Exposure to household air pollution from biomass-burning cookstoves and HbA1c and diabetic status among Honduran women.

Household air pollution from biomass cookstoves is estimated to be responsible for more than two and a half million premature deaths annually, primarily in low and middle-income countries where cardiometabolic disorders, such as Type II Diabetes, are increasing. Growing evidence supports a link between ambient air pollution and diabetes, but evidence for household air pollution is limited. This cross-sectional study of 142 women (72 with traditional stoves and 70 with cleaner-burning Justa stoves) in rural Honduras evaluated the association of exposure to household air pollution (stove type, 24-hour average kitchen and personal fine particulate matter [PM2.5 ] mass and black carbon) with glycated hemoglobin (HbA1c) levels and diabetic status based on HbA1c levels. The prevalence ratio (PR) per interquartile range increase in pollution concentration indicated higher prevalence of prediabetes/diabetes (vs normal HbA1c) for all pollutant measures (eg, PR per 84 µg/m3 increase in personal PM2.5 , 1.49; 95% confidence interval [CI], 1.11-2.01). Results for HbA1c as a continuous variable were generally in the hypothesized direction. These results provide some evidence linking household air pollution with the prevalence of prediabetes/diabetes, and, if confirmed, suggest that the global public health impact of household air pollution may be broader than currently estimated.

Comparison of endoscopy and sonography findings in dogs and cats with histologically confirmed gastric neoplasia.

OBJECTIVE: To compare sonographic and endoscopic findings in a group of dogs and cats with histologically confirmed gastric neoplasia. METHODS: Retrospective analysis of cases with concurrent abdominal ultrasound and endoscopy to evaluate the presence of gastric wall abnormalities, location and tumour appearance between the two examinations. Sonographic findings of the small intestines, liver, spleen and lymph nodes were recorded. Comparison of the findings from each test and assessment of predictive characteristics for neoplasia was evaluated. RESULTS: In total 17 dogs and 5 cats were included, Sonography identified 50% and endoscopy identified 95% of all gastric neoplasms. Lymphoma was the most commonly missed tumour by sonography. There was sonographic and endoscopic tumour location agreement in 36% of cases (Cohen's kappa = 0 · 25). Animals with sonographically normal small intestines had a statistically greater probability of gastric neoplasia (P = 0 · 035). All cats had lymphoma (P < 0 · 001). CLINICAL SIGNIFICANCE: Sonography and endoscopy are useful for the diagnosis of gastric neoplasia. Endoscopy is more accurate in identifying gastric neoplasia; however, sonography can raise the clinical suspicion for gastric neoplasia and may provide a less invasive means of gathering information before endoscopy. Intraluminal gastric gas or fluid may limit diagnostic capabilities of sonographic evaluation.

Impact of a cleaner-burning cookstove intervention on blood pressure in Nicaraguan women.

Few studies have evaluated the cardiovascular-related effects of indoor biomass burning or the role of characteristics such as age and obesity status, in this relationship. We examined the impact of a cleaner-burning cookstove intervention on blood pressure among Nicaraguan women using an open fire at baseline; we also evaluated heterogeneity of the impact by subgroups of the population. We evaluated changes in systolic and diastolic blood pressure from baseline to post-intervention (range: 273-383 days) among 74 female cooks. We measured indoor fine particulate matter (PM(2.5); N = 25), indoor carbon monoxide (CO; N = 32), and personal CO (N = 30) concentrations. Large mean reductions in pollutant concentrations were observed for all pollutants; for example, indoor PM(2.5) was reduced 77% following the intervention. However, pollution distributions (baseline and post-intervention) were wide and overlapping. Although substantial reductions in blood pressure were not observed among the entire population, a 5.9 mmHg reduction [95% confidence interval (CI): -11.3, -0.4] in systolic blood pressure was observed among women aged 40 or more years and a 4.6 mmHg reduction (95% CI: -10.0, 0.8) was observed among obese women. Results from this study provide an indication that certain subgroups may be more likely to experience improvements in blood pressure following a cookstove intervention.

Correlations between numerical chromosomal aberrations in the tumor and peripheral blood in canine lymphoma.

Lymphoma is the most frequently diagnosed hematopoietic malignancy in dogs. Untreated, the survival times are approximately one month. Chemotherapy is the current standard of care and can initiate and temporarily maintain remission, with average remission times of one year. Canine lymphoma is an established model of human non-Hodgkin's lymphoma, and studying this disease in dogs can provide insight to both human and canine disease. Cytogenetic abnormalities can aid in diagnosing tumors as well as in giving a more accurate prognosis for the specific mutations present. Evaluating peripheral lymphocytes instead of tumor cells is less invasive for the affected dog and technically easier. This study was designed to investigate a correspondence between numerical aberrations detected in the tumor and the peripheral blood in dogs with lymphoma. Twenty-five dogs with lymphoma had one lymph node excised, a peripheral blood sample drawn, and a bone marrow aspirate performed. Portions of the lymph node were submitted for immunophenotyping and cytogenetic analysis. The peripheral blood sample was cultured for cytogenetic analysis and the bone marrow aspirate was used for staging purposes. A significant correspondence between the numerical aberrations in the tumor and the peripheral blood was found. The findings in this study pave the way toward an alternative method for evaluating lymphoma. When tumor analysis is not possible, the peripheral blood offers a viable option for cytogenetic assessment. Additionally, this may provide a method to evaluate the efficacy of the treatment protocol during the course of treatment.

Biomechanical characteristics of allogeneic cortical bone pins designed for fracture fixation.

The biomechanical characteristics of 1.2 mm diameter allogeneic cortical bone pins harvested from the canine tibia were evaluated and compared to 1.1 mm diameter stainless steel pins and 1.3 mm diameter polydioxanone (PDS) pins using impact testing and four-point bending. The biomechanical performance of allogeneic cortical bone pins using impact testing was uniform with no significant differences between sites, side, and gender. In four-point bending, cortical bone pins harvested from the left tibia (204.8 +/- 77.4 N/mm) were significantly stiffer than the right tibia (123.7 +/- 54.4 N/mm, P = 0.0001). The site of bone pin harvest also had a significant effect on stiffness, but this was dependent on interactions with gender and side. Site C in male dogs had the highest mean stiffness in the left tibia (224.4 +/- 40.4 N/mm), but lowest stiffness in the right tibia (84.9 +/- 24.2 N/mm). Site A in female dogs had the highest mean stiffness in the left tibia (344.9 +/- 117.4 N/mm), but lowest stiffness in the right tibia (60.8 +/- 3.7 N/mm). The raw and adjusted bending properties of 1.2 mm cortical bone pins were significantly better than 1.3 mm PDS pins, but significantly worse than 1.1 mm stainless steel pins (P < 0.0001). In conclusion, cortical bone pins may be suitable as an implant for fracture fixation based on initial biomechanical comparison to stainless steel and PDS pins used in clinical practice.

Canine lymphoproliferative disease characterized by lymphocytosis: immunophenotypic markers of prognosis.

BACKGROUND: Canine lymphoproliferative disease often presents with lymphocytosis and is immunophenotypically diverse. HYPOTHESIS: Immunophenotype predicts prognosis in canine lymphoproliferative disorders involving circulating lymphocytosis. ANIMALS: Dogs that had peripheral blood evaluation performed by flow cytometry by the Clinical Immunology Service at Colorado State University between 2003 and 2005. METHODS: Outcome data regarding treatment and survival were sought on patients with lymphocytosis comprising a single lymphocyte subset. Ninety-six patients that met the inclusion criteria had sufficient follow-up information to be included in the study. RESULTS: Four main phenotypic classifications were found: CD8+ T-cell, CD21+ B-cell, CD4-8-5+ (aberrant T-cell phenotype), and CD34+ (undifferentiated progenitor). Expression of CD34 predicted poor outcome with median survival of 16 days (P < .0001) compared with other phenotypes. Within the CD8+ phenotype, dogs presenting with a lymphocytosis >30,000 lymphocytes/muL had significantly shorter median survival (131 days) than those presenting with <30,000 lymphocytes/muL (1098 days, P < .0008). Within the T-cell leukemias, there was no difference in outcome between dogs with CD4-8-5+ leukemia and dogs with the CD8+ T-cell phenotype nor was the loss of expression of the pan-leukocyte marker CD45 associated with decreased survival time. A CD21+ lymphocytosis composed of large cells was associated with shorter survival time (129 days) than those with smaller circulating cells (median survival not reached, P < .01). CONCLUSIONS AND CLINICAL IMPORTANCE: Immunophenotyping provides an objective method for determining prognosis in lymphoproliferative disorders characterized by lymphocytosis.

Glucose transporter 1 expression in canine osteosarcoma.

Hypoxia in tumours has been associated with an increased resistance to radiation and chemotherapy, and increased metastatic potential. Hypoxia-inducible factor 1-alpha (HIF-1alpha) is a transcription factor induced by hypoxia. Glucose transporter 1 (GLUT-1), a downstream product of HIF-1alpha pathway activation, is over-expressed in a variety of human tumours. The purpose of this study was to determine if GLUT-1 is expressed in canine osteosarcomas (OSAs) and if the expression is related to tumour necrosis and outcome. Immunohistochemistry was performed on 44 histologically confirmed OSA tissue samples to assess expression of GLUT-1. Of 44 cases, 27 (61%) expressed GLUT-1. There was no statistical correlation between GLUT-1 and disease-free interval, survival time or percentage of necrosis. As hypothesized, GLUT-1 is present in canine appendicular OSAs. A more objective evaluation of GLUT-1 and other proteins in the HIF-1alpha pathway may be warranted.

Identifying public water facilities with low spatial variability of disinfection by-products for epidemiological investigations.

BACKGROUND AND AIMS: Epidemiological studies of disinfection by-products (DBPs) and reproductive outcomes have been hampered by misclassification of exposure. In most epidemiological studies conducted to date, all persons living within the boundaries of a water distribution system have been assigned a common exposure value based on facility-wide averages of trihalomethane (THM) concentrations. Since THMs do not develop uniformly throughout a distribution system, assignment of facility-wide averages may be inappropriate. One approach to mitigate this potential for misclassification is to select communities for epidemiological investigations that are served by distribution systems with consistently low spatial variability of THMs. METHODS AND RESULTS: A feasibility study was conducted to develop methods for community selection using the Information Collection Rule (ICR) database, assembled by the US Environmental Protection Agency. The ICR database contains quarterly DBP concentrations collected between 1997 and 1998 from the distribution systems of 198 public water facilities with minimum service populations of 100,000 persons. Facilities with low spatial variation of THMs were identified using two methods; 33 facilities were found with low spatial variability based on one or both methods. Because brominated THMs may be important predictors of risk for adverse reproductive outcomes, sites were categorised into three exposure profiles according to proportion of brominated THM species and average TTHM concentration. The correlation between THMs and haloacetic acids (HAAs) in these facilities was evaluated to see whether selection by total trihalomethanes (TTHMs) corresponds to low spatial variability for HAAs. TTHMs were only moderately correlated with HAAs (r = 0.623). CONCLUSIONS: Results provide a simple method for a priori selection of sites with low spatial variability from state or national public water facility datasets as a means to reduce exposure misclassification in epidemiological studies of DBPs.

Melatonin metabolite excretion among cellular telephone users.

PURPOSE: The relationship between cellular telephone use and excretion of the melatonin metabolite 6-hydroxymelatonin sulfate (6-OHMS) was evaluated in two populations of male electric utility workers (Study 1, n=149; Study 2, n=77). MATERIALS AND METHODS: Participants collected urine samples and recorded cellular telephone use over 3 consecutive workdays. Personal 60-Hz magnetic field (MF) and ambient light exposures were characterized on the same days using EMDEX II meters. A repeated measures analysis was used to assess the effects of cellular telephone use, alone and combined with MF exposures, after adjustment for age, participation month and light exposure. RESULTS: No change in 6-OHMS excretion was observed among those with daily cellular telephone use >25 min in Study 1 (5 worker-days). Study 2 workers with >25 min cellular telephone use per day (13 worker-days) had lower creatinine-adjusted mean nocturnal 6-OHMS concentrations (p=0.05) and overnight 6-OHMS excretion (p=0.03) compared with those without cellular telephone use. There was also a linear trend of decreasing mean nocturnal 6-OHMS/creatinine concentrations (p=0.02) and overnight 6-OHMS excretion (p=0.08) across categories of increasing cellular telephone use. A combined effect of cellular telephone use and occupational 60-Hz MF exposure in reducing 6-OHMS excretion was also observed in Study 2. CONCLUSIONS: Exposure-related reductions in 6-OHMS excretion were observed in Study 2, where daily cellular telephone use of >25 min was more prevalent. Prolonged use of cellular telephones may lead to reduced melatonin production, and elevated 60-Hz MF exposures may potentiate the effect.

Exposure to tap water during pregnancy.

Studies of disinfection byproducts (DBPs) in drinking water and risk of adverse reproductive outcome have usually relied on approximate measures of exposure. Individual differences in consumption of bottled or filtered water, variability in tap water consumption at home and at work, dermal and inhalation exposure to volatile contaminants, and changes in residency during pregnancy may lead to exposure misclassification. We characterized exposures to tap water and other risk factors among 71 pregnant and 43 non-pregnant women attending public health clinics. Nearly all residences had a municipal water source, but 25% of women drank filtered or bottled water. Fifty percent of the women in our sample reported working outside the home where, on average, one third of their daily water intake took place. Pregnant women consumed more water than non-pregnant women (3.4 vs. 3.0 total l/day), especially cold tap water at home (1.8 vs. 1.3 l/day, 95% CI for the difference=0.1, 0.9). Patterns of showering were similar for both groups of women, but pregnant women were more likely to bathe and to bathe more frequently. The prevalence of smoking was lower among pregnant women (22.5% vs. 32.6%), as was the consumption of alcohol (4.2% vs. 53.5%, 95% CI for the difference=-64.9, -33.7). Thirty-two percent of women had moved during their current pregnancy. The data reaffirm the importance of collecting individual-level data for water consumption and exposure to potential confounders to avoid misclassification bias. This study is the first to target women of low socio-economic status (SES) and therefore of particular interest in studies of adverse reproductive outcomes for which this group is at increased risk.