Publications

Outbreaks of acute hepatitis C virus (HCV) infection are occurring in HIV-infected men who have sex with men. We evaluated risk factors and liver histopathology in 11 consecutively enrolled men with newly acquired HCV infection that was diagnosed on the basis of antibody seroconversion, new elevations in alanine aminotransferase level, and wide fluctuations in HCV RNA level. Ten patients reported unprotected anal intercourse, and 7 reported "club-drug" use, including methamphetamine. Liver biopsy showed moderately advanced fibrosis (Scheuer stage 2) in 9 patients (82%). No cause of liver damage other than acute HCV infection was identified. The specific pathways leading to periportal fibrosis in HIV-infected men with newly acquired HCV infection require investigation.

OBJECTIVES

Those exposed to more degrading sexual references in popular music are more likely to initiate intercourse at a younger age. The purpose of this study was to perform a content analysis of contemporary popular music with particular attention paid to the prevalence of degrading and non-degrading sexual references. We also aimed to determine if sexual references of each subtype were associated with other song characteristics and/or content.

METHODS

We used Billboard magazine to identify the top popular songs in 2005. Two independent coders each analyzed all of these songs (n = 279) for degrading and non-degrading sexual references. As measured with Cohen's kappa scores, inter-rater agreement on degrading vs. non-degrading sex was substantial. Mentions of substance use, violence, and weapon carrying were also coded.

RESULTS

Of the 279 songs identified, 103 (36.9%) contained references to sexual activity. Songs with references to degrading sex were more common than songs with references to non-degrading sex (67 [65.0%] vs. 36 [35.0%], p < 0.001). Songs with degrading sex were most commonly Rap (64.2%), whereas songs with non-degrading sex were most likely Country (44.5%) or Rhythm & Blues/Hip-Hop (27.8%). Compared with songs that had no mention of sexual activity, songs with degrading sex were more likely to contain references to substance use, violence, and weapon carrying. Songs with non-degrading sex were no more likely to mention these other risk behaviors.

CONCLUSIONS

References to sexual activity are common in popular music, and degrading sexual references are more prevalent than non-degrading references. References to degrading sex also frequently appear with references to other risky behaviors.

BACKGROUND

Lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) is expressed abundantly in the necrotic core of coronary lesions, and products of its enzymatic activity may contribute to inflammation and cell death, rendering plaque vulnerable to rupture.

METHODS AND RESULTS

This study compared the effects of 12 months of treatment with darapladib (an oral Lp-PLA(2) inhibitor, 160 mg daily) or placebo on coronary atheroma deformability (intravascular ultrasound palpography) and plasma high-sensitivity C-reactive protein in 330 patients with angiographically documented coronary disease. Secondary end points included changes in necrotic core size (intravascular ultrasound radiofrequency), atheroma size (intravascular ultrasound gray scale), and blood biomarkers.

BACKGROUND

=0.37). In contrast, Lp-PLA(2) activity was inhibited by 59% with darapladib (P<0.001 versus placebo). After 12 months, there were no significant differences between groups in plaque deformability (P=0.22) or plasma high-sensitivity C-reactive protein (P=0.35). In the placebo-treated group, however, necrotic core volume increased significantly (4.5+/-17.9 mm(3); P=0.009), whereas darapladib halted this increase (-0.5+/-13.9 mm(3); P=0.71), resulting in a significant treatment difference of -5.2 mm(3) (P=0.012). These intraplaque compositional changes occurred without a significant treatment difference in total atheroma volume (P=0.95).

CONCLUSIONS

Despite adherence to a high level of standard-of-care treatment, the necrotic core continued to expand among patients receiving placebo. In contrast, Lp-PLA(2) inhibition with darapladib prevented necrotic core expansion, a key determinant of plaque vulnerability. These findings suggest that Lp-PLA(2) inhibition may represent a novel therapeutic approach.

BACKGROUND

Few prospective studies have investigated the relationship between spousal cigarette smoking and the risk of incident stroke.

METHODS

Stroke-free participants in the U.S.-based Health and Retirement Study (HRS) aged >or=50 years and married at baseline (n=16,225) were followed, on average, 9.1 years between 1992 and 2006) for proxy or self-report of first stroke (1,130 events). Participants were stratified by gender and own smoking status (never-smokers, former smokers, or current smokers), and the relationship assessed between the spouse's smoking status and the risk of incident stroke. Analyses were conducted in 2007 with Cox proportional hazards models. All models were adjusted for age; race; Hispanic ethnicity; Southern birthstate; parental education; paternal occupation class; years of education; baseline income; baseline wealth; obesity; overweight; alcohol use; and diagnosed hypertension, diabetes, or heart disease.

RESULTS

Having a spouse who currently smoked was associated with an increased risk of first stroke among never-smokers (hazard ratio=1.42, 95% CI=1.05, 1.93) and former smokers (hazard ratio=1.72, 95% CI=1.33, 2.22). Former smokers married to current smokers had a stroke risk similar to respondents who themselves smoked.

CONCLUSIONS

Spousal smoking poses important stroke risks for never-smokers and former smokers. The health benefits of quitting smoking likely extend to both the individual smoker and his or her spouse.