The effects of 4-nonylphenol in rats: a multigeneration reproduction study.

The alkylphenol breakdown products of alkylphenol ethoxylates have been shown in in vitro studies to be weakly estrogenic, but few in vivo data address this issue in mammals. Because estrogens have been found to be most potent during developmental/perinatal exposures, this study maximized developmental exposure to nonylphenol (NP) by treating 3.5 generations of Sprague-Dawley rats to NP in diet at 200, 650, and 2000 ppm to determine the range and severity of any toxicity. Dose rate was higher for younger rats; calculated dose ranges were 9-35, 30-100, and 100-350 mg/kg/d for the low (200NP), middle (650NP), and high (2000NP) dose groups, respectively. There were adult (F0, F1, F2) and postnatal day (pnd) 21 (F1, F2, F3) necropsies; the oldest F3 rats were killed on pnd 55-58. Body weight gain was reduced by 8-10% in the 650NP and 2000NP groups. Vaginal opening was accelerated by approximately 2 days (650NP) and approximately 6 days (2000NP) in F1, F2, and F3 generations. Uterine weights at pnd 21 were increased in 650NP (14%) and 2000NP (50%) F1 females, but not in other generations. Testis descent, anogenital distance, and preputial separation were not consistently changed. No consistent changes were seen in pup number, weight or viability, litter indices, or other functional reproductive measures. Relative ovary weight in F2 adults was decreased at 650NP and 2000NP by 12%; relative ovary was unchanged in other generations. Follicle counts were unchanged in F2 adults. Sperm indices, including CASA measures, were unchanged in F0 and F1 males. In F2 rats, epididymal sperm density was reduced by 8% and 13% at 650NP and 2000NP, respectively. Testicular spermatid count was reduced by 13% in 2000NP F2 males; testis and epididymis weights were unchanged. Erosion of gastric and duodenal mucosa was monitored grossly and microscopically, and never found. Kidney weights were increased in 650NP and 2000NP males, and renal medullary tubular dilatation and cyst formation were noted in all generations of males, and often at the lowest dose tested. These data show that NP had limited effects on the reproductive system in the presence of measurable nephrotoxicity. The F2 sperm effects are either statistical/biological "noise," or imply heretofore unknown pharmacokinetics or toxicodynamics. These sperm data should be interpreted cautiously until the findings are repeated.

A descriptive approach to bulimia.

The many labels applied to bulimia and its frequent association with anorexia nervosa have often created confusion about its characteristics and causes. Recent research reveals a variety of bulimic types, some without histories of anorexia and with different treatment needs and prognoses. To clarify discussions among researchers and aid clinical decisions, the author proposes replacing the labels with broader descriptions.

Health practice at the technologic/folk interface: witchcraft as a culture-specific diagnosis.

"Witchcraft illness" is a widespread belief among many people, even after acculturation to technological concepts of illness etiology. Two cases are presented to show that such beliefs can complicate physical or psychological dysfunctions, or themselves can be the primary origin of physical or psychological dysfunctions. In both instances, witchcraft beliefs take on a dynamic of their own and must be resolved both in terms of the patient's culture as well as the clinician's treatment plan. Considering such phenomena from the vantage point of family systems provides useful insights into etiology as well as amelioration. The latter requires engaging all parties in the health care system-clinician, patient, family, and indigenous health caretakers.

Ethnic differences in family attitudes towards psychotic manifestations, with implications for treatment programmes.

The tolerance of Irish-American and Jewish-American families towards psycho-social dysfunction in a psychotic family member was studied. As predicted, significantly more Irish families than Jewish families tolerated deviant thinking in a psychotic relative, while significantly more Jewish families than Irish families tolerated deviant verbal emotionality. These and other findings are discussed in terms of psycho-social and socio-cultural theory and lead to a consideration of the goals of treatment programmes. Differences in family attitudes have been shown to affect the decision to send relatives to a mental hospital, or accept them on discharge. Cultural factors are known to be related to attitudes on a variety of health-related issues, but studies have not focused generally on ethnic contributions to family differences in attitudes towards mentally disturbed family members. One reason for this neglect of cultural factors has been the emphasis on sociological phenomena, stimulated by investigations of social class and mental illness. Yet is has been shown that ethnic factors may be responsible for at least some of the correlations that have been found between community, social class and mental illness. Every social class, furthermore, can muster a variety of patterns for seeking professional assistance for psycho-social dysfunctions, and some of these patterns may be differentiated along cultural lines. The present study attempts such a differentiation. It deals with two ethnic groups and their family attitudes towards disturbing symptoms in relatives.