Sexual risk and STI testing behaviour among Dutch female and male self-employed sex workers; a cross-sectional study using an Internet based survey.

BACKGROUND: Sex workers are men, women or transgender people who have sex in exchange for money or goods. Self-employed sex workers solicit clients independently from a third-party. Self-employed sex workers are at risk of acquiring sexually transmitted infections (STIs) through their work. We performed a cross-sectional study, using an Internet survey conducted in 2019-2020 aiming to establish sexual risk behaviour and STI testing behaviour among female and male self-employed sex workers. RESULTS: A total of 76 female self-employed sex workers (FSW) and 79 male self-employed sex workers (MSW) completed the survey. Both FSW and MSW more often had sex with partners of the opposite sex during work (65.8% FSW, 61.6% MSW) and in their private life (63.3% FSW; 64.5% MSW). During vaginal sex 35.7% of FSW and 29.6% of MSW did not always use a condom. Inconsistent condom use was observed in 35.7% of FSW and 29.6% of MSW during vaginal sex, 46.2% of FSW and 35.7% of MSW did not always use a condom during receptive anal sex. The majority of both FSW and MSW tested for STIs in the past year (67.1% FSW; 67.7% MSW) and 67.5% were aware of the possibility of low-threshold testing at an STI clinic. In the past year, 11.6% of FSW and 8.1% of MSW had an STI. CONCLUSION: The reported STI positivity rate among self-employed sex workers was not very high. However, STI prevention efforts remain important considering the low compliance with condom use during sex work. Moreover, not testing for STIs in the past year was substantial with one-third of both FSW and MSW and one-third of both FSW and MSW being unaware of the possibility of low-threshold testing at an STI clinic, warranting efforts to increase testing uptake in this population.

Chikungunya virus outbreak in Sint Maarten: Long-term arthralgia after a 15-month period.

BACKGROUND & OBJECTIVES: The first chikungunya (CHIK) epidemic in the Americas was reported in December 2013. Chikungunya virus (CHIKV) causes an acute febrile illness and is transmitted to humans by Aedes mosquitoes. Although earlier studies have described long-term clinical manifestations of CHIK patients infected with the East/Central/South African (ECSA) genotype, little is known about persistent manifestations in the Caribbean region, for which the Asian genotype is responsible. The objective of this study was to describe the presence of persisting clinical manifestations, specifically arthralgia, in CHIKV-infected patients on the Caribbean Island, Sint Maarten, 15 months after onset of the disease. METHODS: This retrospective cohort study included confirmed CHIK patients that were recorded by the participating general practitioners (GPs) during the chikungunya outbreak in 2014 in Sint Maarten. Between March and July 2015, 15 months after the onset of disease, patients were interviewed via telephone about the presence, duration and impact of clinical CHIKV manifestations. RESULTS: In total, 56 patients were interviewed (median age 47 yr), of which 30 (54%) were females. Out of the total interviewed patients, 52 (93%) reported arthralgia for the first three months after the disease onset, of which 23 (44%) patients reported to have persistent arthralgia, 15 months after the disease onset. Pain intensity of persistent arthralgia was perceived as mild in the majority of patients (n = 14; 60%), moderate in 7 (30%) patients and severe in 2 (9%) patients. During the acute phase of disease, most patients had to miss school or work (n = 39; 72%) due to clinical CHIKV manifestations and reported a negative impact on daily activities (n = 36; 57%). INTERPRETATION & CONCLUSION: Results suggested that persisting arthralgia is a frequent complication in CHIK patients included in the study. Future research on strain-specific clinical long-term manifestations and on their impact on daily life of patients, in the form of a comparative study between patients and controls, is recommended.

Regional differences in mu and kappa opioid receptor G-protein activation in brain in male and female prairie voles.

Prairie voles are unusual mammals in that, like humans, they are capable of forming socially monogamous pair bonds, display biparental care, and engage in alloparental behaviors. Both mu and kappa opioid receptors are involved in behaviors that either establish and maintain, or result from pair bond formation in these animals. Mu and kappa opioid receptors both utilize inhibitory G-proteins in signal transduction mechanisms, however the efficacy by which these receptor subtypes stimulate G-protein signaling across the prairie vole neuraxis is not known. Utilizing [(35)S]GTPγS autoradiography, we characterized the efficacy of G-protein stimulation in coronal sections throughout male and female prairie vole brains by [D-Ala2,NMe-Phe4,Gly-ol5]-enkephalin (DAMGO) and U50,488H, selective mu and kappa opioid agonists, respectively. DAMGO stimulation was highest in the forebrain, similar to that found with other rodent species. U-50,488H produced greater stimulation in prairie voles than is typically seen in mice and rats, particularly in select forebrain areas. DAMGO produced higher stimulation in the core versus the shell of the nucleus accumbens (NAc) in females, while the distribution of U-50,488H stimulation was the opposite. There were no gender differences for U50,488H stimulation of G-protein activity across the regions examined, while DAMGO stimulation was greater in sections from females compared to those from males for NAc core, entopeduncular nucleus, and hippocampus. These data suggest that the kappa opioid system may be more sensitive to manipulation in prairie voles compared to mice and rats, and that female prairie voles may be more sensitive to mu agonists in select brain regions than males.

A quantitative analysis of the sensory and sympathetic innervation of the mouse pancreas.

Pain from pancreatitis or pancreatic cancer can be both chronic and severe although little is known about the mechanisms that generate and maintain this pain. To define the peripheral sensory and sympathetic fibers involved in transmitting and modulating pancreatic pain, immunohistochemistry and confocal microscopy were used to examine the sensory and sympathetic innervation of the head, body and tail of the normal mouse pancreas. Myelinated sensory fibers were labeled with an antibody raised against 200 kD neurofilament H (clone RT97), thinly myelinated and unmyelinated peptidergic sensory fibers were labeled with antibodies raised against calcitonin gene-related peptide (CGRP) and post-ganglionic sympathetic fibers were labeled with an antibody raised against tyrosine hydroxylase (TH). RT97, CGRP, and TH immunoreactive fibers were present in parenchyma of the head, body and tail of the pancreas with the relative density of both RT97 and CGRP expressing fibers being head>body>tail, whereas for TH, a relatively even distribution was observed. In all three regions of the pancreas, RT97 fibers were associated mainly with large blood vessels, the CGRP fibers were associated with the large- and medium-sized blood vessels and the TH were associated with the large- and medium-sized blood vessels as well as capillaries. In addition to this extensive set of sensory and sympathetic nerve fibers that terminate in the pancreas, there were large bundles of en passant nerve fibers in the dorsal region of the pancreas that expressed RT97 or CGRP and were associated with the superior mesenteric plexus. These data suggest the pancreas receives a significant sensory and sympathetic innervation. Understanding the factors and disease states that sensitize and/or directly excite the nerve fibers that terminate in the pancreas as well as those that are en passant may aid in the development of therapies that more effectively modulate the pain that frequently accompanies diseases of the pancreas, such as pancreatitis and pancreatic cancer.

Endothelin and the tumorigenic component of bone cancer pain.

Tumors including sarcomas and breast, prostate, and lung carcinomas frequently grow in or metastasize to the skeleton where they can induce significant bone remodeling and cancer pain. To define products that are released from tumors that are involved in the generation and maintenance of bone cancer pain, we focus here on endothelin-1 (ET-1) and endothelin receptors as several tumors including human prostate and breast have been shown to express high levels of ETs and the application of ETs to peripheral nerves can induce pain. Here we show that in a murine osteolytic 2472 sarcoma model of bone cancer pain, the 2472 sarcoma cells express high levels of ET-1, but express low or undetectable levels of endothelin A (ETAR) or B (ETBR) receptors whereas a subpopulation of sensory neurons express the ETAR and non-myelinating Schwann cells express the ETBR. Acute (10 mg/kg, i.p.) or chronic (10 mg/kg/day, p.o.) administration of the ETAR selective antagonist ABT-627 significantly attenuated ongoing and movement-evoked bone cancer pain and chronic administration of ABT-627 reduced several neurochemical indices of peripheral and central sensitization without influencing tumor growth or bone destruction. In contrast, acute treatment (30 mg/kg, i.p.) with the ETBR selective antagonist, A-192621 increased several measures of ongoing and movement evoked pain. As tumor expression and release of ET-1 has been shown to be regulated by the local environment, location specific expression and release of ET-1 by tumor cells may provide insight into the mechanisms that underlie the heterogeneity of bone cancer pain that is frequently observed in humans with multiple skeletal metastases.

Expression and localization of endothelin receptors: implications for the involvement of peripheral glia in nociception.

The endothelins (ETs) are peptides that have a diverse array of functions mediated by two receptor subtypes, the endothelin A receptor (ET(A)R) and the endothelin B receptor (ET(B)R). Pharmacological studies have suggested that in peripheral tissues, ET(A)R expression may play a role in signaling acute or neuropathic pain, whereas ET(B)R expression may be involved in the transmission of chronic inflammatory pain. To begin to define the mechanisms by which ET can drive nociceptive signaling, autoradiography and immunohistochemistry were used to examine the distribution of ET(A)R and ET(B)R in dorsal root ganglia (DRG) and peripheral nerve of the rat, rabbit, and monkey. In DRG and peripheral nerve, ET(A)R-immunoreactivity was present in a subset of small-sized peptidergic and nonpeptidergic sensory neurons and their axons and to a lesser extent in a subset of medium-sized sensory neurons. However, ET(B)R-immunoreactivity was not seen in DRG neurons or axons but rather in DRG satellite cells and nonmyelinating ensheathing Schwann cells. Thus, when ETs are released in peripheral tissues, they could act directly on ET(A)R-expressing sensory neurons and on ET(B)R-expressing DRG satellite cells or nonmyelinating Schwann cells. These data indicate that ETs can have direct, nociceptive effects on the peripheral sensory nervous system and that peripheral glia may be directly involved in signaling nociceptive events in peripheral tissues.

Ethanol has differential effects on rat neuron and thymocyte reactive oxygen species levels and cell viability.

In rat thymocytes and cerebellar granule cells, reactive oxygen species (ROS) levels were increased and cell viability was decreased as a result of exposure to ethanol (up to 0.4%). Thymocytes showed larger increases in ROS levels, but neurons showed more pronounced decreases in cell viability. These parameters in neurons were relatively unaffected when the cells were incubated with ethanol in the presence of inhibitors of alcohol-oxidizing enzymes, but in thymocytes, the presence of diallyl sulfide (an inhibitor of alcohol-inducible cytochrome P450, CYP2E1) or 4-methylpyrazole (an inhibitor of CYP2E1 and alcohol dehydrogenase) caused decreases in ROS production from ethanol. In both cell types, the presence of 3-aminotriazole (an inhibitor of catalase) did not decrease ROS production from ethanol. These studies show that the cytotoxic effects of ethanol in neurons may not be the result of oxidative metabolism of ethanol, whereas in thymocytes, the cytotoxic effect of ethanol is principally a result of its oxidative metabolism.

Mitogenic signaling by ATP/P2Y purinergic receptors in astrocytes: involvement of a calcium-independent protein kinase C, extracellular signal-regulated protein kinase pathway distinct from the phosphatidylinositol-specific phospholipase C/calcium pathway.

Activation of ATP/P2Y purinergic receptors stimulates proliferation of astrocytes, but the mitogenic signaling pathway linked to these G-protein-coupled receptors is unknown. We have investigated the role of extracellular signal-regulated protein kinase (ERK) in P2Y receptor-stimulated mitogenic signaling as well as the pathway that couples P2Y receptors to ERK. Downregulation of protein kinase C (PKC) in primary cultures of rat cerebral cortical astrocytes greatly reduced the ability of extracellular ATP to stimulate ERK. Because occupancy of P2Y receptors also leads to inositol phosphate formation, calcium mobilization, and PKC activation, we explored the possibility that signaling from P2Y receptors to ERK is mediated by a phosphatidylinositol-specific phospholipase C (PI-PLC)/calcium pathway. However, neither inhibition of PI-PLC nor chelation of calcium significantly reduced ATP-stimulated ERK activity. Moreover, a preferential inhibitor of calcium-dependent PKC isoforms, Gö 6976, was significantly less effective in blocking ATP-stimulated ERK activity than GF102903X, an inhibitor of both calcium-dependent and -independent PKC isoforms. Furthermore, ATP stimulated a rapid translocation of PKCdelta, a calcium-independent PKC isoform, but not PKCgamma, a calcium-dependent PKC isoform. ATP also stimulated a rapid increase in choline, and inhibition of phosphatidylcholine hydrolysis blocked ATP-evoked ERK activation. These results indicate that P2Y receptors in astrocytes are coupled independently to PI-PLC/calcium and ERK pathways and suggest that signaling from P2Y receptors to ERK involves a calcium-independent PKC isoform and hydrolysis of phosphatidylcholine by phospholipase D. In addition, we found that inhibition of ERK activation blocked extracellular ATP-stimulated DNA synthesis, thereby indicating that the ERK pathway mediates mitogenic signaling by P2Y receptors.

Sources of reactive oxygen species production in excitotoxin- stimulated cerebellar granule cells.

Reactive oxygen species (ROS) production in rat cerebellar granule cells in the presence of the excitotoxins N-methyl-d-aspartate (NMDA) and kainic acid (KA) and by the protein kinase C activator phorbol myristate acetate (PMA) was Ca2+-dependent and resulted in decreased cell viability. Exposure of stimulated cells to rotenone (a respiratory chain inhibitor) did not decrease ROS levels and did not affect short-term cell viability. In cells stimulated by NMDA and KA, exposure to indomethacin (a cyclooxygenase inhibitor) and nialamide (a monoamine oxidase inhibitor) caused a decrease in ROS levels and increased cell viability occurred in NMDA-treated cells. In contrast, PMA-stimulated neurons did not show decreased ROS levels when exposed to indomethacin and nialamide. These studies suggest that there is a multiplicity of routes for Ca2+-dependent ROS production in neurons but that ROS generation by cyclooxygenase and monoamine oxidase is not controlled by protein kinase C.

Hydralazine, but not captopril, decreases free radical production and apoptosis in neurons and thymocytes.

The effects of captopril and hydralazine, two commonly used antihypertensive drugs, on free radical generation and the onset of apoptosis in neuron and thymocyte preparations from 10-12 day old rats have been studied. Apoptosis was induced in neurons by kainate or N-methyl-D-aspartate and in thymocytes by heat shock. Intracellular free radical production was measured by 2',7'-dichlorofluorescein fluorescence, and apoptotic cells were detected by cell staining with fluorescein-labelled annexin V. Captopril was found to have no effect on intracellular free radical generation and also had no significant effect on the early stages of apoptosis in neurons and thymocytes. In contrast, hydralazine was found to decrease free radical generation in both neurons and thymocytes, and it also significantly decreased the numbers of apoptotic cells when neurons and thymocytes were stimulated for apoptosis. Hydralazine had a greater effect on decreasing free radical generation in neurons than in thymocytes, but it had a more pronounced effect on decreasing apoptosis in thymocytes compared to neurons, suggesting that apoptosis, under our experimental conditions, may not solely be triggered by free radical generation. These results contrast with earlier reports that captopril is a free radical scavenger and can decrease apoptosis in T-lymphocytes and cardiomyocytes, and the results obtained with hydralazine are in apparent disagreement with earlier reports that this drug is a free radical generator and can cause intracellular damage suggestive of enhanced free radical formation.

Oligarchic forests of economic plants in amazonia: utilization and conservation of an important tropical resource.

Tropical forests dominated by only one or two tree species occupy tens of millions of hectares in Ammonia In many cases, the dominant species produce fruits, seeds, or oils of economic importance. Oligarchic (Gr. oligo = few, archic = dominated or ruled by) forests of six economic species, i. e., Euterpe oleracea, Grias peruviana, Jessenia bataua, Mauritia flexuosa, Myrciaria dubia, and Orbignya phalerata, were studied in Brazil and Peru Natural populations of these species contain from 100 to 3,000 conspecific adult trees/ha and produce up to 11.1 metric tons of fruit/hd/yr. These plant populations are utilized and occasionally managed, by rural inhabitants in the region. Periodic fruit harvests, if properly controlled have only a minimal impact on forest structure and function, yet can generate substantial economic returns Market-oriented extraction of the fruits produced by oligarchic forests appears to represent a promising alternative for reconciling the development and conservation of Amazonian forests.