Mental health and child refugees.

This paper presents an overview of the importance of mental health services for unaccompanied asylum-seeking children in the United Kingdom. It reviews what mental health support appears to be available in the United Kingdom following an on-line search which took place in Spring 2021 and using information gathered through 22 interviews and focus groups with stakeholders. The latter group are defined as people working with asylum-seeking children. The primary stakeholders were local authority staff, although interviews were also conducted with local government associations (London Councils, the Local Government Association), NHS bodies and the voluntary sector. Often, further relevant stakeholders were identified during interviews. The report details the aims, methodology and context, before the findings are presented which is followed by recommendations for improving mental and social care provision for unaccompanied asylum-seeking children in the United Kingdom.

Genetic analysis of a maternal assistance score in sheep.

Maternal behaviour is important for lamb survival, as ewes perform many behaviours that affect the chances of a lamb surviving. Collecting maternal behaviour data directly at lambing is time-consuming and not considered suitable for acquiring the large volumes of data that would be required for using as selection criteria within commercial breeding flocks. The aim of this study was to investigate if a simple scoring system is heritable and assesses the expression of behaviours that reduce the probability of lamb mortality. Ewe behaviour was scored on a 3-point Maternal Assistance Score (MAS): (1) the ewe shows a high level of maternal interest (assumed if no intervention required); (2) the ewe shows limited interest in her lamb; and (3) the ewe shows no interest in her lamb. A total of 19 453 MAS were collected over 12 years, across 24 farms (including both indoor and outdoor lambing systems) and 12 different breed lines that make up the Innovis breeding programme. Ewe parity, breed, number of lambs carried, flock, lambing batch, lambing day within flock and pre-mating weight all had a significant effect on MAS (P < 0.05). The maternal assistance score was shown to be heritable (h2 = 0.05) and repeatable (0.10), positively genetically correlated to lambing difficulty (rg = 0.29) and amount of assistance the lamb required to suckle from the ewe (rg = 0.88), and negatively genetically correlated with the number of lambs successfully reared (rg = 0.49). This study shows that an easy-to-measure score can be used by shepherds with large breeding flocks, based on whether the ewe requires further assistance to support her lamb rearing. The score could be used in breeding programmes to select for lamb rearing ability in the future and potentially lead to an improvement in lamb welfare through a reduction in mortality.

Australian Youth Self-Harm Atlas: spatial modelling and mapping of self-harm prevalence and related risk and protective factors to inform youth suicide prevention strategies.

AIMS: Suicide prevention strategies have shifted in many countries, from a national approach to one that is regionally tailored and responsive to local community needs. Previous Australian studies support this approach. However, most studies have focused on suicide deaths which may not fully capture a complete understanding of prevention needs, and few have focused on the priority population of youth. This was the first nationwide study to examine regional variability of self-harm prevalence and related factors in Australian young people. METHODS: A random sample of Australian adolescents (12-17-year-olds) were recruited as part of the Young Minds Matter (YMM) survey. Participants completed self-report questions on self-harm (i.e., non-suicidal self-harm and suicide attempts) in the previous 12 months. Using mixed effects regressions, an area-level model was built with YMM and Census data to produce out-of-sample small area predictions for self-harm prevalence. Spatial unit of analysis was Statistical Area Level 1 (average population 400 people), and all prevalence estimates were updated to 2019. RESULTS: Across Australia, there was large variability in youth self-harm prevalence estimates. Northern Territory, Western Australia, and South Australia had the highest estimated state prevalence. Psychological distress and depression were factors which best predicted self-harm at an individual level. At an area-level, the strongest predictor was a high percentage of single unemployed parents, while being in an area where ≥30% of parents were born overseas was associated with reduced odds of self-harm. CONCLUSIONS: This study identified characteristics of regions with lower and higher youth self-harm risk. These findings should assist governments and communities with developing and implementing regionally appropriate youth suicide prevention interventions and initiatives.

Clinical characteristics and outcomes of Australian and Indian ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PCI).

INTRODUCTION: The incidence of STEMI and subsequent mortality has been reported to be higher in Indian populations compared to developed countries. However, there is limited data directly comparing contemporary primary percutaneous coronary intervention (pPCI) treatment strategies and clinical outcomes for STEMI patients between developed and developing countries. MATERIALS AND METHODS: We compared population demographics, procedural characteristics, times to reperfusion and mortality in STEMI patients treated with pPCI between two tertiary referral centers in India and Australia respectively over a 3-year period (1st Jan 2017-31st Dec 2019). RESULTS: A total of 1293 STEMI presentations (896 Indian vs 397 Australian) were included. On average, Indian patients had lower median BMI than Australian patients (BMI 25.4 vs 27.8; p < 0.001), were significantly younger (mean age 56.0 vs 63.2 years; p < 0.001), more likely male (84 % vs 80 %; p = 0.046) and diabetic (48 % vs 18 %); p < 0.001). Radial access (50 % vs 88 %; p < 0.001) and TIMI III flow post PCI was also significantly lower (85 % vs 96 %; p < 0.001) with median door-to-balloon time significantly shorter in the Indian cohort (20mins vs 43mins; p < 0.001); however, median symptom to balloon time was significantly longer (245mins vs 160mins; p < 0.001). No significant differences in 30-day mortality (4.0 % vs 2.8 % Australian; p = 0.209) or 1-year mortality (6.5 % vs 4.3 %; p = 0.120) were observed. CONCLUSION: Significant differences in demographics and presentation characteristics exist between Indian and Australian STEMI patients treated with pPCI. Indian patients had significantly longer pre-hospital delays and lower achievement of TIMI III flow post PCI, yet shorter in-hospital time to treatment.

Serological status of cattle to bovine viral diarrhoea virus and bovine herpesvirus 1 at entry to and exit from Australian feedlot backgrounding facilities.

A total of 6195 cattle were enrolled in this observational study. Serum antibody concentrations to bovine herpesvirus 1 (BHV1) and bovine viral diarrhoea virus (BVDV) were measured at entry to and exit from backgrounding facilities to assess their statuses on arrival and the extent of seroconversion to these viruses during backgrounding. The backgrounding facilities were contiguous with five feedlots in: Queensland (two sites), New South Wales, South Australia and Western Australia. Cattle were held in the backgrounding facilities for a minimum of 29 days and a median of 34 days. On backgrounding facility entry, 32.7% of the study population was seronegative to BVDV, but 85.7% was seronegative to BHV1. After commingling in the backgrounding facilities, of the cattle that were seronegative on backgrounding facility entry, 33.9% and 30.3% showed a serological increase to BVDV and BHV1, respectively. At backgrounding facility exit, when cattle were placed in their feedlots, 19.6% and 59.1% were seronegative to BVDV and BHV1, respectively, and 0.26% were persistently infected with BVDV. There was a strong association between seroincrease to BVDV and seroincrease to BHV1 (P = 0.005) at animal level in cohorts known to contain an animal persistently infected with BVDV.

Health and production effects of killed vaccines against Mannheimia haemolytica, bovine viral diarrhoea virus and bovine herpesvirus 1, in locally backgrounded feedlot cattle.

OBJECTIVES: This study evaluates the effects of respiratory vaccines on health and growth rates in cattle placed in local backgrounding facilities then feedlots. METHODS: A total of 7011 cattle entering backgrounding facilities contiguous with six feedlots in Australia were allocated to eight respiratory vaccine categories, including an untreated control category. The vaccines, against Mannheimia haemolytica, bovine viral diarrhoea virus and bovine herpesvirus 1, were administered in various combinations at backgrounding facility entry and subsequent feedlot entry. Cattle were held in the backgrounding facilities for a minimum of 28 days. RESULTS: During their feedlot phase, 3.7% of study animals were detected with bovine respiratory disease (BRD). BRD sub hazard was lowest in cattle vaccinated with Bovilis MH + infectious bovine rhinotracheitis® (sub hazards ratio: 0.47; 95% confidence interval: 0.27-0.83; P = 0.010), and point estimates for other vaccine combinations did not differ (P > 0.10) from controls. Six of the respiratory vaccine combinations decreased growth rate during backgrounding relative to untreated controls (P ≤ 0.003). Overall, the feedlot growth rate was not significantly affected by the vaccine category (overall Wald P = 0.191). CONCLUSIONS: Use of these respiratory vaccines in cattle held for at least 28 days in backgrounding facilities contiguous with their feedlots before feedlot entry reduces growth rate during the backgrounding period and does not result in large beneficial effects on either BRD risk or average daily live weight gain during the feedlot phase.

Mindfulness based cognitive therapy for youth with inflammatory bowel disease and depression - Findings from a pilot randomised controlled trial.

BACKGROUND: Mindfulness-based cognitive therapy (MBCT) is a promising adjunctive treatment for adolescents and young adults (AYAs) with Inflammatory Bowel Disease (IBD) and comorbid depression. OBJECTIVES: This pilot randomised controlled trial (RCT) aimed to evaluate feasibility and efficacy of an adapted MBCT program for AYA, aged 16-29, with IBD. METHODS: Sixty-four AYAs were randomly allocated to MBCT (n = 33) or treatment as usual (TAU) (n = 31). Primary outcome measure was the depression score on Depression, Anxiety and Stress Scale. Secondary outcomes included anxiety, stress, IBD-related quality of life, coping, mindfulness, post-traumatic growth, medication adherence, IBD activity, inflammatory markers, microbiome characteristics and brain functional connectivity. RESULTS: Study recruitment rate was 75%, retention rate 70%, and session attendance 92%. Intention to treat analyses revealed that, compared to TAU group, MBCT group had significantly lower depression (∆ = -6.0; 95%CI = -10.8 to -1.2; P = 0.015) and stress (∆ = -5.1; 95%CI = -10.1 to -0.0; P = 0.049), higher active coping (∆ = 1.0;95%CI = 0.1-1.9; P = 0.022), and total mindfulness scores (∆ = 10.9;95%CI = 1.1-20.8; P = 0.030) at 8 weeks (post-therapy), and improved coping by positive reframing (∆ = 1.1;95%CI = 0.0-2.2; P = 0.043) and planning (∆ = 0.9;95%CI = 0.0-1.9; P = 0.045), mindful awareness (∆ = 5.2.;95%CI = 2.0-8.5; P = 0.002) and total mindfulness scores (∆ = 10.8.;95%CI = 0.4-21.1; P = 0.042) at 20 weeks. On per protocol analysis, MBCT group had significantly lower depression (∆ = -6.3; 95%CI = -11.4 to -1.2; P = 0.015), stress (∆ = -6.0; 95%CI = -11.2 to -0.5; P = 0.032), increased active coping (∆ = 0.9;95%CI = 0-1.7; P = 0.05) at 8 weeks, and mindful awareness (∆ = 5.4; 95%CI = 2.1-8.6; P = 0.001) at 20 weeks. CONCLUSION: In AYAs with IBD, MBCT is feasible and beneficial in improving depression, stress, mindfulness and adaptive coping. It holds promise as an important component of integrated IBD care. Trial registration number ACTRN12617000876392, U1111-1197-7370; Pre-results.

Demographic analysis of oral lichen planus presentations to Auckland Oral Medicine Clinic from 1999 to 2006.

AIM: The objective of this study was to describe the demographic characteristics of a case series of patients with a clinical and histopathological diagnosis of oral lichen planus who presented to the Oral Health Unit (Auckland District Health Board) between the years 1999 and 2006 (an 8-year period). METHOD: The records of patients who had a clinical and histopathological diagnosis of oral lichen planus were audited. Demographic (age, gender, ethnicity), clinical and histopathological data were collated. Patients whose ethnicity was not recorded were noted but not included in this part of the analysis. RESULTS: Between 1999 and 2006, 267 patients (82 males, 185 females; age range 21 to 93 years) had a clinical and histopathological diagnosis of oral lichen planus. Ethnicity data were available for 207 of those, of whom 108 (52.2%) were European; 65 (31.4%) of Indian subcontinent origin (India, Pakistan, Sri Lanka); 20 (9.7%) were Asian; 14 (6.8%) were Pacific Islanders; 50 (24.2%) were 'Other'; and 10 (4.8%) were 'Unknown'. None was Maori. CONCLUSION: The age and gender distribution in this case series were similar to that observed in a comparable UK study. The major findings were in the ethnic distribution of oral lichen planus in the sample, with patients of Indian subcontinent origin being over-represented, and Maori being under-represented.

Retrospective audit of the use of the Marx Protocol for prophylactic hyperbaric oxygen therapy in managing patients requiring dental extractions following radiotherapy to the head and neck.

OBJECTIVE: The study's primary objective was to review (for the years 2003 to 2006) the outcomes of using prophylactic hyperbaric oxygen therapy (HBOT) to prevent osteoradionecrosis (ORN) in a group of patients previously exposed to radiotherapy of the head and neck. A secondary objective was to evaluate any HBOT-associated vision changes. DESIGN: The study was a retrospective audit of the clinical outcomes of HBOT for the prevention of ORN following dental extractions in previously irradiated jaws. METHODS: Information was obtained from dental records held at Green Lane Clinical Centre (Auckland) and Oxygen Therapies Ltd (Quay Park Health, Auckland). Data included patient age, gender, site of tumour, radiation dose, time lapse between radiotherapy and tooth/teeth extracted, extraction procedures and the HBOTprotocol used. Follow-up data were obtained through a telephone interview using a standardised questionnaire. RESULTS: Of the 29 treated patients, 26 (90%) were available for follow-up. Of these, one failed to heal after dental extractions following the use of prophylactic HBOT, and only nine (34%) developed temporary vision changes. CONCLUSION: The outcome of this audit suggests that it is appropriate to use prophylactic HBOT in association with dental extractions in patients who have previously had radiotherapy to the head and neck. Acute vision changes following the 30th HBOT were transient.

Frailty and hospital outcomes within a low socioeconomic population.

BACKGROUND: Clinical frailty scales (CFS) predict hospital-related outcomes. Frailty is more common in areas of higher socioeconomic disadvantage, but no studies exclusively report on the impact of CFS on hospital-related outcomes in areas of known socioeconomic disadvantage. AIMS: To evaluate the association of the CFS with hospital-related outcomes. DESIGN: Retrospective observational study in a community hospital within a disadvantaged area in Australia (Social Economic Index for Areas = 0.1%). METHODS: The CFS was used in the emergency department (ED) for people aged ≥ 75 years. Frailty was defined as a score of ≥4. Associations between the CFS and mortality, admission rates, ED presentations and length of stay (LOS) were analysed using regression analyses. RESULTS: Between 11 July 2017 and 31 March 2018, there were 5151 ED presentations involving 3258 patients aged ≥ 75 years. Frail persons were significantly more likely to be older, represent to the ED and have delirium compared with non-frail persons. CFS was independently associated with 28-day mortality, with odds of mortality increasing by 1.5 times per unit increase in CFS (95% CI: 1.3-1.7). Frail persons with CFS 4-6 were more likely to be admitted (OR: 1.2; 95% CI: 1.0-1.5), have higher geometric mean LOS (1.43; 95% CI 1.15-1.77 days) and higher rates of ED presentations (IRR: 1.12; 95% CI 1.04-1.21) compared with non-frail persons. CONCLUSIONS: The CFS predicts community hospital-related outcomes in frail persons within a socioeconomic disadvantage area. Future intervention and allocation of resources could consider focusing on CFS 4-6 as a priority for frail persons within a community hospital setting.

Migrating foreign body in the tongue.

We present an unusual case where a foreign body entered and migrated through the tongue. In its path, it created a multitude of different symptoms including ecchymoses, small lumps, submental swelling and neuralgic-type pain. The foreign body had migrated from the left postero-lateral surface of the tongue, anteriorly along the lateral then dorsal surfaces of the tongue, until it self-exfoliated on the right anterior floor of the mouth. A brief literature review is also presented.

Mycoplasma bovis and bovine respiratory disease: A risk factor study in Australian feeder cattle.

Mycoplasma bovis can be a bacterial inhabitant of the upper respiratory tract of healthy bovines. In body regions other that the upper respiratory tract however, M. bovis is associated with a number of clinical syndromes such as bovine respiratory disease (BRD). This study used two enzyme-linked immunosorbent assays to assess the sero-status of M. bovis-specific antibodies in Australian feeder cattle at the time of feedlot induction and at approximately 42 days on feed (follow-up). The apparent sero-prevalence of M. bovis-specific antibody at induction was estimated to be 3.5% (95% confidence interval [CI] 2.0-5.0%, 47/1354) and 25.3% (95% CI 21.9-28.8%, 343/1354) at follow-up. Exposure to M. bovis between induction and follow-up as demonstrated by an increase in serum antibodies was estimated to be 19.4% (95% CI 16.2-22.6%, 261/1349). Risk factors associated with sero-positivity at feedlot induction included the region where animals were 28 days prior to induction and saleyard exposure at least 27 days prior to induction. Risk factors associated with a sero-increase between induction and follow-up included breed, source region and access to water shared with an adjoining pen of animals. Of these, shared pen water was considered the most important (odds ratio [OR] 3.3, 95% CI 1.5-7.4, p = 0.003). Animals exposed to M. bovis between induction and follow-up were at a substantially increased risk of BRD (OR 2.2, 95% CI 1.4-3.4, p = 0.001). This is the first Australian study that has identified risk factors for M. bovis sero-positivity and sero-increase and shown an association between sero-increase and the risk of BRD in the feeder cattle population. These findings suggest that M. bovis is a significant pathogen in the Australian feeder cattle population. In addition, identification of defined risk factors associated with an increased risk of exposure to M. bovis can assist in the development of targeted control measures to reduce the economic impact of M. bovis associated disease and BRD in feeder cattle.

Studies on the relationship between electrogustometry and sour taste perception.

OBJECTIVE: Electrogustometry is used as a measurement of taste perception. The prevailing theory is that the anodal current delivered to the tongue mucosa stimulates the sour taste receptors, but this is not universally accepted. Our aim was to evaluate to what extent electrogustometry relates to an ability to detect sour taste--rather than sweet, salt, or bitter. METHODS: We compared automated electrogustometric thresholds with visual analogue scale (VAS) ratings of various tastant solutions in 114 subjects. The whole mouth, and each side of the tongue were tested separately. VAS scores from the strongest set of solutions, and the lowest electrogustometry thresholds for each location were used for statistics. RESULTS: There was a significant correlation between electrogustometry threshold and the whole mouth perception of the salt taste solution. Electrogustometry correlated significantly but weakly for all taste qualities when testing was confined to left and right oral tongue. The positive predictive values of electrogustometry were no better in relation to sour taste perception than to the other taste qualities. CONCLUSIONS: Our results do not support the theory that electrogustometry is mediated by sour taste receptors or even that it reflects the sour taste quality. We postulate that electrogustometry measures a function of taste perception, which is different from that induced by chemical stimuli.

Population-level effects of risk factors for bovine respiratory disease in Australian feedlot cattle.

Results obtained from a nationwide longitudinal study were extended to estimate the population-level effects of selected risk factors on the incidence of bovine respiratory disease (BRD) during the first 50days at risk in medium-sized to large Australian feedlots. Population attributable fractions (PAF) and population attributable risks (PAR) were used to rank selected risk factors in order of importance from the perspective of the Australian feedlot industry within two mutually exclusive categories: 'intervention' risk factors had practical strategies that feedlot managers could implement to avoid exposure of cattle to adverse levels of the risk factor and a precise estimate of the population-level effect while 'others' did not. An alternative method was also used to quantify the expected effects of simultaneously preventing exposure to multiple management-related factors whilst not changing exposure to factors that were more difficult to modify. The most important 'intervention' risk factors were shared pen water (PAF: 0.70, 95% credible interval: 0.45-0.83), breed (PAF: 0.67, 95% credible interval: 0.54-0.77), the animal's prior lifetime history of mixing with cattle from other herds (PAF: 0.53, 95% credible interval: 0.30-0.69), timing of the animal's move to the vicinity of the feedlot (PAF: 0.45, 95% credible interval: 0.17-0.68), the presence of Bovine viral diarrhoea virus 1 (BVDV-1) in the animal's cohort (PAF: 0.30, 95% credible interval: 0.04-0.50), the number of study animals in the animal's group 13days before induction (PAF: 0.30, 95% credible interval: 0.10-0.44) and induction weight (PAF: 0.16, 95% credible interval: 0.09-0.23). Other important risk factors identified and prioritised for further research were feedlot region, season of induction and cohort formation patterns. An estimated 82% of BRD incidence was attributable to management-related risk factors, whereby the lowest risk category of a composite management-related variable comprised animals in the lowest risk category of at least four of the five component variables (shared pen water, mixing, move timing, BVDV-1 in the cohort and the number of animals in the animal's group-13). This indicated that widespread adoption of appropriate interventions including ensuring pen water is not shared between pens, optimising animal mixing before induction, timing of the animal's move to the vicinity of the feedlot, and group size prior to placing animals in feedlot pens, and avoiding BVDV-1 in cohorts could markedly reduce the incidence of BRD in medium-sized to large Australian feedlots.

Effects of sodium sulfate on fecal pH and proliferation of colonic mucosa in patients at high risk for colon cancer.

High fecal pH level has been suggested as a risk factor for colorectal cancer. We previously demonstrated that, although sodium sulfate did not affect the proliferation rate of colonic mucosa, as indicated by thymidine-labeling index, it did lower fecal pH in subjects at average risk for colon cancer. In the current study, we evaluated the effects of sodium sulfate on fecal pH and proliferation of colonic mucosa in subjects at high risk for colon cancer. Fifty-seven patients who had had colonic polyps removed were randomly assigned to two groups to receive either sodium sulfate (27 patients) or a placebo (25 patients) at a mean dose of 4 g/day for 14 days. Age, sex, height, and weight were comparable in both groups. Before intervention, levels of fecal pH were similar in the two groups, but after intervention, fecal pH was reduced only in the sodium sulfate group (mean decrease, 0.3 U; P less than .01). Thymidine-labeling index (number of labeled cells per number of cells counted) was similar in the two groups prior to intervention and did not change significantly after intervention (mean increase, 0.9%; P = .35). Regression analysis revealed no correlation between the change in labeling index and the change in fecal pH. We conclude that high fecal pH level is only indirectly associated with the development of colon cancer and, therefore, may be a secondary, rather than a primary, measure of cancer risk.

Comparisons of diet and biochemical characteristics of stool and urine between Chinese populations with low and high colorectal cancer rates.

In an investigation of the roles of diet and stool biochemistry in human colorectal carcinogenesis, 24-hour food, urine, and stool samples were collected from randomly selected participants from two populations with a fourfold difference in colorectal cancer risk: Chinese in Sha Giao, People's Republic of China (low risk), and Chinese-Americans of similar ages in San Francisco County, Calif, in the United States (high risk). The findings supported the hypotheses that colorectal cancer risk is increased by the consumption of high-fat, high-protein, and low-carbohydrate diets and is associated with high levels of cholesterol in stool as well as increased daily outputs of 3-methyl-histidine and malonaldehyde in urine. However, risk does not increase with low stool bulk and low total stool fibers.

Relative accuracy testing of an X-ray fluorescence-based mercury monitor at coal-fired boilers.

The relative accuracy (RA) of a newly developed mercury continuous emissions monitor, based on X-ray fluorescence, was determined by comparing analysis results at coal-fired plants with two certified reference methods (American Society for Testing and Materials [ASTM] Method D6784-02 and U.S. Environment Protection Agency [EPA] Method 29). During the first determination, the monitor had an RA of 25% compared with ASTM Method D6784-02 (Ontario Hydro Method). However, the Ontario Hydro Method performed poorly, because the mercury concentrations were near the detection limit of the reference method. The mercury in this exhaust stream was primarily elemental. The second test was performed at a U.S. Army boiler against EPA Reference Method 29. Mercury and arsenic were spiked because of expected low mercury concentrations. The monitor had an RA of 16% for arsenic and 17% for mercury, meeting RA requirements of EPA Performance Specification 12a. The results suggest that the sampling stream contained significant percentages of both elemental and oxidized mercury. The monitor was successful at measuring total mercury in particulate and vapor forms.

Association of osteonecrosis of the jaws and bisphosphonate pharmacotherapy: dental implications.

Bisphosphonates are drugs of choice in the management of a variety of bone disorders including osteoporosis, Paget's disease and bone cancer. Recently there have been increasing reports of a possible relationship between bisphosphonate therapy and osteonecrosis of the jaws. Osteonecrosis may occur following extractions or dental surgery and, in some cases, may appear spontaneously. Because of the potentially serious nature of these complications and the failure of exposed bone to heal, dentists must be aware of recommended precautions for the management of patients taking bisphosphonate medication.

Telomerase activity associated with acquisition of malignancy in human colorectal cancer.

Shortening of telomeres may contribute to the control of the proliferative capacity of normal cells, and telomerase, the enzyme that elongates telomeric DNA, may be essential for unlimited cell proliferation. We have shown previously that telomerase activity is present in human cells immortalized in vitro and in metastatic ovarian carcinoma cells but is undetectable in normal cultured cells or normal tissues. We have determined the temporal pattern of telomerase activity during colorectal carcinogenesis in man. We report that telomerase activity is associated with acquisition of malignancy as it is detectable in colorectal carcinoma but not in adenomatous polyps. Mutations leading to reactivation or upregulation of the enzyme may represent an additional required event in the multistep development of colorectal cancer.

Polyethylene glycol 8000 and colon carcinogenesis: inhibition in the F344 rat, promotion in the Min mouse.

It has recently been reported that 5% polyethylene glycol 8000 (PEG 8000; Mr 8000) in the diet markedly inhibits the development of colonic tumors in carcinogen-treated rats. To assess the possible use of this agent as a preventive or treatment agent for patients with familial adenomatous polyposis, we determined the effect of PEG 8000 on spontaneous carcinogenesis in the Min mouse. PEG at a 5% concentration in the diet of Min mice did not affect the number of small intestinal or cecal tumors but did increase the number of colon tumors and the number of animals with colonic tumors (2 of 18 versus 12 of 22 animals; P < 0.001). Although the chemopreventive effect of PEG 8000 in rats is remarkable, we suggest a cautious approach in long-term testing of PEG as a chemopreventive agent for subjects at risk for colonic neoplasia.