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Selected AbstractsQuality of life and symptom attribution in long-term colon cancer survivorsJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 2 2008Etienne Phipps PhD Aims and objectives, This study investigates how long-term colon cancer survivors evaluate their health, functional status and quality of life, and whether there are differences based on age, gender or ethnicity. Methods, Thirty long-term survivors of at least stage I colon cancer were interviewed in person between December 2004 and May 2005. The interview protocol included the Medical Outcomes Study 36-Item Short Form, Quality of Life , Cancer Survivor, and study-specific questions that asked about physical and non-physical problems they attributed to colon cancer. Results, Substantial percentages of survivors attributed their problems with lack of energy (83%), sexual functioning (67%), bowel problems (63%), poor body image (47%) and emotional problems (40%) to having had colon cancer. Of those problems attributed to colon cancer, sexual functioning and pain were given the highest severity rankings by survivors. The majority of long-term colon cancer survivors reported distress regarding future diagnostic tests, a second cancer, and spread of cancer. Women reported greater problems completing daily activities as a result of physical problems (P = 0.003) and more pain (P = 0.07) than men. African Americans appear to report marginally better overall quality of life (P = 0.07) and psychological well-being than whites (P = 0.07). Conclusion, The majority of long-term colon cancer survivors with resected colon cancer and disease-free for 5 years reported problems with low energy, sexual functioning and bowel problems. [source] School Connectedness, Anger Behaviors, and Relationships of Violent and Nonviolent American YouthPERSPECTIVES IN PSYCHIATRIC CARE, Issue 4 2004FAAN, Sandra P. Thomas PhD PROBLEM. Youth violence research often focuses on risk factors arising from early familial interactions rather than school-related factors. METHODS. Via an Internet questionnaire, 282 girls and boys (ages 7,19, mean 15.3) from 47 states and Washington, DC, reported on school connectedness, interpersonal relationships, and anger behaviors. FINDINGS. Substantial percentages of violent youth did not perceive themselves to be liked by classmates and reported loneliness. If not liked by classmates, 80% hated school. Likers and haters of school differed on seven variables (all p,.01). CONCLUSIONS. Insufficient attention is paid to the alienation experienced by disliked and lonely students. Mental health nurses could play a pivotal role in fostering change in the social climate of schools and helping youth to achieve better anger management and social skills. [source] Older adults' alcohol consumption and late-life drinking problems: a 20-year perspectiveADDICTION, Issue 8 2009Rudolf H. Moos ABSTRACT Aims The aim of this study was to identify changes in patterns of alcohol consumption over a 20-year interval among older women and men, and to examine the associations between guideline-defined excessive drinking and late-life drinking problems. Design, participants and measures A community sample of 719 adults between 55 and 65 years of age who consumed alcohol at or prior to baseline participated in a survey of alcohol consumption and drinking problems and was followed 10 years and 20 years later. Findings The likelihood of excessive drinking declined over the 20-year interval as adults matured into their 70s and 80s. However, at ages 75,85, 27.1% of women and 48.6% of men consumed more than two drinks per day or seven drinks per week. At comparable guideline levels of alcohol consumption, older men were more likely to have drinking problems than were older women. Consumption of more than two drinks per day or seven drinks per week was identified as a potential conservative guideline for identifying excessive drinking associated with an elevated likelihood of drinking problems. Conclusions A substantial percentage of older adults who consume alcohol engage in guideline-defined excessive drinking and incur drinking problems. The finding that older men may be more likely than older women to experience problems when they drink beyond guideline levels suggests that alcohol guidelines for men should not be set higher than those for women. [source] Heritability of plasma amyloid , in typical late-onset Alzheimer's disease pedigreesGENETIC EPIDEMIOLOGY, Issue 1 2001Nilufer Ertekin-Taner Abstract Plasma amyloid ,42 peptide (A,42) levels are significantly elevated in all genetic forms of early-onset Alzheimer's disease caused by familial Alzheimer's disease mutations or Down's syndrome. Moreover, recent studies have determined that both plasma A,42 and A,40 levels are significantly elevated in late-onset Alzheimer's disease (LOAD) patients, their cognitively normal first-degree relatives, and members of typical LOAD families when compared to appropriate controls. To determine the magnitude of the genetic component affecting plasma A, levels, we estimated the heritability of plasma A,42 and A,40 in 15 extended, multigenerational LOAD pedigrees, using a variance components method. Heritability estimates as high as 73 and 54% were found for plasma A,42 and A,40 levels, respectively. Inclusion of the ApoE ,4 dosage as a covariate was not found to have a significant effect on the heritability of these traits. These results suggest that genetic determinants other than ApoE account for a very substantial percentage of the phenotypic variance in plasma A, levels. The high heritability and the significant elevation of these traits in LOAD pedigrees suggest that at least some of the genetic determinants of plasma A, levels may lead to elevated A, and LOAD in these families. Thus, we suggest that plasma A, levels are quantitative traits that may be excellent surrogate markers for use in linkage analysis to identify loci that are important in typical LOAD. Genet. Epidemiol. 21:19,30, 2001. © 2001 Wiley-Liss, Inc. [source] Microdeletions involving the SCN1A gene may be common in SCN1A -mutation-negative SMEI patients,HUMAN MUTATION, Issue 9 2006Arvid Suls Abstract Severe myoclonic epilepsy of infancy (SMEI) or Dravet syndrome is a rare epilepsy syndrome. In 30 to 70% of SMEI patients, truncating and missense mutations in the neuronal voltage-gated sodium-channel ,-subunit gene (SCN1A) have been identified. The majority of patients have truncating mutations that are predicted to be loss-of-function alleles. Because mutation detection studies use PCR-based sequencing or conformation sensitive gel electrophoresis (CSGE), microdeletions, which are also predicted to be loss-of-function alleles, can easily escape detection. We selected 11 SMEI patients with or without additional features who had no SCN1A mutation detectable with sequencing analysis. In addition, none of the patients was heterozygous for any of the SNPs in SCN1A, indicating that they were either homozygous for all SNPs or hemizygous due to a microdeletion of the gene. We subsequently analyzed these patients for the presence of microdeletions in SCN1A using a quantitative PCR method named multiplex amplicon quantification (MAQ), and observed three patients missing one copy of the SCN1A gene. All three microdeletions were confirmed by fluorescence in situ hybridization (FISH). These findings demonstrate that a substantial percentage of SCN1A -mutation-negative SMEI patients with or without additional features carry a chromosomal microdeletion comprising the SCN1A gene and that haploinsufficiency of the SCN1A gene is a cause of SMEI. Hum Mutat 27(9), 914,920, 2006. © 2006 Wiley-Liss, Inc. [source] Characteristics of anorexia nervosa-related deaths in Norway (1992,2000): Data from the National Patient Register and the Causes of Death RegisterINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 3 2005Deborah L. Reas PhD Abstract Objective This study investigated demographic and diagnostic characteristics of individuals whose medical record or death certificate indicated the presence of anorexia nervosa at the time of death. Method Two national registers, the National Patient Register (NPR) and the Causes of Death Register (CODR), were examined in Norway for anorexia nervosa-related deaths occurring across a 9-year period (1992,2000). Results The medical record or death certificate listed anorexia nervosa as a diagnosis or cause of death for 66 individuals. Rates of death were 6.46 and 9.93 per 100,000 deaths for the NPR and the CODR, respectively. A substantial percentage of deaths (43.9%) in both registers occurred at or above the age of 65 years. For the NPR, the mean age at the time of death was 61 years and 31% of deaths occurred among men. For the CODR, the mean age at the time of death was 49 years and 18% of deaths occurred among men. Discussion Potential merits and shortcomings of assessing mortality rates using register-based data without linkage to a previously identified clinical sample are discussed. © 2005 by Wiley Periodicals, Inc. [source] Temperament and character associated with depressive symptoms in women: analysis of two genetically informative samples,JOURNAL OF CLINICAL PSYCHOLOGY, Issue 9 2009Jongil Yuh Abstract Although previous research has explored associations between personality and depressive symptoms, a limited number of studies have assessed the extent to which genetic and environmental influences explain the association. This study investigated how temperament and character were associated with depressive symptoms in 131 pairs of twin and sibling women in early adulthood, as well as 326 pairs of twin women in middle adulthood. Results indicated that genetic influences accounted for a moderate to substantial percentage of the association between these personality features and depressive symptoms, emphasizing the role of genetic influences. Nonshared environmental influences made important contributions to the association between character and depressive symptoms, particularly in the sample of middle-aged twin women. These findings suggest that unique social experiences and relationships with a partner in adulthood may play an important role in these associations between character and depressive symptoms. © 2009 Wiley Periodicals, Inc. J Clin Psychol 65: 1,19, 2009. [source] Effects of temperature on disease progression and swimming stamina in Ichthyophonus -infected rainbow trout, Oncorhynchus mykiss (Walbaum)JOURNAL OF FISH DISEASES, Issue 10 2009R Kocan Abstract Rainbow trout, Oncorhynchus mykiss, were infected with Ichthyophonus sp. and held at 10 °C, 15 °C and 20 °C for 28 days to monitor mortality and disease progression. Infected fish demonstrated more rapid onset of disease, higher parasite load, more severe host tissue reaction and reduced mean-day-to-death at higher temperature. In a second experiment, Ichthyophonus -infected fish were reared at 15 °C for 16 weeks then subjected to forced swimming at 10 °C, 15 °C and 20 °C. Stamina improved significantly with increased temperature in uninfected fish; however, this was not observed for infected fish. The difference in performance between infected and uninfected fish became significant at 15 °C (P = 0.02) and highly significant at 20 °C (P = 0.005). These results have implications for changes in the ecology of fish diseases in the face of global warming and demonstrate the effects of higher temperature on the progression and severity of ichthyophoniasis as well as on swimming stamina, a critical fitness trait of salmonids. This study helps explain field observations showing the recent emergence of clinical ichthyophoniasis in Yukon River Chinook salmon later in their spawning migration when water temperatures were high, as well as the apparent failure of a substantial percentage of infected fish to successfully reach their natal spawning areas. [source] Doctors' views about their first postgraduate year in UK medical practice: house officers in 2003MEDICAL EDUCATION, Issue 11 2006Trevor W Lambert Aim, To report house officers' views in 2003 of their first postgraduate year, and to compare their responses with those of house officers 2 and 3 years previously. Methods, Postal questionnaires to all house officers in 2003 who graduated from UK medical schools in 2002. Results, The response rate was 65.3% (2778/4257). The house officers of 2003 enjoyed the year more than those of 2000,1. A total of 78% of respondents in 2003 scored 7,10 in reply to the question ,How much have you enjoyed the house officer year overall?', scored from 0 (no enjoyment) to 10 (enjoyed it greatly), compared with 70% of 2000,1 house officers. They were more satisfied with leisure time available to them (51% scoring 6,10 in 2003; 35% in 2000,1). There were significant improvements in almost every aspect of doctors' experience. Hospital medical posts were rated more highly than surgical posts, and general practice posts higher still. Overall, 38% of respondents regarded their training as having been of a high standard, and 37% felt that they received constructive feedback on their performance. Differences between men and women in their views about their jobs were small. Discussion, The house officers of 2003 reported more positively on their experiences than did those of 2000,1. Although a substantial percentage were negative about specific aspects of clinical support and training, particularly in surgical posts, almost all the responses covering training and clinical support moved in a favourable direction over time. [source] Complications following surgical intervention for stress urinary incontinence: A national perspectiveNEUROUROLOGY AND URODYNAMICS, Issue 7 2005David A. Taub Abstract Aims Stress urinary incontinence (SUI) impacts many women. Treatment is primarily surgical. Post-operative morbidity considerably affects individuals and the health care system. Our objective is to describe complications following surgery for SUI and how they affect resource utilization. Methods Utilizing the Nationwide Inpatient Sample (a nationally representative dataset), 147,473 patients who underwent surgery for SUI from 1988 to 2000 were identified by ICD-9 codes. Comorbid conditions/complications were extracted using ICD-9 codes, including complication rates, length of stay (LOS), hospital charges, and discharge status. Results Overall complication rate was 13.0% (not equal to sum of complication sub-types, as each woman may have had,=,1 complication), with 2.8% bleeding, 1.4% surgical injury, 4.3% urinary/renal, 4.4% infectious, 0.1% wound, 1.1% pulmonary insufficiency, 0.5% myocardial infarction, 0.2% thromboembolic. The "gold standard" surgical technique for SUI, the pubovaginal sling, had the lowest morbidity at 12.5%. Mean LOS increased with morbidity: from 2.9 to 4.1 to 6.1 days for those with 0, 1, and =2 complications respectively (P,<,0.001). Similarly, inflation-adjusted hospital charges increased with morbidity: from $7,918 to $9,828 to $15,181 for those with 0, 1, and =2 complications respectively (P,<,0.001). The percentage of patients requiring post-discharge subacute or home care increased with morbidity: from 4.4% to 8.4% to 14.3% for those with 0, 1, and =2 complications (P,<,0.001). Conclusions A substantial percentage of women experience complications following surgery for SUI. Post-operative morbidity leads to dramatically increased resource utilization. Prospective studies are needed to identify pre-operative risk factors and intraoperative process measures to optimize the quality of care. Neurourol. Urodynam. © 2005 Wiley-Liss, Inc. [source] Elevated expression of interleukin-7 receptor in inflamed joints mediates interleukin-7,induced immune activation in rheumatoid arthritisARTHRITIS & RHEUMATISM, Issue 9 2009Sarita A. Y. Hartgring Objective To evaluate the expression and functional ability of the high-affinity interleukin-7 receptor (IL-7R,) in patients with rheumatoid arthritis (RA). Methods Expression of IL-7R, and IL-7 was determined in synovial tissue from RA patients and was compared with that in synovial tissue from patients with undifferentiated arthritis (UA) and osteoarthritis (OA). IL-7R, expression on CD4 T cells, CD19 B cells, and CD14 monocyte/macrophages from RA synovial tissue, synovial fluid, and peripheral blood was also assessed. The proliferative capacity of IL-7R,bright and IL-7R,dim/, T cells was measured. In addition, we examined IL-7R blockade with soluble human IL-7R, (hIL-7R,) in the prevention of immune activation of peripheral blood mononuclear cells. Results We found significantly higher IL-7R, expression in RA and UA synovial tissue than in OA synovial tissue, and the level of IL-7R, expression correlated significantly with the levels of CD3 and IL-7 expression. CD4 T cells from RA synovial fluid and synovial tissue strongly expressed IL-7R,. A substantial percentage of B cells and macrophages from RA synovial fluid and synovial tissue also expressed IL-7R,, although less prominently than T cells. We found that peripheral blood IL-7R,bright T cells that did not express FoxP3 were highly proliferative as compared with IL-7R,dim/, T cells that did express high levels of FoxP3. Soluble hIL-7R, inhibited IL-7,induced proliferation and interferon-, production by mononuclear cells from RA patients. Conclusion Our data suggest that enhanced expression of IL-7R, and IL-7 in RA patients contributes significantly to the joint inflammation by activating T cells, B cells, and macrophages. The inhibition of IL-7R,mediated immune activation by soluble hIL-7R, further indicates an important role of IL-7R, in inflammatory responses in RA, suggesting IL-7R, as a therapeutic target for immunotherapy in RA. [source] A prospective study of aromatase inhibitor-associated musculoskeletal symptoms and abnormalities on serial high-resolution wrist ultrasonographyCANCER, Issue 18 2010N. Lynn Henry MD Abstract BACKGROUND: Nearly half of women treated with aromatase inhibitors (AI) develop AI-associated musculoskeletal symptoms (AIMSS) such as arthralgias, but to the authors' knowledge the etiology is unclear. The upper extremities are frequently affected, especially the wrists, hands, and fingers. AI use may also increase the risk of developing carpal tunnel syndrome. Tendon sheath fluid and tenosynovial changes have been demonstrated by imaging symptomatic patients who were treated with AIs. The authors hypothesized that these abnormalities are correlated with AIMSS. METHODS: Thirty consecutive patients in whom adjuvant therapy with letrozole or exemestane was initiated on a prospective clinical trial enrolled in a pilot study evaluating tendon and joint abnormalities at baseline and after 3 months of AI therapy. Patients underwent high-resolution ultrasonography of the wrists bilaterally and completed the Health Assessment Questionnaire (HAQ) and pain Visual Analog Scale (VAS). AIMSS were defined as an increase in the HAQ or VAS score during AI therapy that exceeded a predefined cutoff. RESULTS: Twenty-five patients completed both the baseline and 3-month assessments. During the first 12 months of AI therapy, 15 patients developed AIMSS, and 13 discontinued therapy because of musculoskeletal symptoms. There was a trend toward an association between the presence of tendon sheath abnormalities on wrist ultrasound at baseline and the development of AIMSS (P = .06). CONCLUSIONS: Clinically relevant musculoskeletal symptoms develop in women treated with AIs, leading to treatment discontinuation in a substantial percentage of these patients. However, in the current study, patient-reported symptoms were not found to be associated with changes visible on wrist ultrasonography. Cancer 2010. © 2010 American Cancer Society. [source] Pathogenesis and mechanism of disease progression from hemophagocytic lymphohistiocytosis to Epstein,Barr virus-associated T-cell lymphoma: Nuclear factor-,B pathway as a potential therapeutic targetCANCER SCIENCE, Issue 9 2007Huai-Chia Chuang Epstein,Barr virus (EBV) can infect T lymphocytes and manifests as hemophagocytic lymphohistiocytosis (HLH), a distinct entity of hemophagocytic syndrome (HPS) characterized by fever, hepatosplenomegaly, cytopenia, hypercytokinemia, and systemic macrophage activation with hemophagocytosis. In a substantial percentage of HLH patients, the disease may relapse or progress to T-cell lymphoma in months to years. In the present review, the authors summarize the previous studies on the pathogenesis of HLH and the potential mechanism for the progression of disease from HLH to T-cell lymphoma. The infection of T cells by EBV could activate T cells to secrete proinflammatory cytokines, particularly tumor necrosis factor-, (TNF-,), which subsequently activate macrophages. EBV latent membrane protein-1 (LMP-1) is the viral product responsible for the activation of the TNF receptor (TNFR) associated factors/nuclear factor-,B (NF-,B)/ERK pathway to enhance cytokine secretion mediated through the suppression of the SAP/SH2D1A gene. The activation of NF-,B will confer resistance to TNF-,-induced apoptosis on EBV-infected T cells through the down-regulation of TNFR-1. Consistent with in vitro observations, EBV-associated T or natural killer/T-cell lymphoma showed constitutive activation of NF-,B, explaining its drug resistance, hypercytokinemia, and poor prognosis. Therefore, similar to other inflammation-associated cancers, HLH provides a unique model to study the mechanism of disease progression from a benign virus-infected disorder (HLH) to T-cell lymphoma. Inhibition of the NF-,B signal pathway should provide a potential target for the treatment of HLH and EBV-associated T-cell lymphoma. (Cancer Sci 2007; 98: 1281,1287) [source] Dynamic Patterns of Time Use in AdolescenceCHILD DEVELOPMENT, Issue 2 2001Michael J. Shanahan Patterns of time use are tangible representations of individual identity and the meaning of age groups in the life course. How do young people allocate their time to multiple domains of involvement, including the school, workplace, family, and peer group? Drawing on longitudinal data from the Youth Development Study (N= 1,010), a person-centered analytic strategy was used to describe configurations of time use through the high school years. Over half of the students were engaged in many domains, although a substantial percentage of students focused their time on one or two domains outside the school. Students who were highly engaged in multiple domains tended to remain so across grade levels, whereas students focused on one or two domains frequently changed their commitments. Plans for school, grade point average, future orientations that emphasize marriage and good citizenship, and gender significantly predicted time-use patterns. These findings elucidate connections among school, work, and other contexts through the high school years. [source] Risk indicators of edentulism, partial tooth loss and prosthetic status among black and white middle-aged and older adultsCOMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 5 2001Teresa A. Dolan Abstract ,Objectives: To describe the prevalence and risk indicators of edentulism; to describe the frequencies of wearing removable dentures; to describe the prevalence and risk indicators of fixed prosthetic restorations; to test the hypothesis that fixed prosthetic restorations are most likely to have been placed in persons at lower risk for dental and periodontal diseases, and to test the hypothesis that, with dental disease, dental behaviors, dental attitudes and ability to afford crowns taken into account, blacks are less likely than whites to have received crowns. Methods: The Florida Dental Care Study is a cohort study of subjects 45 years old or older. A telephone screening interview was done as a first stage to identify 5254 subjects who met eligibility requirements and who self-reported whether they were edentulous. In a second stage, a subsample of dentate subjects was contacted after they completed their telephone screening interview. Of these, 873 subjects completed a baseline in-person interview and dental examination. Results: A total of 19% of first-stage subjects were edentulous. In a single multiple logistic regression, having a poorer self-rated level of general health was significantly associated with edentulism, as were being poor, older and white. Among the second-stage participants (all of whom were dentate), several prosthetic patterns were observed. For example, a total of 64% of maxillary full denture wearers reported wearing their denture all the time. Participants had also received numerous fixed prosthodontic services. The proportion of subjects with at least one crown varied widely by subject characteristics. Conclusions: A substantial percentage of non-ideal frequencies of wearing removable prostheses was reported, as were prosthesis-related soreness and broken prostheses. Although we expected and observed an association between having a fixed prosthetic crown and periodontal status, dental fillings, dental attitudes and financial resources, a residual association with race suggests that blacks are much less likely to receive prosthetic crowns. The several possible reasons for this circumstance warrant further investigation. [source] Objective, Subjective, and Self-Assessment of Preadolescent Orthodontic Treatment Need , A Function of Age, Gender, and Ethnic/Racial Background?JOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 1 2009Elizabeth A. Christopherson Abstract Children from socioeconomically disadvantaged and/or underrepresented minority backgrounds in the United States have limited or no access to orthodontic treatment. Objectives: To determine whether preadolescents' (a) objectively assessed orthodontic treatment need; (b) subjectively assessed orthodontic treatment need; and (c) self-perceptions of the psychologic aspects of their oral health-related quality of life and desire to have braces vary as a function of age, gender, ethnicity/race, and socioeconomic status (SES). Methods: Data were collected from 1,566 preadolescents (age range: 8 to 11 years; 47.3 percent male/52.7 percent female; 55.7 percent African-American/39.7 percent White/2.9 percent Hispanic) in oral exams and in face to face interviews. Malocclusion was determined with the Index of Orthodontic Treatment Need. Results: Children (17.2 percent) had definite treatment need, 33.7 percent were borderline, and 49.1 percent had little or no need. Objectively and subjectively assessed treatment need was not affected by the children's age or gender. However, girls were more critical of their smiles and wanted braces more than boys. The older the children were, the more critical they were and the more they wanted braces. African-American children and children in schools with higher percentages of children on free school lunches had less treatment need than White children and children in schools with lower percentages of students with free school lunches. While the provider-assessed treatment need was higher for White children than for Black children, Black children were less happy with their smiles than White children, and wanted braces more than White children. SES did not affect the children's self-perceptions. Conclusions: Findings showed that substantial percentages of the preadolescents have an orthodontic treatment need. Orthodontic need and child self-perceptions varied as a function of the children's age, gender, ethnicity/race, and SES. [source] Psychometric Properties of the Brazilian Version of the Drug Use Screening InventoryALCOHOLISM, Issue 10 2002Denise De Micheli Background Adolescent involvement with alcohol and other drugs is rising in Brazil, and there is an increasing need for psychometrically sound assessment tools to detect early drug involvement. Methods The psychometric properties of the Brazilian version of the Drug Use Screening Inventory (DUSI) were examined in a sample composed of 71 non,drug-dependent adolescents and 142 adolescents who met DSM-III-R criteria for drug dependence. Results With a cutoff score of 13% or lower for the absolute density index of the substance use area, DUSI correctly classified 80% of the drug-dependent adolescents and 90% of the non,drug-dependent adolescents, thus correctly classifying 83.6% of the sample. Factor analysis applied to each of the 10 DUSI areas indicated their unidimensionality, with substantial percentages of variance on the first factor. The Brazilian version of DUSI presented strong internal consistency reliability for the whole sample (drug-dependents and non,drug-dependent adolescents) with an average across all 10 scales for Cronbach's , reliability coefficient of 0.96 (standard deviation = 0.02) and for the split-half reliability coefficient of 0.88 (standard deviation = 0.08). Conclusions These results suggest that the Brazilian version of DUSI preserves its original psychometric properties and is a sensitive and useful screening instrument for drug use. [source] | ||||||||||||||||