in subclinical hypocalcemia at some point in the postpartum period. It has been proposed that dynamics of blood Ca and the timing of subclinical hypocalcemia allow cows to be classified into 4 Ca dynamic groups by assessing serum total Ca concentrations (tCa) at 1 and 4 days in milk (DIM). These differing dynamics are associated with different risks of adverse health events and suboptimal production. Our prospective cohort study aimed to characterize the temporal patterns of milk constituents in cows with differing Ca dynamics to investigate the potential of Fourier-transform infrared spectroscopic (FTIR) analysis of milk as a diagnostic tool for identifying cows with unfavorable Ca dynamics. We sampled the blood of 343 multiparous Holsteins on a single dairy in Cayuga County, New York, at 1 and 4 DIM and classified these cows into Ca dynamic groups using threshold concentrations of tCa (1 DIM: tCa <1.98 mmol/L; 4 DIM: tCa <2.22 mmol/L) derived from receiver operating characteristic curve analysis based on epidemiologically relevant health and production outcomes. We also collected proportional milk samples from each of these cows from 3 to 10 DIM for FTIR analysis of milk constituents. Through this analysis we estimated the milk constituent levels of anhydrous lactose (g/100 g of milk and g/milking), true protein (g/100 g of milk and g/milking), fat (g/100 g of milk and g/milking), milk urea nitrogen (mg/100 g of milk), fatty acid (FA) groups including de novo, mixed origin, and preformed FA measured in grams/100 g of milk, by relative percentage, and grams/milking, as well as energy-related metabolites including ketone bodies and milk-predicted blood nonesterified FA. Individual milk constituents were compared among groups at each time point and over the entire sample period using linear regression models. Overall, we found differences among the constituent profiles of Ca dynamic groups at approximately every time point and over the entire sample period. The 2 at-risk groups of cows did not differ from each other at more than one time point for any constituent, however prominent differences existed between the milk of normocalcemic cows and the milk of the other Ca dynamic groups with respect to FA. Over the entire sample period, lactose and protein yield (g/milking) were lower in the milk of at-risk cows than in the milk of the other Ca dynamic groups. In addition, milk yield per milking followed patterns consistent with previous Ca dynamic group research. Though our use of a single farm does limit the general applicability of these findings, our conclusions provide evidence that FTIR may be a useful method for discriminating between cows with different Ca dynamics at time points that may be relevant in the optimization of management or development of clinical intervention strategies.

Development of trans-Chalcone loaded pectin/casein biodegradable microcapsules: Efficacy improvement in the management of experimental colitis

Improved therapies for inflammatory bowel diseases are sorely needed. Novel therapeutic agents and the development of controlled release systems for targeted tissue delivery are interesting approaches to overcome these barriers. We investigated the activity of trans-chalcone (T) in acetic acid-induced colitis in mice and developed, characterized, and determined the therapeutic effect of pectin/casein polymer microcapsules containing T (MT) in a colitis mouse model. In vitro, compound release was achieved in simulated intestinal fluid but not in the simulated gastric fluid. In vivo, since T at the dose of 3 mg/kg but not 0.3 mg/kg ameliorated colitis, we next tested the effects of MT at 0.3 mg/kg (non-effective dose). MT, but not free T at 0.3 mg/kg, significantly improved colitis outcomes such as neutrophil recruitment, antioxidant capacity, cytokine production, and NF-kB activation. This translated into reduced macro and microscopic damage in the colon. T release from the microcapsules is mediated by a pH-dependent and pectinase-regulated mechanism that provide controlled and prolonged release of T. Moreover, MT lowered the required dose for T therapeutic effect, indicating that could be a suitable pharmaceutical approach to colitis treatment. This is the first demonstration that T or MT is effective at reducing the signs of colitis.

Patterns of Fourier-transform infrared estimated milk constituents in early lactation Holstein cows on a single New York State dairy

Cows undergo immense physiological stress to produce milk during early lactation. Monitoring early lactation milk through Fourier-transform infrared (FTIR) spectroscopy might offer an understanding of which cows transition successfully. Daily patterns of milk constituents in early lactation have yet to be reported continuously, and the study objective was to initially describe these patterns for cows of varying parity groups from 3 through 10 d postpartum, piloted on a single dairy. We enrolled 1,024 Holstein cows from a commercial dairy farm in Cayuga County, New York, in an observational study, with a total of 306 parity 1 cows, 274 parity 2 cows, and 444 parity ≥3 cows. Cows were sampled once daily, Monday through Friday, via proportional milk samplers, and milk was stored at 4°C until analysis using FTIR. Estimated constituents included anhydrous lactose, true protein, and fat (g/100 g of milk); relative % (rel%) of total fatty acids (FA) and concentration (g/100 g of milk) of de novo, mixed, and preformed FA; individual fatty acids C16:0, C18:0, and C18:1 cis-9 (g/100 g of milk); milk urea nitrogen (MUN; mg/100 g of milk); and milk acetone (mACE), milk β-hydroxybutyrate (mBHB), and milk-predicted blood nonesterified fatty acids (mpbNEFA) (all expressed in mmol/L). Differences between parity groups were assessed using repeated-measures ANOVA. Milk yield per milking differed over time between 3 and 10 DIM and averaged 8.7, 13.3, and 13.3 kg for parity 1, 2, and ≥3 cows, respectively. Parity differences were found for % anhydrous lactose, % fat, and preformed FA (g/100 g of milk). Parity differed across DIM for % true protein, de novo FA (rel% and g/100 g of milk), mixed FA (rel% and g/100 g of milk), preformed FA rel%, C16:0, C18:0, C18:1 cis-9, MUN, mACE, mBHB, and mpbNEFA. Parity 1 cows had less true protein and greater fat percentages than parity 2 and ≥3 cows (% true protein: 3.52, 3.76, 3.81; % fat: 5.55, 4.69, 4.95, for parity 1, 2, ≥3, respectively). De novo and mixed FA rel% were reduced and preformed FA rel% were increased in primiparous compared with parity 2 and ≥3 cows. The increase in preformed FA rel% in primiparous cows agreed with milk markers of energy deficit, such that mpbNEFA, mBHB, and mACE were greatest in parity 1 cows followed by parity ≥3 cows, with parity 2 cows having the lowest concentrations. When measuring milk constituents with FTIR, these results suggest it is critical to account for parity for the majority of estimated milk constituents. We acknowledge the limitation that this study was conducted on a single farm; however, if FTIR technology is to be used as a method of identifying cows maladapted to lactation, understanding variations in early lactation milk constituents is a crucial first step in the practical adoption of this technology.

Aspirin-Triggered Resolvin D1 (AT-RvD1) Protects Mouse Skin against UVB-Induced Inflammation and Oxidative Stress

Intense exposure to UVB radiation incites excessive production of reactive oxygen species (ROS) and inflammation. The resolution of inflammation is an active process orchestrated by a family of lipid molecules that includes AT-RvD1, a specialized proresolving lipid mediator (SPM). AT-RvD1 is derived from omega-3, which presents anti-inflammatory activity and reduces oxidative stress markers. The present work aims to investigate the protective effect of AT-RvD1 on UVB-induced inflammation and oxidative stress in hairless mice. Animals were first treated with 30, 100, and 300 pg/animal AT-RvD1 (i.v.) and then exposed to UVB (4.14 J/cm²). The results showed that 300 pg/animal of AT-RvD1 could restrict skin edema, neutrophil and mast cell infiltration, COX-2 mRNA expression, cytokine release, and MMP-9 activity and restore skin antioxidant capacity as per FRAP and ABTS assays and control O₂^•- production, lipoperoxidation, epidermal thickening, and sunburn cells development. AT-RvD1 could reverse the UVB-induced downregulation of Nrf2 and its downstream targets GSH, catalase, and NOQ-1. Our results suggest that by upregulating the Nrf2 pathway, AT-RvD1 promotes the expression of ARE genes, restoring the skin's natural antioxidant defense against UVB exposition to avoid oxidative stress, inflammation, and tissue damage.

Rosmarinus officinalis extract-loaded emulgel prevents UVB irradiation damage to the skin

UVB-irradiation increases the risk of various skin disorders, therefore leading to inflammation and oxidative stress. In this sense, antioxidant-rich herbs such as Rosmarinus officinalis may be useful in minimizing the damage promoted by reactive oxygen species. In this work, we report the efficacy of a R. officinalis hydroethanolic extract (ROe)-loaded emulgel in preventing UVB-related skin damage. Total phenols were determined using Folin-Ciocalteu assay, and the main phytocomponents in the extract were identified by UHPLC-HRMS. Moreover, in vitro sun protection factor (SPF) value of ROe was also assessed, and we investigated the in vivo protective effect of an emulgel containing ROe against UVB-induced damage in an animal model. The ROe exhibited commercially viable SPF activity (7.56 ± 0.16) and remarkable polyphenolic content (24.15 ± 0.11 mg (Eq.GA)/g). HPLC-MS and UHPLC-HRMS results showcased that the main compounds in ROe were: rosmarinic acid, carnosic acid and carnosol. The evaluation of the in vitro antioxidant activity demonstrated a dose-dependent effect of ROe against several radicals and the capacity to reduce iron. Therefore, we demonstrated that topical application of the formulation containing ROe inhibited edema formation, myeloperoxidase activity, GSH depletion and maintained ferric reducing (FRAP) and ABTS scavenging abilities of the skin after UVB exposure.

Limited Diagnostic Utility of Alpha Defensin in the Diagnosis of Periprosthetic Joint Infection

Introduction/Objective

A key component of laboratory stewardship is appropriate test utilization. We evaluated the utility of alpha defensin (AD), a synovial fluid biomarker, in the diagnosis of periprosthetic joint infection (PJI). Since PJI remains a diagnostic challenge in the orthopedic community, the Musculoskeletal Infection Society (MSIS) created the PJI score, a point-based criteria to help risk stratify the likelihood of infection. The score includes AD, synovial fluid white blood cell count, synovial fluid percent neutrophils, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). AD is a specialized test which adds substantial cost to the evaluation of PJI .The purpose of this study was to investigate the diagnostic utility of the PJI score with AD and without AD (routine laboratory testing of serum and synovial fluid).

Methods/Case Report

Retrospective chart review was completed on 222 patients with suspected PJI identified at Geisinger Health between January 2019 – March 2021. Data was retrieved through Geisinger’s Phenomic and Analytics Data Core and imported into Excel and JMP v.12 for analysis. All available components of MSIS diagnostic criteria were collected for each patient.

Results (if a Case Study enter NA)

Of the 222 patients with AD testing, 81% of results were negative (n=178) and 19% results were positive (n=44). AD results corresponded with synovial fluid white blood cell count in 96 % of patients (213/ 222). All components of the PJI diagnostic criteria were collected in 69% of the patients (157/222). Diagnostic criteria calculated without AD showed 43% infected (68/157), 37% possibly infected (58/157), and 20% infected (31/157). Diagnostic criteria calculated with AD showed 43% infected (68/157), 35% possible infected (55/157), and 22% infected (34/157). PJI score including AD compared to PJI score excluding AD showed similar correlation (R2 = 0.93).

Conclusion

It was found that AD testing does not provide substantial diagnostic value in the evaluation of PJI. Synovial fluid cell count was found to directly correlate with alpha defensin suggesting it’s potential use as a surrogate marker for clinical decision making. Diagnostic criteria obtained through routine testing of serum (ESR, CRP) and synovial fluid (WBC, percent neutrophils) provides sufficient data for diagnosis.

Evaluation of indeterminate SARS-CoV-2 results with repeat testing on an alternative platform

Introduction/Objective

Accurate SARS-CoV-2 results are crucial for patient management and infection prevention. Result confidence decreases with low viral load because near the assay’s limit of detection (LOD), test results may alternate between positive and negative, as characterized by Poisson distribution for target analytes at low density. Low positive results may indicate past infection, early infection, a vaccinated individual with low level viral shed, or a false-positive result. EUA methods provide guidance on test interpretation, but laboratories should assess clinical accuracy. The purpose of this study was to assess clinical accuracy of specimens with low positive results.

Methods/Case Report

Respiratory specimens were tested by Cepheid Xpert® Xpress SARS-CoV-2 assay with positive results up to a Ct of 45. A low positive (defined as Ct ≥35), which could not be confirmed by Hologic Aptima® SARS-CoV-2 assay was reported as indeterminate and repeat testing recommended. Repeat testing occurred by Cepheid, Hologic, BioFire, Roche, or Quest assays. Retrospectively, final results were extracted from the LIS (Epic Beaker, Madison, WI, version May 2020) for 5-months (12/1/2020 to 5/31/2021), and chart review performed.

Results (if a Case Study enter NA)

A total of 19,969 tests were performed; 10.4% (n=2,083) were positive, 89% (n=17,728) negative, and 0.79% (n=158) indeterminate. Previous infection (up to 3 months prior) was documented in 18% (n=28) of indeterminate results and defined as true positive. Of remaining indeterminate results, 43% (n=68) had repeat testing as recommended by laboratory; 26% (n=18) were positive and 74% (n=50) were negative. The average number of days between indeterminate and negative result was 7.25 (range 1-38).

Conclusion

Result discordance occurred in < 1% of all samples, excellent agreement. For low positive samples, discordance was higher, as expected. It’s impossible to determine if negative results from the 50 repeat samples were false-positive by Cepheid or false-negative by other methods. In summary, 32% (50/158) of indeterminant samples did not repeat as positive. Overall concordance was high and results fluctuate when low virus is present. In absence of symptoms, we conclude repeat testing is not routinely recommended. Laboratories must recognize that normal variability occurs near assay LOD and must critically assess performance against other methods with similar LODs to fully assess performance of EUA methods.

Protection against UVB deleterious skin effects in a mouse model: effect of a topical emulsion containing Cordia verbenacea extract

Cordia verbenacea DC (Boraginaceae) is a flowering shrub found along the Brazilian Atlantic Forest, Brazilian coast, and low areas of the Amazon. The crude extract of its leaves is widely used in Brazilian folk medicine as an anti-inflammatory, both topically and orally. The aim of this study is to evaluate the activity of C. verbenacea ethanolic leaves extract (CVE) against UVB-triggered cutaneous inflammation and oxidative damage in hairless mice. CVE treatment recovered cutaneous antioxidant capacity demonstrated by scavenging ABTS⁺ free radical and iron-reducing antioxidant potential evaluated by FRAP. CVE also controlled the following UV-triggered events in the skin: reduced glutathione (GSH) depletion, catalase activity decrease, and superoxide anion (O^⋅-) build-up. Furthermore, mice treated with CVE exhibited less inflammation, shown by the reduction in COX-2 expression, TNF-α, IL-1β, IL-6, edema, and neutrophil infiltration. CVE also regulated epidermal thickening and sunburn cells, reduced dermal mast cells, and preserved collagen integrity. The best results were obtained using 5% CVE-added emulsion. The present data demonstrate that topical administration of CVE presents photochemoprotective activity in a mouse model of UVB inflammation and oxidative stress. Because of the intricate network linking inflammation, oxidative stress, and skin cancer, these results also indicate the importance of further studies elucidating a possible role of C. verbenacea in the prevention of UVB-induced skin cancer and evaluating a potential synergy between CVE and sunscreens in topical products against UVB damaging effects to the skin.

A topical formulation containing quercetin-loaded microcapsules protects against oxidative and inflammatory skin alterations triggered by UVB irradiation: enhancement of activity by microencapsulation

Ultraviolet B (UVB) irradiation causes free radical production, increase inflammation and oxidative stress, thus, supporting the use of antioxidants by topical administration as therapeutic approaches. Quercetin (QC) is a flavonoid with antioxidant activity, however, high liposolubility makes it difficult to remain in the viable skin layer. Thus, this study evaluated whether microencapsulation of QC would enhance its activity in comparison with the same dose of free QC (non-active dose) and unloaded-microcapsules added in formulation for topical administration in a mouse model of UVB irradiation targeting the skin. Topical formulation containing Quercetin-loaded microcapsules (TFcQCMC) presents physico-chemical (colour, consistence, phase separation and pH) and functional antioxidant stability at 4 °C, room temperature and 40 °C for 6 months. TFcQCMC inhibited the UVB-triggered depletion of antioxidants observed by GSH (reduced glutathione), ability to reduce iron, ability to scavenge 2,2'-azinobis radical and catalase activity. TFcQCMC also inhibited markers of oxidation (lipid hydroperoxides and superoxide anion production). Concerning inflammation, TFcQCMC reduced the production of inflammatory cytokines, matrix metalloproteinase-9 activity, skin edoema, collagen fibre damage, myeloperoxidase activity/neutrophil recruitment, mast cell and sunburn cell counts. The pharmacological activity of TFcQCMC was not shared by the same pharmaceutical form containing the same dose of free QC or unloaded control microcapsules.

Protective effect of oral treatment with Cordia verbenacea extract against UVB irradiation deleterious effects in the skin of hairless mouse

Photochemoprotection of the skin can be achieved by inhibiting inflammation and oxidative stress, which we tested using Cordia verbenacea extract, a medicinal plant known for its rich content of antioxidant molecules and anti-inflammatory activity. In vitro antioxidant evaluation of Cordia verbenacea leaves ethanolic extract (CVE) presented the following results: ferric reducing antioxidant power (886.32 μM equivalent of Trolox/g extract); IC50 of 19.128 μg/ml for scavenging 2,2-diphenyl-1-picrylhydrazyl; IC50 of 12.48 μg/mL for scavenging 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulphonic acid); decrease of hydroperoxides from linoleic acid (IC50 of 10.20 μg/mL); inhibition of thiobarbituric acid reactive substances (IC50 8.90 μg/mL); iron-chelating ability in bathophenanthroline iron assay (IC50 47.35 μg/mL); chemiluminescence triggered by free radicals in the H2O2/horseradish peroxidase/luminol (IC50 0.286 μg/mL) and xanthine/xanthine oxidase/luminol (IC50 0.42 μg/mL) methods. CVE (10-100 mg per kg, 30 min before and immediately after UVB exposure) treatment was performed by gavage in hairless mice. CVE inhibited skin edema, neutrophil infiltration, and overproduction of MMP-9; reduced levels of TNF-α, IL-1β, and IL- 6; numbers of skin mast cells, epidermal thickening, number of epidermal apoptotic keratinocytes, and collagen degradation. CVE increased the skin's natural antioxidant defenses as observed by Nrf-2, NAD(P)H quinone oxidoreductase 1, and heme oxygenase 1 mRNA expression enhancement. Furthermore, CVE inhibited lipid peroxidation and superoxide anion production and recovered antioxidant reduced glutathione, catalase activity, and ROS scavenging capacity of the skin. Concluding, CVE downregulates the skin inflammatory and oxidative damages triggered by UVB, demonstrating its potentialities as a therapeutic approach.

Analgesic activity and mechanism of action of a Beta vulgaris dye enriched in betalains in inflammatory models in mice

Evidence demonstrates the pronounced anti-inflammatory activity of a beetroot (Beta vulgaris) dye enriched in betalains obtained using precipitation with ethanol. Herein, we expand upon our previous observations and demonstrate the analgesic and antioxidant effect of betalains. Betalains [10-1000 mg/kg; intraperitoneal route (i.p.)] diminished acetic acid- and PBQ-induced abdominal contortions, and the overt pain-like behaviour induced by complete Freund`s adjuvant (CFA) and formalin (intraplantar; i.pl.) injection. Moreover, betalains (100 mg/kg) administered by various routes [i.p. or subcutaneous (s.c.)] or as a post-treatment reduced carrageenin- or CFA-induced hyperalgesia. Mechanistically, betalains mitigated carrageenin-induced tumour necrosis factor-alpha (TNF-α), interleukin (IL)-1β, superoxide anion levels, and lipid peroxidation. Betalains also stopped the depletion of reduced glutathione (GSH) levels and ferric reducing ability produced by carrageenin, as well as upregulated Nrf2 and Ho1 transcript expression in the plantar tissue of mice. Furthermore, betalains showed hydroxyl radical, 2,2'-azino-di-(3-ethylbenzthiazoline-6-sulphonic acid) radical (ABTS⁺), and 2,2-diphenyl-1-picryl-hydrazyl radical (DPPH•) scavenging ability and iron-chelating activity (bathophenantroline assay), and inhibited iron-independent and iron-dependent lipid peroxidation (LPO) in vitro. Finally, betalains-treated bone marrow-derived macrophages exhibited lower levels of cytokines (TNF-α and IL-1β), and superoxide anion levels and nuclear factor kappa B (NF-κB) activation following lipopolysaccharide (LPS) stimulation. Therefore, this betalain-rich dye extracted using a novel precipitation approach presents prominent analgesic effect in varied models of pain by mechanisms targeting cytokines and oxidative stress.

The Lipid Mediator Resolvin D1 Reduces the Skin Inflammation and Oxidative Stress Induced by UV Irradiation in Hairless Mice

UV irradiation-induced oxidative stress and inflammation contribute to the development of skin diseases. Therefore, targeting oxidative stress and inflammation might contribute to reduce skin diseases. Resolvin D1 (RvD1) is a bioactive metabolite generated during inflammation to actively orchestrate the resolution of inflammation. However, the therapeutic potential of RvD1 in UVB skin inflammation remains undetermined, which was, therefore, the aim of the present study. The intraperitoneal treatment with RvD1 (3-100 ng/mouse) reduced UVB irradiation-induced skin edema, myeloperoxidase activity, matrix metalloproteinase 9 activity, and reduced glutathione depletion with consistent effects observed with the dose of 30 ng/mouse, which was selected to the following experiments. RvD1 inhibited UVB reduction of catalase activity, and hydroperoxide formation, superoxide anion production, and gp91phox mRNA expression. RvD1 also increased the Nrf2 and its downstream targets NQO1 and HO-1 mRNA expression. Regarding cytokines, RvD1 inhibited UVB-induced production of IL-1β, IL-6, IL-33, TNF-α, TGF-β, and IL-10. These immuno-biochemical alterations by RvD1 treatment had as consequence the reduction of UVB-induced epidermal thickness, sunburn and mast cell counts, and collagen degradation. Therefore, RvD1 inhibited UVB-induced skin oxidative stress and inflammation, rendering this resolving lipid mediator as a promising therapeutic agent.

Topical emulsion containing pyrrolidine dithiocarbamate: effectiveness against ultraviolet B irradiation-induced injury of hairless mouse skin

OBJECTIVES

To evaluate the effects of a topical emulsion containing pyrrolidine dithiocarbamate (PDTC) (EcPDTC) in skin oxidative stress and inflammation triggered by ultraviolet B (UVB) irradiation (dose of 4.14 J/cm² ).

METHODS

Hairless mouse received treatment with 0.5 g of EcPDTC or control emulsion (CTRLE) on the dorsal surface skin 12 h, 6 h and 5 min before and 6 h after the irradiation. Oxidative stress was evaluated by ferric reducing antioxidant power (FRAP), 2,2'-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) radical (ABTS) scavenging capacity, reduced glutathione quantitation, catalase activity, superoxide anion production and lipid peroxidation products. Inflammation parameters were as follows: skin oedema, myeloperoxidase activity (neutrophil marker), matrix metalloproteinase-9 activity, collagen fibre damage, mast cell and sunburn cell counts, and cytokine production.

KEY FINDINGS

Topical treatment with EcPDTC protected from UVB-induced skin injury by maintaining the antioxidant capacity levels similar to non-irradiated control group. Furthermore, EcPDTC inhibited UVB irradiation-induced superoxide anion production, lipid peroxidation and reduced skin inflammation by inhibiting skin oedema, neutrophil recruitment, metalloproteinase-9 activity, collagen fibre damage, mast cell and sunburn cell counts, and cytokine (TNF-α and IL-1β) production.

CONCLUSIONS

Topical treatment with EcPDTC improves antioxidant systems and inhibits inflammation, protecting the skin from the damaging effects of UVB irradiation.

Lipoxin A4 inhibits UV radiation-induced skin inflammation and oxidative stress in mice

BACKGROUND

Lipoxin A4 (LXA4) is a metabolic product of arachidonic acid. Despite potent anti-inflammatory and pro-resolution activities, it remains to be determined if LXA4 has effect on ultraviolet (UV) radiation-induced skin inflammation.

OBJECTIVE

To investigate the effects of systemic administration with LXA4 on UV radiation-induced inflammation and oxidative damage in the skin of mice.

METHODS

Varied parameters of inflammation and oxidative stress in the skin of mice were evaluated after UV radiation (4.14 J/cm2).

RESULTS

Pretreatment with LXA4 significantly inhibited UV radiation-induced skin edema and myeloperoxidase activity. LXA4 efficacy was enhanced by increasing the time of pre-treatment to up to 72 h. LXA4 reduced UV radiation-induced skin edema, neutrophil recruitment (myeloperoxidase activity and LysM-eGFP+ cells), MMP-9 activity, deposition of collagen fibers, epidermal thickness, sunburn cell counts, and production of pro-inflammatory cytokines (TNF-α, IL-1β, IL-6 and IL-33). Depending on the time point, LXA4 increased the levels of anti-inflammatory cytokines (TGF-β and IL-10). LXA4 significantly attenuated UV radiation-induced oxidative damage returning the oxidative status to baseline levels in parameters such as ferric reducing ability, scavenging of free radicals, GSH levels, catalase activity and superoxide anion production. LXA4 also reduced UV radiation-induced gp91phox [nicotinamide adenine dinucleotide phosphate (NADPH) oxidase 2 (NOX2) subunit] mRNA expression and enhanced nuclear factor erythroid 2-related factor 2 (Nrf2) and its downstream target enzyme nicotinamide adenine dinucleotide (phosphate) quinone oxidoreductase (Nqo1) mRNA expression.

CONCLUSION

LXA4 inhibited UV radiation-induced skin inflammation by diminishing pro-inflammatory cytokine production and oxidative stress as well as inducing anti-inflammatory cytokines and Nrf2.

Efficacy of Cerebrolysin in the reduction of spasticity during stroke rehabilitation

AIM

This study assessed the efficacy of Cerebrolysin on post-stroke spasticity, motor recovery, and global functions in an outpatient rehabilitation setting.

METHODS

In this retrospective comparison study, Cerebrolysin was administered at a daily dosage of 10 ml for over 30 days as an intramuscular injection. Control patients did not receive Cerebrolysin. All the patients participated in a standardized physical and occupational rehabilitation therapy for one month at least two times per week. Efficacy was assessed at day 30 by using the Modified Ashworth Scale (MAS) for spasticity and the Manual Muscle Testing (MMT) for motor recovery. Global function was assessed by the modified Rankin Scale (mRS) at day 30.

RESULTS

A total of 50 patients were eligible for participation according to the inclusion and exclusion criteria. Of these, 23 patients were treated with Cerebrolysin and 27 patients represented the control group. No significant group differences were observed at baseline. Patients treated with Cerebrolysin experienced a significant reduction of spasticity in muscles of the upper and lower limbs, whereas only minor changes were observed in the control group. In the Cerebrolysin group, differences were statistically significant at day 30. Significant improvements of muscle strength and global functions were observed in both groups at day 30. Cerebrolysin was safe and well tolerated.

CONCLUSION

Cerebrolysin had a beneficial effect on post-stroke spasticity in an outpatient rehabilitation setting; intramuscular treatment for over 30 days was safe and well tolerated.

trans-Chalcone, a flavonoid precursor, inhibits UV-induced skin inflammation and oxidative stress in mice by targeting NADPH oxidase and cytokine production

trans-Chalcone inhibits UV-induced skin inflammation and also indirectly reduces oxidative stress.

Resveratrol-Loaded Liquid-Crystalline System Inhibits UVB-Induced Skin Inflammation and Oxidative Stress in Mice

Evidence shows beneficial effects of resveratrol (RES) on human health. However, its poor aqueous solubility limits therapeutic effectiveness. Thus, the use of nanostructured delivery systems for RES, such as a liquid-crystalline system (LCS), could be viable. The purpose of this study was to develop, characterize, and determine the in vivo effectiveness of a RES-loaded LCS. We studied an LCS containing silicon glycol copolymer, polyether functional siloxane, and the polymeric dispersion carbomer homopolymer type B (C974) in the ratio 20:55:25 with and without RES. Results obtained using polarized light microscopy, small-angle X-ray scattering, and rheology analysis showed that the RES-loaded LCS system presents a lamellar structure and behaves as a non-Newtonian fluid presenting pseudoplastic (the apparent viscosity decreases as the stress increases) and thixotropic (the apparent viscosity decreases with the duration of stress) behaviors. Cytotoxicity studies showed that the formulation components are noncytotoxic. Topical application of a RES-loaded LCS protected hairless mice from UVB-irradiation-induced skin damage by inhibiting edema, neutrophil recruitment, lipid hydroperoxide and superoxide anion production, gp91phox mRNA expression, and oxidative stress. The RES-loaded LCS maintained 2,2'-azinobis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) and ferric reducing abilities, catalase activity, reduced glutathione levels, and mRNA expression of glutathione peroxidase 1 and glutathione reductase. The RES-loaded LCS also up-regulated matrix metalloproteinase-9 activity, IL-10 production, and mRNA expression of transcription factor Nrf2 and heme oxygenase-1. Therefore, a RES-loaded LCS is a promising new therapeutic approach to mitigate skin photodamage.

Antinociceptive Effect of Tephrosia sinapou Extract in the Acetic Acid, Phenyl-p-benzoquinone, Formalin, and Complete Freund's Adjuvant Models of Overt Pain-Like Behavior in Mice

Tephrosia toxicaria, which is currently known as Tephrosia sinapou (Buc'hoz) A. Chev. (Fabaceae), is a source of compounds such as flavonoids. T. sinapou has been used in Amazonian countries traditional medicine to alleviate pain and inflammation. The purpose of this study was to evaluate the analgesic effects of T. sinapou ethyl acetate extract in overt pain-like behavior models in mice by using writhing response and flinching/licking tests. We demonstrated in this study that T. sinapou extract inhibited, in a dose (1-100 mg/kg) dependent manner, acetic acid- and phenyl-p-benzoquinone- (PBQ-) induced writhing response. Furthermore, it was active via intraperitoneal, subcutaneous, and peroral routes of administration. T. sinapou extract also inhibited formalin- and complete Freund's adjuvant- (CFA-) induced flinching/licking at 100 mg/kg dose. In conclusion, these findings demonstrate that T. sinapou ethyl acetate extract reduces inflammatory pain in the acetic acid, PBQ, formalin, and CFA models of overt pain-like behavior. Therefore, the potential of analgesic activity of T. sinapou indicates that it deserves further investigation.

Topical Formulation Containing Naringenin: Efficacy against Ultraviolet B Irradiation-Induced Skin Inflammation and Oxidative Stress in Mice

Naringenin (NGN) exhibits anti-inflammatory and antioxidant activities, but it remains undetermined its topical actions against ultraviolet B (UVB)-induced inflammation and oxidative stress in vivo. The purpose of this study was to evaluate the physicochemical and functional antioxidant stability of NGN containing formulations, and the effects of selected NGN containing formulation on UVB irradiation-induced skin inflammation and oxidative damage in hairless mice. NGN presented ferric reducing power, ability to scavenge 2,2′-azinobis (3-ethylbenzothiazoline- 6-sulfonic acid) (ABTS) and hydroxyl radical, and inhibited iron-independent and dependent lipid peroxidation. Among the three formulations containing NGN, only the F3 kept its physicochemical and functional stability over 180 days. Topical application of F3 in mice protected from UVB-induced skin damage by inhibiting edema and cytokine production (TNF-α, IL-1β, IL-6, and IL-10). Furthermore, F3 inhibited superoxide anion and lipid hydroperoxides production and maintained ferric reducing and ABTS scavenging abilities, catalase activity, and reduced glutathione levels. In addition, F3 maintained mRNA expression of cellular antioxidants glutathione peroxidase 1, glutathione reductase and transcription factor Nrf2 (nuclear factor erythroid 2-related factor 2), and induced mRNA expression of heme oxygenase-1. In conclusion, a formulation containing NGN may be a promising approach to protecting the skin from the deleterious effects of UVB irradiation.

Topical formulation containing hesperidin methyl chalcone inhibits skin oxidative stress and inflammation induced by ultraviolet B irradiation

Skin exposure to UVB irradiation has increased significantly in recent years due to ozone depletion, and it represents the main cause of many skin diseases.

Naringenin Inhibits UVB Irradiation-Induced Inflammation and Oxidative Stress in the Skin of Hairless Mice

Ultraviolet B (UVB) irradiation may cause inflammation- and oxidative-stress-dependent skin cancer and premature aging. Naringenin (1) has been reported to have anti-inflammatory and antioxidant properties, but its effects and mechanisms on UVB irradiation-induced inflammation and oxidative stress are still not known. Thus, the present study aimed to investigate the potential of naringenin to mitigate UVB irradiation-induced inflammation and oxidative damage in the skin of hairless mice. Skin edema, myeloperoxidase (neutrophil marker) and matrix metalloproteinase-9 (MMP-9) activity, and cytokine production were measured after UVB irradiation. Oxidative stress was evaluated by 2,2'-azinobis(3-ethylbenzothiazoline-6-sulfonic acid) radical (ABTS) scavenging ability, ferric reducing antioxidant power (FRAP), reduced glutathione levels, catalase activity, lipid peroxidation products, superoxide anion production, and gp91phox (NADPH oxidase subunit) mRNA expression by quantitative PCR. The intraperitoneal treatment with naringenin reduced skin inflammation by inhibiting skin edema, neutrophil recruitment, MMP-9 activity, and pro-inflammatory (TNF-α, IFN-γ, IL-1β, IL-4, IL-5, IL-6, IL-12, IL-13, IL-17, IL-22, and IL-23) and anti-inflammatory (TGF-β and IL-10) cytokines. Naringenin also inhibited oxidative stress by reducing superoxide anion production and the mRNA expression of gp91phox. Therefore, naringenin inhibits UVB irradiation-induced skin damage and may be a promising therapeutic approach to control skin disease.

Anti-inflammatory activity of betalain-rich dye of Beta vulgaris: effect on edema, leukocyte recruitment, superoxide anion and cytokine production

We have recently developed betalain-rich beetroot (Beta vulgaris) dye (betalain) to be used in food products. Betalain (30-300 mg/kg) intraperitoneal (i.p.) treatment diminished carrageenan (100 µg/paw)-induced paw edema and neutrophil migration to the paw skin tissue. Betalain (100 mg/kg) treatment by subcutaneous or per oral routes also inhibited the carrageenan-induced paw edema. Importantly, the post-treatment with betalain (100 mg/kg, i.p.) significantly inhibited carrageenan- and complete Freund's adjuvant (10 µl/paw)-induced paw edema. Betalain (100 mg/kg) also reduced carrageenan (500 µg/cavity)-induced recruitment of total leukocytes, including mononuclear cells and neutrophils, as well as increasing vascular permeability in the peritoneal cavity. Furthermore, betalain significantly reduced carrageenan-induced superoxide anion, tumor necrosis factor-alpha (TNF-α) and interleukin (IL)-1β levels in the peritoneal fluid, as well as augmenting IL-10 levels. Therefore, this compound presents prominent anti-inflammatory effect on carrageenan-induced paw edema and peritonitis by reducing the production of superoxide anion and the cytokines TNF-α and IL-1β, in addition to increasing IL-10 levels. These results suggest that betalain shows therapeutic potential that could be utilized in the treatment of inflammation-associated diseases.

Topical formulations containing Pimenta pseudocaryophyllus extract: In vitro antioxidant activity and in vivo efficacy against UV-B-induced oxidative stress

Pimenta pseudocaryophyllus is a Brazilian native plant that presents high concentrations of flavonoids and other polyphenolic compounds. Herein, we evaluated: (1) the chemical properties of P. pseudocaryophyllus ethanolic extract (PPE), (2) the in vitro antioxidant activity (AA) of PPE and of two different topical formulations (F1 and F2) containing PPE, (3) physico-chemical and functional stability, (4) in vitro release of PPE, and (5) in vivo capacity of formulations to prevent UV-B irradiation-induced skin damage. Results show that the polyphenol and flavonoid contents in PPE were 199.33 and 28.32 mg/g, respectively, and HPLC results show the presence of eugenol, tannic acid, and rutin. Evaluation of the in vitro AA of PPE demonstrated a dose-dependent effect and an IC50 of 4.75 μg/mL in 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 3.0 μg/mL in 2,2'-azinobis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) assays. The ferric-reducing antioxidant power (FRAP assay) was 0.046 μmol/L trolox equivalent/μg/mL of extract. Among the AA, only the capacity to scavenge DPPH radical of PPE was maintained in F1 and F2. In addition, both formulations satisfactorily released the extract. The evaluation of the functional stability of F1 and F2 did not demonstrate loss of activity by storage at room temperature and at 4°C/6 months. In irradiated mice, treatment with F1 and F2 added with PPE significantly increased the capacity to scavenge ABTS radical and the FRAP of skin compared to vehicle-treated mice. In conclusion, the present results suggest that formulations containing PPE may be a topical source of antioxidant compounds to decrease oxidative damages of the skin.

Tephrosia sinapou ethyl acetate extract inhibits inflammatory pain in mice: opioid receptor dependent inhibition of TNFα and IL-1β production

CONTEXT. Tephrosia toxicaria is currently known as Tephrosia sinapou (Buc'hoz) A. Chev. (Fabaceae) and is a source of compounds such as flavonoids that inhibit inflammatory pain.

OBJECTIVE

To investigate the analgesic effect and mechanisms of the ethyl acetate extract of T. sinapou in inflammatory pain in mice.

MATERIALS AND METHODS

Behavioral responses were evaluated using mechanical (1-24 h) and thermal hyperalgesia (0.5-5 h), writhing response (20 min) and rota-rod (1-5 h) tests. Neutrophil recruitment (myeloperoxidase activity), cytokines (tumor necrosis factor [TNF]α and interleukin [IL]-1β), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) serum levels were determined by colorimetric assays. Pharmacological treatments were opioid receptor antagonist (naloxone, 0.1-1 mg/kg) and control opioid (morphine, 5 mg/kg). Inflammatory stimuli were carrageenin (100 µg/paw), complete Freund's adjuvant (CFA, 10 µl/paw), prostaglandin E2 (PGE2, 100 ng/paw) and acetic acid (0.8%).

RESULTS

The intraperitoneal pre-treatment with extract inhibited in a dose-dependent (30-300 mg/kg) dependent manner the mechanical hyperalgesia induced by carrageenin (up to 93% inhibition). The post-treatment (100 mg/kg) inhibited CFA-induced hyperalgesia (up to 63% inhibition). Naloxone (1 mg/kg) prevented the inhibitory effect of the extract over carrageenin-induced mechanical (100%) and thermal (100%) hyperalgesia, neutrophil recruitment (52%) and TNFα (63%) and IL-1β (98%) production, thermal threshold in naïve mice (99%), PGE2-induced mechanical hyperalgesia (88%) and acetic acid-induced writhing response (49%). There was no significant alteration in the rota-rod test, and AST and ALT serum levels by extract treatment. Discussion and conclusion. Tephrosia sinapou ethyl acetate extract reduces inflammatory pain by activating an opioid receptor-dependent mechanism.

Natriuretic effect of equol

A furosemide-sensitive Na-K-Cl cotransporter (NKCC2 isoform) accounts for almost all luminal NaCl reabsorption in the thick ascending limb of Henle's loop (TALH). The activity of this transport protein is regulated by humoral factors known as cotransport inhibitory factors. One family of these compounds is represented by the urinary phytoestrogens equol and genistein, which inhibit cotransport fluxes at concentrations similar to furosemide. Moreover, they possess salidiuretic potency similar to furosemide in the isolated perfused rat kidney, but are less potent than furosemide (in vivo). Thus, dietary phytoestrogens can be responsible, at least in part, for the low blood pressure of vegetarians.

Managed care in three states: experiences of low-income African Americans and Hispanics

This article examines the experiences of low-income, nonelderly Hispanics, African Americans, and whites in managed care (MC), and compares them to their racial/ethnic counterparts enrolled in fee-for-service (FFS) health plans. Survey findings from Florida, Tennessee, and Texas show that MC and FFS enrollees do not differ substantially on most access and satisfaction measures, with a few notable exceptions. When compared with their FFS counterparts, African-American MC enrollees are twice as likely to report problems in obtaining needed care, and Hispanic MC enrollees are nearly twice as likely to rate the extent to which their providers care about them as "fair" or "poor." In contrast, whites in MC are less likely to be without a regular provider than their FFS counterparts, but report greater dissatisfaction with the extent to which providers care about them.

Public health departments adapt to Medicaid managed care

Millions of Medicaid beneficiaries have recently moved into private managed care plans across the country. Public health departments--which have acted as providers of primary care and other services for some Medicaid patients--are often not explicitly included in contracts between these designated Medicaid plans and the states. As a result, many of the 3,000 city and county public health agencies nationwide have lost both patients and significant revenue to plans. This Issue Brief describes how public health departments are adapting to this shift in state policy. According to our research conducted in 1997, many are de-emphasizing the delivery of direct health care services in favor of core public health functions, such as investigating community health problems and health promotion. Some are initiating new partnerships with Medicaid managed care plans.

Salidiuretic action by genistein in the isolated, perfused rat kidney

The urinary isoflavonoid genistein inhibits membrane Na-K-Cl cotransporters at similar concentrations as furosemide, but the significance of this action is unknown. Genistein was therefore investigated in rats for its potential salidiuretic actions. In the isolated, perfused rat kidney, genistein induced a maximal salidiuretic action similar to that of furosemide but was 3 to 5 times less potent than furosemide in terms of active doses (natriuresis EC50, 237+/-92 versus 56+/-20 micromol/L for genistein and furosemide, respectively). Genistein and furosemide had no additive salidiuretic actions. Genistein had no significant effect on glomerular filtration rate but was able to significantly reduce renal vascular resistance with respect to vehicle isolated perfused kidney. Indomethacin (10 micromol/L), a blocker of prostaglandin biosynthesis, reduced salidiuresis and renal vasorelaxation by genistein. Subcutaneous genistein (15 mg/kg) induced a statistically significant increase in diuresis and natriuresis with respect to vehicle during the first 6 hours of administration in rats. In conclusion, genistein compares well with furosemide in vitro for its salidiuretic profile and potency in the isolated perfused rat kidney and is also natriuretic by the subcutaneous route in the rat. Further studies are required to investigate potential natriuretic and perhaps hypotensive actions of dietary genistein.

Renal and vascular actions of equol in the rat

BACKGROUND

The urinary isoflavonoid equol inhibits membrane Na-K-Cl cotransporters at similar concentrations to those at which furosemide inhibits them, but the significance of this action is not known.

OBJECTIVE

To investigate the potential salidiuretic and vascular actions of equol in the rat.

METHODS

Renal functioning was assessed in vitro in the isolated perfused kidney and in vivo in conscious rats. The vascular contractility of isolated aorta was assessed.

RESULTS

In the isolated perfused kidney equol was concentrated 50- to 70-fold in the urinary fluid, it was 3-4 times less potent than furosemide at increasing diuresis, natriuresis and kaliuresis (the difference was due to its higher protein-binding affinity), and it induced a modest but significant increase in glomerular filtration rate. In vivo, orally administered equol was a modest natriuretic agent, about 8-fold less potent than orally administered furosemide (in molar terms). In isolated aortic rings precontracted by administration of phenylephrine, administration of equol relaxed the contracted aorta at 10-fold lower concentrations (concentration for half-maximal activity 58.9 +/- 16 micromol/l, n = 3) than did furosemide (concentration for half-maximal activity 633 +/- 145 micromol/l, n = 3).

CONCLUSIONS

Equol is a modest natriuretic and vasorelaxant agent in the rat. Further studies are required in order to investigate the potential natriuretic and perhaps hypotensive actions of dietary equol precursors (daidzein).

Purification and chemical characterization of a potent inhibitor of the Na-K-Cl cotransport system in rat urine

A potent inhibitor of the Na-K-Cl cotransport system was purified from urines of salt-loaded rats. Mass spectroscopy revealed a molecular mass of 242 Da. Nuclear magnetic resonance showed a spectrum identical to that of 3,4-dihydro-3-(4-hydroxyphenyl)-2H-1-benzopyran-7-ol (an "estrogen-like" isoflavonoid: equol). This compound inhibited cotransport fluxes at similar concentrations (IC50=16-24 microM) as furosemide (IC50 approximately 10 microM). Cotransport inhibitory activity of urines from rats drinking tap water was fully explained by urinary equol concentrations (approximately 27 microM, measured by high-performance liquid chromatography). Slat-loading increased urinary equol excretion, but not sufficiently high to fully explain the very important increase in cotransport inhibitory potency. We conclude that: (i) under basal conditions urinary equol can regulate Na-K-Cl cotransport activity in the kidney and (ii) salt-loading should evoke the appearance of other cotransport inhibitors.

Film oxygen transmission rate effects on ground chicken meat quality

Effects of the packaging film oxygen transmission rate (OTR) on the odor, color, aerobic plate count, and cooked volatile compounds in ground chicken leg meat were evaluated over a 14-d refrigerated storage (4 C) period. Freshly desinewed and ground chicken leg meat was packaged under minimal vacuum in five films of different OTR. Films ranged from 30 to 12,000 mL oxygen/m2 per 24 h. Odor scores of meat in packages opened after 10 d were lower for the lowest OTR film than films with higher OTR. Aerobic plate counts increased at a faster rate in the higher OTR films, and cooked meat volatile profiles showed little variation due to OTR film type. Specific products will require different packaging to optimize shelf-life quality. For ground chicken leg meat, an intermediate OTR film is best to maintain a majority of the quality attributes during refrigerated storage.

The effects of ultrapasteurization with and without homogenization on the chemical, physical, and functional properties of aseptically packaged liquid whole egg

The effects of ultrapasteurization with and without homogenization on some chemical, physical, and functional properties of liquid whole egg were observed. Heat treatments of 64, 68, and 72 C each at 30, 60, and 95 s were conducted on liquid whole egg, unhomogenized and homogenized [10.34 mPa (1,500 psi)]. The viscosity of the egg increased with increased processing temperature, and unhomogenized egg was more viscous than homogenized egg. alpha-Amylase was inactivated at 68 C for 30 s. Although cake height was highly correlated to soluble protein content, this relationship did not hold for all time-temperature combinations. Due to homogenization effects on soluble protein results, soluble protein is not a reliable predictor of egg functionality when homogenization is used in the process. Homogenization had no effect on the population reduction of aerobic bacteria in all but three of the nine time-temperature combinations.

[Cutaneous microcirculation in systemic sclerosis. Morpho-functional research using capillaroscopy and laser-Doppler]

Our previous researches proved that, in patients affected by Raynaud disease, microcirculatory alterations were greater in those cases in which the small vessels showed evocative appearances of a sclerodermatous connectivopathy. In this study we evaluated cutaneous microvasculature in 18 patients suffering from clear systemic sclerosis, compared with a group of 16 subjects affected by primitive Raynaud disease and a group of healthy subjects. We used videocapillaroscopy and laser-Doppler fluxmetry for morphological and functional study respectively. In patients affected by systemic sclerosis the rest flow was clearly reduced and morphological pattern of cutaneous small vessels deranged. The response to ischemic test allowed us to subdivide the skin-bounds in two subgroups: "no responders" 8 subjects (44%), in which reactive hyperaemia was completely absent, "responders" 10 patients (56%) in which the hyperaemia was completely overlapped with that of the two other groups, but with longer reaction times. In skinbounds the capillaroscopic pattern was clearly severe in comparison with other two groups (18.8 +/- 5.7 vs 5.7 +/- 2.3 and 3.6 +/- 1). Thus, in advanced stage of the pathology, is microangiopathy (in its tromboischemic and inflammatory aspects) that plays a very important role in the development of organ damage. Therefore, all those clinical and instrumental tests which may allow a differential early diagnosis between a primitive and a secondary Raynaud phenomenon be done, for its prognostic value in connection with the appearance of systemic sclerosis.

Latina and African American women: continuing disparities in health

Women of all races have faced incredible challenges as they sought to realize the promises of America. For women of color, these challenges were compounded by the second-class citizenship of U.S. racial and ethnic minority population groups. In an effort to assess the quality of life experienced by Latina and African American women, this article provides descriptive information on racial/ethnic differences in women's social conditions, health status, exposure to occupational and environmental risks, and use of health services. When possible, indices are stratified by family income to limit the effects of social class on the comparison of racial differences. The authors provide evidence that Latina and African American women are more likely than nonminority women to encounter social environments (e.g., poverty, densely populated neighborhoods, hazardous work conditions) that place them at risk for ill-health and injury. Although persistent racial disparities in health are often attributed to the lifestyle behaviors of racial minority populations, they are undoubtedly a consequence of poorer social conditions as well as barriers in access to quality health services. To achieve further gains, public policies must reduce social inequalities (i.e., by gender, race, and social class) and assure greater equity in access to resources that facilitate healthier environments and lifestyles. Public health initiatives should be community-based, reflecting a shared partnership that actively engages minority women in decision-making about their lives.

Who won't tell: predictors of refusal to report number of sex partners

Data from 1475 respondents to a telephone survey are used to examine whether those who refused to report the number of their sex partners in the 12-month period prior to the interview are more likely to engage in HIV risk behaviours than those who did report this number. Logistic regression shows that refusal is associated with being single of low education (OR(adj) = 8.0, 95% CI 2.7-23.7), using condoms in the last year (OR(adj) = 4.2, 95% CI 1.6-11.1), self-reporting of HIV-risk behaviours (OR(adj) = 3.6, 95% CI 1.3-9.6), and being male (OR(adj) = 2.7, 95% CI 1.1-6.6). These associations apply only to a subsample of individuals who provided complete information for HIV risk and other related behaviours. Results from the total sample indicate that individuals in our study who did not report their number of partners are more likely to have characteristics that are compatible with a higher probability of HIV risk practices. This pattern of associations suggests that refusers are indeed at higher risk for HIV infection than those sexually active individuals who did report the number of partners.

Cutaneous circulation in Raynaud's phenomenon during emotional stress. A morphological and functional study using capillaroscopy and laser-Doppler

In order to assess the effects of emotional stress on the cutaneous microcirculation in patients suffering from Raynaud's phenomenon (RP) a group of 18 patients with this pathology and 16 healthy control subjects underwent an "arithmetical test". The microcirculatory response was examined using a laser Doppler apparatus. The results obtained showed a constantly reduced flow during mental stress in normal subjects; in the RP group it was possible to observe: a first subgroup with a reduced flow similar to that seen in normal subjects, and a second subgroup with a paradoxically increased flow. It is likely that the normal vasoconstrictor response is the expression of the functional impairment of the microcirculation alone (primary RP), whereas vasodilatation in response to mental stress is a sign, of the organic development of the disease right from an early stage.

Intramuscular onchocercoma. Case report

Onchocerciasis is characterized by the presence of numerous microfilariae in the skin, formation of subcutaneous nodules and eye lesions that can lead to blindness. We present a case, rather uncommon in our environment, in which an incomplete life cycle of the parasite, led to a single intramuscular nodule. The clinical symptoms and histological features are described, together with the treatment, using Ivermectin.

[Argon laser trabeculoplasty in simple glaucoma]

In June 1984 the authors started a prospective study on the treatment of open-angle glaucoma with argon laser trabeculoplasty. The technique used was to treat 180 degrees of the anterior nonpigmented part of the trabecular meshwork with 80 to 100 burns. For retreatment the posterior pigmented part of the trabecular meshwork was coagulated with 80 to 100 burns. The burns were always applied to the pretreated half of the meshwork. At present the study includes 47 eyes treated posteriorly. Of these cases 12 eyes required retreatment. Five eyes had previously undergone an unsuccessful trabeculectomy. The preliminary results are satisfactory. The average reduction in intraocular pressure was 5.9 mm Hg; the mean intraocular pressure before therapy was 23 mm Hg. In 8 cases the trabeculoplasty failed, making a fistulating procedure necessary. The treatment was always well tolerated and there were only minor side effects which never led to any lasting damage.

[Change in corneal refractive power following artificial lens implantation]

Report on the changes in the corneal refractive power of 284 eyes surgically treated for cataract, in which an IOL had been implanted. The mean corneal refractive power of the eyes was 43.31 +/- 1.43 D preoperatively and 43.39 +/- 1.46 D postoperatively (16th week). The postoperative astigmatism of 215 eyes in which a PCL had been implanted after ECCE was not higher than 1.1 +/- 1.1 D in the 16th postoperative week after selected removal of the nylon sutures. This study demonstrates that there is no statistically significant change in the mean corneal refractive power after cataract surgery with IOL implantation.