Cotton Irrigation in the Lower Rio Grande Valley.

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Integrated Analysis of Clinical and Microbiome Risk Factors Associated with the Development of Oral Candidiasis during Cancer Chemotherapy.

Oral candidiasis is a common side effect of cancer chemotherapy. To better understand predisposing factors, we followed forty-five subjects who received 5-fluorouracil- or doxorubicin-based treatment, during one chemotherapy cycle. Subjects were evaluated at baseline, prior to the first infusion, and at three additional visits within a two-week window. We assessed the demographic, medical and oral health parameters, neutrophil surveillance, and characterized the salivary bacteriome and mycobiome communities through amplicon high throughput sequencing. Twenty percent of all subjects developed oral candidiasis. Using multivariate statistics, we identified smoking, amount of dental plaque, low bacteriome and mycobiome alpha-diversity, and the proportions of specific bacterial and fungal taxa as baseline predictors of oral candidiasis development during the treatment cycle. All subjects who developed oral candidiasis had baseline microbiome communities dominated by Candida and enriched in aciduric bacteria. Longitudinally, oral candidiasis was associated with a decrease in salivary flow prior to lesion development, and occurred simultaneously or before oral mucositis. Candidiasis was also longitudinally associated with a decrease in peripheral neutrophils but increased the neutrophil killing capacity of Candida albicans. Oral candidiasis was not found to be associated with mycobiome structure shifts during the cycle but was the result of an increase in Candida load, with C. albicans and Candida dubliniensis being the most abundant species comprising the salivary mycobiome of the affected subjects. In conclusion, we identified a set of clinical and microbiome baseline factors associated with susceptibility to oral candidiasis, which might be useful tools in identifying at risk individuals, prior to chemotherapy

Chemotherapy-induced oral mucositis is associated with detrimental bacterial dysbiosis.

BACKGROUND: Gastrointestinal mucosal injury (mucositis), commonly affecting the oral cavity, is a clinically significant yet incompletely understood complication of cancer chemotherapy. Although antineoplastic cytotoxicity constitutes the primary injury trigger, the interaction of oral microbial commensals with mucosal tissues could modify the response. It is not clear, however, whether chemotherapy and its associated treatments affect oral microbial communities disrupting the homeostatic balance between resident microorganisms and the adjacent mucosa and if such alterations are associated with mucositis. To gain knowledge on the pathophysiology of oral mucositis, 49 subjects receiving 5-fluorouracil (5-FU) or doxorubicin-based chemotherapy were evaluated longitudinally during one cycle, assessing clinical outcomes, bacterial and fungal oral microbiome changes, and epithelial transcriptome responses. As a control for microbiome stability, 30 non-cancer subjects were longitudinally assessed. Through complementary in vitro assays, we also evaluated the antibacterial potential of 5-FU on oral microorganisms and the interaction of commensals with oral epithelial tissues. RESULTS: Oral mucositis severity was associated with 5-FU, increased salivary flow, and higher oral granulocyte counts. The oral bacteriome was disrupted during chemotherapy and while antibiotic and acid inhibitor intake contributed to these changes, bacteriome disruptions were also correlated with antineoplastics and independently and strongly associated with oral mucositis severity. Mucositis-associated bacteriome shifts included depletion of common health-associated commensals from the genera Streptococcus, Actinomyces, Gemella, Granulicatella, and Veillonella and enrichment of Gram-negative bacteria such as Fusobacterium nucleatum and Prevotella oris. Shifts could not be explained by a direct antibacterial effect of 5-FU, but rather resembled the inflammation-associated dysbiotic shifts seen in other oral conditions. Epithelial transcriptional responses during chemotherapy included upregulation of genes involved in innate immunity and apoptosis. Using a multilayer epithelial construct, we show mucositis-associated dysbiotic shifts may contribute to aggravate mucosal damage since the mucositis-depleted Streptococcus salivarius was tolerated as a commensal, while the mucositis-enriched F. nucleatum displayed pro-inflammatory and pro-apoptotic capacity. CONCLUSIONS: Altogether, our work reveals that chemotherapy-induced oral mucositis is associated with bacterial dysbiosis and demonstrates the potential for dysbiotic shifts to aggravate antineoplastic-induced epithelial injury. These findings suggest that control of oral bacterial dysbiosis could represent a novel preventive approach to ameliorate oral mucositis

The effects of acute exercise on subsequent cigarette smoking

The present study was conducted to examine the effects of acute aerobic exercise on smoking behavior. On alternate days, 10 healthy young smokers were subjected to half an hour of sustained high exercise (about 56% of maximum work capacity) or of low exercise (about 28% of maximum, simulating normal daytime activity). During the high-exercise condition, there were pronounced increases in physiological markers of physical activity such as mean work, heart rate, and lactic acid as well as elevations in circulating hormones (norepinephrine, epinephrine, and immunoreactive beta-endorphin and cortisol) known to be affected by vigorous exercise. Despite a trend toward decreased desire for cigarettes after the high exercise condition, there were no differences in plasma nicotine levels following the smoking of a usual-brand cigarette 35 min later. The sustained effects of the two exercise conditions were also similar: plasma cotinine levels 24 hr later (reflecting nicotine intake over the entire exercise day) revealed no significant differences between hight and low exercise.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44810/1/10865_2004_Article_BF00846420.pd

Community-level HIV/STI interventions and their impact on alcohol use in urban poor populations in India

This paper describes an Indo-US, research and intervention project for HIV/STI prevention and sexual risk reduction in urban poor communities in Mumbai, India in which formative research established the importance of reduction in alcohol use as one of the central features of the intervention. As a part of formative research, in-depth interviews with married women and men indicated that alcohol had a direct negative effect on marital relationships, violence, household economics and men\u27s involvement in extramarital sex. The project utilized diverse community intervention mechanisms over the course of a three year intervention effort. Comparison of pre-post intervention, cross-sectional samples showed a significant drop in overall use of alcohol in the study communities. Analysis of a longitudinal panel sample identified subgroups of married men based on their demographic, behavioral and attitudinal characteristics at baseline who stopped drinking during the intervention period. Results also demonstrated that a reduction in men\u27s alcohol use during the intervention period was associated with a reduction in sexual risk behavior and related variables

The WHO concept of sexual health applied to an urban poor community in Mumbai, India

Objectives: The objectives of this study were to describe a scale that operationalizes the World Health Organization concept of sexual health and to assess factors associated with scale variation. Methods: Qualitative in-depth interviews (N = 39), sexual health interviews (N = 21), and survey data (N = 1,128) for this article are drawn from an Indo-U.S. project to reduce the incidence of HIV and sexually transmitted infections among poor urban married women (aged 18–49 years old) in Mumbai, India. Results: Lower sexual health status was significantly associated with gender inequity, marital violence, poorer marital relationships and physical health, and lower empowerment and social support. Conclusions: This work demonstrates the need to view sexual health in the broader context of community and family