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PubMed2002

21q22 balanced chromosome aberrations in therapy-related hematopoietic disorders: report from an international workshop.

The International Workshop on the relationship between prior therapy and balanced chromosome aberrations in therapy-related myelodysplastic syndromes (t-MDS) and therapy-related acute leukemia (t-AL) identified 79 of 511 (15.5%) patients with balanced 21q22 translocations. Patients were treated for their primary disease, including solid tumors (56%), hematologic malignancy (43%), and juvenile rheumatoid arthritis (single case), by radiation therapy (5 patients), chemotherapy (36 patients), or combined-modality therapy (38 patients). 21q translocations involved common partner chromosomes in 81% of cases: t(8;21) (n = 44; 56%), t(3;21) (n = 16; 20%), and t(16;21) (n = 4; 5%). Translocations involving 15 other partner chromosomes were also documented with involvement of AML1(CBFA2/RUNX1), identifying a total of 23 different 21q22/AML1 translocations. The data analysis was carried out on the basis of five subsets of 21q22 cases, that is, t(8;21) with and without additional aberrations, t(3;21), t(16;21), and other 21q22 translocations. Dysplastic features were present in all 21q22 cases. Therapy-related acute myeloid leukemia (t-AML) at presentation was highest in t(8;21) (82%) and lowest in t(3;21) (37.5%) patients. Cumulative drug dose exposure scores for alkylating agents (AAs) and topoisomerase II inhibitors indicated that t(3;21) patients received the most intensive therapy among the five 21q22 subsets, and the median AA score for patients with secondary chromosome 7 aberrations was double the AA score for the entire 21q22 group. All five patients who received only radiation therapy had t(8;21) t-AML. The median latency and overall survival (OS) for 21q22 patients were 39 and 14 months (mo), compared to 26 and 8 mo for 11q23 patients, 22 and 28 mo for inv(16), 69 and 7 mo for Rare recurring aberrations, and 59 and 7 mo for Unique (nonrecurring) balanced aberration (latency P < or = 0.016 for all pairwise comparisons; OS, P < or = 0.018 for all pairwise comparisons). The percentages of 21q22 patients surviving 1 year, 2 years, and 5 years were 58%, 33%, and 18%, respectively. Noticeable differences were observed in median OS between 21q22 patients (n = 7) receiving transplant (BMT) (31 mo) compared to 21q22 patients who received intensive non-BMT therapy (n = 46) (17 mo); however, this was nonsignificant because of the small sample size (log-rank, P = 0.33). t-MDS/t-AML with balanced 21q22 aberrations was associated with prior exposure to radiation, epipodophyllotoxins, and anthracyclines, dysplastic morphologic features, multiple partner chromosomes, and longer latency periods when compared to 11q23 and inv(16) t-MDS/AML Workshop subgroups. In general, patients could be divided into two prognostic risk groups, those with t(8;21) (median OS, 19 mo) and those without t(8;21) (median OS, 7 mo) leukemia (log-rank, P = 0.0007).

Adolescent↗

PubMed2001

Sex differences in risk factors for hiv seroconversion among injection drug users: a 10-year perspective.

BACKGROUND: Injection drug use directly or indirectly accounts for nearly half the annual human immunodeficiency virus (HIV) infections in the United States. Prospective studies that investigate both sexual and parenteral HIV risks among injection drug users (IDUs) are needed. We studied factors for HIV seroconversion among male and female IDUs in Baltimore, Md. METHODS: The HIV-negative IDUs (1447 male and 427 female) were recruited into a prospective study from 1988 to 1989 or in 1994. Participants underwent semiannual HIV tests and surveys through December 1998. Poisson regression was used to identify risk factors for HIV seroconversion, stratified by sex. Behaviors were treated as time-dependent covariates that varied at each semiannual period. RESULTS: Subjects were primarily African American (91%), and median age at enrollment was 35 years. Incidence of HIV was 3.14 per 100 person years (95% confidence interval, 2.78-3.53) and did not significantly differ by sex. Younger age independently predicted HIV seroconversion for both men and women. Among men, factors that independently predicted HIV seroconversion were the following: less than a high school education, recent needle sharing with multiple partners, daily injection, and shooting-gallery attendance. The incidence of HIV was double for men recently engaging in homosexual activity and cocaine injection. Among women, the incidence of HIV was more than double for those recently reporting sexually transmitted diseases. CONCLUSIONS: The incidence of HIV remained high among IDUs in Baltimore over the past decade. Risk factors for HIV seroconversion differed markedly by sex. Predominant risks among men included needle sharing and homosexual activity; among women, factors consistent with high-risk heterosexual activity were more significant than drug-related risks. Human immunodeficiency virus interventions aimed at IDUs should be sex-specific and incorporate sexual risks.

Adolescent↗

PubMed2006

A randomized controlled trial testing an HIV prevention intervention for Latino youth.

OBJECTIVE: To test the efficacy of a prevention intervention to reduce sexual risk behavior among Latino adolescents. DESIGN: Randomized controlled trial from April 2000 through March 2003, with data collection before and after intervention and at 3, 6, and 12 months. SETTING: Northeast Philadelphia schools. PARTICIPANTS: Latinos aged 13 through 18 years (249 males and 304 females); 81.6% retained at 12-month follow-up. INTERVENTIONS: The HIV and health-promotion control interventions consisted of six 50-minute modules delivered by adult facilitators to small, mixed-gender groups in English or Spanish. Main Outcome Measure Self-reported sexual behavior. RESULTS: Analyses using generalized estimation equations over the follow-up period revealed that adolescents in the HIV intervention were less likely to report sexual intercourse (odds ratio, 0.66; 95% confidence interval [CI], 0.46-0.96), multiple partners (odds ratio, 0.53; 95% CI, 0.31-0.90), and days of unprotected intercourse (relative risk, 0.47; 95% CI, 0.26-0.84) and more likely to report using condoms consistently (odds ratio, 1.91; 95% CI, 1.24-2.93). Baseline sexual experience and language use moderated intervention efficacy. Adolescents assigned to the HIV intervention who were sexually inexperienced at baseline reported fewer days of unprotected sex (relative risk, 0.22; 95% CI, 0.08-0.63); Spanish speakers were more likely to have used a condom at last intercourse (odds ratio, 4.73; 95% CI, 1.72-12.97) and had a greater proportion of protected sex (mean difference, 0.35; P<.01) compared with similar adolescents in the health-promotion intervention. CONCLUSION: Results provide evidence for the efficacy of HIV intervention in decreasing sexual activity and increasing condom use among Latino adolescents.

Adolescent↗

PubMed1998

The viral origin of cervical cancer in Rabat, Morocco.

In Northern Africa, cervical cancer is the second most common cancer among women. The diagnosis is usually made in advanced stages, and mortality is high, yet few studies have investigated the role of human papillomavirus (HPV) and other risk factors in the etiology of cervical cancer. A hospital-based case-control study was completed at the Institut National d'Oncologie (INO) in Rabat, Morocco. The study included 214 cases of invasive cervical cancer and 203 controls. A structured questionnaire was used to investigate known and suspected risk factors for cervical cancer. A GP 5+/6+ polymerase chain reaction system was used to detect the presence of HPV DNA and HPV type distribution. Probes for 30 HPV types were used in one research laboratory. HPV DNA was the central risk factor and accounted for the large majority of the cases. The adjusted odds ratio (ORa) for any HPV was 61.6 (95% CI, 29.2-130) and the corresponding HPV attributable fraction (AF) was 92%. Among cases of cervical cancer, HPV 16 was the most common type (67.7%) followed by HPV 18. The HPV type-specific prevalence was similar for squamous cell carcinomas and adenocarcinomas. In multivariate adjusted or HPV-stratified analyses, in addition to the strong effect of HPV, other risk factors identified were sexual intercourse with multiple partners before the age of 20 and low socio-economic status. Use of oral contraceptives for 5 or more years and high parity were also found to be related to cervical cancer. Screening was rare in this population but offered substantial protection against cervical cancer. In Morocco, cervical cancer is a late sequel of a viral infection with certain HPV types. Developing screening programs for preneoplastic cervical lesions is a public health priority. When available, HPV vaccination would offer a relevant alternative for preventing cervical cancer.

Adenocarcinoma↗

PubMed1997

Cytogenetic, fluorescence in situ hybridisation, and clinical evaluation of translocations with concomitant deletion at 13q14 in chronic lymphocytic leukaemia.

Deletions and translocations of 13q14 are the most frequent structural chromosome abnormalities found in chronic lymphocytic leukaemia (CLL). We have identified 13q14 translocations in the blood of 30 of 450 (6.6%) CLL patients by conventional cytogenetics, using tetradecanoyl phorbol 12-myristate 13-acetate (TPA) as a mitogen. The translocations are characterised by multiple partner chromosomes and a high incidence, 6 of 30 cases, of complex rearrangements. Seven cases were also studied by fluorescence in situ hybridisation (FISH) using four previously ordered YACs, to define the breakpoints further. Deletions with varying proximal and distal breakpoints were found in six cases. Two of the cases had deletions of the cytogenetically normal chromosome 13 at q14, and in one case the 13q14 translocation was a secondary genetic event. No difference in the clinical features between the patients with 13q14 translocation and 54 patients with 13q14 deletions or four patients with both a translocation and a deletion was observed. These data suggest that the genetic consequence of 13q14 translocations in CLL is the loss of a tumour suppressor gene.

Chromosome Deletion↗

PubMed1981

Uterine cancer (prevention).

Cancer prevention as related to the problem of cervical and endometrial cancer involves a great number of factors that are considered contributory to the development of neoplasms in the uterus. Lifestyles encouraging the development of cervical cancer are different from those encouraging endometrial cancer. Cancer of the cervix is a disease of the inner city. It is seen in those staring intercourse in their teens, having multiple partners, having many children, and coming from the low socioeconomic groups. Semen and herpes virus II may have an adverse effect on immature cells, but there are no hard data to confirm these roles. Cancer of the endometrium is a disease of suburbia. The American Cancer Society estimates that there will be 38,000 new cases of endometrial carcinoma in 1980, making it the most common female genital cancer. Women at highest risk for later carcinoma of the endometrium are those who have obesity, diabetes, infertility, irregular menses and failure of ovulation, adenomatous hyperplasia, and/or prolonged estrogen administration. For both cervical and endometrial cancers, it is possible to identify the high-risk patient, to detect changes at an early stage, and, by instituting appropriate therapy, to prevent a more serious problem. It is obvious that prevention, detection, and treatment are all closely intertwined. This paper identifies the patient at high risk and makes suggestions for correcting any imbalance that may predipose to the development of invasive cancer.

Dietary Fats↗

PubMed1996

Performance characteristics and results of a large-scale screening program for viral hepatitis and risk factors associated with exposure to viral hepatitis B and C: results of the National Hepatitis Screening Survey. National Hepatitis Surveillance Group.

Chronic viral hepatitis frequently goes undetected until cirrhosis develops. Although the effect of interferon on the natural history of hepatitis B virus (HBV) or hepatitis C virus (HCV) infection in asymptomatic persons is unknown, treatment may modify the course of the infection, producing cures in some. In September 1992, screening for HBV and HCV was offered in 40 centers throughout the United States. Demographic features, potential risk factors, and symptoms were studied. Blood samples were obtained for the determination of serum alanine aminotransferase levels and for markers of HBV and HCV infection. Thirteen thousand nine hundred ninety seven subjects were screened. The prevalence of infection with HBV or HCV was 24.8% (HBV 17.8%; HCV 7.0%; and both 2.8%). Hepatitis B and C disease was present in 0.7% and 4.4% of the population, respectively. Risk factors for HBV and HCV infection were similar in: blood transfusions, hemodialysis, IV drug use, and sex with an IV drug user. For HBV infection, sex with multiple partners, increasing age, and birth in South East Asia or Africa were additional risk factors. The cost to find a case of HCV infection is less than the costs for finding many other treatable diseases. Screening for HBV, though more costly, is reasonably efficient, and simultaneous screening for HBV and HCV provides greater efficiency. It is practical to consider screening for HBV and HCV in the United States, particularly if any risk factor is present. Improved treatment strategies will make screening even more cost effective.

Adult↗

PubMed1990

Prevalence of cervical dysplasia and HPV infection according to sexual behavior.

A total of 165 uterine cervix smears from Venezuelan women were examined by cytological techniques to identify malignant and pre-malignant cervical changes, as well as to identify Human Papilloma Virus (HPV) DNA types 6, 11, 16, 18, 31, 33 and 35. Of these smears, 119 were from nonmonogamous women who participated in a cervical carcinoma screening program. In this group, HPV-DNA was detected by hybridization in 42 samples (35%) and cervical intraepithelial neoplasia (CIN) in 13 (11%). Forty-six monogamous aboriginal women were similarly studied and no evidence of abnormal cytology or HPV-DNA of the types studied here was found in any of them. In the non-monogamous group, age at first sexual intercourse and index of parity were not associated with cervical HPV infection and/or CIN. The rates of HPV infection, however, were significantly different between the two populations, confirming that sexual behavior involving multiple partners is associated with HPV infection.

Adult↗

PubMed1977

Carcinoma of the cervix uteri in Ibadan: coital characteristics.

Carcinoma of the cervix uteri has been found to be the most common female malignancy in Ibadan, excluding the reticuloendothelial tumors. In a study to investigate associated etiological factors in this environment, it was demonstrated that certain coital characteristics of women with cervical cancer can be identified. These were a common denominator which could explain the frequency of the disease among some categories of patients who engage in early sexual practice, have intercourse frequently and with multiple partners, and have many pregnancies. Support was given to the view that a sexually transmitted factor might be important in the cause of carcinoma of the cervix.

Adolescent↗

PubMed1985

A surgical oncology perspective on AIDS.

During the summer of 1981 reports of unusual opportunistic infections among male homosexuals first began to appear in the literature and by December 1983, 3000 cases has been reported to the Center for Disease Control in Atlanta, Georgia. Homosexual and bisexual men comprise 71% of the reported cases, while 17% are known intravenous drug users, and the remaining 12% made up of persons with other risk factors. Approximately 80% of AIDS patients with Kaposi's sarcoma have identifiable gastrointestinal lesions. Specific risk factors for Kaposi's sarcoma in AIDS patients have not been exclusively identified, but it is thought that repeated sexual involvement with multiple partners exposes the victim to the immunosuppressive effect of cytomegalovirus and allogenic sperm, which may in turn impair lymphoid cells. The immunological abnormalities associated with AIDS have included striking changes in T-cell ratios, with more profound changes in the Kaposi-AIDS groups. Increases in IgG, decreased antibody production by B-cells to challenge antigen, decreased B-cell proliferative responses to B-cell mitogens, abnormalities in macrophage function, and increased serum thymosin levels have been found. Various opportunistic infections afflict the patient with AIDS. Antimicrobial therapy, various interferons, interleukin-2, and immunomodulation with thymosin have all been used without much success. The distribution and transmission of AIDS parallels hepatitis B virus infection which is transmitted sexually and parenterally. On the whole the same precautions as for hepatitis B should be taken for AIDS. Health care personnel treating patients with AIDS should also wear masks and eye protection against the splatter of body fluids and secretions.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗

PubMed2002

Developmental expression and biochemical characterization of Emu family members.

Kidney development has often served as a model for epithelial-mesenchymal cell interaction where the branching epithelium of the ureteric bud induces the metanephrogenic mesenchyme to form epithelial nephrons. In a screen for genes differentially expressed during kidney development, we have identified a novel gene that is dynamically expressed in the branching ureter and the developing nephrons. It was designated Emu1 since it shares an N-terminal cysteine-rich domain with Emilin1/2 and Multimerin. This highly conserved EMI domain is also found in another novel protein (Emu2) of similar protein structure: an N-terminal signal peptide followed by the EMI domain, an interrupted collagen stretch, and a conserved C-terminal domain of unknown function. We identified two further secreted EMI domain proteins, prompting us to compare their gene and protein structures, the EMI domain phylogeny, as well as the embryonic expression pattern of known (Emilin1/2, Multimerin) and novel (Emu1/2, Emilin3, Multimerin2) Emu gene family members. Emu1 and Emu2 not only show a similar structural organization, but furthermore a striking complementary expression in organs developing through epithelial-mesenchymal interactions. In these tissues, Emu1 is restricted to epithelial and Emu2 to mesenchymal cells. Preliminary biochemical analysis of Emu1/2 confirmed that they are secreted glycoproteins which are attached to the extracellular matrix and capable of forming homo- and heteromers via disulfide bonding. The widespread, but individually distinct expression patterns of all Emu gene family members suggest multiple functions during mouse embryogenesis. Their multidomain protein structure may indicate that Emu proteins interact with several different extracellular matrix components and serve to connect and integrate the function of multiple partner molecules.

3T3 Cells↗

PubMedDate not supplied

The importance of marital and socioeconomic status in incidence and survival of prostate cancer. An analysis of complete Norwegian birth cohorts.

BACKGROUND: Previous studies of the association between social and family status and prostate cancer (PCa) have given somewhat divergent results. Little attention has been paid to the possible importance of these factors for survival. METHODS: In this study, hazard regression models for PCa incidence and mortality were estimated on the basis of register- and census-based histories for complete Norwegian birth cohorts, giving a follow-up time of 16 million person years and 30,000 cases of PCa. RESULTS: A significant excess incidence of about 20% was found for ever-married men and for those with higher education. Marriage and socioeconomic resources appeared, however, to have a favorable effect on survival. Five-year relative survival from metastasized cancer among men with a high educational level was found to be 15 percentage points higher than among men with lower education. CONCLUSIONS: The observed differences in incidence are not easily explained. They apparently run counter to the hypothesis that multiple partners give a higher PCa risk, but may be consistent with the view that fat and meat consumption is risky. Better survival from PCa in higher socioeconomic groups and among married men may reflect differences in the search for, access to, or quality of treatment or a better constitution to fight the disease.

Aged↗

PubMed1999

University students' knowledge and awareness of HPV.

BACKGROUND: The purpose of this study was to evaluate the knowledge, attitudes, and behaviors of university students regarding the human papillomavirus (HPV). METHODS: A random sample of 500 university students was mailed a self-administered questionnaire that elicited their knowledge and awareness about HPV and compared their knowledge and attitudes with those of other sexually transmitted diseases (STDs). Among the 480 deliverable addresses, 289 students responded (response rate 60%). RESULTS: Only 37% of respondents had ever heard of HPV, and the median score on a 13-item knowledge scale was only 3. Of seven STDs assessed, respondents indicated they knew the least about HPV and perceived that this STD has received the least educational effort. In multivariate analyses, predictors of lower knowledge and awareness about HPV were male gender and sexual behavior (having multiple partners, not using condoms). CONCLUSIONS: Despite the high prevalence of HPV among young adults, most students knew very little about this infection. Implementing HPV educational programs and measuring their effectiveness should be a priority.

Adult↗

PubMed1991

French intravenous drug users: knowledge and sexual behavior change.

In a population based survey conducted in France in 1988, 41 respondents reported present or past intravenous drug use. Controlling for age and gender, intravenous drug users (IDUs) engage in more high risk sexual behavior than the general population (sex with other IDUs, multiple partners), but they do not use condoms more frequently. They are five times more likely to have had an HIV test.

Acquired Immunodeficiency Syndrome↗

PubMed1996

Evaluation of a HIV/AIDS education program for adolescents.

The adolescent population has recently been recognized as one of the groups at risk for human immunodeficiency virus (HIV) infection. Statistics are beginning to document the extent of this trend. This study is aimed at determining adolescent sexual behaviors and the efficacy of a medical student-run acquired immune deficiency syndrome (AIDS) education program. Medical students taught 2,169 high school students in the St. Louis area with a pre- and post- intervention questionnaire administered to record levels of HIV/AIDS knowledge and sexual practices. Data revealed that 56.4% of the respondents were sexually active with 70.4% having multiple partners and 61.0% admitting to unprotected sex. These students demonstrated a significant increase in their knowledge about HIV infection after the educational program. The results show that, adolescents are sexually active and more importantly, they are practicing behaviors that put them at risk for HIV/AIDS, a risk which they recognize. Finally, the educational intervention did increase students' knowledge of HIV/AIDS. This may not translate into a change in behaviors, but it is a first step.

Adolescent↗

PubMedDate not supplied

Hepatitis B and C in heterosexual patients with various sexually transmitted diseases.

The seroprevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections were prospectively assessed in 356 heterosexuals with STDs (sexually transmitted diseases) and compared to a control group of 381 healthy first-time blood donors. Eighty-one of 356 STD patients were anti-HBC positive (22.8%) compared to 14/381 blood donors (3.8%; p less than 0.001). In addition, 18 of the 81 anti-HBC positive STD patients, but none of the controls, were positive for HBSAg (p = 0.06). The prevalence for anti-HCV was also significantly higher in the STD group than in the controls (5.3% vs. 0.5%; p less than 0.001). Among the various STDs syphilis (anti-HBC: 67.5%; anti-HCV: 12.5%) and Chlamydia trachomatis infections (anti-HBc: 20.2%, anti-HCV: 8.1%) had the highest prevalence for both infections. This study provides strong evidence of heterosexual transmission of hepatitis B and C virus infections. Thus, heterosexuals with STDs or multiple partners should be actively vaccinated against hepatitis B.

Adolescent↗

PubMed1995

AIDS related information, attitudes and behaviours among Italian male young people.

In order to evaluate the AIDS related sources of information, knowledge, attitudes and behaviours among male young people it was filled in a multi-choice anonymous questionnaire by 2018 subjects, called for the first medical examination to Italian Navy and by 1348 recruits. The data from the latter group were used to make comparisons with our previous survey carried out in 1988. The most important sources of information on AIDS were mass media and school, on sexuality friends and family. AIDS awareness was greater among the high educated subjects and positively influenced by mass media and school as sources of information. In agreement with these data, knowledge was better about AIDS than about sexuality. Risk perception was positively influenced by the AIDS-related knowledge for called youth and a greater intolerance towards infected people was observed among the less educated and the less AIDS-aware subjects. On average 46% of the called up young men and 74% of recruits declared to be sexually active: among these, the mean age at the first sexual intercourse was 16, over 60% declared to have had multiple partners, over 30% unknown partners and over 30% didn't use condoms; 20% of called up and 38% of recruits indicated 2 or 3 risk behaviours. Factors determining sex-related risks were different according to the behaviour and the considered group. These results suggest that it is important for young people to be well informed about sex and AIDS before the beginning of sexual activity, if possible during compulsory school.

Acquired Immunodeficiency Syndrome↗

PubMed1994

Sexual risk profiles of delinquent and homeless youths.

Relatively little is know about the sexual behaviors of high-risk adolescents, such as delinquent and homeless youths. Having secured data from medical examinations, this study provides sexual risk profiles for a sample of delinquent (N = 245) and homeless (N = 160) youths in San Francisco, California. The study found several indicators of high-risk behaviors, such as high levels of STDs, trading sex for money or drugs, and unprotected sexual relations with multiple partners. The study suggests that communities provide better sex education and medical services to high-risk adolescents through multi-service health clinics, public health clinics, and street outreach.

Adolescent↗