HIV infection amongst leprosy patients in south India

We use the trapezoidal lamellar incision as standard construction for sutureless self-sealing wound closure in our clinic: a 7 mm incision for phacoemulsification and implantation of a 6.5 mm optic diameter PMMA posterior chamber less (PCL) and an incision up to 11 mm for ECCE with standard PCL. The operation can be performed in a nearly closed system because of the self-sealing wound construction. Experiments in cadaver eyes showed that the wound closure of a 7 mm incision with the no-stitch technique ruptured at a pressure five times greater than the cross-stitch-sutured corneoscleral incision and in an 11 mm incision four times greater (602 +/- 149 mmHg and 150 +/- 29 mmHg). Due to the high stability of the wound closure, no sutures are necessary. Complications arising in connection with sutures are therefore avoided. Clinically, two typical postoperative complications were observed: hypotony occurred in 1% and anterior chamber hemorrhage in 5%. These complications are exclusively caused by imperfection of the internal corneal opening.     

Sequential pattern of non-medical drug use in the drug career of opiate dependents in Nagpur, India

OBJECTIVE: To evaluate low- and high-dose dexamethasone suppression tests for differentiating pituitary dependent hyperadrenocorticism (PDH) from adrenal tumor hyperadrenocorticism (ATH) in dogs. DESIGN: Prospective study. ANIMALS: 181 dogs with PDH and 35 dogs with ATH. PROCEDURE: Plasma cortisol concentrations from dogs with naturally developing hyperadrenocorticism were evaluated before, and 4 and 8 hours after administration of standard low- and high-doses of dexamethasone (0.01 mg/kg of body weight, i.v., and 0.1 mg/kg, i.v.; respectively). RESULTS: In response to the low-dose test, all but 3 dogs had an 8-hours post-dexamethasone plasma cortisol concentration that was consistent with a diagnosis of hyperadrenocorticism, that is, > or = 1.4 micrograms/dl. Criteria used to distinguish PDH from ATH in response to low-dose dexamethasone included a 4-hour post-dexamethasone plasma cortisol concentration < 50% of the basal value or < 1.4 micrograms/dl, or an 8-hours post-dexamethasone plasma cortisol concentration < 50% of the basal concentration. Criteria used to distinguish PDH from ATH in response to high-dose dexamethasone included 4- or 8-hour post-dexamethasone plasma cortisol concentrations < 50% of the basal concentration or < 1.4 micrograms/dl. In response to the low-dose test, 111 dogs met criteria for suppression (each had PDH). In response to the high-dose test, 137 dogs met criteria for suppression (2 had ATH, 135 had PDH). Twenty-six dogs with PDH (12%) had indications of adrenal suppression in response to high-dose but not low-dose testing. CLINICAL IMPLICATIONS: Low-dose dexamethasone test has value as a discrimination test to distinguish dogs with PDH from those with ATH. The high-dose test need only be considered in dogs with hyperadrenocorticism that do not have adrenal suppression in response to the low-dose test.     

Group self-identification as a prospective predictor of drug use and violence in high-risk youth.

This study provides a 1-year prospective analysis of group self-identification as a predictor of adolescent drug use and violence. Youth identified with discrete groups. In most comparisons, 1 year later, a high-risk group reported greater levels of drug use and violence-related exposure than other groups, and the statistical relation between group self-identification and drug use or violence remained after baseline assessment of the drug use or violence measure was controlled for. This is the 1st study to demonstrate that group self-identification is a significant prospective predictor of drug use and other problem behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alternative medicine use by homeless youth

BACKGROUND: Mainstream health care for homeless youth is often fragmented or unavailable. OBJECTIVE: To evaluate the use of complementary and alternative medicine (CAM) by homeless youth who use our free clinic. DESIGN: Self-administered cross-sectional survey. SUBJECTS AND METHODS: Subjects included homeless youth between the ages of 14 and 21 years receiving care at the 45th Street Clinic Youth Program in Seattle, Wash, between January 29,1998, and March 5, 1998. The self-administered survey included items on demographics, health issues, use frequency of different therapists or therapies, referral sources, and perceived effectiveness of treatment. RESULTS: The response rate by patients was 96.3% (157/163) with an average respondent age of 18.5 years (range, 14-21 years). Complementary and alternative medicine was used by 70.1% of the subjects. Referrals most often came from friends (52.7%). The most common reason for using CAM was because it was "natural" (43.9%). Most of those who used alternative therapies (87.3%) believed they had been helped "some" or "a lot." Given a choice of providers to visit when they were ill, 51.7% would seek care from a physician, 36.9% from a CAM provider, and 11.4% would treat themselves. CONCLUSIONS: Care with CAM is frequently used and accepted by homeless youth. Cost-effectiveness and contributions to overall health care require additional evaluation. Integrating CAM into allopathic health centers may serve as an incentive to entice youth into mainstream health care.     

Prevalence of hypertension and borderline hypertension in students. Comparison with a non-student group

A blood pressure detection program was conducted at the University of Zurich in June 1978. Three consecutive blood pressure measurements using random-zero mercury sphygmomanometers (n = 4) were performed in 1364 students and 440 other subjects by 8 different investigators. Height and body weight were also measured and used to calculate the body mass index (Quetelet index). Personal history, physical activity, smoking and dietary habits were analyzed with the aid of a questionnaire. In comparison to initially measured values, there was a statistically significant decrease in systolic and diastolic pressure readings as the trial proceeded (p less than 0.001). Based on the mean value of all three measurements, hypertension was observed in only 1.7% of the male and 0.9% of the female students. In the other subjects covered by the trial the comparable values were 7.9% in males and 4.5% in females. The true prevalence of hypertension (addition of those persons with normotensive blood pressure values and simultaneous antihypertensive therapy) was 1.9% in male and 1.1% in female students, whereas 12.0% of the male and 8.5% of the female non-students suffered from hypertension. The prevalence of border-line hypertension (mean value of all three tests) was 7.4% in male and 3.0% in female students. Corresponding values for the other subjects tested were 18.7% (males) and 11.6% (females).     

Psychotropic drug use in family practice

In an attempt to assess the precision of an illness-treatment "fit" between dispensing and actual need for psychotropic medications, the present study examined the dispensing patterns to consecutive attenders of private general practice. "Conservative" use of psychotropic drugs was indicated insofar as patients were seldom dispensed medication in the absence of emotional problems, and the presence of emotional problems frequently was not accompanied by the dispensing of medication. In addition, specific social and illness factors were located which could differentially predict either the presence of emotional problems, the use of psychotropic drugs, or both of these variables. The potential for constructing a more precise illness-treatment fit was considered.     

Prevalence and a drug use development model for the study of adolescent drug use in Japan

The purposes of this study were to estimate the prevalence of drug use, to examine the correlation between drug use and drinking/smoking in Japan, and to test a developmental model of adolescents' drug use based on three basic theories of deviance: Strain, Social control, and Differential association. The survey was conducted from April to May, 1996, in 14 public high schools in Tokyo, using anonymous self-reporting. A total of 4,171 (99.45%) students responded to our questionnaire. It included central concept items in the three deviant theories, beliefs about the ill effects of drugs, sex, grades, etc. The following findings were obtained: 1) Among the subjects, 255 students (6.1%) reported drug use within the past year. Of these drug users, 73.3% used drugs soon after being "tempted" by friends. Responding to "When was it.", as a first year junior high school was the most common first experience, and the next most common was during the sixth year of elementary school. 2) Drinking and smoking appeared to be gateway drugs for adolescents in Japan as has been shown in the United States. 3) Multiple regression and logistic multiple regression analyses suggested that differential association variables were far more powerful predictors of adolescent drinking, smoking and drug use than either the control or strain variables. Results provided modest support for the Differential Association Theory as an explanation of drug use. 4) LISREL's goodness-of-fit statistic indicated a much better fit between the model and the data. (CN: 282, GFI: 0.967, AGFI: 0.941). These findings show two processes by which adolescents become involved in drug use. Strain and Social Control do not directly affect drug use. However, Social Control is important because it works indirectly, through Differential Association resulting in drug use. Second, though weaker, Differential Association appears to lead to dangerous beliefs in drug use followed by actual drug use.     

Personality factors in student drug use.

Interviewed a random sample of 160 male and female undergraduates concerning illicit psychotropic drug use and administered the Personality Research Form. Univariate and multivariate analyses strongly supported the hypothesis that nonusers, moderate users, and heavy users of illicit drugs differ in personality characteristics. Dramatic sex differences were observed in the personality characteristics associated with illicit drug use, suggesting that sex and personality interact in a crucial way to influence drug use. The relationships between illicit drug use and GPA, satisfaction with academic performance, aptitude, and other relevant variables were also investigated. The data are interpreted as suggesting that both male and female heavy users may have rejected their stereotypic sex roles. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Implicit cognition in adolescent drug use.

Implicit cognitive responses to drug use cues and drug outcomes, assessed with measures of memory association, were studied in a sample of high-risk White and Latino adolescents. The utility of these responses as predictors of drug use was examined and compared with potentially confounding predictors, including gender, socioeconomic status, ethnicity, and acculturation. The background variables also served as potential moderators of the effects of implicit cognition. The results revealed that measures of memory association were consistent, direct-effect predictors of marijuana and alcohol use. In addition, these implicit cognitive measures were stronger predictors than were the background variables, and their predictive effects were not moderated by other variables. The results provide further support for the implicit cognition perspective in drug use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The consequences of drug use in adolescence

This article is a overview of the multiple consequences of drug use, abuse and dependence among adolescents. Developmental issues on transition to adulthood are highlighted. The usual behavioural problems of drug addicts are explained on the basis of pathological defense mechanisms. A contemporary approach is made of the physical, psychological and social consequences of drug use.     

The phenomenon of abusable psychotropic use among North American youth

Abusable psychotropic use can, and does, affect all North American youth, either directly or indirectly, regardless of age, gender, culture, ethnic background, education, race, or socioeconomic status. Over the last decade, the morbidity and mortality associated with abusable psychotropic use among youth have become staggering. A current overview of the phenomenon of abusable psychotropic use among youth in North America, including the use of alcohol, cannabis, cocaine, LSD, nicotine, and polyabusable psychotropic use, is presented with attention to the expanding role of clinical pharmacologists in relation to both prevention and treatment. The Mega Interactive Model of Abusable Psychotropic Use Among Youth is presented as a heuristic device to assist clinical pharmacologists, and other health care providers, in addressing the multifactorial interactive aspects of this complex phenomenon as observed in the pediatric age group. In this regard, attention is given to the interaction of the Abusable Psychotropic Dimension, including the Abusable Psychotropic Variables (e.g., pharmacokinetics, abuse potential) and Pattern of Use Variables (e.g., social use, abuse, compulsive use), with the Young Person, Societal, and Time Dimensions.     

Preliminary results for an adaptive family treatment for drug abuse in Hispanic youth.

A small randomized trial investigated a new family-based intervention for Hispanic adolescents who met DSM–IV criteria for substance abuse disorder. The Culturally Informed and Flexible Family-Based Treatment for Adolescents (CIFFTA) is a tailored/adaptive intervention that includes a flexible treatment manual and multiple treatment components. The study used an “add on” design to isolate the effects on substance abuse, behavior problems, and parenting practices attributable to the newly developed components. Twenty-eight Hispanic adolescents and their families were randomized either to the experimental treatment or to traditional family therapy (TFT) and were assessed at baseline and 8-month follow-up. Despite the small sample, results revealed statistically significant time × treatment effects on both self-reported drug use (marijuana + cocaine), F(1, 22) = 10.59, p     

An 8-year study of multiple influences on drug use and drug use consequences.

Multiple long-term influences on young adult drug use and abuse were tested within an interactionist perspective using latent-variable causal models. Intrapersonal influences included early drug use and social conformity. Proximal interpersonal influences were captured by perceived peer drug use, perceived adult drug use, and family disruption. More distal influences included perceptions of community approval or disapproval for drug use. Outcome measures included not only use of drugs but also disruptive drug use (getting high at work or school) and self-admitted problems with drugs. Data were obtained from 654 participants at three equally spaced time points during an 8-year longitudinal study that began when the subjects were in junior high school. Stability effects were found for all repeatedly measured latent variables across the 4-year spans. Social conformity strongly influenced other latent variables across time. Early drug use and perceived adult drug use were prominent predictors of young adult drug use, whereas prior drug use predicted disruptive drug use and a lack of social conformity predicted problems with drug use. Early adult alcohol use predicted later disruptive drug use and problems with drug use. Perceived adult drug use generally influenced later alcohol use, whereas peer drug use influenced later cannabis and hard-drug use. Implications for prevention and treatment using a multicausal interactionist perspective are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictors of outpatient mental health service use by American youth.

Among American children and adolescents aged 1 to 17 years, the 12- to 17-year-olds represent the largest users of outpatient mental health services. This study utilizes a nationally representative sample of this age group from the 2005 National Survey on Drug Use and Health to illuminate predictors of services use from three treatment settings: day treatment programs, mental health clinics/centers, and private/in-home settings. Univariate analyses were used to calculate the percentages of the study sample that used mental health services in these settings. In bivariate analyses, the authors estimated the strength of the associations between available predisposing, need, and enabling factors and the outcomes. Multiple logistic regressions estimated the independent effects of each covariate on the outcomes. Lifetime depression, lifetime general anxiety, delinquent behaviors, drug dependence, and Medicaid were consistent predictors of services use in the three treatment settings. Several other factors were associated with services use in bivariate analyses but lost most of their statistical significance when the authors adjusted for other confounders. Interpreted in light of its potential limitations, this study has important research and policy significance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)