Metabolic and anthropometric changes in female weight cyclers and controls over a 1-year period

OBJECTIVE: Women who diet to lose weight often regain the weight over time, and the cycle repeats itself. The objective of this study was to identify a group of female weight cyclers and to match them with a control group who had never consciously tried to lose weight. For 1 year, weight patterns, eating habits, metabolic parameters, and body composition were assessed to determine whether there was a relationship between weight cycling and these variables. DESIGN: Measurements were done at baseline and at 6 and 12 months. Changes in weight, diet, and exercise were monitored throughout the year. SETTING: All testing was done at a university physiology laboratory. SUBJECTS/SAMPLES: Nine weight cyclers with a notable history of dieting and food restriction were recruited. Subsequently, nine control subjects were selected and matched for age, height, weight, lean body mass, and exercise habits. MAIN OUTCOME MEASURE: The observational study included measures of 3-day diet records, skinfold and girth, serum glucose, insulin and triiodothyronine, and resting energy expenditure. STATISTICAL ANALYSES PERFORMED: The main variables were analyzed using a 2 x 3 (diet group x time) analysis of variance with repeated measures on the time factor. Comparison of the means was done by Tukey post hoc test. RESULTS: A 7-point satisfaction scale indicated that the weight cyclers were dissatisfied with their weight compared with the noncyclers (P = .03). Otherwise, there were no differences between groups in dietary intakes or the physiologic variables. APPLICATIONS/CONCLUSIONS: In the parameters measured, a history of weight cycling did not affect the metabolic profiles of the weight cyclers compared with the noncyclers.     

5-year reoperation rates after different types of lumbar spine surgery

STUDY DESIGN: Population-based cohort study of Washington State patients who underwent lumbar spine surgery for degenerative conditions in 1988. OBJECTIVES: To compare complications and reoperation rates during the 5-year period after surgery between patients who have undergone lumbar spine fusion surgery and those who have undergone laminectomy or discectomy alone. SUMMARY OF BACKGROUND DATA: Spinal fusion is associated with wider surgical exposure, more extensive dissection, and longer operative times than lumbar surgery without fusion, and previous studies have shown higher complication rates and hospital charges associated with these more complex procedures. In elderly patients, spinal fusion operations were associated with higher mortality rates than laminectomy or discectomy alone, and reoperation rates were not lower. In the current study, reoperations, mortality, and complications following lumbar spine surgery were examined for the general population. METHODS: A statewide hospital discharge database was used to identify all Washington patients who underwent spine surgery in 1988 and to determine the rate of reoperation during the subsequent 5 years. Administrative records also were used to identify complications, mortality, and hospital charges associated with the operations. Unadjusted complication and reoperation rates for the groups were compared using chi-square statistics. Adjusted rates were compared using logistic regression and proportional hazards (Cox) regression after controlling for age, gender, prior spine surgery, diagnosis, comorbidity, type of surgery, and coverage by Workers' Compensation. RESULTS: Of 6376 patients who underwent lumbar surgery for degenerative conditions in Washington in 1988, 1041 (16%) had operations involving spine fusion. Diagnoses of degenerative disc disease or possible instability were more frequent among patients undergoing fusion surgery, whereas herniated discs were more frequent among those undergoing discectomy or laminectomy alone. Complications were recorded in 18% of fusion patients and 7% of nonfusion patients (P < 0.01), but mortality rates did not differ. Unadjusted reoperation rates over the 5-year period were greater for patients who underwent fusion than for patients who underwent nonfusion surgery (18% vs. 15%, respectively), but after adjustment for baseline characteristics, fusion patients had only a slightly greater (and nonsignificant) risk of reoperation (relative risk 1.1, confidence interval .9-1.3). CONCLUSION: As in previous studies, complications in the current study occurred more frequently among patients who underwent lumbar spine fusion than among those who underwent laminectomy or discectomy alone. Reoperations were at least as frequent after fusion, but the authors could not assess treatment efficacy in terms of pain relief or improved function. Although the characteristics of patients undergoing fusion differed from those undergoing a laminectomy or discectomy alone, there appeared to be sufficient overlap in the clinical populations to warrant closer scrutiny of the safety, efficacy, and indications for spinal fusions, preferably in randomized trials.     

Decline and stabilization of managerial motivation over a 20-year period.

Investigated the decline in managerial motivation that began in the early 1960's to determine when and if it stabilized. Data for 1972–1973 (N?=?86) and 1980 (N?=?124) were added to findings for 1960–1961 (N?=?287) and 1967–1968 (N?=?129) showing that managerial motivation as measured by the Miner Sentence Completion Scale (MSCS) continued to decline into the early 1970's and then apparently leveled off. These findings for University of Oregon undergraduate business students were substantiated using similar samples from Georgia State University obtained in 1975 and 1979, as well as comparable groups from other universities. Previously existing differences between male and female business students, which showed that females obtained considerably lower scores on the MSCS, have now disappeared. The overall results continue to indicate major managerial talent shortages for some years to come. Managerial motivation may have experienced a resurgence in the business schools in recent years. The data indicate that decreases have been most conspicuous on attitudes toward authority, competitiveness, assertiveness, and the desire to perform routine communications and decision-making functions. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Transmural pressure of epidural veins in the thoracic and lumbar spine of pigs

We recently cloned a new leukemogenesis-associated gene MmTRA1a (Mm-1 cell derived transplantability-associated gene 1a, former name "TRA1") from a mouse leukemogenic and monocytic Mm-P cell cDNA library and also cloned its normal counterpart MmTRA1b (former name "NOR1") from a normal mouse kidney cDNA library. The mouse MmTRA1a is a truncated form of mouse MmTRA1b. Here we report the cloning of a cDNA (human MmTRA1b) homologous to the mouse MmTRA1b from a human monocytic U937 cell cDNA library. The human MmTRA1b cDNA predicts a peptide containing 318 amino acids with a calculated molecular weight of 35,047 Da. The predicted human MmTRA1b protein sequence shared 78% amino acid identity with the mouse counterpart (328 amino acids). Both the human homologue and mouse MmTRA1b protein but not MmTRA1a protein possess a proline-rich domain at the N-terminal end. The human MmTRA1b gene was mapped to chromosome 3q23. Expression of the human homologue was increased during differentiation of U937 cells induced by most typical differentiation inducers. Moreover, predicted amino acid sequence analysis of human MmTRA1b cDNA revealed perfect identity with the human plasma membrane phospholipid scramblase that is required for transbilayer movement of membrane phospholipids. These results provide new information on the possible roles of MmTRA1b/phospholipid scramblase and the truncated MmTRA1a in the leukemogenesis and differentiation of monocytic leukemia cells.     

The McKenzie method: a general practice interpretation: the lumbar spine

The McKenzie method is a widely used method of physiotherapy that clinically divides traumatic back pain into three fundamental groups. The author attempts to translate some of the arcane terminology into a medical context. An attempt is made to give some indication of the utility of the approach in general practice.     

Changes in nonprofessional (novice) interviewers over a 3-year training period

This is a study of the changes that occur in undergraduate interviewers as traced in 3 interviews over a 3-yr training period and replicated over 2 classes. For each class, the 3 sets of novice interviews were compared with a single set of professional interviews. Interviewees were female freshmen students. A total of 46 interviewers, student and professional, participated. Student interviewees perceived student interviewers as more benign than professional interviewers over the series of interviews. They rated the professionals as more skilled but only on the 1st set of interviews. On warmth and genuineness, student interviewers either maintained or acquired advantages over the professional group over the duration of the study. Student interviewers were more verbally flustered than professionals in their first interviews but not later. The payoff variable of interviewee productivity did not distinguish between professionals and novices at any time. Implications for the concept of interviewer status and for the use of paraprofessionals in conducting mental health interviews are considered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Survival after cardiac arrest outside hospital over a 12-year period in Gothenburg

BACKGROUND: A two-tiered ambulance system with a mobile coronary care unit and standard ambulance has operated in Gothenburg (population 434,000) since 1980. Mass education in cardiopulmonary resuscitation (CPR) commenced in 1985 and in 1988 semiautomatic defibrillators were introduced. Aim: To describe early and late survival after cardiac arrest outside hospital over a 12-year period. Target population: All patients with prehospital cardiac arrest in Gothenburg reached by mobile coronary care unit or standard ambulance between 1980 and 1992. RESULTS: The number of patients with cardiac arrest remained fairly steady over time. Among patients with witnessed ventricular fibrillation, the time to defibrillation decreased over time. The proportion of patients in whom bystander initiated CPR was increased only moderately over time. The proportion of patients given medication such as lignocaine and adrenaline successively increased. The number of patients with cardiac arrest who were discharged from hospital per year remained steady between 1981 and 1990 (20 per year), but increased during 1991 and 1992 to 41 and 31 respectively. CONCLUSIONS: Improvements in the emergency medical service in Gothenburg over a 12-year period have lead to: (1) a shortened delay time between cardiac arrest and first defibrillation and (2) an improved survival of patients with cardiac arrest outside hospital probably explained by this shortened delay time.     

On the degree of stability of measured hypnotizability over a 25-year period.

Conducted a longitudinal study of hypnotizability, as measured by the Stanford Hypnotic Susceptibility Scale, Form A, that yielded a relatively high degree of stability in hypnotic responsiveness over repeated testings spanning a 25-year period. The 50 Ss were retested in 1985, after tests when they were students, between 1958–1962 and again in 1970. The statistically significant stability coefficients were .64 (10-year retest), .82 (15-year retest), and .71 (25-year retest). The means did not change significantly, and the median change in the scores of individuals was only 1 point on the 12-item scale. A set of score measures and their intercorrelations are insufficient to resolve the issue of why stability occurs. The stability of hypnotizability over time compares favorably with that of other measures of individual differences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical evaluation of four dental amalgams over a three year period

The aim of this study was to compare the clinical durability of four dental amalgams. In each of eighty-two patients one class 2 cavity was restored with Dispersalloy (Johnson and Johnson) which served as the control and all the other class 2 cavities were randomly restored with one of the following amalgams: Amalgaphase, Amalga 43 (Amalgam Alloys-South Africa) or Permite C (Southern Dental Industries). Matrix bands were placed and Kalzinol bases and Polyvar varnishes applied in all cavities. The amalgams were mixed according to the manufacturers' instructions, the cavities overpacked with amalgam, condensed by hand, carved and then burnished with a ball burnisher. Twenty-four hours later all restorations were polished and colour photographs taken. The restorations were evaluated using the Ryge and Snyder (1973) evaluation system, as well as comparison of the colour photographs. The Fisher's Exact Test was used for the statistical analysis. The two South African manufactured amalgams compared well with the two imported amalgams. However, at the end of the third year the score for the marginal integrity of Amalgaphase, one of the local products, was significantly different (p < 0.083) and inferior to that of the control, Dispersalloy. Evidence is produced to suggest that over a three year period Amalgaphase performed better than Dispersalloy, Amalga 43 and Permite C.     

Translaminar screw fixation of the lumbar and lumbosacral spine. A 5-year follow-up

STUDY DESIGN: In a retrospective study, the long-term results of translaminar facet screw fixation of the lumbar and lumbosacral spine are reviewed. OBJECTIVES: To evaluate the clinical results, fusion rates and complications of this posterior fusion technique in various conditions of the lumbar spine. SUMMARY OF BACKGROUND DATA: Posterior fusion of the lumbar and lumbosacral spine is one of the possible methods to relieve pain and eliminate instability in degenerative conditions. Data in the literature support the use of internal fixation to optimize the rate of fusion. METHODS: Posterior lumbar and lumbosacral fixation with translaminar screws and fusion in 173 patients with degenerative changes with or without compressive syndromes including failed back syndromes, monosegmental hypermobilities, and posttraumatic conditions were investigated. Fixation and fusion with translaminar screws was performed in 57% monosegmentally, in 40% across two segments and in 2% over three segments. Decompressive surgery was performed in addition in 52% and nucleotomy in 30% of the cases. Clinical and radiologic assessment with flexion/extension x-rays was performed in 145 (83%) patients by two independent orthopedic surgeons. After an average follow-up of 68 months (range, 52-83). RESULTS: Ninety-four percent of the patients showed solid bony fusion in the radiologic follow-up. Loosening of the screws was noted in 3%, and two screws were broken without apparent motion on the functional x-rays. Pain scores decreased from 7.6 before surgery to 2.9 after surgery on a 10-point pain scale. The results were further analyzed according to Stauffer and Coventry with 99 good results, 70 satisfactory results, and 4 bad results. CONCLUSIONS: Translaminar screw fixation offers an immediate postoperative stability of the lumbar and lumbosacral spine and enhances fusion. In the present series no neurologic complications were noted. It represents a useful and inexpensive technique for short segment fusion of the nontraumatic lumbar and lumbosacral spine.     

Oh, my aching back: evaluation and surgical treatment of lumbar spine disorders

Low back pain is a common cause of disability and reason for seeking medical care. Surgery rates for low back pain are escalating, and the overall costs exceed $1 billion. Primary care physicians are increasingly responsible for the initial evaluations and management of these individuals. Recognition of surgical indications by these physicians will decrease costs by initiating management and will limit morbidity by expediting appropriate referrals. The important aspects of the evaluation of low back pain are reviewed in this article. Surgical indications in low back pain including infection, tumor, degenerative conditions, and nonacute traumatic sequelae are discussed.     

Responses to nervous breakdowns in America over a 40-year period: Mental health policy implications.

The 1957 and 1976 Americans View Their Mental Health surveys from the Institute of Social Research were partially replicated in the 1996 General Social Survey (GSS) to examine the policy implications of people's responses to feeling an impending nervous breakdown. Questions about problems in modern living were added to the GSS to provide a profile of the public's view of mental health problems. Results were compared for 1957, 1976, and 1996. In 1957, 19% of respondents had experienced an impending nervous breakdown; in 1996, 26% had had this experience. Between 1957 and 1996, participants increased their use of informal social supports, decreased their use of physicians, and increased their use of nonmedical mental health professionals. These findings support policies that strengthen informal support seeking and access to effective psychosocial treatments rather than current mental health reimbursement practices, which emphasize the role of primary care physicians. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Toward a clinical test of lumbar spine kinesthesia

Communication with intensive care patients is of paramount importance, especially when communicating with a critically ill patient who is sedated and ventilated, and therefore unable to speak. Disclosure under these circumstances is extremely difficult, so in this situation touch is a valuable means of conveying messages. Consequently, touch as a way of communicating is discussed in this paper, highlighting the advantages and disadvantages. Barriers to communication in this environment are also discussed.     

Referential communication and reading performance in learning disabled children over a 3-year period.

Examined the ability of 30 learning disabled (LD) and 30 non-LD (NLD) 6- and 7-yr-olds to understand a sequence of instructions, communicate the steps in a sequence to others, and rephrase their verbal messages across a 3-yr period using a referential communication task. In order to perform the puzzle-box task correctly, Ss had to execute 6 steps in an invariant sequence. After Ss demonstrated a perfect nonverbal enactment of the sequence, they were asked to communicate all information about how to open the box to a puppet. Upon completion, the puppet feigned poor memory and asked the Ss to explain the step-by-step process again. Subsequently, the puppet requested that Ss rephrase their explanation of each step by either a verbal or nonverbal rephrase request. Results reveal that LD children differed from NLD peers consistently on referential communication over the 3-yr period in terms of listener competence and speaker competence. For LD Ss, the ability to produce competent verbal messages was highly related to reading comprehension both concurrently and 3 yrs later. By the 3rd yr, NLD Ss were better able to rephrase information, indicating a growing awareness of the speaker's responsibility in communication. Findings suggest that the communication measures studied play very different roles for LD and NLD Ss with regard to reading achievement. (27 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Molecular analysis of glycopeptide-resistant Enterococcus faecium isolates collected from Michigan hospitals over a 6-year period

The purpose of this study was to evaluate the molecular relatedness of clinical isolates of glycopeptide-resistant Enterococcus faecium isolates collected from hospitals in Michigan. A total of 379 isolates used in this study were all vancomycin-resistant E. faecium isolates collected from 28 hospitals and three extended-care facilities over a 6-year period from 1991 to 1996. For the 379 isolates, there were 73 pulsed-field gel electrophoresis (PFGE) strain types. Within strain types, there were as many as six restriction fragment differences. Most isolates (70%) belonged to six strain types, which were designated M1 (36%), M2 (3%), M3 (18%), M4 (6%), M10 (4%), and M11 (3%). PFGE strain M1 was cultured from 135 patients in 13 hospitals during the period 1993 to 1996. Strain type M2 was cultured from 11 patients in two hospitals during the period 1991 to 1992 and was not observed after 1992. Strain type M3 was cultured from 70 patients in 10 hospitals during the period of 1994 to 1996. Both M4 and M10 were cultured from 23 patients in three hospitals and from 15 patients in two hospitals, respectively, during 1995 to 1996. M11 was cultured from 13 patients in four hospitals during 1996. A total of 23 of 28 hospitals had evidence of clonal dissemination of some isolates. Plasmid content and hybridization analysis done on 103 isolates from one hospital and two affiliated extended-care facilities indicated that the strains contained from one to eight plasmids. Mating experiments indicated transfer of vancomycin resistance from 94 of these isolates into plasmid-free E. faecium GE-1 at transfer frequencies of <10(-9) to 10(-4). Gentamicin resistance and erythromycin resistance were cotransferred at various frequencies. A probe for the vanA gene hybridized to the plasmids of 23 isolates and to the chromosomes of 72 isolates. A probe for the vanB gene hybridized to the chromosomes of 8 isolates. The results of this study suggest inter- and intrahospital dissemination of vancomycin-resistant E. faecium strains over a 6-year period in southeastern Michigan. The majority of isolates studied belonged to the same few PFGE strains, indicating that clonal dissemination was responsible for most of the spread of resistance that occurred.     

Personality stability and change over a 30-year period—middle age to old age.

A group of physically healthy and emotionally stable men were periodically evaluated over a 30-yr period from middle age (M age?=?49) to old age (M age of surviving group group?=?77). Complete MPPI test results were obtained for 71 men in this group over 4 testing periods spanning the 30-yr interval. The results indicate considerable stability in the group profile configurations and individual scale correlations over the 4 evaluation periods. The relative increase in score with age on Scale 1, Scale 2, and Scale 3 is consistent with previous findings with aged populations. The results of the present investigation suggest that the increase in mean score on the Depression scale may reflect realistic bodily concerns and the presence of actual physical illness. Overall, this group manifested personality strengths in middle age and continued to function reasonably well in old age. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ursodeoxycholic acid does not improve the clinical course of primary sclerosing cholangitis over a 2-year period

BACKGROUND: Ursodeoxycholic acid has been shown to be a useful agent in the clinical management of patients with primary biliary cirrhosis and autoimmune chronic active hepatitis. Its efficacy is presumed to be based upon its ability to act as a detergent and to incite a choleresis. Recent additional data suggest it also reduces HLA antigen expression on liver and biliary epithelial cells and impairs T cell reactivity. METHODS: A randomized controlled study of 59 patients with primary sclerosing cholangitis was performed over a 24 months period with 3 groups being studied. Group I consisted of 20 patients who were given ursodeoxycholic acid 300 mg orally twice a day; group II consisted of 19 patients who were given colchicine 0.6 mg orally BID; and group III was an untreated medical control group. All three groups were seen at regular 3-month intervals and had quarterly, annual and terminal studies performed to assess their disease status. RESULTS: No difference between groups was evident after two full years of therapy when parameters of liver injury, liver function, liver size and hepatic copper content were compared between groups. Similarly, no difference in ERCP findings was evident between groups either at entry or after two years of therapy. CONCLUSIONS: These data suggest that ursodeoxycholic acid is no better than colchicine or simple medical follow-up. Thus, neither ursodeoxycholic acid or colchicine can be considered to be effective therapies for primary sclerosing cholangitis.     

The changing molecular epidemiology and establishment of endemicity of vancomycin resistance in enterococci at one hospital over a 6-year period

The contributions of clonal spread, transfer of genetic elements, and introduction of new strains to the establishment of endemicity of vancomycin-resistant enterococci (VRE) were determined. The study took place at one hospital between 1990, when VRE were first detected, and 1996, when endemicity had become established. Isolates from 183 patients were categorized into 24 strain types by pulsed-field gel electrophoresis; the resistance genotype was determined by polymerase chain reaction. Between 1990 and 1993, 69% of patients were infected with the same vanB Enterococcus faecium strain. VanA resistance was not detected until 1993, but in 1996, the ratio of vanA to vanB was 2.2:1. Over time, 8 vanA strains were detected; a 35- or 40-kb conjugative vanA plasmid was found in 4 of the 8 strains. Clonal spread was a major factor in the establishment of endemicity. Transfer of genetic elements and introduction of new strain types were detected less often. However, these events may have been equally important evolutionarily.     

Was it a phase? Young women's relinquishment of lesbian/bisexual identities over a 5-year period.

There have been many anecdotal accounts of individuals who self-identify as lesbian, gay, or bisexual only to relinquish these identities later. The current study examines this phenomenon among a sample of young nonheterosexual women who underwent 3 interviews over a 5-year period. Over a quarter of the women relinquished their lesbian/bisexual identities during this period: half reclaimed heterosexual identities and half gave up all identity labels. These women did not differ from those who maintained lesbian/bisexual identities regarding the age at which they underwent sexual identity milestones, the factors that precipitated their sexual questioning, or their recollection of childhood "indicators" same-sex sexuality. Women who relinquished their identities for heterosexual identities had small ratios of same-sex to other-sex attractions across the 5-year assessment period, but their attractions did not significantly change. Only 1 woman described her previous same-sex identification as a phase; the rest emphasized changes in how they interpreted or acted on their attractions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)