Opioid and stimulant attributed treatment admissions and fatal overdoses: Using national surveillance data to examine the intersection of race, sex, and polysubstance use, 1992-2020.

BACKGROUND: We use national surveillance data to evaluate race/ethnicity by sex/gender differences and trends in substance use treatment admissions and overdose deaths involving opioid and stimulant use. METHODS: We used data (1992-2019) from the Treatment Episode Dataset-Admissions to identify treatment admissions and the Center for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research (1999-2020) to identify overdose deaths. We assessed treatment admissions and related drug overdose deaths per 100,000 adults by sex and race/ethnicity for opioid and stimulant groups: cocaine, opioid, methamphetamines, cocaine and opioid use, cocaine and methamphetamines, and opioid and methamphetamines. RESULTS: We found significant variations in treatment admissions and deaths by race/ethnicity and sex/gender. Cocaine-related treatment admissions and deaths were most prevalent among Non-Hispanic Black individuals over the study years, yet lower rates were evident among individuals from other racial/ethnic groups. Notably, Non-Hispanic Black men experienced larger increases in cocaine-only admissions than men of other racial/ethnic groups between 1992 and 2019. Men had higher opioid and stimulant treatment admissions and overdose deaths than women. We observed skyrocketing methamphetamine deaths among American Indian/Native Alaskan men and women from 1992 to 2019. DISCUSSION: Steep increases in overdose deaths fueled by methamphetamines among Non-Hispanic Native Americans and cocaine among Non-Hispanic Black individuals suggest a need for more effective interventions to curb stimulant use. Variations by race/ethnicity and sex/gender also suggest interventions should be developed through an intersectionality lens.

Daily opioid and stimulant co-use and nonfatal overdoses in the context of social disadvantage: Findings on marginalized populations.

OBJECTIVE: Opioids and stimulants are increasingly implicated in overdose deaths, particularly among minoritized groups. We examined daily opioid and cocaine co-use, nonfatal overdoses, and naloxone carrying among minoritized people who inject drugs (PWID). METHODS: The study derived data from 499 PWID in Baltimore City, MD, recruited using street-based outreach between 2016 and 2019. Participants reported overdoses; sociodemographic characteristics; and use of nonmedical prescription opioids, heroin, cocaine, and naloxone. RESULTS: Among the participants, the mean age was 46, 34 % were female, 64 % self-identified as Black, and 53 % experienced recent homelessness. Black PWID, compared to White PWID, were as likely to use opioids and cocaine daily but were 61 % less likely to have naloxone. After controlling for sociodemographic characteristics, women (aOR:1.88, 95%CI: 1.14, 3.11), persons experiencing homelessness (aOR:3.07, 95%CI: 1.79, 5.24), and those who experienced a recent overdose (aOR:2.14, 95%CI: 1.29, 3.58) were significantly more likely to use opioids and any form of cocaine every day. In a subanalysis of only female PWID, females engaged in sex work (aOR:2.27, 95%CI: 1.02, 5.07) and females experiencing recent homelessness (aOR:5.82, 95%CI: 2.50, 13.52) were significantly more likely to use opioids and cocaine daily. Furthermore, females (aOR:1.69, 95%CI:1.03, 2.77), persons experiencing homelessness (aOR:1.94, 95%CI:1.16, 3.24), and those with higher educational attainment (aOR:2.06, 95%CI:1.09, 3.91) were more likely to often/always carry naloxone, while Black PWID were less likely to have naloxone (aOR:0.39, 95%CI:0.22, 0.69). CONCLUSIONS: These findings highlight the need for targeted naloxone distribution and other harm-reduction interventions among minoritized groups in urban areas.

Social Networks, Stigma, and Hepatitis C Care Among Women Who Inject Drugs: Findings from A Community Recruited Sample.

This study explores the role of perceived HCV stigma and social networks on HCV care among people who inject drugs (PWID) of both sexes, and solely among women who inject drugs (WWID). Data were from 269 HCV positive PWID, community-recruited through street-based outreach in Baltimore, MD. We defined HCV stigma based on participants' perceptions of treatment by others and their need to conceal their HCV status. Among WWID, HCV stigma was linked with decreased odds of undergoing liver disease staging (aOR = 0.33, 95% CI: 0.13,0.85) or to have attempted to get the HCV cure (aOR = 0.39, CI: 0.16,0.97), these associations were not evident in the overall sample with both sexes. Social network characteristics were significant correlates of HCV care in the overall sample, and these associations were stronger among WWID. WWID with more HCV positive social network members had higher odds of an HCV-related healthcare visit in the prior 12 months (aOR = 4.28, CI: 1.29,14.17) and to have undergone liver disease staging (aOR = 2.85, CI: 1.01,8.05). WWID with more social network members aware of the HCV cure were more likely to report an attempt at obtaining the HCV cure (aOR = 5.25, CI: 1.85,14.89). Our results suggest complexity in the role of social networks and stigma on HCV care.

Racial differences in overdose training, naloxone possession, and naloxone administration among clients and nonclients of a syringe services program.

OBJECTIVE: To evaluate racial (Black/White) differences in overdose response training and take-home naloxone (THN) possession and administration among clients and nonclients of the Baltimore syringe service program (SSP). METHODS: The study derived data from a cross-sectional survey of 263 (183 SSP clients, 80 nonclients) people who inject drugs (PWID). The study recruited SSP clients using targeted sampling and recruited nonclients through peer referral from April to November 2016. RESULTS: In our sample, 61% of the participants were Black, 42% were between the ages of 18 and 44, and 70% were males. SSP clients, regardless of race, were more likely to have received overdose response training than Black nonclients (Black clients AOR: 3.85, 95% CI: 1.88, 7.92; White clients AOR: 2.73, 95% CI: 1.29, 5.75). The study found no significant differences in overdose response training between Black and White nonclients. SSP clients and White nonclients were more likely to possess THN than Black nonclients (Black clients: AOR: 4.21, 95% CI: 2.00, 8.87; White clients: AOR: 3.54, 95% CI: 1.56, 8.04; White nonclients AOR: 4.49, 95% CI: 1.50,13.47). CONCLUSION: SSP clients were more likely to receive overdose response training than their nonclient peers who they referred to the study, illustrating the utility of SSPs in reaching PWID at high risk of overdose. We also observed that Black PWID, who did not access services at the SSP, were the least likely to possess THN, suggesting the need to employ outreach targeting Black PWID who do not access this central harm reduction intervention.

Differential regulation of CaMKII inhibitor beta protein expression after exposure to a novel context and during contextual fear memory formation.

Understanding of the molecular basis of long-term fear memory (fear LTM) formation provides targets in the treatment of emotional disorders. Ca(2+)/calmodulin-dependent protein kinase II (CaMKII) is one of the key synaptic molecules involved in fear LTM formation. There are two endogenous inhibitor proteins of CaMKII, CaMKII N alpha and N beta, which can regulate CaMKII activity in vitro. However, the physiological role of these endogenous inhibitors is not known. Here, we have investigated whether CaMKII N beta protein expression is regulated after contextual fear conditioning or exposure to a novel context. Using a novel CaMKII N beta-specific antibody, CaMKII N beta expression was analysed in the naïve mouse brain as well as in the amygdala and hippocampus after conditioning and context exposure. We show that in naïve mouse forebrain CaMKII N beta protein is expressed at its highest levels in olfactory bulb, prefrontal and piriform cortices, amygdala and thalamus. The protein is expressed both in dendrites and cell bodies. CaMKII N beta expression is rapidly and transiently up-regulated in the hippocampus after context exposure. In the amygdala, its expression is regulated only by contextual fear conditioning and not by exposure to a novel context. In conclusion, we show that CaMKII N beta expression is differentially regulated by novelty and contextual fear conditioning, providing further insight into molecular basis of fear LTM.

Mapping loss of heterozygosity in normal human breast cells from BRCA1/2 carriers.

We have studied loss of heterozygosity at the BRCA1 and BRCA2 loci in 992 normal cell clones derived from topographically defined areas of normal tissue in four samples from BRCA1/BRCA2 mutation carriers. The frequency of loss of heterozygosity in the clones was low (1.01%), but it was found in all four samples, whether or not a tumour was present. Topographical mapping revealed that the genetic changes were clustered in some breast samples. Our study confirms the previous finding that a field of genetic instability can exist around a tumour, suggesting that sufficient tissue must be removed at surgery to avoid local recurrence. We also demonstrate that such a field of genetic change can exist in morphologically normal tissue before a tumour develops and, for the first time, we demonstrate that the field is of a size greater than one terminal duct-lobular unit. The genetic changes are not identical, however, which suggests that genetic instability in these regions may play an early role in tumour development. We also confirm and extend our original observation of loss of the wild-type BRCA1 allele in some clones, and loss of the mutant allele in others, demonstrating that loss of either allele is a stochastic event.

Evaluation of recombinant human bone morphogenetic protein-2 in oral applications including the use of endosseous implants: 3-year results of a pilot study in humans.

BACKGROUND: This study evaluated patients who had been treated with recombinant human bone morphogenetic protein-2 (rhBMP-2) loaded in an absorbable collagen sponge (ACS) in human extraction sites or in sites that required alveolar ridge augmentation. An earlier report on the same patients revealed that after 4 months, implantation of rhBMP-2/ACS was safe, as determined by clinical, radiographic, systemic, and immunological analyses. In this longer-term follow-up, eligible patients were restored with endosseous dental implants in the area treated with rhBMP-2/ACS and bone biopsy samples were taken for histological analysis of the treated human bone tissue. The primary objective was to monitor the long-term safety of patients treated with rhBMP-2/ACS. Another objective was to evaluate the dental implants placed in the sites treated with rhBMP-2. METHODS: Patient safety was evaluated by clinical examinations, periapical radiographs, and occurrence of adverse experiences. Dental implants were evaluated by radiographic and clinical examination. All 12 patients have been followed for 3 years. RESULTS: Two years following surgical implantation of rhBMP-2/ACS, no serious or unexpected adverse experiences occurred. The adverse experiences that did occur were mostly benign and compatible with the dental implant surgeries performed in these patients. No adverse experiences were deemed as related to the rhBMP-2/ACS. Furthermore, no safety concerns in the local area of rhBMP-2/ACS placement were noted, based on oral wound examinations. In the 10 patients (6 extraction socket patients and 4 augmentation patients) who received endosseous implants, all implants were clinically stable at all assessments and all 10 patients have been functionally restored. Histological evaluation of the human bone core biopsies revealed normal bone tissue formation identical to the surrounding native bone. Three-year follow-up clinical examinations revealed that all implants had stable marginal bone levels and healthy peri-implant tissues. CONCLUSIONS: These 3-year results demonstrate that rhBMP-2/ACS can be used safely in human patients. Human bone biopsies reveal normal bone formation in areas treated with rhBMP-2/ACS. Endosseous implants placed in these areas were all stable with no radiographic or clinical complications. The results from this study suggest that rhBMP-2/ACS (0.43 mg/ml) can be safely used in tooth extraction sites and in local ridge augmentation procedures and that endosseous dental implants placed in bony areas treated with rhBMP-2/ACS are stable and can be functionally restored without complication.

Volunteer services for vulnerable families and at-risk elderly.

OBJECTIVE: The purpose of this paper is to explore the role of the volunteer with vulnerable populations, specifically, new parents and their infants and at-risk elderly. As demand for volunteer services increases due to budgetary and personnel reductions, a better understanding of volunteers as service providers is imperative. METHOD: A review of the literature related to volunteers who work with these two populations was conducted. Volunteer characteristics, roles, needs of populations served, recruitment, and training issues were addressed, specifically as they relate to the two populations. RESULTS: Studies indicate that the socio-demographic range of volunteers is wide, as are the motivations for volunteering. Similarities between the needs of new families and the elderly exist, and volunteers for both populations often provide supportive and pragmatic services. Volunteers for both populations are further challenged to maintain a client-focused intervention, a task which may be more difficult in the home. Training of volunteers was found to be both client and volunteer driven, with the needs of the population being served and the role of the volunteer within a specific service domain of prime importance. CONCLUSION: Similarities between infant and elder populations exist, as do volunteer interventions with these populations. A theoretical framework for defining motivation, designing need-based training, and addressing the role of volunteers is discussed. The use of volunteers as compassionate and cost-effective service providers for populations across the lifespan not only provides an increase in the number of skilled workers involved with these vulnerable populations, but also allows professional staff to expand the care which they are able to provide.

Linking lost voices: reading 'The Dead'.

The author presents an individual reading of James Joyce's short story. 'The Dead' from 'Dubliners'. Language evokes subjective responses and associations that become part of the depth of experience one finds in a book. The author describes how uses of language give the reader a sense of sharing the main character's experience. She focuses on nodal moments in the story, in which external and internal worlds intersect. Images focused on include those of seeing and touching, inside and outside, crossing gaps between worlds and the way in which these sensory events shift the character's knowledge of his internal objects. The metaphor of lost voices highlights the presence of the dead throughout the story. The main character's evolution from being in a constricted state to one of expanded self-awareness is discussed. Britton's concept of triangular space is used to describe the character's transformation at the story's conclusion.

Recombinant human bone morphogenetic protein-2 stimulation of bone formation around endosseous dental implants.

BACKGROUND: Successful endosseous implant placement requires that the implant be stable in alveolar bone. In certain cases, the implant can be stabilized in native bone but some part of the implant is not covered by bone tissue. This often occurs during placement of implants into extraction sites or in areas where bone resorption has occurred and the ridge width is not sufficient to completely surround the implant. In those cases, the clinician usually employs a procedure to encourage bone formation. These procedures typically include a bone graft and/or membrane therapy. Recent advances have led to the isolation, cloning, and production of recombinant human proteins that stimulate bone formation. One of these bone morphogenetic proteins (rhBMP-2) has been extensively studied in animal models and is currently being tested in human clinical trials. METHODS: In this study, rhBMP-2 was tested using a collagen sponge carrier to stimulate bone formation in defects in the canine mandible around endosseous dental implants. Six animals had a total of 48 implants placed. rhBMP-2 with the collagen carrier was implanted around 24 of these, the remainder having only the collagen carrier placed. Half the sites were covered with a nonresorbable expanded polytetrafluoroethylene membrane. Histologic analysis was performed after 4 and 12 weeks. The area of new bone formed, percentage of bone-to-implant contact in the defect area, and percentage fill of the defect was calculated. RESULTS: The addition of rhBMP-2 resulted in significantly greater amounts of new bone area and percentage of bone-to-implant contact and with more percentage fill after 4 and 12 weeks of healing. The area of new bone formed was reduced after 4 weeks when a membrane was present but after 12 weeks, there was no significant difference between membrane and non-membrane treated sites. In some specimens, new bone was found coronal to the membranes, with rhBMP-2-treated sites having greater amounts than non-rhBMP-2-treated sites. CONCLUSIONS: These data demonstrate that a bone differentiation factor significantly stimulates bone formation in peri-implant bone defects in the canine mandible. In addition, bone-to-implant contact was significantly enhanced along the rough implant surface. Membrane-treated sites had less new bone formation after 4 weeks of healing but were similar to non-membrane sites after 12 weeks. These results demonstrate that rhBMP-2 can be used to stimulate bone growth both around and onto the surface of endosseous dental implants placed in sites with extended peri-implant osseous defects.

A 129Xe NMR study on an ionomeric polymer blend system.

The morphology of an ionomeric polymer blend consisting of an amino-silicone copolymer and zinc neutralized sulfonated polystyrene (ZnSPS) has been studied using proton spin diffusion and small angle X-ray scattering (SAXS). The extent of reaction between the two components in the blend was monitored by 13C CP MAS spectroscopy. All three types of experiment point to domain sizes in the nanometer range. 129Xe NMR was used to study exchange by translational diffusion between domains. A single xenon resonance was detected in temperatures ranging from 25 degrees C to -90 degrees C, and the chemical shift followed a weighted average of the isolated polymer shifts consistent with the small domain sizes. Pulse field gradient 129Xe NMR was used to determine the effective diffusion constants in the amino silicone starting material and the blend. The diffusion constant of xenon in poly(styrene) is known, allowing for comparison of the predictions of effective diffusion constants in the blend based on the values in the constituents of the blend. Simple two-site exchange equations incorrectly predict that diffusion in the blend would be dominated by the constituent with slow diffusion. The blend diffusion constant is close to the value of the amino silicone or the constituent with fast diffusion which is correctly predicted for a rapid exchange solution of the diffusion equation.

Clinical evaluation of bioactive glass in the treatment of periodontal osseous defects in humans.

The purpose of this study was to compare the use of bioactive glass to demineralized freeze-dried bone allograft (DFDBA) in the treatment of human periodontal osseous defects. Fifteen systemically healthy patients (6 males and 9 females, aged 30 to 63) with moderate to advanced adult periodontitis were selected for the study. All patients underwent initial therapy, which included scaling and root planing, oral hygiene instruction, and an occlusal adjustment when indicated, followed by re-evaluation 4 to 6 weeks later. Paired osseous defects in each subject were randomly selected to receive grafts of bioactive glass or DFDBA. Both soft and hard tissue measurements were taken the day of surgery (baseline) and at the 6-month re-entry surgery. The clinical examiner was calibrated and blinded to the surgical procedures, while the surgeon was masked to the clinical measurements. Statistical analysis was performed by using the paired Student's t test. The results indicated that probing depths were reduced by 3.07 +/- 0.80 mm with the bioactive glass and 2.60 +/- 1.40 mm with DFDBA. Sites grafted with bioactive glass resulted in 2.27 +/- 0.88 mm attachment level gain, while sites grafted with DFDBA had a 1.93 +/- 1.33 mm gain in attachment. Bioactive glass sites displayed 0.53 +/- 0.64 mm of crestal resorption and 2.73 mm bone fill. DFDBA-grafted sites experienced 0.80 +/- 0.56 mm of crestal resorption and 2.80 mm defect fill. The use of bioactive glass resulted in 61.8% bone fill and 73.33% defect resolution. DFDBA-grafted defects showed similar results, with 62.5% bone fill and 80.87% defect resolution. Both treatments provided soft and hard tissue improvements when compared to baseline (P < or = 0.0001). No statistical difference was found when comparing bioactive glass to DFDBA; however, studies with larger sample sizes may reveal true differences between the materials. This study suggests that bioactive glass is capable of producing results in the short term (6 months) similar to that of DFDBA when used in moderate to deep intrabony periodontal defects.

Randomized, placebo-controlled trial of platelet glycoprotein IIb/IIIa blockade with primary angioplasty for acute myocardial infarction. ReoPro and Primary PTCA Organization and Randomized Trial (RAPPORT) Investigators.

BACKGROUND: The benefit of catheter-based reperfusion for acute myocardial infarction (MI) is limited by a 5% to 15% incidence of in-hospital major ischemic events, usually caused by infarct artery reocclusion, and a 20% to 40% need for repeat percutaneous or surgical revascularization. Platelets play a key role in the process of early infarct artery reocclusion, but inhibition of aggregation via the glycoprotein IIb/IIIa receptor has not been prospectively evaluated in the setting of acute MI. METHODS AND RESULTS: Patients with acute MI of <12 hours' duration were randomized, on a double-blind basis, to placebo or abciximab if they were deemed candidates for primary PTCA. The primary efficacy end point was death, reinfarction, or any (urgent or elective) target vessel revascularization (TVR) at 6 months by intention-to-treat (ITT) analysis. Other key prespecified end points were early (7 and 30 days) death, reinfarction, or urgent TVR. The baseline clinical and angiographic variables of the 483 (242 placebo and 241 abciximab) patients were balanced. There was no difference in the incidence of the primary 6-month end point (ITT analysis) in the 2 groups (28.1% and 28.2%, P=0.97, of the placebo and abciximab patients, respectively). However, abciximab significantly reduced the incidence of death, reinfarction, or urgent TVR at all time points assessed (9.9% versus 3.3%, P=0.003, at 7 days; 11.2% versus 5.8%, P=0.03, at 30 days; and 17.8% versus 11.6%, P=0.05, at 6 months). Analysis by actual treatment with PTCA and study drug demonstrated a considerable effect of abciximab with respect to death or reinfarction: 4.7% versus 1.4%, P=0.047, at 7 days; 5.8% versus 3.2%, P=0.20, at 30 days; and 12.0% versus 6.9%, P=0.07, at 6 months. The need for unplanned, "bail-out" stenting was reduced by 42% in the abciximab group (20.4% versus 11.9%, P=0.008). Major bleeding occurred significantly more frequently in the abciximab group (16.6% versus 9.5%, P=0.02), mostly at the arterial access site. There was no intracranial hemorrhage in either group. CONCLUSIONS: Aggressive platelet inhibition with abciximab during primary PTCA for acute MI yielded a substantial reduction in the acute (30-day) phase for death, reinfarction, and urgent target vessel revascularization. However, the bleeding rates were excessive, and the 6-month primary end point, which included elective revascularization, was not favorably affected.

Risk of blood contamination of health care workers in spine surgery. A study of 324 cases.

STUDY DESIGN: The relative risk of blood contamination during spine surgery was studied using data collected from 324 procedures. OBJECTIVES: To analyze demographic factors that predict blood-borne pathogens in the population of spine surgery patients, study the rates and patterns of blood contamination in health care workers (i.e., skin-penetrating incidents and nonpenetrating surface skin contamination from patients' blood) and compare those risks with those in other surgical departments, and analyze the effectiveness of barrier systems worn by the surgical team. SUMMARY OF BACKGROUND DATA: The Centers for Disease Control and Prevention has reported 49 health care workers infected by the human immunodeficiency virus through occupational exposure. Several studies have noted the risk of blood contamination in various surgical departments, but the relative risk during spine surgery has not been determined. METHODS: This year-long survey included 9795 cases, or 60,789 health care worker--patient contacts, of which spine disorders comprised 324 cases (2234 health care workers and patients). Data collection forms were designed and inservice training conducted with operating room staffs. Information regarding type of case, staff position (surgeon, assistant, scrub nurse, circulator), protective clothing worn, length of operating room time, blood loss, incidence of blood spills, was recorded, among other data. RESULTS: Prevalence of human immunodeficiency virus in patients in the overall series was 0.19% versus 0.93% in spine patients. The rate of HCW contamination in the overall series was 7.76%, of which 0.92% resulted from skin-penetrating incidents. Contamination in spine surgery occurred in 31.86% of cases, of which 1.23% were the result of skin-penetrating incidents. CONCLUSIONS: Health care workers in spine surgery have a statistically significant overall higher risk of blood contamination than do those in other surgical departments. The increased risk occurred with blood contacting intact skin. There was no higher risk for skin penetrating injury. Analysis of data suggests that health care workers always should wear double gloves, forearm-reinforced gowns, and eye protection.

Plasma diamine oxidase activities in renal dialysis patients, a human with spontaneous copper deficiency and marginally copper deficient rats.

OBJECTIVES: Intestine and kidney are generally the most concentrated sources of the copper metalloenzyme diamine oxidase (DAO). Clinically, plasma DAO activities are used to diagnose disruptions in intestinal integrity. This study determined whether DAO activities were also affected by kidney injury or copper nutritional status. DESIGN AND METHODS: Plasma DAO activities were measured in renal dialysis patients without diagnosed intestinal disease (n = 75), controls (n = 23), an adult with spontaneous copper deficiency before and after copper repletions, and in rats fed either adequate or marginal copper diets (8 or 2 mg copper/kg diet) for 7 months. RESULTS: This study found high DAO activities in renal dialysis patients and low activities during spontaneous copper deficiency. Low activities were also seen for marginally copper deficient rats. CONCLUSIONS: Tissue injury-induced elevation of DAO activities is not limited to intestinal injury, and low DAO values may be useful for assessing copper nutritional status.

Experiencing language: some thoughts on poetry and psychoanalysis.

The author uses her experiences as a poet and as a psychoanalyst to compare the two. She discusses poems by James Merrill, Philip Larkin, and Theodore Roethke in order to consider how the analyst listens, how the poet writes, how each listens to what is unsaid in the music of language. Rhythm, meter, and the sounds of words constitute this music. Sound and image are means by which language bypasses logic and touches us. Considering how a poem has an impact can teach us something about how words affect us in psychoanalysis.

Suspected neonatal isoerythrolysis in two Baird's tapirs (Tapirus bairdii).

Two Baird's tapir (Tapirus bairdii) calves born at the Columbus Zoo from the same sire and dam developed hemolytic anemia that was consistent in history and clinical signs with neonatal isoerythrolysis (NI). One calf developed severe, fatal hemolytic anemia after being fed maternal colostrum, and the other developed moderate hemolytic anemia after being fed equine colostrum. No cross-reactivity was demonstrated between sire and dam blood samples, and both tapirs possessed serum antibodies reactive against equine blood group Ca and antigens reactive with several equine blood group D antibodies. Electrophoresis demonstrated significant genetic diversity between tapir and equine blood proteins. Agglutination testing demonstrated strong reactivity between a far greater percentage of equine colostrum samples when tested against sire and dam tapir blood (61% and 65%, respectively) than would be expected for equine blood (2%). These data are suggestive of a diagnosis of NI but are not definitive. Further study is required to determine whether NI occurs in tapirs and whether equine colostrum is harmful to tapir calves.

Radiographic analysis of regenerated bone around endosseous implants in the canine using recombinant human bone morphogenetic protein-2.

Ideal endosseous implant placement involves a congruent bony housing in close apposition to the implant surface. Clinical situations are encountered, however, in which the entire implant surface cannot be in close apposition to bone. In these instances, bone grafting materials are generally used to regenerate bone around the implant. In this study, a biologically active bone differentiation factor, recombinant human bone morphogenetic protein-2 (rhBMP-2), was used with two different carriers to regenerate bone around implants in standardized critical-sized defects in the canine mandible. Half of the sites had a nonresorbable membrane placed over the defect. Longitudinal standardized radiographs were obtained to assess the amount of bone regeneration on the mesial and distal of the implants after 4 and 12 weeks of healing. Ninety-six implants were placed in 12 fox-hounds. Bone fill was determined by linear measurement of bone on the radiographs, and changes in bone density were evaluated by computer-assisted densitometric image analysis of discrete areas adjacent to the implant. After 4 weeks of healing, nonmembrane sites had significantly greater bone height than membrane-protected sites. Following 12 weeks of healing, sites treated with rhBMP-2 had significantly greater bone formation than untreated sites. Sites treated with rhBMP-2 and a membrane had the greatest bone fill, followed by sites treated with rhBMP-2 but no membrane. Sites without rhBMP-2, whether with or without a membrane, had less bone fill than sites with rhBMP-2. At 12 weeks, sites with a membrane resulted in significantly more gain in bone density than sites without a membrane. Furthermore, sites treated with a collagen carrier resulted in greater gains in bone density than sites treated with a polylactide/glycolide carrier. The results from this study demonstrate by radiographic evidence that new bone formation in critical-sized defects around implants is dependent on time after defect treatment, the type of carrier used, the use of a barrier membrane, and the presence of rhBMP-2. In addition, these findings suggest that rhBMP-2, a bone differentiation factor, can significantly stimulate bone formation around endosseous dental implants.

Copper supplementation of adult men: effects on blood copper enzyme activities and indicators of cardiovascular disease risk.

In rats, copper deficiency leads to low copper metalloenzyme activity, high serum cholesterol, and cardiovascular lesions. In humans, moderately low copper intake may be common, but the consequences remain largely uncertain. The present study examined the effects of copper supplementation (2 mg/d for 4 weeks in a copper/placebo crossover design) in 20 adult men with moderately high plasma cholesterol. End-point measurements were three copper enzyme activities, erythrocyte superoxide dismutase (SOD), plasma ceruloplasmin (Cp), and plasma diamine oxidase (DAO), and three parameters related to the risk of cardiovascular disease (CVD), plasma cholesterol, plasma lipoprotein (a) [Lp(a)], and lag times for very-low-density lipoprotein (VLDL) and low-density lipoprotein (LDL) oxidation in vitro. Although copper had no significant effects on any parameter for the entire study group, it did significantly increase two enzyme activities (SOD and DAO), as well as lipoprotein oxidation lag times, in 10 subjects in the lower half of a median split for precopper values. Thus, copper supplementation appeared to influence some types of measurements in subjects beginning with less than median values.

High ceruloplasmin levels in rats without high lipoprotein oxidation rates.

The serum copper protein ceruloplasmin, though sometimes considered an antioxidant, can promote lipoprotein oxidation in vitro under certain conditions. However, an inflammation-induced, two week elevation of rat serum ceruloplasmin levels did not render low plus very low density lipoproteins more prone to oxidation in vitro. Thus, high ceruloplasmin levels in vivo are not necessarily associated with high lipoprotein oxidation rates.