Associations of whole-blood fatty acids and dietary intakes with prostate cancer in Jamaica.

OBJECTIVE: To investigate the association of whole-blood fatty acids and reported intakes of fats with risk of prostate cancer (PCa). DESIGN: Case-control study of 209 men 40-80 years old with newly diagnosed, histologically confirmed prostate cancer and 226 cancer-free men attending the same urology clinics. Whole-blood fatty acid composition (mol%) was measured by gas chromatography and diet assessed by food frequency questionnaire. RESULTS: High whole-blood oleic acid composition (tertile 3 vs. tertile 1: OR, 0.37; CI, 0.14-0.0.98) and moderate palmitic acid proportions (tertile 2: OR, 0.29; CI, 0.12-0.70) (tertile 3: OR, 0.53; CI, 0.19-1.54) were inversely related to risk of PCa, whereas men with high linolenic acid proportions were at increased likelihood of PCa (tertile 3 vs. tertile 1: OR, 2.06; 1.29-3.27). Blood myristic, stearic and palmitoleic acids were not associated with PCa. Higher intakes of dietary MUFA were inversely related to prostate cancer (tertile 3 vs. tertile 1: OR, 0.39; CI 0.16-0.92). The principal source of dietary MUFA was avocado intake. Dietary intakes of other fats were not associated with PCa. CONCLUSIONS: Whole-blood and dietary MUFA reduced the risk of prostate cancer. The association may be related to avocado intakes. High blood linolenic acid was directly related to prostate cancer. These associations warrant further investigation.

Body size and risk of prostate cancer in Jamaican men.

We investigated the associations between body size and risk of prostate cancer in a hospital-based case-control study in Jamaica. Height, weight, waist, and hip circumference were measured at enrollment, and data collected on medical and lifestyle factors for newly diagnosed cases (n = 243) and controls (n = 275). Compared with men in the normal range of waist-hip ratio (WHR), men with WHR > or =0.95 were at greater risk of total prostate cancer (OR,1.72; CI, 1.01-3.00) and high-grade cancer (OR, 2.02; CI, 1.03-3.96). With additional control for BMI, the association with WHR remained significant for total prostate cancer (OR, 1.90; CI, 1.01-3.53) and high-grade disease (OR, 2.94; CI, 1.34-6.38). There was no association between waist circumference and cancer without control for BMI but after controlling for BMI, waist circumference >90 cm (OR, 2.45; CI, 1.01-5.94) and >102 cm (OR, 5.57; CI, 1.43-18.63) showed a dose-response relationship with high-grade disease. Height and BMI were not associated with risk of prostate cancer. Abdominal obesity may be associated with risk of high-grade prostate cancer. Risk may be greater in those with higher abdominal obesity relative to overall size. The results further highlight the importance of investigating relationships by characteristics of the tumor.

The potential of saponin from Jamaica's Blighia sapida (ackee) as a substitute for sodium lauryl sulphate in toothpaste.

Discovering novel means of protection from harmful substances in toothpaste is essential due to its mass production, and frequent exposure to its ingredients by consumers. This method of safeguarding through discovery demonstrates toothpaste safety, which is at risk of being stifled by other commercial priorities. Among the ingredients in toothpaste that cause adverse effects is sodium lauryl sulphate (SLS). An understanding of this source and its effects therefore allows for investigating preventative strategies through the use of safer alternatives. Saponin, a naturally occurring chemical in several plant species was discovered to be an alternative compound that may parallel the effects of sodium lauryl sulphate, yet exude less ill effects. This article highlights the benefits of saponin and its presence in a heavily consumed and exported fruit in Jamaica (ackee, Blighia sapida). The possibility of extracting saponin from ackee, and its use in the toothpaste industry as an alternative to sodium lauryl sulphate are discussed. Through consideration of this alternative, the potential exists to improve the safety of toothpastes and consequently improve oral health.

Teaching medical students in their last leg of the undergraduate journey.

BACKGROUND: This short biographical piece provides a brief description of the experience of a medical teacher at the University of the West Indies in Jamaica. It traces his initial response to being chosen as a teacher and shows movement from self-doubt to assertive thinking about the role of the teacher. The development of the teacher, though buttressed by a formal training intervention, is couched within a sensitive understanding of the whole student.

Cyclosporine treatment of anal furunculosis in 26 dogs.

OBJECTIVES: To evaluate the effect of cyclosporine on anal furunculosis lesions in 26 dogs. METHODS: Lesions were graded as mild in 11 dogs, moderate in eight and severe in seven. Each dog was treated with approximately 4 mg/kg cyclosporine orally every 12 hours until the lesions resolved or showed no further improvement. Residual lesions were resected surgically. RESULTS: Eighteen dogs (69 per cent) experienced complete resolution, seven (27 per cent) improved but had residual lesions and one (4 per cent) showed no improvement. The mean duration of treatment until resolution or no further improvement was 8.8 weeks (range four to 24 weeks). Nine dogs (35 per cent) experienced recurrence. Six were from the group that had shown complete resolution and three were from the group that had surgery. Fifteen dogs (58 per cent) developed side effects to cyclosporine, although none required treatment to be discontinued. Mean duration of follow-up was 6.8 months (range one to 20 months). CLINICAL SIGNIFICANCE: Cyclosporine was effective at resolving or reducing anal furunculosis lesions in 25 of 26 dogs (96 per cent). However, residual or recurrent lesions remain a potential problem, and surgical resection or long-term cyclosporine treatment may be necessary in some dogs.

Viscosity of food gums determined in vitro related to their hypoglycemic actions.

Experiments were carried out in vitro and in normal human subjects to evaluate alternative food-grade viscous polysaccharides as agents for reducing postprandial hyperglycemia and to assess the relationship between the in vitro and in vivo performance of the polysaccharides. A 1:1 mixture of xanthan and locust bean gum (X/LBG) had the greatest viscosity at equivalent concentrations and shear rates and was more effective than guar gum, xanthan, or locust-bean gum at inhibiting glucose movement in vitro. It was not, however, more efficient in lowering postprandial blood glucose and plasma insulin in human subjects when incorporated in a drink containing 50 g glucose. When the different gums were acidified and reneutralized to mimic conditions in the gut, there was a better correlation between viscosity and blood glucose and plasma insulin levels. This effect may explain why X/LBG was no more effective than the other gums in reducing postprandial hyperglycemia in man.

Towards a complete North American Anabaptist genealogy: A systematic approach to merging partially overlapping genealogy resources.

Genetic studies on closed populations benefit from comprehensive, searchable genealogy resources. To support studies of Anabaptists, a computerized database has been developed that merges two large genealogy books, the "Fisher Family History" and the "Amish and Amish Mennonite Genealogies." The former is more current but the latter is more comprehensive for the 18th and 19th centuries. Therefore, the merger of the two books is significantly more useful than either book alone. We demonstrate the utility of the merged database with two results: an increase in inbreeding coefficients and the identification of parent-child relationships that do not exist in either book. Am. J. Med. Genet. 86:156-161, 1999. Published 1999 Wiley-Liss, Inc.

A comparative study of the effects on colon function caused by feeding ispaghula husk and polydextrose.

Polydextrose is a new soluble food ingredient which cannot be digested by intestinal enzymes and so may affect colonic function. Studies in healthy volunteers compared the effects of diet supplementation with 30 g/day polydextrose, a standard dose of 7 g/day ispaghula and two mixtures containing 2 g/day ispaghula with either 30 g/day polydextrose or 10 g/day polydextrose with a control period. During the 10-day periods, the mass, frequency and consistency of faeces were assessed as well as the whole-gut transit time, ease of defaecation, flatulence and palatability of the preparations. All preparations significantly increased the weekly faecal mass above control values (P less than 0.05) but there were no significant differences between the preparations. Transit time and stool frequency were not affected significantly by any of the preparations (P greater than 0.05). Both preparations supplying 30 g/day polydextrose softened stool consistency equally but the other preparations had no effect. All preparations caused flatulence and other gas-related problems but polydextrose caused more than ispaghula, even at the lowest dose of 10 g/day. More volunteers preferred taking the polydextrose drinks than the sachets of ispaghula which formed a viscous drink with water. Despite superior palatability and equally effective stool bulking, polydextrose is unlikely to be an alternative laxative to ispaghula because of the unacceptable levels of flatulence.

The effect of oral vancomycin on chronic idiopathic constipation.

BACKGROUND: A case study reporting the efficacy of oral vancomycin in a patient with chronic idiopathic constipation prompted this prospective trial of oral vancomycin in eight female patients (aged 21-61 years) with severe constipation resistant to the action of dietary fibre. METHODS: The trial was divided into two consecutive 14-day periods. During the first period, each patient was given ispaghula, 3.5 g twice a day, and during the subsequent period they took 250 mg vancomycin t.d.s. per os, as well as the fibre supplement. During both periods they collected stools and recorded daily bowel symptoms (stool frequency, straining, stool consistency, subjective stool volume) in a diary. At the end of each period whole gut transit time and the breath hydrogen response to a standard meal, giving oro-caecal transit time, were measured along with gastrointestinal symptoms which were assessed on visual analogue scales. RESULTS: Vancomycin caused a significant improvement in stool frequency, consistency, ease of defecation and the amount of stool patients felt they produced (all P < 0.05), but objective measures of daily stool weight and whole gut or oro-caecal transit time were not significantly different. Basal breath hydrogen levels were higher after vancomycin treatment in seven out of eight patients. One patient experienced a complete remission of symptoms when she took vancomycin and remains in remission after 14 months. This patient showed no elevation in basal breath hydrogen level. CONCLUSION: Although this study does not support the use of vancomycin for most patients with constipation, the results suggest that modification of the intraluminal flora may be of value in the treatment of the occasional case of idiopathic constipation.

Comparison of the effects on colonic function caused by feeding rice bran and wheat bran.

A study was designed to investigate the effects of a new fibre source, rice bran, on colonic function, and to compare it with wheat bran. The diet of eight normal male volunteers was supplemented with similar amounts of indigestible residue from rice (17.1 g/d) and wheat bran (15.0 g/d) for periods of 10 d each. During the last 7 d of each of these periods, and also of a 10-d control period when no supplement was taken, the volunteers collected their stools into plastic bags. This allowed calculation of stool mass and frequency, and gastrointestinal transit time by a continuous radio-opaque marker technique. Rice bran increased the mass of faeces produced and the stool frequency by more than the wheat bran, but both had a similar accelerating effect on the transit time. The mechanism of the efficient stool bulking caused by the rice bran may be due to a high content of retrograded starch.

Calcium channel blockers do not enhance increases in plasma potassium after succinylcholine in humans.

STUDY OBJECTIVE: To determine whether chronic calcium channel blocker therapy exaggerates the rise in plasma potassium concentration ([K+]) after succinylcholine administration. DESIGN: Prospective clinical study. SETTING: University and Veterans Affairs hospitals. PATIENTS: 36 ASA physical status III and IV male patients: 21 patients taking chronic calcium channel blockers and 15 patients not receiving calcium channel blockers, all of whom were scheduled for inpatient surgical procedures with general anesthesia. INTERVENTIONS: In all patients, anesthesia was induced with high-dose opioids plus a sedative-hypnotic, and intubation was facilitated with 1 to 1.5 mg/kg succinylcholine without nondepolarizing neuromuscular blocker pretreatment. MEASUREMENTS AND MAIN RESULTS: Plasma [K+] was measured prior to induction and 1, 3, 5, 8, 11, and 15 minutes after succinylcholine was administered. A modest average peak rise of 0.5 mEq/L in plasma [K+] was observed, but there were no differences between patients who were or were not receiving calcium channel blockers. CONCLUSIONS: Patients receiving chronic calcium channel blocker therapy are at no greater risk of hyperkalemia after succinylcholine than those not taking such medications.

Use of the bisphosphonate drug alendronate for palliative management of osteosarcoma in two dogs.

The bisphosphonate drug alendronate was used to suppress bone remodelling and tumour osteolysis as a palliative treatment for two dogs with osteosarcoma, one of the tibia and one of the maxilla. A spiral fracture associated with the tibial tumour healed after it was stabilised with an external skeletal fixator. Both dogs remained comfortable and survived for 12 and 10 months respectively after diagnosis, despite the fact that neither primary tumour was resected.

Methicillin-resistant Staphylococcus aureus infections in 11 dogs.

Methicillin-resistant Staphylococcus aureus infection was identified in 11 dogs. The infection was associated with surgical treatment especially orthopaedic surgery. Infection after traumatic wounding, and recurrent pyoderma was also seen. Oral antibiotic treatment improved or resolved the infection in nine of the 11 dogs, although the methicillin-resistant isolates were susceptible to relatively few antibiotics.

Veterinary students' understanding of a career in practice.

Lack of a clear perception of the realities of a career in veterinary medicine could adversely affect young graduates' satisfaction with the profession and their long-term commitment to it. Veterinary students' understanding of a career in practice were explored. Traditional-entry first-year and final-year students, as well as entry-level 'Gateway' (widening participation) students, were invited to complete a questionnaire exploring their pre-university experiences and their understandings of a career in general practice. Broadly speaking, the undergraduate students taking part in the survey (the majority of whom were entry-level students) had a realistic view of average weekly working hours, out-of-hours duties and the development of their remuneration packages over the course of their careers. The main attractions of the profession were working with animals and the perception of a rewarding job. The main concerns were making mistakes and balancing work and home life. The vast majority of students wanted to pursue a career in general practice, and other career opportunities did not appear to be well understood, particularly by entry-level students.

Influences on the decision to study veterinary medicine: variation with sex and background.

A questionnaire was developed to look at attitudes to veterinary medicine as a career choice among students at different stages of the veterinary course at the Royal Veterinary College. Traditional-entry first-year and final-year students, as well as entry-level 'Gateway' (widening participation) students, were invited to participate. Wanting to work with animals and exposure to a veterinary role model through taking a sick animal to visit a veterinary surgeon appeared to be major factors in choosing a veterinary career for all undergraduates, regardless of their socioeconomic background. Overall, women were more strongly influenced by owning animals (P=0.014), and men were more positively influenced by the challenging reputation of the course (P=0.028). When the students were asked to indicate their top three reasons for wanting to become a vet, men were 9.5 times as likely as women to select 'Want to train as a scientist', 5.3 times as likely to select 'Join a profession' and 13.2 times as likely to select 'Hardest course to get in to'; the top choice for both sexes was 'Want to work with animals'. Thirty-one per cent of the students felt their careers adviser had been a negative influence on their decision to become a vet.

Public and private health care utilization differences between socioeconomic strata in Jamaica.

OBJECTIVE: To assess trends in the use of private and public health care services among Jamaicans over a 15-year period (1991-2007). DESIGN AND METHODS: Statistics on the use of health care services were taken from the Jamaica Survey of Living Conditions (JSLC) for the 15-year period 1993 to 2007. Use of hospital services were represented in income quintiles and compared for private and public facilities. The difference in percentage use between public and private was compared by quintiles over the period and the variability in those differentials assessed. RESULTS: This study highlights the increasing use of private services by increasing wealth, exaggerated for the wealthiest quintile. There is a widening of the differences in utilization between public and private centers as income level increases (P < 0.001). CONCLUSIONS: Internal and external economic conditions influence the use of private and public health care services in Jamaica. Although the relative increase in the cost (to the user) of public health care is more than that for private health care, the actual cost to use the public health care system is still significantly cheaper than using the private system. Lower income health care users tend to take the lesser cost option.