Macroalgae Has No Effect on the Severity and Dynamics of Caribbean Yellow Band Disease

By removing herbivores and promoting increases in macroalgae, overfishing is thought to indirectly cause coral disease and mortality. We performed three field manipulations to test the general hypothesis that overfishing and the subsequent alteration of coral reef trophic dynamics are a cause of coral epizootics. Specifically, we asked whether the presence of macroalgae can influence within- and among-colony spread rates of Caribbean Yellow Band Disease in Montastraea faveolata. Macroalgae were placed next to infected and healthy, adult and small coral colonies to measure effects on disease spread rate, coral growth and coral survival. Surprisingly, the addition of macroalgae did not affect disease severity or coral fitness. Our results indicate that macroalgae have no effect on the severity and dynamics of Caribbean Yellow Band Disease and that fisheries management alone will not mitigate the effects of this important epizootic

An Evaluation of the Effectiveness of the HPV Vaccine in Preventing Cervical Disease Among Young Women at Duke

The objective of this study was to evaluate the effectiveness of the Human Papilloma Virus (HPV) vaccine in preventing HPV-related cervical disease and genital warts among young women receiving health care services from Duke Health. A retrospective review of filtered electronic medical record (EMR) data was performed to identify women ages 18-34 years old with HPV-related diagnoses of interest from 2000-2015. The annual overall, age-specific and race-specific incidences of each considered diagnosis were then calculated for the State of North Carolina using the EMR data and publicly available census data. Overall NC county-level incidences were also calculated. The calculated incidences were generally downward trending over the study period across all HPV-related diagnoses for the younger evaluated age groups (18-19 years old and 20-24 years old) while results were less consistent for women ages 25-34 years old. A 2015 increase in the overall incidence of all considered diagnoses except high risk HPV infection was observed and appears to have been driven largely by women 25-34 years old. The annual incidence of all considered diagnoses were consistently higher among African American women than Caucasian women, suggesting the need for further research to evaluate potential causes of these disparate racial outcomes and potential strategies to address them.Master of Public Healt

Gastric Reacidification with Betaine HCl in Healthy Volunteers with Rabeprazole-Induced Hypochlorhydria

Previous studies have demonstrated that increased gastric pH from the use of acid-reducing agents, such as proton-pump inhibitors or H2-receptor antagonists, can significantly impact the absorption of weakly basic drugs that exhibit pH-dependent solubility. Clinically practical strategies to mitigate this interaction have not been developed. This pilot study evaluated the extent and time course of gastric reacidification after a solid oral dosage form of anhydrous betaine HCl in healthy volunteers with pharmacologically induced hypochlorhydria. Six healthy volunteers with baseline normochlorhydria (fasting gastric pH < 4) were enrolled in this single period study. Hypochlorhydria was induced via 20 mg oral rabeprazole twice daily for four days. On the fifth day, an additional 20 mg dose of oral rabeprazole was given and gastric pH was monitored continuously using the Heidelberg pH capsule. After gastric pH > 4 was confirmed for 15 min, 1500 mg of betaine HCl was given orally with 90 mL of water and gastric pH was continuously monitored for 2 h. Betaine HCl significantly lowered gastric pH by 4.5 (± 0.5) units from 5.2 (± 0.5) to 0.6 (± 0.2) (P < 0.001) during the 30 min interval after administration. The onset of effect of betaine HCl was rapid, with a mean time to pH < 3 of 6.3 (± 4.3) min. The reacidification period was temporary with a gastric pH < 3 and < 4 lasting 73 (± 33) and 77 (± 30) min, respectively. Betaine HCl was well tolerated by all subjects. In healthy volunteers with pharmacologically induced hypochlorhydria, betaine HCl was effective at temporarily lowering gastric pH. The rapid onset and relatively short duration of gastric pH reduction gives betaine HCl the potential to aid the absorption of orally administered weakly basic drugs that exhibit pH-dependent solubility when administered under hypochlorhydric conditions

Results of experiments 2 and 3.

<p>Effects of algal treatments on percent mortality and infection (%) by CYBD of <i>M. faveolata</i> in two field experiments (n = 12 for experiment 2 and 8 for experiment 3).</p

Results of experiment 3.

<p>Algal treatment effects on coral calcification (g/cm²). The experiment ran for 21 days. n = 8.</p

Images of experimental coral colonies.

<p>(A) A colony of <i>Montastraea faveolata</i> infected with CYBD from experiment 1, treated with a <i>Dictyosphaeria cavernosa</i> pouch. (B) An experimental control colony of <i>Montastraea faveolata</i> from experiment 3. Photos courtesy J. Bruno.</p

Field measurements of DOC concentration.

<p>Concentration of DOC next to the algal pouches and on the surface of the experimental corals. Measurements are pooled from experiments 1 and 2. NA = not applicable (there was no algal pouch for the control treatment). Values are means±1 SE (n = 10).</p

Results of experiment 1.

<p>Algal treatment effects on final host tissue mortality and lesion advancement. Values are means±1 SE (n = 12).</p

The Use of Betaine HCl to Enhance Dasatinib Absorption in Healthy Volunteers with Rabeprazole-Induced Hypochlorhydria

Many orally administered, small-molecule, targeted anticancer drugs, such as dasatinib, exhibit pH-dependent solubility and reduced drug exposure when given with acid-reducing agents. We previously demonstrated that betaine hydrochloride (BHCl) can transiently re-acidify gastric pH in healthy volunteers with drug-induced hypochlorhydria. In this randomized, single-dose, three-way crossover study, healthy volunteers received dasatinib (100 mg) alone, after pretreatment with rabeprazole, and with 1500 mg BHCl after rabeprazole pretreatment, to determine if BHCl can enhance dasatinib absorption in hypochlorhydric conditions. Rabeprazole (20 mg b.i.d.) significantly reduced dasatinib Cmax and AUC0-∞ by 92 and 78%, respectively. However, coadministration of BHCl significantly increased dasatinib Cmax and AUC0-∞ by 15- and 6.7-fold, restoring them to 105 and 121%, respectively, of the control (dasatinib alone). Therefore, BHCl reversed the impact of hypochlorhydria on dasatinib drug exposure and may be an effective strategy to mitigate potential drug-drug interactions for drugs that exhibit pH-dependent solubility and are administered orally under hypochlorhydric conditions

The Use of Betaine HCl to Enhance Dasatinib Absorption in Healthy Volunteers with Rabeprazole-Induced Hypochlorhydria

Many orally administered, small-molecule, targeted anticancer drugs, such as dasatinib, exhibit pH-dependent solubility and reduced drug exposure when given with acid-reducing agents. We previously demonstrated that betaine hydrochloride (BHCl) can transiently re-acidify gastric pH in healthy volunteers with drug-induced hypochlorhydria. In this randomized, single-dose, three-way crossover study, healthy volunteers received dasatinib (100 mg) alone, after pretreatment with rabeprazole, and with 1500 mg BHCl after rabeprazole pretreatment, to determine if BHCl can enhance dasatinib absorption in hypochlorhydric conditions. Rabeprazole (20 mg b.i.d.) significantly reduced dasatinib C(max) and AUC(0-∞) by 92 and 78%, respectively. However, coadministration of BHCl significantly increased dasatinib C(max) and AUC(0-∞) by 15- and 6.7-fold, restoring them to 105 and 121%, respectively, of the control (dasatinib alone). Therefore, BHCl reversed the impact of hypochlorhydria on dasatinib drug exposure and may be an effective strategy to mitigate potential drug-drug interactions for drugs that exhibit pH-dependent solubility and are administered orally under hypochlorhydric conditions