The effectiveness of targeting never or rarely screened women in a national cervical cancer screening program for underserved women.

PURPOSE: To evaluate the effectiveness of a policy supporting early detection and prevention of cervical cancer among low-income and uninsured women by comparing women who reported never or rarely being screened (last screen >5 years) to those who reported screening in the past ≤5 years. METHODS: We analyzed data from 1,485,251 women who received their first Pap test in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) from July 2002 through June 2012. Of these, 461,893 women (31 %) reported being never or rarely screened and 1,023,358 (69 %) reported being screened in the past 5 years. Demographic (age, race/ethnicity, residence, and region) and clinic (cytologic and histologic results) characteristics were examined for the two groups. RESULTS: Women who were aged ≥50 years, Asian and Pacific Islander, American Indian or Alaska Native, multiracial, living in non-metro areas, or living in the South or a territory were more likely to report being never or rarely screened. The percentage of abnormal Pap tests and the rate of precancer and cancer (combined) was higher in the never or rarely screened group compared with the screened group (abnormal percentage: 2.9 vs 2.6 %, p value < 0.01; rate of precancer and cancer: 6.9 vs 3.7 per 1,000 women, p value < 0.01). CONCLUSIONS: The priority of reaching never or rarely screened women should continue since those women who entered the NBCCEDP not adequately screened had a greater prevalence of high-grade histological lesions and invasive cervical cancers at later stages than women screened more recently.

Incidence of HIV among injection drug users entering drug treatment programs in four US cities.

We estimated seroincidence of human immunodeficiency virus (HIV) and prevalence of risk behaviors among injection drug users (IDUs) who accepted voluntary HIV testing on entry to drug treatment. Record-based incidence studies were conducted in 12 drug treatment programs in New York City (n = 890); Newark, New Jersey (n = 521); Seattle, Washington (n = 1,256); and Los Angeles, California (n = 733). Records of confidential HIV tests were abstracted for information on demographics, drug use, and HIV test results. More detailed data on risk behaviors were obtained by a standardized questionnaire. Although overall incidence rates were relatively low in this population (<1/100 person-years), there was a high prevalence of risk behaviors. Needle sharing was reported by more than one-third of the participants in each of the cities. HIV seroincidence rates were up to three-fold higher among younger ID Us. We found that HIV continued to be transmitted among ID Us who had received both drug treatment and HIV counseling and testing. HIV/AIDS (acquired immunodeficiency syndrome) prevention education should continue to be an important component of drug treatment.

Effects of prenatal ethanol exposure on juvenile play-fighting and postpubertal aggression in rats.

The effects of prenatal ethanol exposure on juvenile play-fighting and postpubertal aggressive behavior in rats were longitudinally assessed in the context of more conventionally applied physical and behavioral measures. Pregnant animals were treated with either 2 gm/kg/day ethanol or isocaloric sucrose over gestation Days 6-19. Reproduction and somatic variables included maternal weight over gestation, offspring weight over Days 1-90, and age at eye opening and incisor eruption. Behavioral variables consisted of negative geotaxis, olfactory discrimination, activity, juvenile play-fighting, and postpubertal aggression. Ethanol offspring had lower birth weights, but there was no significant prenatal treatment effect on subsequent offspring weights or on any other reproductive or somatic variable. Both male and female ethanol-exposed offspring exhibited more play-fighting responses when paired with same-sex controls. Postpubertal aggression levels were assessed in males only. Ethanol-exposed offspring were more aggressive than controls and there was a significant positive correlation between play-fighting and postpubertal aggression ranks. No other behavioral measures discriminated between prenatal treatment groups and none were significantly correlated with either play-fighting or postpubertal aggression rank. The results are consistent with the position that juvenile play-fighting and postpubertal aggression are subserved by common substrates. They also are consistent with predictions derived from the hypothesis concerning a response-inhibition deficit as an effect of prenatal ethanol exposure on behavior.

Chronic maintenance of rat sperm reserves into old age by previous sexual contact.

Extensive copulatory experiences at a younger age provoked chronic changes in the reproductive physiology of old male rats. Continuous access to females was not necessary, sperm numbers were elevated in the 22-month-old males 7 months after a final sexual interaction.

The effects of prenatal exposure to methylmercury on aggressive behavior in the rat.

The sensitivity of isolation-induced aggressive behavior to prenatal treatment of 6.0 mg/kg methylmercuric chloride (MMCl) by gavage on gestation days 6-9 was assessed in a subset of animals from the Collaborative Behavioral Teratology Study (CBTS). CBTS behavioral measures consisted of negative geotaxis, olfactory discrimination, auditory startle habituation, 1-hr activity, 23-hr activity, activity following pharmacological challenge and visual discrimination learning. Auditory startle was the only CBTS behavioral measure that discriminated among prenatal treatment groups. MMCl animals also were reliably more aggressive than vehicle controls in dyadic encounters. The results suggest that tests of aggressive behavior, which rarely have been included in teratologic assessments, be considered in the formulation of behavioral screening paradigms. The advantages of including tests of aggression and the relationship between aggressive and startle responses are discussed.

Social behaviour and testicular activity of juvenile rats.

The juvenile stage of ontogeny is often characterized as a time of inactivity and quiescence for the immature reproductive system. The principle social behaviour by juveniles of many mammalian species is a rough-and-tumble activity known as play-fighting. An experiment is reported in which play-fighting by male rats was observed after various manipulations of gonadal steroids. Rats were housed in groups and castrated either on day 1 or day 10, times which are respectively during and after the sensitive period for androgen-induced organization of neural tissues in rats. Animals were injected with either 40 micrograms testosterone propionate or vehicle between 21 and 45 days of age, and play-fighting with unoperated, unfamiliar rats was examined. Castration on days 1 and 10 suppressed play-fighting. The behaviours remained suppressed in rats castrated on day 1 and injected with testosterone propionate, but testosterone propionate restored play-fighting to near-normal levels until 35 days of age in rats castrated on day 10. Moreover, gonadally intact juvenile males exposed to the androgen antagonist flutamide play-fought less than intact control males, although their social activity increased appreciably after day 35. It is concluded that the juvenile is not experiencing endocrine quiescence. Behavioural and physiological data suggest a reproductive system which is active, although differently from that in the adult. Hypersensitivity to testosterone and surges of gonadotrophin-releasing factors and LH at 35 days of age may be the events responsible for changes in play-fighting resulting from manipulations of gonadal steroids in juvenile rats.

Quantitative cytocentrifugation in the evaluation of cerebrospinal fluid.

Five hundred sixteen samples of cerebrospinal fluid (CSF) were subjected to cytocentrifugation to determine whether this technique is reliable in quantifying the cells present while simultaneously allowing precise cytologic identification of the types of malignant and atypical cells present. Cell counts obtained by the cytocentrifuge method were comparable to those obtained by the standard hemocytometer method. Because of the larger volume of fluid used in cytocentrifugation, cells (0.2/cu mm) were found in 264 specimens that would have been considered devoid of cells by hemocytometry. Six of these samples contained malignant cells. The Wright's-stained cytocentrifuged specimens also allowed precise identification of hematopoietic cell types. CSF cytocentrifugation offers the advantages of (1) a simple and rapid method of quantifying the number of cells present, (2) use of larger volumes than the hemocytometer method, thereby minimizing the possibility that the specimen will be classified as acellular, and (3) improved morphology of hematopoietic cell types by use of the Wright's stain. We conclude that the cytocentrifugation method is useful in the routine quantification and diagnosis of CSF specimens.