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PubMed2004

Breast cancer in black African women: a changing situation.

Black African women in rural South Africa have a very low incidence rate of breast cancer, 5-10 per 100,000. The rate, however, is rising in the considerably increasing urban population. During the period 1994 to 1999 in Durban, enquiries revealed an average of 57 urban patients admitted to hospital each year, from a population of about 600,000 African women, indicating an age-adjusted annual incidence rate of 15.1 per 100,000. This incidence rate is very low in comparison with those in developed populations, which range from 40 to 89 per 100,000. In the African patients studied, the mean age on admission was relatively young, 54.1 +/- 10.9 years, almost a decade earlier than patients of developed populations. Moreover, the disease was very far advanced; 21.1% were at Stage III and 63.1% at Stage IV. As to exposure to risk factors, African women in general are characterised by certain protective factors. These factors, which closely resemble those of importance in patients in developed populations are, late menarche, early age at birth of first child, high parity (with usually prolonged lactation), and being physically active. However, with ongoing changes in the lifestyle of urban African women, the protective factors are decreasing in their intensity. Changes in these respects have been associated with rises in the disease's incidence rate. Clearly, because of the late stage of the disease at the time of the patients' admission to hospital, and hence their poor survival rate, intensive efforts should be made to educate women to seek help at an early stage of their disease. For its avoidance, feasible protective or restraining measures are primarily to adopt a 'prudent' lifestyle, in respect of both dietary and non-dietary components. However, the chances of these measures being meaningfully adopted in African urban communities, unfortunately, are negligible. In consequence, further increases in incidence rate would seem inevitable.

Adult↗
PubMedDate not supplied

Reperfusion strategy after regional ischaemia: comparative study of reperfusion conditions and compositions.

We investigated the effects of pressure, temperature and additives on aortic root reperfusion success. Cardiopulmonary bypass and heart arrest were initiated in mongrel dogs and sudden uncontrolled normothermic (group 1), pressure controlled substrate enriched normothermic (group 2a), pressure controlled unmodified normothermic (group 2b) and pressure controlled unmodified tepid (group 3) reperfusion compared. In group 1, the first cardiac rhythm was ventricular fibrillation, but dogs in the other groups showed spontaneous sinus rhythm. Recovery times were significantly longer and cardiac output levels significantly decreased in group 1 compared with the other groups. Prolonged lactate production and oxygen uptake failure were observed in group 1 compared with the other groups; oxidative stress markers and microscopic studies confirmed significant tissue injury in group 1. All parameters were similar between groups 2a, 2b and 3, indicating that low reperfusion pressure in the first 2 min is the most effective component of reperfusion.

Animals↗
PubMed1992

Nutrients and contaminants in human milk from mothers on macrobiotic and omnivorous diets.

The effect of alternative dietary habits and prolonged lactation on the nutrient and contaminant concentrations in human milk was studied. The study sample consisted of mothers on macrobiotic diets, containing little or no diary products and meat, at 2-3 months postpartum (n = 9) and 9-13 months postpartum (n = 12), and mothers on omnivorous diets at 2-3 months postpartum (n = 10). Protein and zinc concentrations in breast-milk from macrobiotic mothers decreased with stage of lactation. After adjustment for stage of lactation, milk from macrobiotic mothers contained less calcium, magnesium and saturated fatty acids C15:0-C20:0, and more polyunsaturated fatty acids. Observed tendencies for lower protein and fat and higher lactose concentrations in the macrobiotic group were not statistically significant. Concentrations of vitamin B12, HCB and polychlorinated biphenyls (PCB 118, PCB 138, PCB 153 and PCB 180) were lower in the macrobiotic group. After adjustment for confounding variables, meat and fish consumption, but not dairy products, contributed to vitamin B12 concentrations. Meat and diary products strongly contributed to breast-milk concentrations of dieldrin and PCBs, fish to PCB 118, and smoking to DDT and dieldrin. Our findings suggest that breast-milk contamination could be reduced by abstinence from smoking and a moderate intake of animal products. However, risk of nutritional deficiencies rules out complete avoidance of meat, fish or diary products. Quantitative research on the effects of a reduced consumption of animal products, as well as smoking, on breast-milk contamination is warranted.

Adult↗
PubMed1988

[The nutritional and health status of the Latin American woman].

Latin America is a region where countries have various levels of socioeconomic development. Thus, the living standards and health status of its people differ significantly in the midst of a mosaic of social, ethnic, cultural and economic realities. Social inequalities and extreme poverty determine significant differences, not only in the magnitude of health indicators, but also in the type of pathology prevalent. People in the high socioeconomic levels are affected by nutritional diseases characterized by excessive food intake, while people from the low socioeconomic levels are affected by undernutrition and its associated pathology. Undernutrition occurs fundamentally among the age groups at higher risk in the population segments with low income, low food intake, illiteracy and poor access to the health care and preventive medicine centers. Among families exposed to undernutrition, women are usually in worse condition than men. This is due to the long working hours and the increased nutritional requirements caused by frequent gestations and prolonged lactation. It is estimated that one fourth of newborns in Latin America are affected by low birth weight, which has been associated to adolescent mothers, their excessive physical work, anemia, low maternal pregestational weight, low weight gain during gestation, and frequent maternal infections. Nutritional anemia due to iron deficiency is highly prevalent among pregnant women in Latin America. In some countries, the prevalence of folate deficiency during pregnancy appears to have increased significantly in the past 15 years and is becoming a nutritional problem that needs preferential attention. Diets generally are inadequate and, in the case of pregnant and lactating women, usually deficient in calories, protein, iron and folic acid. It is urgent that the health and nutritional status of Latin American women of low socioeconomic condition be given special attention, particularly mothers during gestation and lactation. Otherwise, women will not be able to altogether fulfill their important role in the home and within the family, nor will they successfully participate in the economic development of their countries.

Adolescent↗
PubMed1979

Economic importance of breastfeeding.

While an increasing body of research has documented the importance of breastfeeding for infant health, very little research has been done on its economic implications. From an economic perspective, breast milk can in many respects be regarded like any other food commodity. For example, it could be stored in milk banks, and redistributed from areas of surplus to areas of scarcity. But breast milk is inique in that many of its benefits are associated more with its method of delivery than with its physical or nutritional properties per se. In this study based on field work in West Africa, the authors evaluate the economics of breast-feeding versus artificial feeding, but point out that the major impact of breastfeeding at national level is associated with its health-promoting and birth-spacing effects, neither of which are quantifiable at present.

Africa, Western↗
PubMedDate not supplied

[Breast feeding].

The research that was carried out with comparative groups showed the influence of the work done by a coordinated health group on the prolonged natural lactation. This experience has proved the evident reduction of percentages of malnutrition and diarrhoea in children under 6 months of age.

Breast Feeding↗
PubMed1984

Breast-feeding behavioral patterns among La Leche League mothers: a descriptive survey.

Many studies have documented the behavioral patterns of unrestricted breast-feeding among Third World mothers, but knowledge of this behavior among Western women is lacking. La Leche League International is a strong advocate of unrestricted breast-feeding, a feeding behavior more characteristic of women in developing countries than in Western society. To investigate the breast-feeding patterns of La Leche League mothers, a pilot study of 24 active members was undertaken. Utilizing a home diary, a 2-month record of suckling frequency, vaginal bleeding, sexual intercourse, solid food supplements, and six-hour intervals without a suckling episode was maintained. The results show the La Leche League mother in this sample to be an average of 29 years old, white, and well-educated. She fed an infant an average of 15 times per day and frequently slept with her child. Frequency of mother and child sleeping together was inversely related to the frequency of marital intercourse. Prolonged lactational amenorrhea was also found, as 92% of the mothers nursing infants 5 to 16 months old had not regained their normal menstrual flow. La Leche League mothers represent a subset of nursing mothers who have a life-style of which the primary care physician must be aware in order to provide optimal maternal-infant care.

Adult↗
PubMed1982

Fertility regulation in nursing women. II. Comparative performance of progesterone implants versus placebo and copper T.

A clinical study was designed to test whether sustained administration of progesterone to nursing mothers could prolong lactation and delay the postpartum recovery of fertility. The hormone was administered by subdermal implantation of six pellets that each contained 100 mg of progesterone. This treatment was administered to 84 fully nursing women on day 30 post partum. Control groups were composed of 130 fully nursing women who received an injectably placebo, and by 125 fully nursing women who received a TCu 200 intrauterine contraceptive device. An exacting list of requirements for admission to and continuation in the study was applied to all groups. No pregnancies occurred in the progesterone-treated group from the second to the sixth postpartum month. This period coincided with the period of elevation plasma progesterone attributable to hormone released from the implants. The cumulative probability of pregnancy in the placebo group was 10.2 per 100 women at the sixth month. Treatment with progesterone did not change the duration of lactation or the rate of child growth, and no adverse effects were recorded. These results warrant further investagation of the use of progesterone as an alternative method to prevent conception in nursing women.

Birth Weight↗
PubMed1993

Prevalence and risk factors of iron-deficiency in women of Chukotka.

A study of iron deficiency states (IDS) in Chukotkan native women aged 20-59 years revealed a relatively high prevalence of 36.4%. The prevalence of anemia was 5.6%. Some risk factors of IDS have been defined including frequent deliveries, prolonged lactation and also some peculiarities in the nutrition of these women.

Adult↗
PubMed1977

Family planning attitudes and practices in rural eastern Nigeria.

A survey was conducted in August 1974 in 16 Ngwa Igbo villages in the East Central State of Nigeria to determine the attitudes and practices of currently married women with regard to fertility and contraception. The results revealed that 50-60 percent of wives had ever used traditional contraceptives (abstinence, prolonged lactation, and rhythm), although data suggest that some of these methods may have been used for purposes other than contraception. Ever-use of modern contraceptives (pill, IUD, and tubal ligation) was shown to be very low and the desire for many children very strong. Nearly 80 percent of the women interviewed, however, expressed a willingness to attend a family planning clinic if one were accessible to them. This finding suggests that a significant interest in family planning services exists in Ngwa Igbo.

Abortion, Induced↗
PubMed1995

Effects of prolonged treatment of lactating goats with bovine somatotropin on aspects of adipose tissue and liver metabolism.

The effects of prolonged (22 weeks) treatment of lactating goats with bovine somatotropin on the metabolism of adipose tissue and liver has been investigated. Somatotropin treatment resulted in smaller adipocytes, decreased rate of fatty acid synthesis and decreased total acetyl-CoA carboxylase activity of adipocytes, but with no change in the proportion of this enzyme in the active state. The rate of acylglycerol glycerol synthesis from glucose of adipocytes tended to decrease as did total glucose utilization by the tissue. Glucose conversion to lactate was unchanged by somatotropin treatment but glucose conversion to other products was decreased. Maximum response of adipose tissue to insulin was unchanged but the sensitivity to insulin decreased on somatotropin treatment. Treatment with somatotropin had no effect on basal lipolysis and decreased maximum response to the beta-agonist isoproterenol, but this probably reflects the rate of isoproterenol-stimulated lipolysis varying with cell volume in adipocytes. No apparent change in response either to alpha 2-adrenergic agonists or to adenosine was apparent. The number of beta-adrenergic receptors was unchanged in adipocyte membranes but the number of alpha 2-adrenergic receptors increased. The rate of hepatic gluconeogenesis in vitro, the activity of key gluconeogenic enzymes and the modulation of the rate of gluconeogenesis by butyrate were unchanged except for the effect of this latter agent on gluconeogenesis from propionate. Hepatic ketogenic activity, as indicated by the activity of carnitine palmitoyl-CoA-transferase-1 and the concentrations of carnitine and acyl carnitines, was unchanged by treatment. Thus at the end of a prolonged period of treatment with somatotropin in lactating goats, lipid synthesis in adipose tissue is still decreased but no effects on liver lipid and carbohydrate metabolism were apparent.

Acetyl-CoA Carboxylase↗
PubMed1992

Response of high-energy phosphates and lactate release during prolonged regional ischemia in vivo.

BACKGROUND: The functional impairment of persistently ischemic, or "hibernating," myocardium may serve to maintain myocardial cell viability through a reduction of energy requirements. Although previous studies have, in a variety of experimental models, independently shown variable responses in lactate metabolism and intracellular phosphates during prolonged ischemia, the responses of these metabolites under identical flow conditions have not been adequately described. METHODS AND RESULTS: To examine the responses of high-energy phosphates and lactate metabolism to prolonged ischemia induced by partial coronary artery stenosis, 12 open-chest pigs were studied using 31P nuclear magnetic resonance spectroscopy. Concurrent measurements of blood flow, segment shortening, high-energy phosphates, and lactate release (in nine animals) were made during 2 hours of regional ischemia. Subendocardial blood flow and segment shortening were persistently depressed during ischemia, with parallel reductions in ATP, phosphocreatine (PCr), and the ratio of phosphocreatine to inorganic phosphate (PCr/Pi). Pi was persistently elevated during the ischemic period. In contrast, lactate release increased significantly from 0.23 +/- 0.04 to 1.34 +/- 0.28 mumol/ml after 15 minutes of ischemia (p less than 0.05) but then decreased to 0.73 +/- 0.17 mumol/ml at 2 hours (p less than 0.05 versus 15 minutes, p = NS versus control). Similarly, pH increased significantly from a nadir of 6.82 +/- 0.07 at 30 minutes of ischemia to 6.98 +/- 0.05 at 2 hours. CONCLUSIONS: Changes in high-energy phosphates parallel changes in blood flow and function during prolonged ischemia, whereas there is a partial amelioration in lactate production and acidosis. These data support the concept that reduction of myocardial energy requirements during prolonged flow reduction results in signs of reduced ischemia.

Animals↗