Kavain analogues as potential analgesic agents.

BACKGROUND: Kavalactones are pharmacologically active compounds present in preparations of the root trunk of Piper methysticum Forst, known as kava. This work describes the analgesic activity of some synthesized analogues of synthetic kavain, which is the main component of kava. METHODS: The essays were initially performed against the writhing test in mice, and the most promising compound was analyzed using other classical models of nociception, including formalin-, capsaicin-, glutamate-induced nociception, the hot plate test, and measurement of motor performance. RESULTS: The results indicated that compound 6-(4-fluorophenyl)-4-methoxy-5,6-dihydropyran-2-one (2d) exerts potent and dose-dependent analgesic activity, inhibiting abdominal constrictions caused by acetic acid in mice, and being more active than some reference drugs. It also presented activity in the other models of pain, with the exception of the hot plate test and the measurement of motor performance. CONCLUSIONS: Although compound 2d exerts antinociceptive activity, the mechanism of action remains uncertain, but it does not involve the opioid system and does not appear to be associated with non-specific effects such as changes in locomotor activity or motor coordination.

Comparison of diabetes control among Haitians, African Americans, and non-Hispanic whites in an urban safety-net hospital.

OBJECTIVE: To compare diabetes care and outcomes among Haitians, African Americans, and non-Hispanic whites. RESEARCH DESIGN AND METHODS: We analyzed data from 715 Haitian, 1,472 African American, and 466 non-Hispanic white adults with diabetes using χ² testing and multiple logistic regression. RESULTS: Haitians had a higher mean A1C than African Americans (8.2 ± 1.9 vs. 7.7 ± 2.0%) and non-Hispanic whites (7.5 ± 1.7%) (both P < 0.0001). There was no difference in completion of process measures. Haitians were more likely than non-Hispanic whites to have elevated LDL cholesterol or blood pressure. Macrovascular complications were fewer among Haitians than African Americans (adjusted odds ratio 0.35 [95% CI 0.23-0.55]), as were microvascular complications (0.56 [0.41-0.76]). Haitians also had fewer macrovascular (0.32 [0.20-0.50]) and microvascular (0.55 [0.39-0.79]) complications than non-Hispanic whites. CONCLUSIONS: Haitians have worse glycemic control than African Americans or non-Hispanic whites. Future research and interventions to improve diabetes care should target Haitians as a distinct racial/ethnic group.

Avaliação da condição gengival em resposta aos picos hormonais do ciclo reprodutivo da mulher: estudo clínico controlado / Evaluation of the gingival condition in response to the hormonal peaks of the women’s reproductive cycle: controlled clinical trial

Vários autores consideram que os hormônios podem influenciar significativamente as doenças periodontais, particularmente em períodos de desequilíbrio do nível de hormônios sexuais relacionados ao ciclo da vida reprodutiva da mulher, desde a puberdade até a menopausa. O objetivo deste estudo foi avaliar as características gengivais relacionadas às alterações hormonais do ciclo mensal da mulher. Foram incluídas no estudo 32 mulheres, com idades entre 18 e 30 anos, independente de raça, com bom controle de placa bacteriana que foram avaliadas em três períodos distintos: 4 a 5 dias após o início da menstruação (Período controle – PC), 12 dias após o início da menstruação (Pico de estrogênio - PE) e 24 dias após o início da menstruação (Pico de progesterona - PP). Um questionário foi aplicado e em cada período de avaliação foram realizados os índices gengivais (IG) e os índices de placa (IPL). Os resultados demonstraram que não houve alterações estatisticamente significativas nos níveis de IG entre os períodos PC e PE do ciclo menstrual (p > 0,05), porém no PP verificou-se um aumento nos graus de sangramento gengival (p < 0,05). O IPL não demonstrou diferenças significativas em nenhum período experimental, com excelentes níveis de controle de placa (p > 0,05). Diante dos achados obtidos, pode-se concluir que os hormônios do ciclo menstrual, especialmente a progesterona, exercem alguma influência sobre os tecidos gengivais clinicamente saudáveis, com aumento dos sinais inflamatórios locais

Several authors consider that hormones may significantly influence the periodontal diseases, particularly in times of imbalance in the level of sex hormones related to the women’s reproductive cycle, from puberty to menopause. The aim of this study was to evaluate the characteristics of the gingiva related to hormonal changes during the mensal woman’s cycle. This study included 32 women, aged between 18 and 30 years, regardless of race, with good control of plaque, which were evaluated in three different periods: 4 to 5 days after onset of menstruation (Control period - PC), 12 days after the menstruation period (peak of estrogen - PE) and 24 day safter the menstruation period (peak of progesterone - PP). A questionnaire was applied, and the gingival index (GI) and plaque index (IPL) were performed in each period of evaluation. The results showed no statistically significant differences in the levels of GI between the periods PC and PE of the menstrual cycle (p> 0.05), but there was an increase in the degree of gingival bleeding in the condition of PP (p< 0.05). The IPL showed no significant differences in any experimental period, with excellent levels of plaque control in all of them (p> 0.05). Considering Our findings, it can be concluded that the hormones of the menstrual cycle, especially the progesterone, can exert some influence on the clinically healthy gingival tissues, with increased of the local inflammatory signs

Pap smear rates among Haitian immigrant women in eastern Massachusetts.

OBJECTIVE: Given limited prior evidence of high rates of cervical cancer in Haitian immigrant women in the U.S., this study was designed to examine self-reported Pap smear screening rates for Haitian immigrant women and compare them to rates for women of other ethnicities. METHODS: Multi-ethnic women at least 40 years of age living in neighborhoods with large Haitian immigrant populations in eastern Massachusetts were surveyed in 2000-2002. Multivariate logistic regression analyses were used to examine the effect of demographic and health care characteristics on Pap smear rates. RESULTS: Overall, 81% (95% confidence interval 79%, 84%) of women in the study sample reported having had a Pap smear within three years. In unadjusted analyses, Pap smear rates differed by ethnicity (p=0.003), with women identified as Haitian having a lower crude Pap smear rate (78%) than women identified as African American (87%), English-speaking Caribbean (88%), or Latina (92%). Women identified as Haitian had a higher rate than women identified as non-Hispanic white (74%). Adjustment for differences in demographic factors known to predict Pap smear acquisition (age, marital status, education level, and household income) only partially accounted for the observed difference in Pap smear rates. However, adjustment for these variables as well as those related to health care access (single site for primary care, health insurance status, and physician gender) eliminated the ethnic difference in Pap smear rates. CONCLUSIONS: The lower crude Pap smear rate for Haitian immigrants relative to other women of color was in part due to differences in (1) utilization of a single source for primary care, (2) health insurance, and (3) care provided by female physicians. Public health programs, such as the cancer prevention programs currently utilized in eastern Massachusetts, may influence these factors. Thus, the relatively high Pap rate among women in this study may reflect the success of these programs. Public health and elected officials will need to consider closely how implementing or withdrawing these programs may impact immigrant and minority communities.

Mammography use.

OBJECTIVES: The goal of this study was to compare mammography use in Haitian women versus that of other racial/ethnic groups in the same neighborhoods and to identify factors associated with mammography use in subpopulations that are seldom studied. METHODS: A community-based, cross-sectional survey sampled a multiethnic group of inner-city women from eastern Massachusetts. Bivariate analyses and logistic regression models were used to predict lifetime and recent (within two years) mammography screening. RESULTS: Self-reported lifetime mammography use was similar for Haitian (82%), African-American (78%), Caribbean (81%) and Latina women (86%) but higher for white women (94%, p = 0.008). Mammography use in the past two years was also similar in all groups (66-82%, p = 0.41). In multivariate models, African-American (adjusted odds ratio [AOR]; 0.3; 95% CI 0.1-0.9) and Haitian women (AOR 0.3; 95% CI 0.1-0.9) had lower odds of lifetime mammography compared to white women. Factors independently related to lifetime and recent mammography included having a regular healthcare provider, greater knowledge of breast cancer screening; higher education, and private health insurance. CONCLUSIONS: Haitian women with a regular provider and knowledge of breast cancer screening reported recent mammography use similar to women from other racial/ethnic groups. The racial/ethnic patterns of mammography use in our study do not explain racial/ethnic differences in breast cancer stage or mortality.