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BackgroundAmong women, trichomoniasis is the most common non-viral sexually transmitted infection worldwide, and is associated with serious reproductive morbidity, poor birth outcomes, and amplified HIV transmission. Single-dose metronidazole is the first-line treatment for trichomoniasis. However, bacterial vaginosis can alter treatment efficacy in HIV-infected women, and single-dose metronidazole treatment might not always clear infection. We compared single-dose metronidazole with a 7-day dose for the treatment of trichomoniasis among HIV-uninfected, non-pregnant women and tested whether efficacy was modified by bacterial vaginosis.MethodsIn this multicentre, open-label, randomised controlled trial, participants were recruited at three sexual health clinics in the USA. We included women positive for Trichomonas vaginalis infection according to clinical screening. Participants were randomly assigned (1:1) to receive either a single dose of 2 g of metronidazole (single-dose group) or 500 mg of metronidazole twice daily for 7 days (7-day-dose group). The randomisation was done by blocks of four or six for each site. Patients and investigators were aware of treatment assignment. The primary outcome was T vaginalis infection by intention to treat, at test-of-cure 4 weeks after completion of treatment. The analysis of the primary outcome per nucleic acid amplification test or culture was also stratified by bacterial vaginosis status. This trial is registered with ClinicalTrials.gov, number NCT01018095, and with the US Food and Drug Administration, number IND118276, and is closed to accrual.FindingsParticipants were recruited from Oct 6, 2014, to April 26, 2017. Of the 1028 patients assessed for eligibility, 623 women were randomly assigned to treatment groups (311 women in the single-dose group and 312 women in the 7-day-dose group; intention-to-treat population). Although planned enrolment had been 1664 women, the study was stopped early because of funding limitations. Patients in the 7-day-dose group were less likely to be T vaginalis positive at test-of-cure than those in the single-dose group (34 [11%] of 312 vs 58 [19%] of 311, relative risk 0·55, 95% CI 0·34-0·70; p

Describes the effectiveness of the Gimme 5 intervention to increase high school students' fruit and vegetable consumption. Intervention included media campaigns, classroom workshops, school meal modification, and parental support. After two years, daily servings increased more in the intervention group. Control students, who received Gimme 5 measurements without interventions, increased their consumption to similar levels by three years. (SM)

Regulatory T (T[sub.reg]) cells mediate homeostatic peripheral tolerance by suppressing autoreactive T cells. Failure of host antitumor immunity may be caused by exaggerated suppression of tumor-associated antigen-reactive lymphocytes mediated by T[sub.reg] cells; however, definitive evidence that T[sub.reg] cells have an immunopathological role in human cancer is lacking. Here we show, in detailed studies of CD4[sup.+]CD25[sup.+]FOXP3[sup.+] T[sub.reg] cells in 104 individuals affected with ovarian carcinoma, that human tumor T[sub.reg] cells suppress tumor-specific T cell immunity and contribute to growth of human tumors in vivo. We also show that tumor T[sub.reg] cells are associated with a high death hazard and reduced survival. Human T[sub.reg] cells preferentially move to and accumulate in tumors and ascites, but rarely enter draining lymph nodes in later cancer stages. Tumor cells and microenvironmental macrophages produce the chemokine CCL22, which mediates trafficking of T[sub.reg] cells to the tumor. This specific recruitment of T[sub.reg] cells represents a mechanism by which tumors may foster immune privilege. Thus, blocking T[sub.reg] cell migration or function may help to defeat human cancer., Author(s): Tyler J Curiel [1]; George Coukos [2]; Linhua Zou [1]; Xavier Alvarez [1]; Pui Cheng [1]; Peter Mottram [1]; Melina Evdemon-Hogan [1]; Jose R Conejo-Garcia [2]; Lin Zhang [2]; [...]

Suppression of dendritic cell function in cancer patients is thought to contribute to the inhibition of immune responses and disease progression. Molecular mechanisms of this suppression remain elusive, however. Here, we show that a fraction of blood monocyte-derived myeloid dendritic cells (MDCs) express B7-H1, a member of the B7 family, on the cell surface. B7-H1 could be further upregulated by tumor environmental factors. Consistent with this finding, virtually all MDCs isolated from the tissues or draining lymph nodes of ovarian carcinomas express B7-H1. Blockade of B7-H1 enhanced MDC-mediated T-cell activation and was accompanied by downregulation of T-cell interleukin (IL)-10 and upregulation of IL-2 and interferon (IFN)-[gamma]. T cells conditioned with the B7-H1-blocked MDCs had a more potent ability to inhibit autologous human ovarian carcinoma growth in non-obese diabetic-severe combined immunodeficient (NOD-SCID) mice. Therefore, upregulation of B7-H1 on MDCs in the tumor microenvironment downregulates T-cell immunity. Blockade of B7-H1 represents one approach for cancer immunotherapy., Author(s): Tyler J. Curiel (corresponding author) [1]; Shuang Wei [1]; Haidong Dong [2]; Xavier Alvarez [1]; Pui Cheng [1]; Peter Mottram [1]; Roman Krzysiek [3]; Keith L. Knutson [4]; Ben [...]

This study investigated whether self-esteem precedes various academic behaviors and beliefs among 593 high school students (63.7% female, 60.9% African American). Measures of home and school self-esteem, grade point average, perceived academic standing and progress, and educational plans were collected by survey and archival review of grade and attendance records at the beginning (pre-test) and end of the school year (post-test). Self-esteem and academic variables differed by gender, race, and guardianship. Self-esteem related significantly to academics and absenteeism. Results suggest selected academic variables predict self-esteem even when the effects of gender, race, and guardianship are removed and pretest self-esteem scores are controlled. In conclusion, student academic performance influences subsequent academic and home self-esteem. Creation of positive academic experiences for youth may be a critical activity, since experts contend that low self-esteem is associated with subsequent behavioral problems. The markedly lower self-esteem of Native American and Hispanic youth warrants further investigation. (J Sch Health. 1998;68(2):68-72), Self-esteem enhancement is a component of many school health curricula largely due to its relationship to adolescent health behavior and its purported amenability to improvement.[1-6] Gurney[7] reviewed school-based intervention studies [...]

To study the nutritional adequacy of a high carbohydrate diet as consumed by children in a 24-h period, a sample of 568 10-y-old children was stratified into four levels of carbohydrate intake: 55% energy. Composition of the diet for those consuming >55% energy from carbohydrates was adequate in total energy, with 29% energy from fat, 11% energy from saturated fatty acid, an average of 88 mg dietary cholesterol/4200 kJ and less than 10% energy from sucrose. Increased carbohydrate intake was attributed to an increased consumption of total sugars, starch and fiber. The percentage of children meeting two thirds or more of the Recommended Dietary Allowances for niacin and zinc was lower in the high carbohydrate intake group than in any of the low carbohydrate intake groups. Children with a high carbohydrate intake consumed more fruits, breads, grains, milk, desserts, candy and non-dairy beverages than those with a lower carbohydrate intake who consumed more meats. To meet current dietary recommendations for increased carbohydrate intake when meal patterns are designed, it is necessary to incorporate adequate amounts of foods from all of the food groups to maximize nutritional quality. J. Nutr. 126: 1382-1388, 1996. INDEXING KEY WORDS: * dietary intakes * eating patterns * high carbohydrate intakes * child nutrition

This report describes the alcohol consumption of adolescents and young adults who participated in the Bogalusa Heart Study, 1981 to 1991. Data were collected in three cross-sectional surveys of school-age children (11 to 19 years) and three surveys of young adults (18 to 32 years). White males had the highest proportion of drinkers and Black females had the lowest. By the end of the decade, adult White and Black male drinkers were about equal. Most individuals drank once or twice a week, but daily drinkers had the highest weekly alcohol intake. An association between alcohol and highdensity lipoprotein cholesterol was found only in the latest survey and probably reflects the aging of the cohort. (Am J Public Health. 1995; 85:979-982), The changes in drinking patterns as a group of teenagers moved into adulthood and the effect on a marker for heart disease are described. Between 1981 and 1991, 3600 Louisiana students in grades 7 through 12 were surveyed. Surveys followed up 2900 of the earlier participants, now between 18 and 32 years old. Among students, whites and males were more likely to drink than blacks or females. Most drinkers drank once or twice weekly. Among young adults, men were more likely to drink than women, and black males drank as frequently as white males. Adults were more likely than teenagers to drink daily. The percentage of male drinkers increased during adolescence, plateauing around age 25. The percentage of white female drinkers peaked around age 19 and then declined whereas black females continued to increase. No correlations with risk factors for heart disease were found. Drinkers had higher levels of high-density-lipid (HDL) cholesterol whether they smoked or not compared with nondrinking smokers but the HDL levels seemed to factor.