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Selected AbstractsComparison of ADHD symptom subtypes as source-specific syndromesTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 6 2004Kenneth D. Gadow Background:, This study examines differences between the three subtypes of attention-deficit/hyperactivity disorder (ADHD), inattentive (I), hyperactive-impulsive (H), and combined (C), in a heterogeneous sample of 248 boys (ages 6 to 10 years) with emotional and behavioral problems who were recruited for participation in a diagnostic study. Method:, The boys and their mothers participated in an extensive evaluation that involved multiple assessments of cognitive, behavioral, academic, and family functioning. ADHD subtypes were defined on the basis of teacher alone, mother alone, and mother/teacher ratings of DSM-IV symptoms. Results:, Results indicated ADHD symptom groups showed a differential pattern of impairment socially (H,C>I) and cognitively (I,C>H). The C and H groups were the most and least impaired overall, respectively, and all subtypes were differentiated from the nonADHD clinical control or NONE (N) group in a manner consistent with the primary findings. External validation of group differences was limited, and there were marked inconsistencies in the pattern of findings depending on how groups were defined. For the most part, although the mother/teacher grouping strategy (compared with either alone) captured a greater diversity of differences between subtypes, it also obscured some. Conclusions:, Observed findings are consistent with the notion that mothers and teachers interpret symptom statements in terms of behaviors that are most relevant for their daily concerns. [source] Quality of evidence for the present Swedish child health surveillance programmeACTA PAEDIATRICA, Issue 2000S Bremberg The present Swedish health surveillance programme includes 15 examinations by a nurse, 5 examinations by a physician, 7 assessments of development, 2 assessments of hearing and 1 assessment of visual acuity. The WHO criteria for evaluation of screening programmes can be applied to the Swedish health surveillance programme. These criteria state that the health problem must be important, that there should be an early phase during which the condition is only detectable by medical professionals and that treatment at an early phase should favourably affect the prognosis. The quality of evidence for fulfilment of these criteria has been graded I-III. Grade II-2 refers to evidence obtained from well-designed cohort or case-control analytical studies. The following disorders might be affected by health surveillance at child health centres: amblyopia, ADHD/DAMP, failure to thrive, cerebral palsy, congenital heart failure, congenital luxation of hip, hearing impairment (severe or moderate), mental retardation, retentio testis and hydrocephalus. None of these conditions fulfils the WHO criteria with quality of evidence grade II-2 or better. Thus, the evidence for the present Swedish health surveillance programme is problematic. [source] Habitat Loss and Extinction in the Hotspots of BiodiversityCONSERVATION BIOLOGY, Issue 4 2002Thomas M. Brooks None of these hotspots have more than one-third of their pristine habitat remaining. Historically, they covered 12% of the land's surface, but today their intact habitat covers only 1.4% of the land. As a result of this habitat loss, we expect many of the hotspot endemics to have either become extinct or,because much of the habitat loss is recent,to be threatened with extinction. We used World Conservation Union [ IUCN ] Red Lists to test this expectation. Overall, between one-half and two-thirds of all threatened plants and 57% of all threatened terrestrial vertebrates are hotspot endemics. For birds and mammals, in general, predictions of extinction in the hotspots based on habitat loss match numbers of species independently judged extinct or threatened. In two classes of hotspots the match is not as close. On oceanic islands, habitat loss underestimates extinction because introduced species have driven extinctions beyond those caused by habitat loss on these islands. In large hotspots, conversely, habitat loss overestimates extinction, suggesting scale dependence (this effect is also apparent for plants). For reptiles, amphibians, and plants, many fewer hotspot endemics are considered threatened or extinct than we would expect based on habitat loss. This mismatch is small in temperate hotspots, however, suggesting that many threatened endemic species in the poorly known tropical hotspots have yet to be included on the IUCN Red Lists. We then asked in which hotspots the consequences of further habitat loss (either absolute or given current rates of deforestation) would be most serious. Our results suggest that the Eastern Arc and Coastal Forests of Tanzania-Kenya, Philippines, and Polynesia-Micronesia can least afford to lose more habitat and that, if current deforestation rates continue, the Caribbean, Tropical Andes, Philippines, Mesoamerica, Sundaland, Indo-Burma, Madagascar, and Chocó,Darién,Western Ecuador will lose the most species in the near future. Without urgent conservation intervention, we face mass extinctions in the hotspots. Resumen: Casi la mitad del total de plantas vasculares del mundo y un tercio de los vertebrados terrestres son endémicos en 25 "áreas críticas" para la biodiversidad, cada una de las cuales tiene por lo menos 1500 especies de plantas endémicas. En ninguno de estos sitios permanece más de un tercio de su hábitat prístino. Históricamente, cubrían 12% de la superficie terrestre, pero en la actualidad su hábitat intacto cubre solo 1.4% del terreno. Como resultado de esta pérdida de hábitat esperamos que muchas de las especies endémicas a estos sitios estén extintas o , porque la pérdida de hábitat es reciente , se encuentren amenazadas de extinción. Utilizamos Listas Rojas de UICN para comprobar esta predicción. En general, entre la mitad y dos tercios de las plantas amenazadas y el 57% de los vertebrados terrestres amenazados son endémicos de áreas críticas para la biodiversidad. Para aves y mamíferos en general, las predicciones de extinción en las áreas críticas para la biodiversidad, basadas en la pérdida de hábitat, coinciden con el número de especies consideradas extintas o amenazadas independientemente. En dos clases de áreas críticas para la biodiversidad la coincidencia no es muy grande. En islas oceánicas, la pérdida de hábitat subestima la extinción porque las especies introducidas han causado más extinciones que las producidas por la reducción del hábitat. Por lo contrario, la pérdida de hábitat sobrestima la extinción en áreas críticas para la biodiversidad extensas, lo que sugiere una dependencia de escala (este efecto también es aparente para plantas). Para reptiles, anfibios y plantas mucho menos especies endémicas son consideradas amenazadas o extintas por pérdida de hábitat. Sin embargo, esta discordancia es pequeña en áreas críticas para la biodiversidad en zonas templadas templadas, lo que sugiere que muchas especies endémicas amenazadas en las poco conocidas áreas críticas para la biodiversidad en zonas tropicales aun están por incluirse en las Listas Rojas. Posteriormente nos preguntamos en que áreas críticas para la biodiversidad serían más serias las consecuencias de una mayor pérdida de hábitat (absoluta o con las tasas actuales de deforestación). Nuestros resultados sugieren que el Arco Oriental y los Bosques Costeros de Tanzania/Kenia, Filipinas, Polinesia/Micronesia no pueden soportar mayores pérdidas y que, si continúan las tasas de deforestación actuales, el Caribe, Andes Tropicales, Filipinas, Mesoamérica, Sundaland, Indo-Burma, Madagascar y Chocó/Darién/Ecuador Occidental perderán más especies en el futuro. Sin acciones urgentes de conservación, habrá extinciones masivas en las áreas críticas para la biodiversidad. [source] Possible Environmental Factors Underlying Amphibian Decline in Eastern Puerto Rico: Analysis of U.S. Government Data ArchivesCONSERVATION BIOLOGY, Issue 4 2001Robert F. Stallard I examined changes in environmental conditions by examining time-series data sets that extend back at least into the 1980s, a period when frog populations were declining. The data include forest cover; annual mean, minimum, and maximum daily temperature; annual rainfall; rain and stream chemistry; and atmospheric-dust transport. I examined satellite imagery and air-chemistry samples from a single National Aeronautics and Space Administration aircraft flight across the Caribbean showing patches of pollutants, described as thin sheets or lenses, in the lower troposphere. The main source of these pollutants appeared to be fires from land clearing and deforestation, primarily in Africa. Some pollutant concentrations were high and, in the case of ozone, approached health limits set for urban air. Urban pollution impinging on Puerto Rico, dust generation from Africa ( potential soil pathogens), and tropical forest burning ( gaseous pollutants) have all increased during the last three decades, overlapping the timing of amphibian declines in eastern Puerto Rico. None of the data sets pointed directly to changes so extreme that they might be considered a direct lethal cause of amphibian declines in Puerto Rico. More experimental research is required to link any of these environmental factors to this problem. Resumen: Las pasadas tres décadas han visto grandes disminuciones poblacionales de especies de anfibios en altas elevaciones de Puerto Rico oriental, una región única en los trópicos húmedos debido al grado de monitoreo ambiental que se ha llevado a cabo mediante los esfuerzos de las agencias de gobierno de los Estados Unidos. Examiné los cambios en condiciones ambientales mediante el análisis de datos de series de tiempo que se extienden hasta los 1980s, un periodo en el que las poblaciones de ranas estaban declinando. Los datos incluyen cobertura forestal; temperatura diaria media, mínima y máxima anual; precipitación anual; química de la lluvia y arroyos; y el transporte atmosférico de polvo. Examiné imágenes de satélite y muestras de química del aire obtenidos de un solo vuelo de una nave de la NASA a lo largo del Caribe que mostraba parches de contaminantes descritas como capas delgadas de lentes en la inferior troposfera. La mayor fuente de contaminantes parece ser los incendios de tierras clareadas y la deforestación, principalmente en África. Algunas concentraciones de contaminantes fueron altas y en el caso del ozono, se aproximó a los límites de salud establecidos para aire urbano. La contaminación urbana afectando a Puerto Rico, la generación de polvo en África ( patógenos del suelo potenciales) y la quema de bosque tropical (contaminantes gaseosos) han incrementado durante las últimas tres décadas, superponiéndose con el periodo en que oturrieron las disminuciones de anfibios en Puerto Rico oriental. Ninguno de estos conjuntos de datos señaló directamente hacia cambios tan extremos que debieran ser considerados como una causa letal directa de las disminuciones en Puerto Rico. Se requiere de más investigación experimental que vincule a estos factores ambientales con este problema. [source] Heavy Extinctions of Forest Avifauna in Singapore: Lessons for Biodiversity Conservation in Southeast AsiaCONSERVATION BIOLOGY, Issue 6 2000Marjorie Castelletta In Southeast Asia, Singapore, a newly developing country, has had 95% of its native lowland rainforest cleared. Most of the rainforest was lost in the mid- to late-nineteenth century. We compared avifauna checklists from 1923, 1949, and 1998 to determine the extent of extinctions between 1923 and 1998 in Singapore. Of 203 diurnal bird species, 65 were extirpated in Singapore in the past 75 years. Four of these species were nonforest- dependent species, whereas 61 (94%) were forest bird species dependent on the primary or old secondary forest to survive. Twenty-six forest bird species became extinct between 1923 and 1949, whereas 35 forest species disappeared after 1949. We compared the body lengths, feeding guilds, and vertical feeding zones between extinct and extant forest bird species to determine whether extinction patterns were dependent on these characteristics. Larger forest bird species went extinct between 1923 and 1949. Body sizes, however, did not affect the loss of forest bird species between 1949 and 1998. We observed high losses of insectivorous birds; the insectivore-carnivore and insectivore-granivore guilds lost> 80% of the species present in 1923. The highest losses were among birds that fed in the canopy. None of the forest bird species are currently common (>100 individuals/species) within Singapore. Our study shows that more than half the forest avifauna became locally extinct after extensive deforestation. Based on this fact, the countries within Southeast Asia should reconsider their heavy deforestation practices. Resumen: Las consecuencias de la tala rápida del bosque lluvioso sobre la avifauna nativa son poco conocidas. En Asia sudoriental, Singapur, un país en desarrollo, un 95% de su bosque nativo de tierras bajas ha sido talado. La mayoríia del bosque se perdió entre mediados y finales del siglo diecinueve. En este trabajo comparamos las listas de avifauna de 1923, 1949 y 1998 para determinar la extensión de las extinciones en Singapur entre 1923 y 1998. Sesenta y cinco de las 203 especies diurnas de aves fueron extirpadas de Singapur en los últimos 75 años. Cuatro de estas especies fueron especies no dependientes del bosque, mientras que 61 (94%) fueron especies de aves del bosque (especies que dependen del bosque primario o secundario viejo para sobrevivir). Veintiséis de las especies de aves del bosque se extinguieron entre 1923 y 1949, mientras que 35 especies del bosque desaparecieron después de 1949. Comparamos las longitudes del cuerpo, los gremios de alimentación y las zonas de alimentación vertical entre especies de aves de bosque extintas y existentes para determinar si los patrones de extinción fueron dependientes de estas características. Las especies de aves grandes del bosque se extinguieron entre 1923 y 1949. Sin embargo, el tamaño del cuerpo no afectó la pérdida de especies del bosque entre 1949 y 1998. Observamos altas pérdidas de aves insectívoras; los gremios de insectívoros-carnívoros e insectívoros-granívoros perdieron> 80% de las especies que estaban presentes en 1923. Los números más altos de pérdidas fueron de aves que se alimentan en el dosel. Ninguna de las especies de aves del bosque es común en la actualidad (>100 individuos/especie) dentro de Singapur. Nuestro estudio muestra que más de la mitad de la avifauna del bosque se ha extinguido localmente después de una deforestación extensiva. Con base en este hecho, los países dentro de Asia Sudoriental deberían reconsiderar sus prácticas de intensa deforestación. [source] Effects of Fragmentation of Araucarian Vine Forest on Small Mammal CommunitiesCONSERVATION BIOLOGY, Issue 4 2000Jocelyn M. Bentley We examined the abundance of small mammal species in forests, corridors, remnants of araucarian vine forest, and Araucaria cunninghamii plantations and pastures. None of the forest mammal species persisted following conversion of forest to pasture. Plantations supported lowered abundances of a subset of forest species that were mainly habitat generalists with respect to their occurrence in different floristic types of undisturbed native forest. Within plantations, an increased subcanopy cover was associated with a more forest-like small mammal assemblage. Species' responses to habitat fragmentation varied. The floristic habitat generalists were largely tolerant of habitat fragmentation, their abundance being similar in forests, corridors, and remnants, and were capable of persisting in remnants a few hectares in area. Floristic habitat specialists were vulnerable to habitat fragmentation and thus were abundant in continuous forest, were less abundant in corridors, and were generally absent from remnants. Species that avoid the corridor matrix and are therefore constrained to the corridor may be disadvantaged by the linearity of the habitat, consistent with the predictions of central-place foraging theory. Although small remnants and corridors provide habitat for some species, those that are more specialized in their use of undisturbed habitat types require the retention or reestablishment of large intact areas. Resumen: La pérdida de hábitat y la fragmentación son amenazas importantes para la sobrevivencia de la fauna que depende del bosque. Examinamos la abundancia de especies de mamíferos pequeños en bosques, corredores, y en remanentes de bosques de vid araucarios y en plantaciones de Araucaria cunninghamii y pastizales. Ninguna de las especies de mamíferos del bosque persistió después de la conversión del bosque a pastizal. Las plantaciones favorecieron abundancias menores de un conjunto de especies del bosque integrado principalmente por generalistas de hábitat con respecto a su presencia en diferentes tipos florísticos de bosque nativo sin perturbar. Dentro de las plantaciones, cuanto mayor era la cobertura por debajo del dosel más se parecía el ensamblaje de mamíferos pequeños al del bosque. Las respuestas de las especies a la fragmentación del hábitat fueron variadas. Los generalistas del hábitat florístico por lo general toleraban la fragmentación del hábitat ( la abundancia en bosques, corredores y remanentes era similar) y fueron capaces de persistir en remanentes de unas pocas hectáreas de extensión. Los especialistas de hábitat florístico fueron vulnerables a la fragmentación del hábitat y por ello fueron más abundantes en bosques continuos, menos abundantes en corredores y generalmente ausentes en los remanentes. Las especies que evitaron la matriz de corredores y por lo tanto se encuentran limitadas al corredor pueden estar en desventaja por la linearidad del hábitat, consistente con las predicciones de la teoría del forrajeo de sitio central. A pesar de que los remanentes pequeños y los corredores proveen hábitat para algunas especies, aquéllas que son más especializadas en el uso de tipos de hábitat sin perturbar requieren de la retención o del restablecimiento de áreas intactas grandes. [source] Patch testing with components of water-based metalworking fluids: results of a multicentre study with a second seriesCONTACT DERMATITIS, Issue 6 2006Johannes Geier Background:, Although many allergens in metalworking fluids (MWF) are identified, there are still some MWF components, which are not sufficiently investigated concerning their sensitizing properties. Objectives:, To investigate sensitization to 10 frequently used MWF components, which are not part of the established MWF test series, in metalworkers with suspected occupational dermatitis due to MWF. Patients/Methods:, Oleyl alcohol, myristyl alcohol, dimethylolurea, 4,4,-methylenebis morpholine, imazalil, 1-amino-2-propanol (monoisopropanolamine; MIPA), 2-amino-2-ethyl-1,3-propanediol (AEPD), 2,5-bis(n-octyldithio)-1,3,4-thiadiazole, zinc alkyl dithiophosphate and dibenzyl disulfide have been patch tested in 144 patients. Results:, 7 patients reacted positively to the formaldehyde releaser 4,4,-methylenebis morpholine, and 6 of these patients also reacted to formaldehyde and/or other formaldehyde releasers. 4 patients reacted positively to myristyl alcohol tested at 10% petrolatum (pet.). Additionally, 20 doubtful or irritant reactions occurred. 1 patient each reacted positively to oleyl alcohol, MIPA, and AEPD. None of the other test substances mentioned above elicited any clear-cut positive reaction. Patch testing with well-known MWF allergens showed proportions of positive reactions, which were comparable to those from other studies, e.g. 11% to monoethanolamine, 8% to colophonium and 3%,5% to various preservatives. Conclusions:, 4,4,-methylenebis morpholine may be an important MWF allergen, although clinical relevance could not be stated definitely in every case. Myristyl alcohol should not be patch tested at 10% pet., but at a lesser concentration, due to irritant properties. [source] Regulation of nickel-induced T-cell responsiveness by CD4+CD25+cells in contact allergic patients and healthy individualsCONTACT DERMATITIS, Issue 2 2005H. Moed In this study, we investigated the capacity of CD4+CD25+ regulatory T cells to suppress nickel-specific effector T cells, both in nickel-allergic patients and healthy controls. CD4+ cells isolated from allergic patients showed an increased proliferative response to nickel, whereas CD4+ cells from negative controls did not respond to allergen. When CD4+CD25+ cells were depleted, nickel-specific responsiveness was strongly increased both in allergic and in non-allergic individuals, with the most pronounced effect in allergic patients. These regulatory T cells were anergic to nickel but inhibited nickel-specific CD4+CD25, effector T cells in coculture experiments. CD4+CD25+ cells from nickel-allergic patients showed only a limited capacity to suppress effector T-cell responsiveness, because an increased nickel reactivity could still be detected in these cocultures. None of the isolated CD4+CD25+ cells, either isolated from healthy controls or allergic patients, produced IL-10 in response to nickel. Overall, these results support the view that CD4+CD25+ cells can control the activation of nickel-specific effector T cells in non-allergic individuals, whereas this regulatory capacity is impaired in allergic patients. To investigate the presence of allergen-specific regulatory T cells in truly naïve, non-sensitized individuals, T-cell reactivity should also be studied with non-environmental contact allergens, such as para-phenylenediamine. [source] Chloroatranol, an extremely potent allergen hidden in perfumes: a dose-response elicitation studyCONTACT DERMATITIS, Issue 4 2003Jeanne Duus Johansen Oak moss absolute is a long-known, popular natural extract widely used in perfumes. It is reported as the cause of allergic reactions in a significant number of those with perfume allergy. Oak moss absolute has been the target of recent research to identify its allergenic components. Recently, chloroatranol, a hitherto unknown fragrance allergen, was identified in oak moss absolute. The objective was to assess the clinical importance of chloroatranol as a fragrance allergen by characterizing its elicitation profile. 13 patients previously showing a positive patch test to oak moss absolute and chloroatranol were included, together with a control group of 10 patients without sensitization to either of the 2 materials. A serial dilution patch test was performed on the upper back with concentrations ranging from 200 to 0.0063 p.p.m. of chloroatranol in ethanol. Simultaneously, the participant performed an open test simulating the use of perfumes on the volar aspect of the forearms in a randomized and double-blinded design. A solution with 5 p.p.m. chloroatranol was used for 14 days, and, in case of no reaction, the applications were continued for another 14 days with a solution containing 25 p.p.m. All test subjects (13/13) developed an allergic reaction at the site of application of the solution containing chloroatranol. Among them, 12/13 (92%) gave a positive reaction to the 5 p.p.m. solution and 1 to 25 p.p.m. None of the controls reacted (P < 0.001). The use test was terminated at median day 4. The dose eliciting a reaction in 50% of the test subjects at patch testing was 0.2 p.p.m. In conclusion, the hidden exposure to a potent allergen widely used in perfumes has caused a highly sensitized cohort of individuals. Judged from the elicitation profile, chloroatranol is the most potent allergen present in consumer products today. [source] Imaging of the lymphatic system: new horizons,CONTRAST MEDIA & MOLECULAR IMAGING, Issue 6 2006Tristan Barrett Abstract The lymphatic system is a complex network of lymph vessels, lymphatic organs and lymph nodes. Traditionally, imaging of the lymphatic system has been based on conventional imaging methods like computed tomography (CT) and magnetic resonance imaging (MRI), whereby enlargement of lymph nodes is considered the primary diagnostic criterion for disease. This is particularly true in oncology, where nodal enlargement can be indicative of nodal metastases or lymphoma. CT and MRI on their own are, however, anatomical imaging methods. Newer imaging methods such as positron emission tomography (PET), dynamic contrast-enhanced MRI (DCE-MRI) and color Doppler ultrasound (CDUS) provide a functional assessment of node status. None of these techniques is capable of detecting flow within the lymphatics and, thus, several intra-lymphatic imaging methods have been developed. Direct lymphangiography is an all-but-extinct method of visualizing the lymphatic drainage from an extremity using oil-based iodine contrast agents. More recently, interstitially injected intra-lymphatic imaging, such as lymphoscintigraphy, has been used for lymphedema assessment and sentinel node detection. Nevertheless, radionuclide-based imaging has the disadvantage of poor resolution. This has lead to the development of novel systemic and interstitial imaging techniques which are minimally invasive and have the potential to provide both structural and functional information; this is a particular advantage for cancer imaging, where anatomical depiction alone often provides insufficient information. At present the respective role each modality plays remains to be determined. Indeed, multi-modal imaging may be more appropriate for certain lymphatic disorders. The field of lymphatic imaging is ever evolving, and technological advances, combined with the development of new contrast agents, continue to improve diagnostic accuracy. Published in 2006 by John Wiley & Sons, Ltd. [source] The targets of violence committed by young offenders with alcohol dependence, marijuana dependence and schizophrenia-spectrum disorders: findings from a birth cohortCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 2 2002Louise Arseneault Background: Estimates of who is most at risk from violence by people with mental illness rest mainly on identified patient samples. This study, without such selection bias, examined the targets of violence committed by young adults with as-yet untreated alcohol dependence, marijuana dependence, or schizophrenia-spectrum disorders, to determine the extent to which their victims were co-residents or non-household members. Methods: In a total birth cohort of 21-year-olds (n = 956), past-year prevalence of alcohol dependence, marijuana dependence and schizophrenia-spectrum disorders were diagnosed using standardized DSM-III-R interviews. None of the people with schizophrenia-spectrum disorder has been hospitalized in the past year. Past-year violence and victim targets were measured using self-reports. Results: Compared with controls, cohort members with substance dependence or schizophrenia-spectrum disorders had higher prevalence and frequency rates of assault against co-residents, against non-household members, and also robbery and gang fights. Out of 39, five individuals with schizophrenia-spectrum disorder committed violent street crimes. Persons with substance dependence had similar proportions of violence against co-resident and non-household members, but persons with schizophrenia-spectrum disorders tended to victimize co-residents more than others. Conclusions: At the age when they are most likely to contribute to the community's violence burden, young untreated offenders with alcohol or marijuana dependence or with schizophrenia-spectrum disorders assault not only co-residents, but others as well, and commit violent street crimes. Families, schoolteachers and primary care physicians have an important potentially preventive role in early identification and treatment of the disorders. Copyright © 2002 Whurr Publishers Ltd. [source] SIZE OF HOUSEHOLD FIREARM COLLECTIONS: IMPLICATIONS FOR SUBCULTURES AND GENDER,CRIMINOLOGY, Issue 3 2007BRIAN R. WYANT Recent work (Cook and Ludwig, 2003) has linked local firearm density to increased burglary victimization risk. The current work investigates within-household gun density or household firearm collection size. Previous work has suggested two subcultures of gun owners: protection-minded and sport- or hunting-minded. It also has identified gender gaps in reporting any household guns and in the number reported. None of the earlier work, however, has controlled for selection into gun-owning household status. This limitation raises potential questions about earlier findings. The current research controls for selection. If the two subcultures thesis is correct, protection-minded owners should report smaller household firearm collections. The expected impact is observed in one national survey and is partially replicated in a second. Gender gaps seemed more independent than previously suggested. This study is the first to provide evidence of two partially overlapping subcultures of gun owners even after controlling for selection into gun-owning household status. Practical implications for burglary risk may exist. [source] Trials update in walesCYTOPATHOLOGY, Issue 2007A. Fiander Three ongoing studies will be presented and discussed. Prevalence of Human Papillomavirus Infection in a South Wales Screening population Methods: A total of 10 000 consecutive, anonymous liquid based cytology screening samples were collected over a five month period in 2004. Age, cytology result and social deprivation score was provided for each specimen. The methodology was chosen to ensure inclusion of all women attending routine cervical screening, avoiding potential constraints associated with obtaining individual informed consent. The liquid based cytology samples were processed and reported by the receiving cytology laboratory and the residual specimens sent to the HPV Research Laboratory, Wales College of Medicine, where they were processed and stored at -80°C until analysis. High risk and low risk HPV Typing was undertaken using PCR , EIA (Jacobs et al 1997). Full high risk typing was performed on HPV positive specimens. Results: The study population had a mean age of 38 years with 92% negative, 5% borderline and 3% dyskaryotic cytology. The average social deprivation score was 17.4 (based upon the Welsh Index of multiple deprivation). The following results will be presented: HPV prevalence by age. HPV prevalence by cytology result. Type specific HPV prevalence in single and multiple infection. Conclusion: This study represents the largest type specific HPV Prevalence Study in the UK to date. As such it will form a useful base line against which to access performance of marketed HPV tests and evaluating the impact following implementation of HPV vaccination. [Funded by Welsh Office for Research and Development] CRISP , 1 Study (Cervical Randomized Intervention Study Protocol -1) Background: Indole-3-carbinol (I3C) and Diindolylmethane (DIM) are found in cruciferous vegetables and have been identified as compounds that could potentially prevent or halt carcinogenesis. I3C spontaneously forms DIM in vivo during acid digestion. I3C has been shown to prevent the development of cervical cancer in HPV 16 transgenic mice and both I3C and DIM have been shown to promote cell death in cervical cancer cell models. DIM is the major active bi-product of I3C and preliminary data indicate that DIM is active in cervical dysplasia and may be better tolerated than I3C. Aim: To investigate chemoprevention of high grade cervical neoplasia using Diindolylmethane (DIM) supplementation in women with low grade cytological abnormalities on cervical cytology. Objectives: To observe any reduction in the prevalence of histological proven high-grade cervical intraepithelial neoplasia (CIN) after 6 months of supplementation. ,,To observe any reduction in the prevalence of cytological abnormalities. ,,To observe any changes in the clinical appearance of the cervix. To assess acceptability and monitor any side effects of DIM supplementation. ,,To assess whether any benefit is seen in relation to Human Papillomavirus (HPV) status including HPV Type, Viral load and integration. Methods: This is a double blind randomized placebo-controlled trial involving 600,700 women with low grade cytological abnormalities on a cervical smear. Randomization is in the ratio of 2 : 1 in favour of active medication. Women with first mildly dyskaryotic smear or second borderline smear are eligible. They are asked to take two capsules daily for 6 months. At the end of 6 months they undergo repeat cervical cytology, HPV testing and colposcopy. Results: A progress report will be given for this ongoing study. [Funded: - Cancer Research UK] Type Specific HPV Infection in Welsh Cervical Cancers Background: Whilst there have been numerous studies of HPV infection associated with cervical cancer and on prevalence of Human Papillomavirus in diverse populations there have been no studies of these variables in the same population. Against a background of prophylactic HPV vaccination it is important to assess potential protection against cervical cancer within a given population. The most comprehensive analysis of HPV type specific cervical cancer is a meta-analysis published by the IARC in 2003. This however included only three UK based studies, totalling 118 cases, 75 of which were only investigated by HPV type PCR for four high risk types. None of this data was presented with associated population based prevalence data. Therefore, the research objectives for this study in combination with the first study above, are as follows: To determine the frequency of specific HPV types in cervical cancers in Wales. To compare the distribution of specific HPV types amongst cervical cancers with their prevalence in the general population. This will allow accurate delineation of the relationship between prevalence of specific HPV types in the general population and their association with clinically relevant disease. This information is a pre-requisite to assess the potential impact of prophylactic vaccination against HPV infection in Wales. Methods: Welsh Cervical Cancer specimens from 2000,2005 will be identified from pathology departments within Wales. The pathology of each tumour will be reviewed by a single Gynaecological Pathologist. The age of the patient and pathological features of the tumour will be noted. DNA will be extracted from the paraffin sections and HPV typed by PCR-EIA. Results: A progress report will be given for this ongoing study. [Funded by Welsh Office for Research and Development] [source] Protein kinase A RII-like (R2D2) proteins exhibit differential localization and AKAP interaction,CYTOSKELETON, Issue 7 2008Amy E. Hanlon Newell Abstract A-kinase anchoring proteins (AKAPs) bind to protein kinase A (PKA) via an amphipathic helix domain that interacts with a dimerization/docking domain on the regulatory (R) subunit of PKA. Four other mammalian proteins (ROPN1, ASP, SP17, and CABYR) also contain a highly conserved RII dimerization/docking (R2D2) domain, suggesting all four proteins may interact with all AKAPs in a manner similar to RII. All four of these proteins were originally detected in the flagellum of mammalian sperm. In this report, we demonstrate that all four R2D2 proteins are expressed in a wide variety of tissues and three of the proteins SP17, CABYR, and ASP are located in motile cilia of human bronchus and fallopian tubes. In addition, we detect SP17 in primary cilia. We also provide evidence that ROPN1 and ASP bind to a variety of AKAPs and this interaction can be disrupted with anchoring inhibitor peptides. The interaction of SP17 and CABYR with AKAPs appears to be much more limited. None of the R2D2 proteins appears to bind cAMP, a fundamental characteristic of the regulatory subunits of PKA. These observations suggest that R2D2 proteins utilize docking interactions with AKAPs to accomplish their function of regulating cilia and flagella. Based on location, affinity for AKAPs and lack of affinity for cAMP, it appears that each R2D2 protein has a unique role in this process. Cell Motil. Cytoskeleton 2008. © 2008 Wiley-Liss, Inc. [source] Actin stress fiber pre-extension in human aortic endothelial cellsCYTOSKELETON, Issue 4 2008Lan Lu Abstract Actin stress fibers (SFs) enable cells to sense and respond to mechanical stimuli and affect adhesion, motility and apoptosis. We and others have demonstrated that cultured human aortic endothelial cells (HAECs) are internally stressed so that SFs are pre-extended beyond their unloaded lengths. The present study explores factors affecting SF pre-extension. In HAECs cultured overnight the baseline pre-extension was 1.10 and independent of the amount of cell shortening. Decreasing contractility with 30 mM BDM or 10 ,M blebbistatin decreased pre-extension to 1.05 whereas increasing contractility with 2 nM calyculin A increased pre-extension to 1.26. Knockdown of ,-actinin-1 with an interfering RNA increased pre-extension to 1.28. None of these affected the wavelength of the buckled SFs. Pre-extension was the same in unperturbed cells as in those in which the actin cytoskeleton was disrupted by both chemical and mechanical means and then allowed to reassemble. Finally, disrupting MTs or IFs did not affect pre-extension but increased the wavelength. Taken together, these results suggest that pre-extension of SFs is determined primarily by intrinsic factors, i.e. the level of actin-myosin interaction. This intrinsic control of pre-extension is sufficiently robust that pre-extension is the same even after the actin cytoskeleton has been disrupted and reorganized. Unlike pre-extension, the morphology of the compressed SFs is partially determined by MTs and IFs which appear to support the SFs along their lengths. Cell Motil. Cytoskeleton 2008. © 2008 Wiley-Liss, Inc. [source] Pulp and periodontal healing of laterally luxated permanent teeth: results after 4 yearsDENTAL TRAUMATOLOGY, Issue 6 2008Elena C. Ferrazzini Pozzi Material and methods:, Patients presenting with lateral luxation of permanent teeth during 2001,2002 were enrolled in this clinical study. Laterally luxated teeth were repositioned and splinted with a TTS/composite resin splint for 4 weeks. Immediate (prophylactic) root-canal treatment was performed in severely luxated teeth with radiographically closed apices. All patients received tetracycline for 10 days. Re-examinations were performed after 1, 2, 3, 6, 12 and 48 months. Results:, All 47 laterally luxated permanent teeth that could be followed over the entire study period survived. In 10 teeth (21.3%), a prophylactic root-canal treatment was performed within 2 weeks following injury. The remaining 37 teeth showed the following characteristics at the 4-year re-examination: 19 teeth (51.4%) had pulp survival (no clinical or radiographic signs or symptoms), nine teeth (24.3%) presented with pulp canal calcification, and pulp necrosis was seen in another nine teeth (24.3%), within the first year after trauma. None of the teeth with a radiographically open apex at the time of lateral luxation showed complications. External root resorption was only seen in one tooth. Conclusions:, Laterally luxated permanent teeth with incomplete root formation have a good prognosis, with all teeth surviving in this study. The most frequent complication was pulp necrosis that was only seen in teeth with closed apices. [source] Long-term effect of different treatment modalities for traumatized primary incisors presenting dark coronal discoloration with no other signs of injuryDENTAL TRAUMATOLOGY, Issue 1 2006Gideon Holan Abstract,,, The aim was to compare the long-term outcomes of root canal treatment with that of follow-up-only in traumatized primary incisors in which dark discoloration is the only sign of injury. Root canal treatment was performed in 48 dark discolored asymptomatic primary incisors following trauma. Twenty-five of them [root canal treatment (RCT) group] were followed till eruption of their permanent successors. Ninety-seven dark discolored asymptomatic primary incisors were left untreated and invited for periodic clinical and radiographic examination. Of these, 28 [follow-up (FU) group] were followed till eruption of their permanent successors. The parameters examined included early extraction of the traumatized primary incisor, early or delayed eruption of the permanent successors, ectopic eruption of the permanent successor and signs of enamel hypopcalcification or hypoplasia in the permanent successor. Chi-square test was used for statistical analysis. Seven of 25 (28%) of the RCT group and 32% (nine of 28) of the FU group required early extraction. Five of 25 (20%) of the RCT group and 21% (six of 28) of the FU group showed early or delayed eruption of the permanent successors. Sixteen of 25 (64%) of the RCT group and 79% (22 of 28) of the FU group showed ectopic eruption of the permanent successors. Enamel hypopcalcification or hypoplasia in the permanent successors was equally found (36%) in both groups (nine of 25 in the RCT group and 10 of 28 in the FU group). None of differences was statistically significant. Root canal treatment of primary incisors that had change their color into a dark-gray hue following trauma with no other clinical or radiographic symptom is not necessary as it does not result in better outcomes in the primary teeth and their permanent successors. [source] Effects and distribution of the enamel matrix derivative Emdogain® in the periodontal tissues of rat molars transplanted to the abdominal wallDENTAL TRAUMATOLOGY, Issue 1 2002Yoshioki Hamamoto Abstract , The enamel matrix derivative Emdogain® (EMD) has been found to promote regeneration of lost periodontal tissues. We have studied the effects and distribution of EMD in the periodontal tissues of maxillary rat molars transplanted to a subcutaneous position in the abdominal wall. The molars were transplanted with or without EMD either immediately after extraction or after drying for 30 min. After 2 days, 1, 2 or 4 weeks the rats were killed and the teeth were examined by means of light microscopy and immunohistochemistry with anti-amelogenin antibodies. Teeth transplanted immediately after extraction showed formation of alveolar bone separated from the dental roots by a periodontal space, regardless of the use of EMD. Among the teeth that were transplanted with EMD after drying for 30 min, new alveolar bone was formed in five out of eight teeth after 2 and 4 weeks. None of the teeth that were dried for 30 min and transplanted without EMD showed alveolar bone formation. Only one tooth transplanted with EMD showed root resorption after drying, while resorption was noted in all teeth transplanted without EMD. All teeth that were transplanted with EMD and none of the teeth that were transplanted without EMD showed an immunohistochemical reaction for amelogenin. After 2 days, amelogenin was precipitated on all surfaces exposed at the transplantation procedure. Later, the immunoreactive material was redistributed to cells at the root surface, where it was still demonstrable after 4 weeks. In conclusion, EMD is accumulated in cells at the root surface and promotes regeneration of the periodontal tissues of the transplanted teeth. It also seems to promote healing of root resorption. [source] Treatment of Lentigo Maligna with Imiquimod before Staged ExcisionDERMATOLOGIC SURGERY, Issue 2 2008MURRAY A. COTTER MD BACKGROUND Imiquimod 5% cream has demonstrated effectiveness in the treatment of lentigo maligna (LM) in several small studies. None of the studies to date have included posttreatment surgical removal to confirm negative histologic margins. OBJECTIVE The aim of this retrospective analysis was to assess the efficacy of topical imiquimod in LM by circumferentially examining vertically oriented sections from a geometrically designed "picture frame" margin as well as bread-loafed sections of the central portion after staged excisions of imiquimod-treated lesions of LM. METHODS Forty patients with biopsy-confirmed LM were treated five times a week for 3 months with 5% imiquimod cream before staged excision. Tazarotene 0.1% gel was added when no clinical signs of erythema developed with imiquimod alone after 1 month (10 patients). After the course of topical therapy, patients were assessed for clinical and complete histologic clearance after staged excision. RESULTS A total of 33 of 40 patients had a complete clinical response as determined by the absence of remaining clinical lesion on physical examination. Upon histologic review, 30 of 40 patients had no evidence of LM whereas 10 of 40 harbored residual disease. One patient was found to have histologic evidence of invasion after completing the topical protocol. After a mean follow-up of 18 months (range, 12,34 months) and after complete surgical excision of the treatment site, none of the imiquimod-treated patients had evidence of recurrence. CONCLUSIONS Imiquimod appears to be an effective adjunctive treatment for LM but does not qualify as a replacement therapy for surgery. [source] Multiple Primary Acral Melanomas in African-Americans: A Case Series and Review of the LiteratureDERMATOLOGIC SURGERY, Issue 1 2007ANGELA C. S. HUTCHESON MD BACKGROUND Although melanoma accounts for only 4% to 5% of all skin cancers in the United States, it causes most skin cancer,related deaths. We describe a unique group of African-American patients with multiple primary acral lentiginous melanomas (ALMs). OBJECTIVE The purpose of this study was to review the case histories and management of a cohort of patients in the Mohs practice of our dermatologic surgeon with multiple primary ALM. METHODS This is a case series of patients with multiple ALM identified by chart review from 2000 to 2005. A thorough review of the literature was performed. RESULTS Four patients, all African-American, were identified with multiple ALM. All patients were managed with excision or Mohs micrographic surgery utilizing permanent sections. None of the patients with ALM had melanomas at nonacral sites or other types of skin cancer. Several had acral melanosis. Information in the literature on patients with multiple primary acral melanomas was insufficient. CONCLUSION Patients with multiple acral melanomas have not, to our knowledge, been reported thus far. It can be extrapolated from current literature, however, that appropriate management of these patients, including staging work and surgical intervention, is to be determined by the individual characteristics of the melanoma and the patient's concomitant risk factors, if any. [source] A Simple, Pain-Free Treatment for Ingrown Toenails Complicated with Granulation TissueDERMATOLOGIC SURGERY, Issue 11 2006F. GÜLRU ERDOGAN MD BACKGROUND The treatment of ingrown toenail complicated with granulation tissue is usually partial or total nail avulsion with or without matricectomy. It costs loss of occupational power, however, because most patients cannot go to work or school for some time after surgery, and it is a costly and uncomfortable procedure for most patients. OBJECTIVE This study aimed to find an easy, painless, and inexpensive alternative. MATERIALS AND METHODS Seven patients with ingrown toenails complicated with granulation tissue are included. A small apparatus was applied on the nails, granulation tissue was chemically cauterized, and a foot bath was recommended twice daily. They were followed on a weekly basis or every other week until recovery. None of the patients received systemic treatment. RESULTS All seven patients were completely cured without requiring surgery and/or systemic treatment. The procedure did not have any effect on their daily life. The follow-up examination of the patients at 6 months revealed that they were totally cured, and there were no recurrences. CONCLUSION Patients with ingrown toenails complicated by granulation tissue might have an inexpensive and pain-free treatment alternative, although new studies with more patients are required. [source] Combination Surgical Lifting with Ablative Laser Skin Resurfacing of Facial Skin: A Retrospective AnalysisDERMATOLOGIC SURGERY, Issue 9 2004Tina S. Alster MD Background. Cutaneous aging is manifested by rhytides, dyschromias, and skin laxity. Ablative laser skin resurfacing can effectively improve many signs of skin aging; however, the photoaged patient with facial laxity often requires a surgical lifting procedure in order to obtain optimal results. Concerns with delayed or impaired wound healing has led to reluctance to perform both procedures simultaneously. Objective. To report the clinical results and side effect profiles after concomitant surgical facial lifting procedures and ablative carbon dioxide or erbium:YAG laser resurfacing in a series of patients. Methods. A retrospective analysis and chart review was performed in 34 consecutive patients who underwent combination CO2 or erbium:YAG laser skin resurfacing and surgical lifting procedures, including S-lift rhytidectomy, blepharoplasty, and brow lift. Side effects and complication rates were tabulated. Results. The side effect profile of the combined surgical-laser procedures was similar to that reported after a laser-only procedure. The most common side effect was transient hyperpigmentation which occurred in 20.6% of treated patients. None of the patients experienced delayed reepithelialization, skin necrosis, or prolonged healing times. Conclusions. Concurrent laser skin resurfacing and surgical lifting of facial skin maximizes aesthetic results without increased incidence of adverse effects. Patients benefit from the consolidation of anesthesia and convalescent times as well as enhanced global clinical outcomes. [source] Mechanical ventilation for respiratory failure in children with severe neurological impairment: is it futile medical treatment?DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 5 2010JOSEPHUS PJ VAN GESTEL Aim, To assess outcome for children with severe neurological impairment receiving invasive mechanical ventilation for respiratory failure. Method, Medical charts for all such children treated in our intensive care unit (ICU) between January 2003 and July 2008 were reviewed. Outcomes were compared with those for children with moderate neurological impairment. Results, Twenty-two children with severe neurological impairment were included (nine females, 13 males; median age 7y 10mo; range 4mo,17y). The median duration of mechanical ventilation was 16 days. Six children had an uneventful 1-year survival, the others required reintubation or readmission to the ICU, or died. Eleven children were still alive 1 year after discharge from the ICU. Nine patients died of respiratory failure. None of the children in the severe group died of a heart defect. Eleven children with moderate neurological impairment were included (eight females, three males; median age 1y 1mo, range 4mo,13y). Four children had an uneventful 1-year survival. Eight children were still alive 1 year after discharge from the ICU. Two of the three non-survivors died of their heart defects. Interpretation, Mechanical ventilation for respiratory failure in children with severe neurological impairment is complex and associated with limited survival. However, it cannot be regarded as futile medical treatment. Further studies are urgently needed for the rational guidance of clinical decision-making. [source] Psychotherapy for depression among children and adolescents: a systematic reviewACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2007N. Watanabe Objective:, To examine the clinical benefit, the harm and the cost-effectiveness of psychotherapies in comparison with no treatment, waiting-list controls, attention-placebos, and treatment as usual in depressed youths. Method:, Meta-analyses were undertaken by using data from all relevant randomized-controlled trials identified by a comprehensive literature search. The primary outcome was relative risk (RR) of response. Results:, We identified 27 studies containing 35 comparisons and 1744 participants. At post-treatment, psychotherapy was significantly superior (RR = 1.39, 95% CI 1.18,1.65, P = 0.0001, number-needed to treat 4.3). There was an evidence of the existence of small study effects, including a publication bias (P < 0.001). The superiority of psychotherapy was no longer statistically significant (1.18 [0.94,1.47], P = 0.15) at 6-month follow-up. None of the studies reported adverse effects or cost-effectiveness outcomes. Conclusion:, Although the findings were biased by some small positive trials, psychotherapies appear to help depressed youths for the short term, but are no longer significantly favourable at 6-month follow-up. [source] The use of tiagabine in pediatric spasticity managementDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 6 2006Mary Lynn Chu MD Tiagabine, developed as an anti-epileptic medication, has the potential to reduce spasticity. The purpose of the present study was to assess the effectiveness of tiagabine in decreasing spasticity and improving the functional abilities of children with spastic cerebral palsy (CP). Nine children (seven females, two males) with CP (six spastic quadriplegia, three moderate to severe spastic diplegia) were treated with tiagabine for a mean of 7.2 months. Median age was 4y 5mo (range 3y 2mo-10y). All children were non-ambulatory. According to the Gross Motor Function Classification System, six were Level IV and three were Level V. Only one child showed a median decrease ,1.0 grade on the modified Ashworth scale in upper extremities, lower extremities, and overall. Another child had significant improvement in the Pediatric Evaluation of Disability Inventory Self-care score and improved feeding. None of the participants was found to have a significant improvement in motor function or a decrease in the number of motions (passive range of motion and muscle length test) that were limited. Reduction of nocturnal awakenings from painful spasms was reported in one child. Eight of the nine children experienced adverse side-effects during treatment. Although tiagabine was not found to be effective in decreasing children's spasticity or improving their function, its potential use in the relief of painful spasms associated with neurological conditions in the pediatric population warrants further investigation. [source] Cortical radial glial cells in human fetuses: Depth-correlated transformation into astrocytesDEVELOPMENTAL NEUROBIOLOGY, Issue 3 2003Leonardo C. deAzevedo Abstract In the human brain, the transformation of radial glial cells (RGC) into astrocytes has been studied only rarely. In this work, we were interested in studying the morphologic aspects underlying this transformation during the fetal/perinatal period, particularly emphasizing the region-specific glial fiber anatomy in the medial cortex. We have used carbocyanine dyes (DiI/DiA) to identify the RGC transitional forms and glial fiber morphology. Immunocytochemical markers such as vimentin and glial fibrillary acidic protein (GFAP) were also employed to label the radial cells of glial lineage and to reveal the early pattern of astrocyte distribution. Neuronal markers such as neuronal-specific nuclear protein (NeuN) and microtubule-associated protein (MAP-2) were employed to discern whether or not these radial cells could, in fact, be neurons or neuronal precursors. The main findings concern the beginning of RGC transformation showing loss of the ventricular fixation in most cases, followed by transitional figures and the appearance of mature astrocytes. In addition, diverse fiber morphology related to depth within the cortical mantle was clearly demonstrated. We concluded that during the fetal/perinatal period the cerebral cortex is undergoing the final stages of radial neuronal migration, followed by involution of RGC ventricular processes and transformation into astrocytes. None of the transitional or other radial glia were positive for neuronal markers. Furthermore, the differential morphology of RGC fibers according to depth suggests that factors may act locally in the subplate and could have a role in the process of cortical RGC transformation and astrocyte localization. The early pattern of astrocyte distribution is bilaminar, sparing the cortical plate. Few astrocytes (GFAP+) in the upper band could be found with radial processes at anytime. This suggests that astrocytes in the marginal zone could be derived from different precursors than those that differentiate from RGCs during this period. © 2003 Wiley Periodicals, Inc. J Neurobiol 55: 288,298, 2003 [source] Rising cortisol at childcare: Relations with nap, rest, and temperamentDEVELOPMENTAL PSYCHOBIOLOGY, Issue 1 2002Sarah E. Watamura Abstract An unexpected rise in cortisol across the day in full-day, center-based childcare has been recently observed. Most of the children in these studies exhibited the rise across the day at childcare, but the expected drop at home. Possible explanations include more or less napping at childcare than at home. This study measured cortisol during childcare at 10:30 a.m., pre-rest, post-rest, and 3:30 p.m. for 35 children, and at 10:30 a.m. and 3:30 p.m. at home for 8 children. Duration and quality of rest were coded during nap periods. For 91% of children, cortisol rose at childcare and for 75% dropped at home. None of the napping variables were related to the rise at childcare nor were differences found between home and childcare rest. Factors other than daytime rest periods seem likely to account for the rise in cortisol across the childcare day, possibly factors involving the interactional demands of group settings during this developmental period. © 2002 John Wiley & Sons, Inc. Dev Psychobiol 40: 33,42, 2002 [source] Letrozole normalizes serum testosterone in severely obese men with hypogonadotropic hypogonadismDIABETES OBESITY & METABOLISM, Issue 3 2005H. De Boer Background:, Morbid obesity is associated with increased estradiol production as a result of aromatase-dependent conversion of testosterone to estradiol. The elevated serum estradiol levels may inhibit pituitary LH secretion to such extent that hypogonadotropic hypogonadism can result. Normalization of the disturbed estradiol-testosterone balance may be beneficial to reverse the adverse effects of hypogonadism. Aim:, To examine whether aromatase inhibition with Letrozole can normalize serum testosterone levels in severely obese men with hypogonadotropic hypogonadism. Patients and Methods:, Ten severely obese men, mean age 48.2 ± 2.3 (s.e.) years and body mass index 42.1 ± 2.6 kg/m2, were treated with Letrozole for 6 weeks in doses ranging from 7.5 to 17.5 mg per week. Results:, Six weeks of treatment decreased serum estradiol from 120 ± 20 to 70 ± 9 pmol/l (p = 0.006). None of the subjects developed an estradiol level of less than 40 pmol/l. LH increased from 4.5 ± 0.8 to 14.8 ± 2.3 U/l (p < 0.001). Total testosterone rose from 7.5 ± 1.0 to 23.8 ± 3.0 nmol/l (p < 0.001) without a concomitant change in sex hormone-binding globulin level. Those treated with Letrozole 17.5 mg per week had an excessive LH response. Conclusion:, Short-term Letrozole treatment normalized serum testosterone levels in all obese men. The clinical significance of this intervention remains to be established in controlled, long-term studies. [source] Relationship between mean blood glucose and glycated haemoglobin in Type 2 diabetic patientsDIABETIC MEDICINE, Issue 2 2008K. Makris Abstract Aims To correlate the values of MBG to HbA1c in Greek patients with Type 2 diabetes and/or metabolic syndrome. Methods We followed up 140 Greek adult patients: 92 patients with Type 2 diabetes treated with insulin or oral glucose-lowering medication, and 48 patients with newly diagnosed Type 2 diabetes or metabolic syndrome not receiving any treatment. MBG was calculated for each patient from self-measurements of blood glucose using a portable glucometer, made six times a day (before eating and 2 h after a meal), three times a week for 1 month. HbA1c was determined by HPLC at 0 and 12 weeks. Results, HbA1c at 0 (x) and 12 weeks (y) correlated strongly (y = 0.790x + 1.115, r = 0.92), confirming that the patient's glycaemic status remained stable during the whole period of follow-up. Linear regression was performed on MBG values; HbA1c at 12 weeks, sex, age, body mass index (BMI) and patient status (Type 2 diabetes treated or not) were used as independent variables. None of the independent variables reached statistical significance in the model, with the exception of HbA1c at 12 weeks. The final model was: MBG (mg/dl) = (34.74 × HbA1c) , 79.21, r = 0.93; or MBG (mmol/l) = 1.91 × HbA1c , 4.36, r = 0.93. Conclusions Our results establish for the first time a strong correlation between MBG and HbA1c in Type 2 diabetic patients and support the idea of expressing HbA1c results as MBG. This will help patients to gain a clearer interpretation of the result, with less confusion. This simplification will allow every person with diabetes using home glucose-monitoring to understand his or her own target level. [source] The association of coronary calcium score and conventional cardiovascular risk factors in Type 2 diabetic subjects asymptomatic for coronary heart disease (The PREDICT Study)DIABETIC MEDICINE, Issue 10 2004R. S. Elkeles Abstract Aim To determine the association between coronary calcification score (CACS) obtained by electron beam computed tomography (EBCT) and cardiovascular risk factors in Type 2 diabetic subjects entered into a prospective cohort study. Methods Type 2 diabetic subjects attending routine hospital diabetic clinics without known coronary heart disease (CHD) underwent EBCT to measure CACS. Demographic data were obtained and conventional cardiovascular risk factors were measured at baseline. Results Four hundred and ninety-five subjects were assessed of whom 67.7% were male. They had a mean (sd) age of 62.9 (7.1) years, with median (inter-quartile range) duration of diabetes of 8 (4,13) years. None had a history of coronary artery disease. Forty-five per cent were receiving lipid-lowering agents (including 36% statins). In a univariate analysis, there were significant associations between increased CACS and age, duration of diabetes, male gender, waist,hip ratio (WHR), systolic blood pressure, and the use of statins. In a multivariate model adjusting for the possible interaction of these and other factors, the significant association between CACS and WHR, systolic blood pressure, male gender and statin use remained. Conclusions The close association between CACS and WHR and the association with systolic blood pressure suggest that coronary calcification may be particularly linked to the metabolic syndrome in Type 2 diabetes. [source] | |||||||||||||||||||||||||