Utilizing a Global Cancer Center Network for Tobacco Control: Baseline Survey of MD Anderson´s Global Academic Program´s Sister Institution

Background: Globally, tobacco can be attributed to more than 7 million deaths each year. To address this potentially avoidable mortality, The University of Texas MD Anderson Cancer Center has engaged its Global Academic Program´s (GAP) sister institutions (SI) by conducting an inaugural tobacco control assessment survey. A similar survey was done with our University of Texas academic and health science center affiliates that led to improved adoption of tobacco control policies as well as prevention and cessation services on all campuses. The baseline data collected will serve as a mechanism to develop a tobacco prevention and control strategy within a global cancer center network. Aim: To assess SI laws and policies regarding tobacco use, existing screening and cessation services. Strategy/Tactics: Qualtrics was used to administer a 27-item survey to our GAP SI from April-October 2017. Survey questions focused on key areas of tobacco prevention and control: policy, tobacco use screening, and cessation services. A survey link was emailed to 34 institutions in 23 countries. Program/Policy process: Survey GAP SI to determine current tobacco prevention and control measures being implemented. Convene GAP SI in May 2018 to share tobacco control best practices across the network and identify resources and supports to strengthen tobacco control efforts at each institution. Build collaborations aimed at progressive actions in tobacco control policies, educational programs and cessation services culturally appropriate to the needs and resources of the GAP network. Outcomes: Of the 34 GAP SI, 26 responded to the survey (76% response rate). Key findings among the 26 responding institutions: policy - 96% are located in cities with laws regulating the sale and/or use of tobacco products by minors and 77% of the cities have laws regulating the use of tobacco in the workplace; 42% of the campuses have designated smoking areas; tobacco use screening - 65% screen for and document patients´ tobacco status, however only 27% screen “all the time”; cessation services - 19% offer telephone counseling as a cessation service; 38% offer cessation services to the community; 46% offer cessation services to employees. What was learned: The baseline assessment identified areas of institutional needs: cessation services and campus policies. Further discussion with the SI will help engage them in further efforts to address gaps in tobacco control. Collectively, we aim to develop action steps to collaborate and enhance existing services by creating a global platform in which tobacco control best practices and resources can be shared.

Does Lung Donation by Heart Donors Have an Impact on Survival in Heart Transplant Recipients?

Lung procurement is increasing during multiorgan recovery and substantially alters the explant process. This study evaluated whether lung donation by a heart donor affects survival in heart transplant recipients. Retrospective analysis of United Network for Organ Sharing (UNOS) adult heart transplantation data from 1998 to 2012 was performed. Lung donors (LDs) were defined as those having at least one lung procured and transplanted. Non-LDs had neither lung transplanted. Heart transplant recipients who had previous transplants, who had heterotopic transplants, who were waitlisted for other organs or who were temporarily delisted were excluded from the analysis. Kaplan-Meier survival analysis and Cox proportional hazards regression were performed. Of 23 590 heart transplant recipients meeting criteria during the study period, 8638 (36.6%) transplants were from LDs. Donors in the LD group had less history of cigarette use (15.5% vs. 29.5%, p < 0.001). On univariate analysis, LDs were associated with improved patient survival (p < 0.001). On multivariate analysis, LDs were not significantly associated with patient survival (adjusted hazard ratio 0.98, 95% confidence interval 0.94-1.03). Analysis of the UNOS registry suggested that donor pulmonary status and lung procurement had no detrimental effect on survival in heart transplant recipients, supporting the present practice of using donor lungs whenever possible.

Discrimination in the workplace, reported by people with major depressive disorder: a cross-sectional study in 35 countries

OBJECTIVE

Whereas employment has been shown to be beneficial for people with Major Depressive Disorder (MDD) across different cultures, employers' attitudes have been shown to be negative towards workers with MDD. This may form an important barrier to work participation. Today, little is known about how stigma and discrimination affect work participation of workers with MDD, especially from their own perspective. We aimed to assess, in a working age population including respondents with MDD from 35 countries: (1) if people with MDD anticipate and experience discrimination when trying to find or keep paid employment; (2) if participants in high, middle and lower developed countries differ in these respects; and (3) if discrimination experiences are related to actual employment status (ie, having a paid job or not).

METHOD

Participants in this cross-sectional study (N=834) had a diagnosis of MDD in the previous 12 months. They were interviewed using the Discrimination and Stigma Scale (DISC-12). Analysis of variance and generalised linear mixed models were used to analyse the data.

RESULTS

Overall, 62.5% had anticipated and/or experienced discrimination in the work setting. In very high developed countries, almost 60% of respondents had stopped themselves from applying for work, education or training because of anticipated discrimination. Having experienced workplace discrimination was independently related to unemployment.

CONCLUSIONS

Across different countries and cultures, people with MDD very frequently reported discrimination in the work setting. Effective interventions are needed to enhance work participation in people with MDD, focusing simultaneously on decreasing stigma in the work environment and on decreasing self-discrimination by empowering workers with MDD.

Cardiovascular effects of the methanol and dichloromethanol extracts from Mentha suaveolens Ehrh

Methanol and dichloromethanol extracts of the leaves and stems of Mentha suaveolens Ehrh. have been tested for their effects on resting arterial blood pressure, heart rate and noradrenaline induced hypertension. Both extracts administered by i.v. bolus to urethane anaesthetized normotensive rats reduced the mean arterial blood pressure and heart rate, while only the dichloromethanol extract prevented the noradrenaline induced hypertension.

Pharmacological screening of different Juniperus oxycedrus L. extracts

Methanol and dichloromethanol extracts of leaves and stems of Juniperus oxycedrus have been tested for their toxicity, analgesic, antiinflammatory and central effects. Both extracts showed low acute toxicity and decreased spontaneous motility. The methanol extract exhibited an analgesic effect in models of chemical, mechanical and thermal stimulation whereas dichloromethanol extract showed only a significant effect in models of pain induced by chemical stimulation. Both extracts showed a significant antiinflammatory activity and inhibition of the rat paw oedema induced by carrageenin.

Triterpenoid compounds from Araujia sericifera B. Effects on the isolated guinea pig ileum

Different fractions from the methanol insoluble extract of Araujia sericifera were obtained by chromatography and evaluated for their antihistaminic effects on guinea pig ileum in vitro. In order to determine the compounds responsible for the pharmacological effects observed, separation of the components from the active fraction was performed using HPLC.

[Activity of ondansetron on the systemic vascular resistance and venous capacitance during cardiopulmonary bypass]

OBJECTIVE

To study the effect of ondansetron administered during cardio-pulmonary bypass surgery, in terms of mean arterial pressure, systemic vascular resistance and venous system capacitance.

PATIENTS AND METHOD

Twenty patients scheduled for non coronary cardiac surgery were randomly assigned to 2 groups. The study group received 4 mg ondansetron during the bypass and the control group received the same volume of physiological saline solution. The following parameters were recorded during the 10 minutes following administration of either substance: mean arterial pressure, calculated systemic vascular resistance, and the venous reservoir volume at the beginning and end of the study period.

RESULTS

Increased mean arterial pressure and systemic vascular resistance were recorded in both groups from the time of injection, with the highest levels recorded at 10 minutes. There were no statistical differences between the 2 groups. No changes in venous system capacitance were observed in either group, as there were no significant changes in venous reservoir volume of the extracorporeal circulation pump.

CONCLUSIONS

Ondansetron at the dose used has no effect on arterial or venous vessels. The increased resistance recorded in both groups can be attributed to the release of catecholamines during non pulsatile extracorporeal circulation with a non pulsatile flow.

[Adrenergic response during general anesthesia with propofol as maintenance agent]

To determine plasma catecholamine levels during the use of propofol for maintenance of anesthesia. We studied 20 randomly chosen patients undergoing elective orthopedic surgery under general intravenous anesthesia with propofol as the agent of maintenance along with pancuronium and fentanyl. Plasma concentrations of dopamine, noradrenalin and adrenalin were measured at the following times: baseline, after intubation and every 15 min during surgery. The levels obtained for the different samples were compared with baseline levels. At the doses used in our study, there were no significant differences in the way dopamine plasma levels varied. This was not the case with the other two hormones, however. Adrenalin levels were significantly higher at the first 3 extractions (post-intubation, 15 min and 30 min), and noradrenalin was significantly higher (p < 0.05) at all extraction times. Total intravenous anesthesia with propofol is associated with a significant increase in plasma concentrations of adrenalin and noradrenalin. Adrenalin returns to baseline levels 45 min after induction.

[Production of biological silage from fish scraps]

Fish waste from the fish processing industry were used as a raw material to produce biological silage. The technology used had been previously developed and tested to optimize the process. The degree of grinding, molasses concentration, process temperature, Lactobacillus plantarum inoculation, and utilization of tropical fruit wastes as a source of proteolytic enzymes were tested. Results indicated that after process and storage for 90 days at room temperature, a stable product is obtained by using no less than 15% of molasses and 10% of fruit waste, process temperature should be around 40 degrees C, the fish have to be ground to a very small particle size, and microbial inoculation is necessary.

[Microbial silage production from eviscerated fish]

Microbial fish silage was produced from a mixture of several fish species that belong to the shrimp by-catch. They were mixed with molasses, fruits (pineapple and papaya), sorbate and a starter of Lactobacillus plantarum ATCC8014. Process was evaluated by pH, acidity, consistency, exudate liquid, non-protein nitrogen, total volatile bases, microbial and toxicological tests. Results indicated that acid production and pH reduction occurs during the first two days of processing, later these values were maintained stable during 64 storage days. Total volatile bases increased during storage period. Consistency, non-protein nitrogen and exudate liquid showed that hydrolysis and liquefaction occurs during the first 8 days of processing. Raw material showed high counts of aerobic mesophilic and psicrotrophic organisms, in addition to Pseudomonas, coliform and S. aureus. However silage showed only a few aerobic mesophilic organisms due to low pH values and development of lactic acid bacteria. Silage dehydration reduces possibilities of microbial growth, and only spores of Bacillus were observed. Low levels of lead, mercury and chrome were detected in the dry silage. Proximal analysis values did not change during process and storage period.

[Effect of the addition of tropical fruits--pineapple (Ananas comosus) and papaya (Carica papaya)--on the production of biological silage from fish]

Microbial Fish Silage was produced from under-utilized fish mixed with juice and waste fruits (pineapple and papaya) at 35 degrees C. Six different products were elaborated as following: A: fish muscle with pineapple juice; B: fish muscle with fruit wastes; C: gutted fish with pineapple juice; D: gutted fish with fruit wastes; E: whole fish with pineapple juice; F: whole fish with fruit wastes. Process development was evaluated by measuring: pH, acidity, non-protein nitrogen, consistency and exudate liquid. Results indicated a slow decrease in pH value and production of acidity during 20 storage days. The addition of fruits to silage did not have any effect on these values. Silage liquefaction or hydrolysis was related to the following parameters: consistency, non-protein nitrogen and exudate liquid. The addition of fruits was related to silage liquefaction or hydrolysis, and it was measured by the consistency. Exudate liquid and non-protein nitrogen increased during storage time. However silage made from whole fish showed highest values in those parameters than other processing conditions. This results suggested that hydrolysis involve first enzymes from guts and second enzymes from muscle and head. Pineapple juice did not contribute to hydrolysis process. Mainly sensory changes in the silage occurs during first 24 hours and they were related to chemical changes. Proximal analysis did not change during silage process and microbial counts indicated the freshness of raw material used i this study.

[Composition and stability of fatty acids from deboned cachama and sardine meat during freezer storage]

Free fatty acids from total lipids and phospholipids in minced fish flesh from three sizes of Cachama (Colossoma macropomum) and Sardine (Sardinella anchovia) were evaluated. Cachama's most abundant unsaturated fatty acids from the total lipid fraction were: C18:1 (31-38%); C18:2, n-6 (13-15%); and C20:4, n-6 (3-5%), while in sardine were the follows: C18:1; C20:5 n-3 (12-24%) and C22: 6,n-3 (7-24%). C20:5, n-3 increased with the size and C22:6,n-3 decreased. The variance analysis indicated that percentage of polyunsaturated fatty acids of n-6 series in the total lipids of cachama and n-3 series in sardine were affected by the storage temperature from -10C to -20 degrees C (p < 0.01). Storage time had effect on the stability of sardine fatty acids (p-0.01) and cachama (p < 0.05). Sardine minced flesh presented the highest value of free fatty acids at-10 degrees C during the second month of storage (620 mg%) while cachama at the fourth month (230 mg%). TBA- value in sardine increased at -10 degrees C from 5.5 to 23 mg of malonaldehyde in fourth months while in cachama these value were almost the same (2-6 mg-kg) during the storage period at -10 degrees C and -20 degrees C.

[Preparation of microbial silage from fish of underutilized species]

Fish silage was produced by microbial means from a mixture of several fish species which are not used for human consumption, and form part of the shrimp by-catch. The fish was mixed with a carbohydrate source (molasses) and a starter culture of Lactobacillus plantarum 8014. The mixture was fermented at 30 +/- 2 degrees C. Several tests were undertaken to determine the optimal conditions and concentration of molasses (5, 10 and 15%) and Lactobacillus (0.5, 1.0, 2.5, 5.0 and 10.0%). Results indicated that 1% of microorganisms and 15% of molasses were the optimal proportions to produce a stable fish silage. The production process and stability study of fish silage were followed through chemical, physical and microbiological tests. As findings revealed, the first six days of the process are related to acid production, pH reduction and microbial control, while after this period the process is basically related to protein hydrolysis. In addition, sensory tests of flavor and color were performed. The results of this study suggest the feasibility of utilizing this marine resource at present discarded, through a technological scheme, to produce fish silage for animal feed.

[Processing and evaluation of fish silage from accompanying fauna of shrimps]

Fish silage for animal feed was produced from a mixture of several fish species belonging to the shrimp by catch. All of them were ground and mixed with formic and sulfuric acids, 3.5% w/w at 1:2; 1:3 and 1:4, respectively, and stored at room temperature for 15 days, to complete liquefaction. The pH, exuded liquid, consistency, soluble nitrogen, total volatile bases, trimethylamine, lipid oxidation by thiobarbituric acid test and microbial count were measured during the 60 days of the storage period. Fish silage was dried and used for biological tests in chicken fed a diet with 6% of silage as a substitute of fish meal. Results of proximal analysis, amino acid profile and mineral content, as well as of the biological test with the dried product, indicated the feasibility of using fish silage as a substitute of traditional fish meal for the chicks included in the trial. This fact, coupled to its simple processing technology, make fish silage adequate for utilization as animal feed.

Exerimental evaluation of antianginal drugs

A technique for testing antianginal drugs has been developed measuring hemodynamic variables, such as heart rate, left ventricular pressure and its dp/dt, aortic root and coronary sinus pressure, Veragut's index and area under the curve of LVP and metabolic variables, such as A-V difference of oxygen and lactate, oxygen content in coronary sinus, percentage extraction of oxygen, excess lactate. Physiological experimental conditions included spontaneously breathing dogs, catheters introduced under X-rays control and closed chest. A commentary about activity criteria, usefulness and inconvenients of this technique is presented.