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Abstract: Inorganic arsenic (In-As) is a well-known toxicant and carcinogen found naturally in surface and groundwater around the world. Exposure can cause skin lesions, adverse reproductive outcomes, and cancer. There are two main pathways of arsenic (As) metabolism in humans: the reduction reactions, and the oxidative methylation reactions, where methyl groups are attached to As compounds to form monomethylarsenate (MMA) and dimethylarsenate (DMA). MMA, DMA, and In-As are excreted in urine. Urinary levels of another metalloid, selenium (Se), have recently been shown to be associated with increased As excretion and altered metabolite distribution. This study investigates this association, using data collected in a larger prospective study of arsenic and reproductive effects in Chile. This analysis included 93 pregnant women from Antofagasta. Data on demographic, behavioral, and other characteristics were obtained via interviews conducted by trained midwives, and spot urine samples were analyzed for As and Se concentration using inductively coupled plasma-mass spectrometry (ICP-MS). Urinary Se levels were found to be correlated with urinary As levels in bivariate analysis (, ). Multiple linear regression analyses revealed that higher urinary Se levels were associated with increased urinary As excretion, increased %DMA, and decreased %In-As. The results of this study suggest that in populations exposed to arsenic, Se intake may be correlated with urinary As excretion, and may alter As methylation. [Copyright &y& Elsevier]

Abstract: Background. : Invasive cervical cancer (ICC) rates remain elevated in the Appalachian region of the United States. We investigated patterns of invasive cervical cancer incidence rates in three Appalachian states (Kentucky, West Virginia, Pennsylvania) to uncover specific high-risk subgroups within this large and heterogeneous region. Methods. : The analysis was conducted for the three states combined and individually. Invasive cervical cancer rates were characterized by individual and county-level sociodemographic variables, including age, race, poverty, education, Appalachian status, and rural/urban status. Bivariate analyses and multivariable Poisson regression models were conducted to address the relative contributions of each variable to the risk of invasive cervical cancer. Results. : The three states differed in the contribution of each factor to the risk of invasive cervical cancer. The overall invasive cervical cancer incidence rates for Kentucky, West Virginia, and Pennsylvania were 13.4, 13.9, and 10.2 per 100,000/yr, respectively. After controlling for other demographic variables, the effect of Appalachian status on invasive cervical cancer was weaker, while rural status, education, and race were stronger, significant predictors. Conclusions. : This study illustrates the heterogeneity of population demographics and invasive cervical cancer risk, and the need to identify subregions and subgroups within Appalachia at highest risk for this disease. [Copyright &y& Elsevier]

Abstract: The use of generic antiepileptic drugs (AEDs) in patients with epilepsy is controversial. The purpose of this study is to identify patient characteristics associated with increased odds of receiving a generic AED product. A large commercial database was used to identify patients with a primary diagnosis of epilepsy who were prescribed an AED during a three-month window. Data analysis found that those ≥65years old had 15.7% greater odds of receiving a generic AED (OR=1.157; 95% CI=1.056–1.268). Patients with Medicaid were found to have 2.44 times the odds of having had a generic AED prescription (OR=2.44; CI=2.168–2.754). Patients residing in the Northeast had 12.6% decreased odds of receiving a generic AED (OR=0.874; CI=0.821–0.931). These patient characteristics could signify certain health care disparities and may represent potential confounders to future observational studies. [Copyright &y& Elsevier]