Injectable and Oral Contraceptive Use and Cancers of the Breast,Cervix, Ovary,and Endometrium in Black South African Women: Case–Control Study

Background

Oral contraceptives are known to influence the risk of cancers of the female reproductive system. Evidence regarding the relationship between injectable contraceptives and these cancers is limited, especially in black South Africans, among whom injectable contraceptives are used more commonly than oral contraceptives.

Methods and Findings

We analysed data from a South African hospital-based case–control study of black females aged 18–79 y, comparing self-reported contraceptive use in patients with breast (n = 1,664), cervical (n = 2,182), ovarian (n = 182), and endometrial (n = 182) cancer, with self-reported contraceptive use in 1,492 control patients diagnosed with cancers with no known relationship to hormonal contraceptive use. We adjusted for potential confounding factors, including age, calendar year of diagnosis, education, smoking, alcohol, parity/age at first birth, and number of sexual partners. Among controls, 26% had used injectable and 20% had used oral contraceptives. For current and more recent users versus never users of oral or injectable contraceptives, the odds ratios (ORs) for breast cancer were significantly increased in users of oral and/or injectable contraceptives (OR 1.66, 95% CI 1.28–2.16, p<0.001) and separately among those exclusively using oral (1.57, 1.03–2.40, p = 0.04) and exclusively using injectable (OR 1.83, 1.31–2.55, p<0.001) contraceptives; corresponding ORs for cervical cancer were 1.38 (1.08–1.77, p = 0.01), 1.01 (0.66–1.56, p = 0.96), and 1.58 (1.16–2.15, p = 0.004). There was no significant increase in breast or cervical cancer risk among women ceasing hormonal contraceptive use ≥10 y previously (p = 0.3 and p = 0.9, respectively). For durations of use ≥5 y versus never use, the ORs of ovarian cancer were 0.60 (0.36–0.99, p = 0.04) for oral and/or injectable contraceptive use and 0.07 (0.01–0.49, p = 0.008) for injectable use exclusively; corresponding ORs for endometrial cancer were 0.44 (0.22–0.86, p = 0.02) and 0.36 (0.11–1.26, p = 0.1).

Conclusions

In this study, use of oral and of injectable hormonal contraceptives was associated with a transiently increased risk of breast and cervical cancer and, for long durations of use, with a reduced risk of ovarian and endometrial cancer. The observed effects of injectable and of oral contraceptives on cancer risk in this study did not appear to differ substantially. Please see later in the article for the Editors'' Summary     

WHO 2010 guidelines for prevention of mother-to-child HIV transmission in Zimbabwe: modeling clinical outcomes in infants and mothers

Background

The Zimbabwean national prevention of mother-to-child HIV transmission (PMTCT) program provided primarily single-dose nevirapine (sdNVP) from 2002–2009 and is currently replacing sdNVP with more effective antiretroviral (ARV) regimens.

Methods

Published HIV and PMTCT models, with local trial and programmatic data, were used to simulate a cohort of HIV-infected, pregnant/breastfeeding women in Zimbabwe (mean age 24.0 years, mean CD4 451 cells/µL). We compared five PMTCT regimens at a fixed level of PMTCT medication uptake: 1) no antenatal ARVs (comparator); 2) sdNVP; 3) WHO 2010 guidelines using “Option A” (zidovudine during pregnancy/infant NVP during breastfeeding for women without advanced HIV disease; lifelong 3-drug antiretroviral therapy (ART) for women with advanced disease); 4) WHO “Option B” (ART during pregnancy/breastfeeding without advanced disease; lifelong ART with advanced disease); and 5) “Option B+:” lifelong ART for all pregnant/breastfeeding, HIV-infected women. Pediatric (4–6 week and 18-month infection risk, 2-year survival) and maternal (2- and 5-year survival, life expectancy from delivery) outcomes were projected.

Results

Eighteen-month pediatric infection risks ranged from 25.8% (no antenatal ARVs) to 10.9% (Options B/B+). Although maternal short-term outcomes (2- and 5-year survival) varied only slightly by regimen, maternal life expectancy was reduced after receipt of sdNVP (13.8 years) or Option B (13.9 years) compared to no antenatal ARVs (14.0 years), Option A (14.0 years), or Option B+ (14.5 years).

Conclusions

Replacement of sdNVP with currently recommended regimens for PMTCT (WHO Options A, B, or B+) is necessary to reduce infant HIV infection risk in Zimbabwe. The planned transition to Option A may also improve both pediatric and maternal outcomes.     

Multi-disciplinary evidence of the Holocene history of a cultivated floodplain area in the wetlands of northern Colombia

An environmental reconstruction of the last 10,000 ¹⁴C years of a frequently flooded wetland ecosystem in the lower Magdalena valley in northern Colombia is presented, on the basis of a multi-disciplinary study of the sediments of the upper 15 m of the core from Boquillas (74°33'E, 9°7'N; 20 m a. s. l.). We used the following studies: pollen, lithology, organic structures, clay mineralogy, soil and sediment geochemistry, and δ¹³C values. The chronology is based on 13 AMS radiocarbon dates; the humic acid fractions were used in the case of seven samples. Pollen from local origin (swamps, open grass-rich vegetation, and gallery forest) show the development of the wetland area. River-transported pollen from a greater distance (dry forest, montane forest, Alnus) show changes in river activity and reflect large-scale changes of climatic conditions in the Momposina basin. From c. 10,010 to 9370 uncal B. P. (zone BQS-Ia) the river system was of high energy, as inferred by the lithological changes. The landscape was dominated by open grass-rich vegetation with gallery forest along the streams. A marked representation of Alnus and montane forest taxa indicate significant water transport and river dynamics. Climatic conditions were dry. From c. 9370-8430 uncal B. P. (zone BQS-Ib) wetlands were isolated from the main river system, and clayey sediments with kaolinite, smectite and illite as the main minerals accumulated in a lower-energy environment. Climatic conditions were dry and changes in the seasonal precipitation favoured the expansion of the gallery forest. From c. 8430 to 8040 uncal B. P. (zone BQS-Ic) low values of river-transported pollen indicate dry climatic conditions and open vegetation became more abundant. The flooding frequency of the Boquillas site diminished. From 8040 to 4900 uncal B. P. (zone BQS-Id) the Boquillas site was dominated by open vegetation with patches of gallery forest along the streams. Supply of river-transported allochthonous pollen (from many sources) was minimal. Clay minerals from the sediments suggest variable temperature and precipitation. From c. 4900 to 1550 uncal B. P. )zone BQS-II) the site was within the reach of the main river system as is the case today. Frequent flooding, coinciding with peaks of river-transported grains of Alnus and high sediment supply, point to high precipitation in the composite catchment area of the Magdalena, Cauca, San Jorge, and Cesár rivers. High values of phosphorous in the upper part of the core point to the presence of a pre-Hispanic civilization, approximately from 2000 uncal B. P. onward. Construction of an extensive drainage system allowed irrigation as well as drainage depending the annual cycle of precipitation. The landscape was significantly modified and allowed an extensive crop production on a system of raised fields. Received May 18, 2001 / Accepted June 15, 2001     

Quenching autofluorescence in the alimentary canal tissues of Bactericera cockerelli (Hemiptera: Triozidae) for immunofluorescence labeling

Immunofluorescence has been widely used to localize microbes or specific molecules in insect tissues or cells. However, significant autofluorescence is frequently observed in tissues which can interfere with the fluorescent identification of target antigens, leading to inaccurate or even false positive fluorescent labeling. The alimentary canal of the potato psyllid, Bactericera cockerelli ?ulc, exhibits intense autofluorescence, hindering the application of immunolocalization for the detection and localization of the economically important pathogen transmitted by this insect, “Candidatus Liberibacter solanacearum” (Lso). In the present study, we tested the use of irradiation, hydrogen peroxide (H₂O₂) and Sudan black B (SBB) treatments to reduce the autofluorescence in the B. cockerelli alimentary canal tissues. Furthermore, we assessed the compatibility of the above‐mentioned treatments with Lso immunolocalization and actin staining using phalloidin. Our results showed that the autofluorescence in the alimentary canal was reduced by irradiation, H₂O₂, or SBB treatments. The compatibility assays indicated that irradiation and H₂O₂ treatment both greatly reduced the fluorescent signal associated with Lso and actin. However, the SBB incubation preserved those target signals, while efficiently eliminating autofluorescence in the psyllid alimentary canal. Therefore, herein we propose a robust method for reducing the autofluorescence in the B. cockerelli alimentary canal with SBB treatment, which may improve the use of immunofluorescence labeling in this organism. This method may also have a wide range of uses by reducing the autofluorescence in other arthropod species.     

Genotypic proportions in hybrid zones

We study a hybrid zone between two populations of a diploid organism. The populations differ at one locus. Homozygotes have equal fitnesses and the heterozygote fitness is reduced by + ( is the birth rate deviation and is the death rate deviation). The populations extend along a one dimensional continuous habitat, and migration occurs by diffusion of individuals. The model is formulated as a set of simple continuous time demographic models without age structure for the three genotypes, and the system is transformed into three new variables, the total population size N, the gene frequency p, and the deviation from Hardy-Weinberg proportions F. The gene frequency in a steady state cline always follows a hyperbolic tangent closely. Analysis of the asymptotic behavior of the cline far from the hybrid zone suggests a qualitative prediction of the shape of N, p and F over the zone. For weak selection the shape is determined by a central steepness of , as observed by Bazykin in 1969, where D is the diffusion coefficient. For strong selection the cline is less steep than the Bazykin cline, and the form is dominated by the migration process. The steepness at the center of the cline is close to where b is the birth rate of homozygotes.Supported in part by grant 11-9639-1 from the Danish Natural Science Research Council and grant 5.18.2023 from the Danish Biotechnological Research and Development Programme     

Incubation of innovative methanogenic communities to seed anaerobic digesters

Applied Microbiology and Biotechnology - The methanogenic communities in alternative inocula and their potential to increase CH4 production in mesophilic and psychrophilic dairy manure-based...     

A two-locus mutation—Selection model and some of its evolutionary implications

The deterministic properties of a two-locus model with mutation and selection have been investigated. The mutation process is unidirectional, and the model is so constructed that the genetic variation at one locus is selectively neutral in the absence of a mutant allele at the other locus. All genotypes with three or four mutant alleles are deleterious, while the double heterozygotes may have the same fitness as the standard genotype. If one of the mutant alleles becomes fixed in the population, then the other locus will show a regular one-locus mutation-selection balance. Such a boundary equilibrium may be unstable or stable in the full two-locus setting. In the symmetric case, which is analyzed in details, the population will either go to one of the two boundary equilibria, or to a fully polymorphic equilibrium at which both the mutant alleles are rare. The origin of reproductive separation between two populations via the fixation of complementary deleterious mutants at different loci, and the fixation of nonfunctional alleles at duplicated loci, are two biological processes which both can be studied with the present model. In the last part of the paper we show how the results from the deterministic analysis can be used to predict how different factors will influence the rates of evolution in these systems.     

Geographical Patterns of Four Polymorphisms in ZOARCES VIVIPARUS as Evidence of Selection

Two unlinked polymorphisms of a marine teleost, one in hemoglobin and one in esterase, show parallel clines through Danish waters, while two unlinked phosphoglucosemutase polymorphisms maintain constant gene frequencies. It is argued that the clinal and the constant polymorphisms cannot be accounted for simultaneously by random genetic drift of selectively neutral genes. It is therefore concluded that selection is responsible for at least one of the two classes of geographical patterns, be it the clinal, the constant, or both.