Search

Cervical cytology screening using a Papanicolaou (Pap) smear has played a significant role in reducing the mortality and incidence of cervical cancer in developed countries since its introduction in the 1940s (Mbulaiteye, Bhatia, Adebamowo, & Sasco, 2011). Despite this evidence, the success has not yet been achieved in sub-Saharan Africa. Therefore, cervical cancer remains the leading cancer in women in sub-Saharan Africa. It is estimated that 34.8 new cases of cervical cancer are diagnosed per 100,000 women annually, and 22.5 per 100,000 women die from the disease, compared to 6.6 and 2.5 per 100,000 women, respectively, in North America (World Health Organization, 2013). The incidence of cervical cancer in sub-Saharan Africa is reported to be even higher in rural areas. It is noted that 60% to 75% of women in sub-Saharan Africa who develop cervical cancer live in rural areas, and that many of these women go untreated, mostly due to lack of access to health care (Parkin, Whelan, Ferlay, Teppo, & Thomas, 2002).The link between cervical cancer and sexually transmitted human papillomavirus (HPV) has been clearly established (Bosch, Lorincz, Munoz, Meijer, & Shah, 2002). Evidence has shown that sub-Saharan women are at risk for infection by HPV as a result of early marriages and polygamy in some societies and high parity (Bayo et al., 2002). It has been noted that in some societies, girls as young as 15 years are married to older men, which exposes them to early sexual activity, increasing their risk for contracting HPV (Anorlu, 2008). The rising incidence of cervical cancer in sub-Saharan Africa may also be fueled by the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic. Research has shown that cervical cancer progresses faster in women whose immune systems have been compromised by HIV infection, and that survival rates for these women are poor (Denny et al., 2014). Research has also found that HPV types 16 and 18 are the most common in women with invasive cervical cancer, and were the most common infections in HIV-positive women (Denny et al., 2014). It is further noted that sub-Saharan women tend not to seek medical attention until their cancer is in advanced stages, leading to high mortality. Such deaths could be prevented by early detection with Pap smear screening. Other screening techniques, specifically visual inspection with acetic acid wash, could also be used as alternatives for the Pap smear.Cervical cancer screening in developing countries is very complex and has been hampered by many barriers. For instance, it has been found that most women in developing countries do not screen regularly because the screening services are either unavailable or ineffective (Denny, Quinn, & Sankaranarayanan, 2006). Evidence further suggests that where services are available, they are largely accessible to younger women through postnatal and family planning services, or to a smaller percentage of women through private practitioners (Sherris, Herdman, & Elias, 2001). It is also noted that barriers to establishing screening programs and the pitfalls encountered may differ from country to country. In many sub- Saharan countries, cervical cancer screening programs have not been effective due to a number of barriers, including inadequate health services, poor laboratory infrastructure, and a myriad of service delivery challenges (Moodley, Med, Kawonga, Bradley, & Hoffman, 2006). Researchers also indicate that the magnitude of the problem in sub-Saharan Africa has been under-recognized and underprioritized compared to competing health priorities such as HIV/AIDS, tuberculosis, and malaria. The aim of this integrative review was therefore to review published studies to identify and describe barriers to Pap smear screening among women in sub-Saharan Africa. The information obtained could guide effective interventions and further research. The review was conducted from August 2015 to December 2015. …

We have developed the means to recycle 3He exhaled by patients after imaging the lungs using magnetic resonance of hyperpolarized 3He. The exhaled gas is collected in a helium leak proof bag and further compressed into a steel bottle. The collected gas contains about 1–2% of 3He, depending on the amount administered and the number of breaths collected to wash out the 3He gas from the lungs. 3He is separated from the exhaled air using zeolite molecular sieve adsorbent at 77 K followed by a cold head at 8 K. Residual gaseous impurities are finally absorbed by a commercial nonevaporative getter. The recycled 3He gas features high purity, which is required for repolarization by metastability exchange optical pumping. At present, we achieve a collection efficiency of 80–84% for exhaled gas from healthy volunteers and cryogenic separation efficiency of 95%. Magn Reson Med, 2011. © 2011 Wiley-Liss, Inc.

Purpose: To illustrate the incongruence of ethical standards and fiscal and policy constraints on quality care for the oldest old. As the fastest growing demographic segment in the United States, care needs of the oldest old are a special challenge to the health care system. Design: Narrative analysis of interviews with centenarians who used nursing home services. The sample was three participants of the Georgia Centenarian Study who had been community dwelling and cognitively intact at the onset of participation (between 1988 and 1997). Interviews were conducted in nursing homes or after discharge. Methods: Case histories were constructed from interviews in 1997 to improve understanding of quality of care. Findings: Less-than-optimal care was provided for these elders, and little consideration was given to their input to care decisions and prospects for medical improvement. Appropriate consideration was not given to providing least-restrictive environments, appropriate restraint use, and options for community care. Conclusions: Six policy reforms are suggested for meeting the needs of the oldest-old before and after institutionalization. These include: integration of resident involvement in care decisions; development of alternate models of care; greater input from nurses concerning nursing care of special populations; more effective family and community involvement in the caring of elderly populations; increased research to promote function and independence; and increased education of personnel and nursing students to allow for more accurate assessment of cognitive and physical status.

Background: Securing transvenous left ventricular (LV) pacing leads without an active fixation mechanism in proximal coronary vein (CV) segments is usually challenging and frequently impossible. We investigated how active fixation leads can be safely implanted in this location, how to avoid perforating the free wall of the CV, and how to recognize and respond to perforations. Materials and Methods: In five patients with no alternative to LV pacing from proximal CV segments, 4 Fr SelectSecure (Medtronic, Minneapolis, MN, USA) leads, which have a fixed helix, were implanted through a modified 6 Fr guide catheter with a pre-shaped tip (Launcher, Medtronic). Results: Active fixation leads were successfully implanted in proximal CVs in five patients. There were no complications. Acute and chronic pacing thresholds were comparable to those of conventional CV leads. The pre-shaped guide catheter tip remains in close proximity to the myocardial aspect of the CV, directing the lead helix toward a safe implantation site. Conclusions: If only proximal CV pacing sites are available, 4 Fr SelectSecure leads can be safely implanted through a modified Launcher guide catheter, avoiding more invasive implantation techniques. Other than venous stenting or implantation of leads with retractable tines, SelectSecure leads are expected to remain extractable.

A B S T R A C T When the chemical constitution of the essential oils of six species within three genera of the family Malvaceae were investigated, the essential oils of Gossypium hirsu'tum L. and Cienfuegosia rosei Fryxell were found to contain 67.0 % and 58.2 % hydrocarbons, respectively. Those of Hibiscus lasiocarpus (Cav.) and Callirhoe involucrata (Nutt.) Gray contained equal percentages of hydrocarbons (14 %), but that of Cienfuegosia drummondii (A. Gray) Lewt. contained only 2.9 % hydrocarbons. Beta-bisabolol was the major oxygenated component in G. hirsutum (13.7 %), Hibiscus militaris (Cav.) (55.0 %), and Hibiscus lasiocarpus (32.6 %), but the major constituents in the essential oil of C. involuerata were myrtenal (32.0 %) and trans-2-cis-6-nonadienal (12.0 %), and the major oxygenated component in C. rosei was an unknown sesquiterpene alcohol (17.4 %) with chemical and physical properties resembling those of beta-bisabolol. The concentration of total oil was 150.0 ppm in G. hirsutum; 50.0 ppm in H. militaris; 46.3 ppm in C. rosei; 41.0 ppm in H. lasiocarpus; 25.4 ppm in C. drummondii; and 10.0 ppm in C. involucrata, all based on wet weight.

When phospholipids of newly-emerged adults of the boll weevil,Anthonomus grandis Boheman, were studied in detail, phosphatidyl choline and phosphatidyl ethanolamine were found to be the major phospholipids; sphingomyelin and cardiolipin were present in smaller amounts, and four other minor components were identified. Fatty acid analyses performed on the intact phospholipids and on the enzyme degradation products of phosphatidyl choline and phosphatidyl ethanolamine demonstrated that oleic and linoleic acids were the major fatty acids present in the glycerophosphatides; the sphingomyelin contained fatty acids in the range of 20–22 carbons.

The ketoneβ-ionone is reported to be one of the naturally occurring volatile metabolites of developing corn ears. In testing the effects of volatile compounds onAspergillus flavus andA. parasiticus, we found thatβ-ionone applied to the surface of PDA plates had a striking inhibition of growth and sporulation of these fungi. The colonies were restricted, remained buff-colored and had little or no sporulation. There were major effects on the morphology of the asexual reproductive structures. The conidiophore development was arrested and normal sporulation did not occur. Mycelial transfers from these atypical cultures to potato dextrose agar had normal growth and conidia. Incorporation ofβ-ionone at levels of 10-1000μL/L, in liquid media seeded with spore suspensions ofA. parasiticus (NRRL 2999) severely depressed aflatoxin accumulation in shake culture.

About 60% of the total sterols in the cotton bud appeared in the free state; the esterified sterol glycosides contained about 50% saturated fatty acids, largely palmitic acid; the principal unsaturated fatty acid was linolenic acid. β-Sitosterol was the major sterol in all classes of sterol derivatives. The sugar moiety of the esterified sterol glycosides and the sterol glycoside was galactose. Efforts are continuing to evaluate the minor sterols of cotton buds, some of which appear to be hydroxylated ecdysones, and to study their relationship to the development of the Boll weevil,Anthonomus grandis Boheman.