Gender in bioethics: theory and practice -- an introduction

Does the care perspective make a difference? Can it reach as far as we would like? It is the goal of this special issue on Gender in Bioethics: Theory and Practice to begin to address some of these important questions. In the first article, Virginia Sharpe provides a comprehensive and thoughtful analysis of how the orientations of justice and care are played out in medical ethical theory. In the second article, James Nelson argues that the more traditional approach in Bioethics to maternal-fetal conflicts is not useful, and that a care perspective is more appropriate. Thoughtful commentary on Nelson's article is provided by Rosemarie Tong. For readers new to the justice-care debate in moral theory, the following articles will provide an informative introduction. For those who are more familiar, it is hoped that you will be challenged by the extension of the debate to the practical issue of maternal-fetal conflicts.     

Cardiorespiratory capacity of Thai workers in different age and job categories

The objective of this study was to assess the cardiorespiratory capacity of Thai male and female blue-collar workers in different age and occupational categories. The maximal oxygen uptake (VO2max) of 70 men and 56 women was assessed using a submaximal bicycle-ergometer test supplemented with ventilatory gas analyses. The age of the subjects varied from 16 to 55 years. They worked in construction, manual materials handling and metal jobs. For the male subjects the VO2 max ranged from 1.43 to 3.50 l/min and from 21.3 to 66.3 ml/min/kg. The corresponding values for the female subjects were 0.97-2.97 l/min and 16.2-42.4 ml/min/kg. According to the European fitness classifications the mean age related VO2max of the male and female subjects can be considered moderate or poor. When compared to the European data heart rate of the subjects was 25-30% higher at submaximal levels of oxygen uptake, confirming earlier results. The low cardiorespiratory capacity of many Thai workers may be a limiting or even risk factor in physically demanding jobs.     

Epidemiological and statistical aspects of the AIDS epidemic: introduction

In 1988, a government working party studied estimates of incidence and prevalence of numbers of acquired immunodeficiency syndrome (AIDS) cases. They investigated a series of epidemiological, statistical and mathematical problems associated with predicting trends in incidences of AIDS. This paper introduces a series of papers that give a fuller and more technical exposition of the appendixes of that working party report. The papers provide a brief background to the current state of knowledge on the epidemiology of the infection and the disease; a deterministic model for human immunodeficiency virus (HIV) transmission in the male homosexual community in England and Wales is introduced. Back-projection methods are studied in two papers, following the distribution of the incubation period of the disease. The concept of minimum size of the epidemic is introduced. Mathematical functions to describe the spread of HIV infection are refined by using past trends in the incidence of AIDS to estimate values for some parameters. Survival times for AIDS patients from the point of diagnosis are considered and evidence for changes in male homosexual sexual behaviour is studied; lag-time from the point of diagnosis to the report of the case is also examined. There is a comparative analysis of the AIDS epidemic in various European countries. The incubation period of HIV in patients with haemophilia A and B infections and the problems associated with making predictions for different at-risk groups or small subgroups based on geographical area are discussed. Reasons for fluctuation between the number of reported cases from month to month are provided.     

Glutamatergic mechanisms in different disease states: overview and therapeutical implications -- an introduction

Summary.  Glutamate is the most widely distributed excitatory transmitter in the central nervous system (CNS). It is acting via large – and still growing – families of receptors: NMDA-, AMPA-, kainate-, and metabotropic receptors. Glutamate has been implicated in a large number of CNS disorders, and it is hoped that novel glutamate receptor ligands offer new therapeutic possibilites in disease states such as chronic pain, stroke, epilepsy, depression, drug addiction and dependence or Parkinson's disease. While an extensive preclinical literature exists showing potential beneficial effects of NMDA-, AMPA-, kainate- and metabotropic receptor ligands, only NMDA receptor antagonists have been characterized clinically to any appreciable degree. In these trials it has been shown that while several compounds are therapeutically active, they also produce serious side effects at therapeutic doses. Current interest largely centers on the development of receptor subtype-selective compounds, namely compounds selective for receptors containing the NR2B subunit. Preclinical findings and the first clinical results are encouraging, and it may be that such subunit-selective compounds may have a sufficiently wide therapeutic window to be safe for human use. Received July 6, 2001 Accepted August 6, 2001 Published online August 9, 2002     

AIDS epidemic at age 25 and control efforts in China

Retrovirology announces new editorial board members and reprises progress over the first two years of publishing.     

Declining incidence of AIDS dementia complex after introduction of zidovudine treatment.

OBJECTIVE--To assess the incidence of the AIDS dementia complex and the presence of HIV I p24 antigen in cerebrospinal fluid in relation to zidovudine treatment. DESIGN--Retrospective study of a consecutive series of patients with AIDS from 1982 to 1988. SETTING--An academic centre for AIDS. PATIENTS--196 Patients with AIDS and neurological symptoms examined from 1982 to 1988. INTERVENTIONS--Zidovudine treatment, which was introduced to The Netherlands on 1 May 1987 for patients with severe symptoms of HIV infection (Centers for Disease Control groups IVA, B, C, and D). MAIN OUTCOME MEASURES--Diagnosis of AIDS dementia complex and presence of HIV I p24 antigen in cerebrospinal fluid. RESULTS--The AIDS dementia complex was diagnosed in 40 of the 196 (20%) patients with AIDS. Thirty eight of 107 patients with AIDS (36%) not taking zidovudine developed the AIDS dementia complex compared with two of the 89 (2%) taking the drug (p less than 0.00001). The incidence of the AIDS dementia complex increased to 53% in the first half of 1987, after the introduction of zidovudine in May 1987, decreasing to 10% in the second half of 1987 and to 3% in 1988. Dementia was diagnosed before definition of the AIDS dementia complex (1986) according to DSM-III criteria and there was good agreement between diagnosis before and after 1986. Sixteen of 61 samples of cerebrospinal fluid (26%) from patients with AIDS (10 with the AIDS dementia complex) not taking zidovudine were positive for HIV I p24 antigen, whereas none of 37 cerebrospinal fluid samples from patients with AIDS (two with the AIDS dementia complex) taking zidovudine were positive. CONCLUSIONS--The incidence of AIDS dementia complex in patients with AIDS declined after the introduction of systematic treatment with zidovudine; the AIDS dementia complex might be prevented by inhibiting viral replication in the central nervous system.     

Marked improvement in survival among adult Croatian AIDS patients after the introduction of highly active antiretroviral treatment

We compared the survival of patients following the first AIDS event in Croatia from the period 1986-1996 to the period 1997-2000. A total of 72 (81.8%) out of 88 patients from 1986-1996 and 18 (32.1%) out of 56 from 1997-2000 died. Survival following the first AIDS-defining illness markedly improved in the period 1997-2000 compared to the period 1986-1996 (adjusted Hazard Ratio (HR) for patients surviving more than 6 months: 0.11, 95% confidence interval (95% CI) = 0.04-0.29). A CD4+ cell count of < 100 x 10(6)/L was an independent risk factor for patients surviving up to 2 years (adjusted HR = 1.96, 95% CI = 1.1-3.43, p = 0.02). Patients with tuberculosis or fungal infections had a longer survival when compared to other diagnosis (adjusted HR = 0.53, 95% CI = 0.32-0.90, p = 0.01). However, despite dramatic survival benefit of combination antiretroviral therapy, mortality at six months following the first AIDS event was similar in the two study periods and the one-year probability of death was still substantial (27.2%) in the period 1997-2000.     

Biotypes, genotypes and ketoconazole susceptibility of Candida albicans isolates from a group of Thai AIDS patients

A total of eighty-seven Candida albicans isolates from a group of Thai AIDS patients were characterized for phenotypic and genotypic profiles and antifungal susceptibility to ketoconazole. Phenotyping of the isolates was carried out by a biotyping method based on the enzyme profiles, carbohydrate assimilation patterns and boric acid resistance of the yeasts. Genotyping was performed through randomly amplified polymorphic DNA (RAPD) analysis. Antifungal susceptibility of ketoconazole was performed using the NCCLS broth microdilution method. Combination of the biotypic tests revealed a total of 49 different biotypes. The most predominant was A1S (31%), the remaining biotypes represented only few isolates in each. RAPD profiles identified 14 clusters of genotype among the 87 isolates. Almost every individual harboured his/her own specific isolate and in 25 of 26 (96.2%) harboured more than one clonal type. The heterogeneity of both phenotypic and genotypic profiles of C. albicans isolates in this study was similar to previous reports from other oral sources in different geographic areas. All isolates were susceptible to ketoconazole. The findings may be useful as baseline information of oral C. albicans colonization in Thai population living in the south of Thailand.     

Biparental inheritance and the question of sexuality in Paramecium

Ohne Zusammenfassung

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Biparental inheritance and the question of sexuality in Paramecium

     

棉蚜性蚜的研究

调查了棉蚜性蚜的种群动态,对性母、性雄、性雌内外生殖系统进行了研究、观察、解剖与描述,并对性雌产卵习性、产卵量以及交配习性进行了研究。讨论了性蚜产生的生态条件及性雄、性雌性别决定先后次序和来源问题。     

Sexual development and sexuality in the Nassau grouper

Hermaphroditic sexual patterns are widespread among teleosts and are especially characteristic of certain perciform families. Among the most diverse groups of hermaphroditic species are the groupers, hamlets and sea basses of the family Serranidae. Like other groupers, the epinepheline serranid, Epinephelus striatus , the Nassau grouper, has long been assumed to exhibit monandric protogyny (a form of hermaphroditism in which all males derive from adult females by sex change). Histological and demographic data, however, indicate that the sexual pattern of this species is not monandric, and that, unlike other group species, the juveniles pass through a bisexual stage of gonadal development. Sexuality in the Nassau grouper is essentially gonochoristic, with potential for sex change. The combination of bisexuality and gonochorism is previously undescribed in the serranids.     

Genetic Optimism: Framing Genes and MentalIllness in the News

Over the past two decades the pace andspecificity of discoveries associating geneticswith mental illness has accelerated, which isreflected in an increase in news coverage aboutthe genetics of mental disorder. The newsmedia is a major source of public understandingof genetics and a strong influence on publicdiscourse. This paper examines the newscoverage of genetics and mental illness (i.e.,bipolar illness and schizophrenia) over a 25year period, emphasizing the peak period of1987–1994. Using a sample of 110 news storiesfrom 5 major American newspapers and 3 newsmagazines, we identify the frame of ``geneticoptimism' which dominated the reporting ofgenetics and mental illness beginning in themid-1980s. The structure of the frame iscomprised of 3 elements: a gene for thedisorder exists; it will be found; and it willbe good. New discoveries of genes wereannounced with great fanfare, but the mostpromising claims could not be replicated orwere retracted in short order. Despite thesedisconfirmations, genetic optimism persisted insubsequent news stories. While the scientificaccuracy of the gene stories is high, thegenetic optimism frame distorts some of thefindings, misrepresents and reifies the impactof genes on mental disorder, and leaves nospace for critics or an examination ofpotential negative impacts. The stances ofreporters, scientists and editors may all indifferent ways contribute to the perpetuationof genetic optimism. Genetic optimism presentsan overly sanguine picture of the state ofgenetics; as we enter the genetic age it isimportant to balance the extraneous ``hype andhope' contained in news stories of genetics andmental illness.