HCV epidemiology in high-risk groups and the risk of reinfection

Injecting risk behaviours among people who inject drugs (PWID) and high-risk sexual practices among men who have sex with men (MSM) are important routes of hepatitis C virus (HCV) transmission. Current direct-acting antiviral treatment offers unique opportunities for reductions in HCV-related liver disease burden and epidemic control in high-risk groups, but these prospects could be counteracted by HCV reinfection due to on-going risk behaviours after successful treatment. Based on existing data from small and heterogeneous studies of interferon-based treatment, the incidence of reinfection after sustained virological response range from 2-6/100 person years among PWID to 10-15/100 person years among human immunodeficiency virus-infected MSM. These differences mainly reflect heterogeneity in study populations with regards to risk behaviours, but also reflect variations in study designs and applied virological methods. Increasing levels of reinfection are to be expected as we enter the interferon-free treatment era. Individual- and population-level efforts to address and prevent reinfection should therefore be undertaken when providing HCV care for people with on-going risk behaviour. Constructive strategies include acknowledgement, education and counselling, harm reduction optimization, scaled-up treatment including treatment of injecting networks, post-treatment screening, and rapid retreatment of reinfections

Immigration, social integration and mental health in Norway, with focus on gender differences

ABSTRACT: BACKGROUND: Studies have shown that social integration may have a positive as well as a negative effect on the mental health of immigrants, depending on the social circumstances. AIMS OF THE STUDY: To investigate the relationship between social integration and psychological distress in immigrants in Oslo, Norway, with focus on gender differences. METHODS: The study was based on data from a community survey in Oslo (N = 15899), and included 1448 immigrants from non-Western and 1059 immigrants from Western countries. Psychological distress was measured by a 10 items version of Hopkins Symptom Check List (HSCL-10), and social integration was measured by an index based on four items: Knowledge of the Norwegian language, reading Norwegian newspapers, visits by Norwegians and receiving help from Norwegians. Information on paid employment, household income, marital status, social support and conflicts in intimate relationships was also included in the study. RESULTS: The non-western immigrants showed a higher level of psychological distress than the immigrants from western countries. In men this could be explained by the combination of less social integration, less employment, lower income, less social support and more conflicts in intimate relationships among non-western compared to western immigrants. In women the difference in level of psychological stress could not be explained by these variables, even if it was reduced. A reason for this seemed to be that social integration in non-western immigrants had a different effect on mental health in men and women. In men, social integration showed a positive effect through employment and income, as well as a positive effect in other areas. Also in non-western women social integration showed a positive effect through greater access to employment and income, but this effect was levelled out by integration causing problems in other areas. CONCLUSION: Unexpectedly, social integration in non-western immigrants was associated with good mental health in men, but not in women. A possible explanation for this might be that the traditional female role in these countries is more challenged by social integration into a Western country than the male role, resulting in conflicting norms, threat to the self and/or loss of identity

Self-Reported Skin Morbidity among Adults: Associations with Quality of Life and General Health in a Norwegian Survey

Life-quality studies among dermatologic patients have shown that chronic skin diseases have an impact on patients' lives. The purpose of this study was to assess the burden of skin morbidity at a community level. This was presented as prevalence of self-reported skin morbidity and dermatologic life-quality items. The association of skin disease and general health measures like feeling depressed and self-reported general health were measured. The method used was a questionnaire on self-reported skin complaints, including variables such as demographic, psychosocial, general health, dermatologic life-quality items. The design of the study was cross-sectional, with answers from 18,770 adult responders. The results confirmed that skin morbidity is common; itch was the dominating symptom. Younger adults reported more social problems as a result of skin problems than older. The life-quality domain most affected by skin disease was the social one. In a regression model skin disease was as well as rheumatism more strongly associated with feeling depressed than asthma, diabetes, and angina pectoris. Skin disease was also strongly associated with reporting poor general health, although less than other nondermatologic chronic diseases. In conclusion, in this study skin morbidity was strongly associated with general health measures among adults in a population-based setting. To the best of our knowledge these associations have not been described previously at a community level

Histone deacetylase inhibitors SAHA and sodium butyrate block G1-to-S cell cycle progression in neurosphere formation by adult subventricular cells

BACKGROUND: Histone deacetylases (HDACs) are enzymes that modulate gene expression and cellular processes by deacetylating histones and non-histone proteins. While small molecule inhibitors of HDAC activity (HDACi) are used clinically in the treatment of cancer, pre-clinical treatment models suggest they also exert neuroprotective effects and stimulate neurogenesis in neuropathological conditions. However, the direct effects of HDACi on cell cycle progression and proliferation, two properties required for continued neurogenesis, have not been fully characterized in adult neural stem cells (NSCs). In this study, we examined the effects of two broad class I and class II HDACi on adult mouse NSCs, the hydroxamate-based HDACi suberoylanilide hydroxamic acid (vorinostat, SAHA) and the short chain fatty acid HDACi sodium butyrate. RESULTS: We show that both HDACi suppress the formation of neurospheres by adult mouse NSCs grown in proliferation culture conditions in vitro. DNA synthesis is significantly inhibited in adult mouse NSCs exposed to either SAHA or sodium butyrate and inhibition is associated with an arrest in the G1 phase of the cell cycle. HDACi exposure also resulted in transcriptional changes in adult mouse NSCs. Cdk inhibitor genes p21 and p27 transcript levels are increased and associated with elevated H3K9 acetylation levels at proximal promoter regions of p21 and p27. mRNA levels for notch effector Hes genes and Spry-box stem cell transcription factors are downregulated, whereas pro-neural transcription factors Neurog1 and Neurod1 are upregulated. Lastly, we show HDAC inhibition under proliferation culture conditions leads to long-term changes in cell fate in adult mouse NSCs induced to differentiate in vitro. CONCLUSION: SAHA and sodium butyrate directly regulate cdk inhibitor transcription to control cell cycle progression in adult mouse NSCs. HDAC inhibition results in G1 arrest in adult mouse NSCs and transcriptional changes associated with activation of neuronal lineage commitment programs and a reduction of stem/progenitor state. Changes in differentiated cell state in adult mouse NSCs treated with HDACi under proliferation culture conditions suggests an intrinsic relationship between multipotency, cell cycle progression and HDAC activity in these cells

Vitamin D Status in Relation to Glucose Metabolism and Type 2 Diabetes in Septuagenarians

Objective: Vitamin D deficiency is thought to be a risk factor for development of type 2 diabetes, and elderly subjects at northern latitudes may therefore be at particular risk. Research Design and Methods: Vitamin D status was assessed from serum concentrations of 25-hydroxyvitamin D3 [25(OH)D3] in 668 Faroese residents aged 70–74 years (64% of eligible population). We determined type 2 diabetes prevalence from past medical histories, fasting plasma concentrations of glucose, and/or glycosylated hemoglobin (HbA1c). Results: We observed 70 (11%) new type 2 diabetic subjects, whereas 88 (13%) were previously diagnosed. Having vitamin D status <50 nmol/L doubled the risk of newly diagnosed type 2 diabetes after adjustment for BMI, sex, exposure to polychlorinated biphenyls, serum triacylglyceride concentration, serum HDL concentration, smoking status, and month of blood sampling. Furthermore, the HbA1c concentration decreased at higher serum 25(OH)D3 concentrations independent of covariates. Conclusions: In elderly subjects, vitamin D sufficiency may provide protection against type 2 diabetes. Because the study is cross-sectional, intervention studies are needed to elucidate whether vitamin D could be used to prevent development of type 2 diabetes

The psychological burden of skin diseases: a cross-sectional multicenter study among dermatological out-patients in 13 European countries.

The contribution of psychological disorders to the burden of skin disease has been poorly explored, and this is a large-scale study to ascertain the association between depression, anxiety, and suicidal ideation with various dermatological diagnoses. This international multicenter observational cross-sectional study was conducted in 13 European countries. In each dermatology clinic, 250 consecutive adult out-patients were recruited to complete a questionnaire, reporting socio-demographic information, negative life events, and suicidal ideation; depression and anxiety were assessed with the Hospital Anxiety and Depression Scale. A clinical examination was performed. A control group was recruited among hospital employees. There were 4,994 participants--3,635 patients and 1,359 controls. Clinical depression was present in 10.1% patients (controls 4.3%, odds ratio (OR) 2.40 (1.67-3.47)). Clinical anxiety was present in 17.2% (controls 11.1%, OR 2.18 (1.68-2.82)). Suicidal ideation was reported by 12.7% of all patients (controls 8.3%, OR 1.94 (1.33-2.82)). For individual diagnoses, only patients with psoriasis had significant association with suicidal ideation. The association with depression and anxiety was highest for patients with psoriasis, atopic dermatitis, hand eczema, and leg ulcers. These results identify a major additional burden of skin disease and have important clinical implications.Peer reviewedFinal Published versio

Self reported skin morbidity and ethnicity: a population-based study in a Western community

<p>Abstract</p> <p>Background</p> <p>Recent studies have shown ethnic differences concerning cardio-vascular disease, diabetes and mental health. Little is known about ethnic differences in skin morbidity. The purpose of this study was to describe possible ethnic differences in self-reported skin morbidity in a Western urban community.</p> <p>Methods</p> <p>The design was cross sectional. 40 888 adults in Oslo, Norway, received a postal questionnaire providing information on socio-demographic factors and self-reported health, including items on skin complaints.</p> <p>Results</p> <p>18770 individuals answered the questionnaire. In the sample 84% were from Norway. The largest immigrant group was from Western countries (5%) and the Indian Subcontinent (3%). Itch was the most prevalent reported skin symptom (7%), and was significantly more reported by men from East Asia (18%) and Middle East/North Africa (13%). The same observations were seen for reported dry and sore skin. Hair loss was a dominating complaint for men from the Indian Subcontinent and the Middle East/North Africa (23% and 25%) and for women from the same ethnic groups. Women from Sub-Saharan Africa reported significantly more pimples than in the other groups (17%).</p> <p>Conclusion</p> <p>The study showed that there were significant differences in self-reported skin complaints among ethnic groups. Issues concerning the cultural value of some skin symptoms should be examined further.</p