Dyslipidemia and oxidative stress contribute to atherogenesis. Astaxanthin (ASTX) is a red-colored carotenoid well known for its high antioxidant capacity. However, its effects on lipid metabolism and antioxidant defense mechanisms have received only limited investigation. We fed male apoE knockout (apoE)(-/-) mice, a mouse model for atherosclerosis, a high-fat (15%)/high-cholesterol (0.2%) diet alone (control) or supplemented with ASTX-rich Hematococcus pluvialis extract (0.03% ASTX by weight) for 4 wk. ASTX-fed apoE(-/-) mice had significantly lower plasma total cholesterol and TG concentrations than controls, but body weight and plasma alanine aminotransferase and aspartate aminotransferase did not differ between the groups. qRT-PCR analysis demonstrated significantly greater mRNA levels of LDL receptor (LDLR), 3-hydroxy-3-methylglutaryl CoA reductase, and sterol regulatory element binding protein 2 (SREBP-2) and greater mature SREBP-2 protein in the livers of ASTX-fed mice, indicating that increased LDLR expression may be responsible for the hypocholesterolemic effect of ASTX. Hepatic lipogenic gene expression was not altered, but carnitine palmitoyl transferase 1, acetyl-CoA carboxylase β, and acyl-CoA oxidase mRNA abundance were significantly increased by ASTX supplementation, suggesting the TG-lowering effect of ASTX may be due to increased fatty acid β-oxidation in the liver. Expression of the nuclear factor E2 related factor 2-responsive endogenous antioxidant gene also was induced with concomitantly lower glutathione disulfide levels in the livers of ASTX-fed apoE(-/-) mice compared to controls. In conclusion, these results suggest that supplementation of ASTX-rich H. pluvialis extract improves cholesterol and lipid metabolism as well as antioxidant defense mechanisms, all of which could help mitigate the progression of atherosclerosis.

Objectives An assessment of temporal trends in patient survival is important to determine the progress towards patient outcomes and to reveal where advancements must be made. This study assessed temporal changes spanning 22 years in demographics, clinical characteristics, and overall survival of small cell lung cancer (SCLC) patients. Materials and methods This analysis included 1,032 SCLC patients spanning two time-periods from the H. Lee Moffitt Cancer Center and Research Institute: 1986 to 1999 (No. = 410) and 2000 to 2008 (No. = 622). Kaplan-Meier survival curves and log-rank statistics were used to assess survival rates across the two time-periods and multivariable Cox proportional hazards models were used to generate hazard ratios (HRs) and 95% confidence intervals (CIs). Results The overall 5-year survival rate significantly increased from 8.3% for the 1986 to 1999 time-period to 11.0% (P < 0.001) for the 2000 to 2008 time-period, and the median survival time increased from 11.3 months (95% CI 10.5–12.7) to 15.2 months (95% CI 13.6–16.6) We also observed significant increases in stage-specific median survival times and survival rates across the two time-periods. A multivariable Cox proportional hazards model for the entire cohort revealed significant increased risk of death for patients diagnosed in 1986 to 1999 (HR = 1.29; 95% CI 1.11 – 1.49), patients diagnosed between 60 and 69 years of age (HR = 1.33; 95% CI 1.04 – 1.49) and over 70 years of age (HR = 1.63; 95% CI 1.26 – 2.11), men (HR = 1.33; 95% CI 1.16 – 1.53), patients with no first course treatment (HR = 2.17; 95% CI – 3.00) and extensive stage SCLC (HR = 2.79; 95% CI 2.35 – 3.30) Conclusion This analysis demonstrated significant improvements in overall and stage-specific median survival times and survival rates of SCLC patients treated at the Moffitt Cancer Center from 1986 to 2008.

Objectives Moderate alcohol consumption can impair host defense against viral infections. The objective of this cross-sectional analysis was to assess the association between alcohol intake and prevalent HPV infection among U.S. men enrolled in the HIM (HPV in Men) Study utilizing quantitative alcohol intake measured from a food frequency questionnaire. Methods The HIM study is a prospective, multinational study of the natural history of HPV infection. For this report we restricted our analyses to men from the US cohort (No. = 1,313). Samples from the corona of glans penis, penile shaft, and scrotum were combined for HPV DNA testing. Self-reported alcohol intake was quantified by grams of alcohol intake per day. Multivariable prevalence ratios (mPR) were used to assess the association between alcohol intake and HPV infections. Results Prevalent infections were significantly higher among men in the highest quartile of alcohol intake and multivariable models revealed that the highest quartile of alcohol intake was associated with significantly increased risks for any- (mPR=1.13; 95% CI 1.00–1.27) and oncogenic (mPR=1.35; 95% CI 1.08–1.68) HPV types. The fourth quartile of alcohol intake was associated with elevated risks for prevalent HPV infection across all strata of number of sexual partners and among never- and current smokers, but not among former smokers. Conclusions These results demonstrate that high intake of alcohol is associated with an increased risk for prevalent HPV infections among men. The biological role that alcohol plays in genital HPV infection remains understudied and limited epidemiologic data exist especially among men.

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Background: Previous attempts at reporting oronasal fistula development and secondary speech surgery following cleft palate surgery have been limited to single-center case series. This limitation can be overcome by querying large databases created by health care governing bodies or health care alliances. The authors examined the effect of cleft type and demographic variables on the clinical outcomes. Methods: Data from the Pediatric Health Information System database were queried for patients, aged 6 to 18 months, who had undergone primary palatoplasty between 2004 and 2009. Subsequent repair of an oronasal fistula and/or secondary speech surgery between 2004 and 2015 was identified by procedure codes. Logistic regression models were used to assess the associations between cleft type with oronasal fistula and with secondary speech surgery. Results: Seven thousand three hundred twenty-five patients were identified, and 6.4 percent (n = 468) had a subsequent repair of an oronasal fistula and 18.5 percent (n = 1355) had a secondary speech operation. Adjusted for age, sex, and race, patients with cleft lip and palate have increased odds of oronasal fistula (OR, 5.60; 95 percent CI, 4.44 to 7.07) and secondary speech surgery (OR, 2.32; 95 percent CI, 2.05 to 2.63). Conclusions: Using a large, multi-institution billing database, the authors were able to estimate the prevalence of oronasal fistula and surgically treated velopharyngeal insufficiency following primary palatoplasty in the United States. In addition, the authors demonstrated that patients with isolated cleft palate develop fewer oronasal fistulas and require less secondary speech surgery than patients with cleft lip and palate. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.

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Among clinic-based studies, intimate partner violence (IPV) has been shown to contribute to HIV/AIDS among young girls and women. Results from studies among the general population have been less consistent. This study evaluated the associations between HIV infection, any sexually transmitted infections (STIs), and IPV in a population-based sample of Togolese women. Data from the Togo 2013-2014 Demographic and Health Survey were utilized for these analyses. Women aged 15-49, who were currently married, had HIV test results, and answered the Domestic Violence Module were analyzed (n = 2386). Generalized linear mixed-models adjusting for sociodemographic variables, risk behaviors, and cluster effect were used to estimate HIV and STI risks with experience of IPV. HIV prevalence was 2.8%. Prevalence of IPV was 39% among HIV-positive women and 38% among HIV-negative women. Significant associations between IPV and HIV infection were not detected. Adjusted models found significant associations between experience of any IPV and having had STIs (OR 2.05, 95% CI 1.25-3.35). The high rates of violence in this setting warrant community-based interventions that address abuse and gender inequity. These interventions should also discuss the spectrum of STIs in relation to IPV.

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