Prevalence of comorbidities in women with and without breast cancer in Soweto, South Africa: Results from the SABC study.

BACKGROUND: Comorbidities occurring concurrently in breast cancer patients can be burdensome, as they may negatively influence time and stage of presentation. OBJECTIVES: To describe the comorbid health conditions among South African (SA) black women with and without breast cancer and to determine factors associated with advanced-stage presentation of breast cancer. METHODS: A population-based case-control study on breast cancer was conducted in black women in Soweto, SA, the SABC (South Africa Breast Cancer) study. Lifestyle information and blood samples were collected from 399 women with histologically confirmed new cases of invasive primary breast cancer, recruited prior to any therapy, and 399 age- and neighbourhood-matched controls without breast cancer. We compared self-reported metabolic diseases, depression, anthropometric measurements, blood pressure, HIV status and point-of-care lipid and glucose levels between patients with breast cancer and the control group. RESULTS: In the whole population, the mean (standard deviation) age was 54.6 (12.9) years, the majority (81.2%) of the participants were overweight or obese, 85.3% had abdominal adiposity, 61.3% were hypertensive, 47.1% had impaired fasting plasma glucose, 8.4% had elevated total cholesterol, 74.8% had low high-density lipoprotein and 10.9% were assessed to be depressed. Ninety-one percent of the whole cohort had at least one metabolic disease. In the breast cancer group, 72.2% had one or more metabolic diseases only (HIV-negative and no evidence of depression), compared with 64.7% of the control group. From a multivariate logistic regression adjusted model, higher household socioeconomic status conferred a 19% reduction in the odds of having advanced-stage breast cancer at diagnosis, while hypertension, dyslipidaemia and HIV were not significantly associated with stage at breast cancer diagnosis in the adjusted model. CONCLUSIONS: A large proportion of women experience several comorbidities, highlighting the need to address the chronic non-communicable disease epidemic in SA and to co-ordinate multidisciplinary primary-, secondary- and tertiary-level care in the country's complex healthcare system for better outcome.

Genetic control of lipoprotein(a) concentrations is different in Africans and Caucasians.

Lipoprotein(a) (Lp(a)) represents a quantitative trait in human plasma associated with atherothrombotic disease. Large variation in the distribution of Lp(a) concentrations exists across populations which is at present unexplained. Sib-pair linkage analysis has suggested that the apo(a) gene on chromosome 6q27 is the major determinant of Lp(a) levels in Caucasians. We have here dissected the genetic architecture of the Lp(a) trait in Africans (Khoi San, South African Blacks) and Caucasians (Austrians) by family/sib-pair analysis. Heritability estimates ranged from h2 = 51% in Blacks, h2 = 61% in Khoi San, to h2 = 71% in Caucasians. Analysis by a variance components model also demonstrated that the proportion of the total phenotypic variance explained by genetic factors is smaller in Africans (65%) than in Caucasians (74%). Importantly the sib-pair analysis clearly identified the apo(a) gene as the major locus in Caucasians which explained the total genetic variance. In the African samples the apo(a) gene accounted for only half the genetic variance. Together with previous results from population studies our data indicate that genetic control of Lp(a) levels seems to be distinctly different between Africans and Caucasians. In the former genetic factors distinct from the apo(a) locus and also non-genetic factors may play a major role.

Growth characteristics of Geotrichum ingens on propionic acid and acetic acid in batch and continuous culture.

Growth of Geotrichum ingens in batch cultures was completely inhibited by 47 g acetic acid/l or 33 g propionic acid/I. With mixtures of acetic and propionic acids, however, growth only ceased at 55 g/l. Acetic acid inhibited growth linearly, whereas propionic acid inhibited growth non-linearly. In continuous culture, two steady states at each dilution rate were observed at high dilution rates for acetic acid and propionic acid. The highest yield coefficient (0.69 g cells/g substrate) was achieved with propionic acid as substrate. On both substrates and their mixtures, the protein content of the biomass increased when the dilution rate was increased.

In vitro activity of a new 'higher-lactam' antibacterial agent LY 193239.

In vitro activity of the new bicyclic pyrazolidinone LY 193239 (Eli Lilly) was evaluated against 52 clinical isolates of Haemophilus influenzae (4 were beta-lactamase producers), 32 Enterococcus faecalis, 14 Neisseria gonorrhoeae (1 beta-lactamase-positive) and 19 Neisseria meningitidis. Activity was best against Neisseria spp. and H. influenzae, including penicillinase-producing strains. Results of the time-kill study against a non-enzyme-mediated penicillin resistant strain of N. meningitidis indicate that exposure to an antibacterial concentration four times the minimal inhibitory concentration was bactericidal. E. faecalis was insensitive.

In vitro evaluation of the cyclic lipopeptide LY 146032 (daptomycin).

In vitro activity of the new cyclic lipopeptide LY 146032 (daptomycin, Eli Lilly) was evaluated against 67 clinical isolates of Staphylococcus aureus, 15 clinical isolates of S. epidermidis and 80 clinical isolates of Streptococcus faecalis. Activity was best against methicillin-resistant S. epidermidis (minimal inhibitory concentrations of LY 146032 0.25-0.5 mg/l). Minimal inhibitory concentrations and minimal bactericidal concentrations were of similar value. LY 146032 requires physiological concentrations of Ca++ ion for the expression of antibacterial activity. Results of the time-kill curves indicated that exposure to a concentration of the antibiotic equivalent to the minimal inhibitory concentration abolished recovery in the strains of S. aureus and S. epidermidis investigated. Response by S. faecalis was less predictable although most S. faecalis strains were killed in vitro by LY 146032 concentrations of less than or equal to 8 mg/l which is within the predicted clinically achievable range.

[The role of public relations in medical practice. With special reference to medical research]. / Die rol van openbare betrekkinge in geneeskundige praktyk. Met spesifieke verwysing na mediese navorsing.

Because medical practice and especially medical research depend on the goodwill of others, increased emphasis should be placed on the role of public relations, especially in the complex area of communication between medical scientists and the man in the street. The nature of these communication problems is described, and suggestions are made as to how public relations, if properly managed, can give substance to an otherwise ill-defined concept. Opportunities and problems in the marketing of medical research are briefly described.