Heart failure and echocardiographic changes during long-term follow-up of patients with sick sinus syndrome randomized to single-chamber atrial or ventricular pacing

OBJECTIVE: In the present study, physical and sexual abuse among incarcerated youth were examined with respect to sexual activity, contraceptive use, and pregnancy. METHOD: The self-report survey data were collected from 62 females and 334 males who were incarcerated in Nevada youth correctional facilities in the summer of 1994. Of the males, 46.8% (n = 156) reported a history of physical abuse and 9.9% (n = 33) reported sexual abuse. A surprisingly high 73% (n = 46) of the females reported a history of physical abuse and 68.3% (n = 43) reported sexual abuse. RESULTS: The analyses indicated that females who reported a history of sexual abuse had an earlier mean age of first intercourse than those who reported no sexual abuse. In addition, male and female respondents with a history of physical and/or sexual abuse reported using no method of contraception as compared to youth with no history of abuse. CONCLUSIONS: Implications of these results for detention-based counseling and prevention programming are discussed.     

Student veterans: A national survey exploring psychological symptoms and suicide risk.

The current study explored psychological symptoms, symptom severity, and suicide risk in a national sample (N = 628) of student veterans. We hypothesized that the rates, types, and severity of problems experienced by student veterans on campus would in many ways mirror those reported by active duty service members as well as the Operation Iraqi Freedom/Operation Enduring Freedom veteran population. Almost 35% of the sample experienced “severe anxiety,” 24% experienced “severe depression,” and almost 46% experienced significant symptoms of posttraumatic stress disorder. Of particular concern, there were significant numbers of participants thinking about suicide (46%), with 20% having a plan, 10.4% thinking about suicide “often or very often,” 7.7% making an attempt, and 3.8% believing that suicide is either “likely” or “very likely.” Implications of the findings are discussed, with a particular focus on college and university campuses. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

A bleach program for inmates in NSW: an HIV prevention strategy

Syringe cleaning guidelines for injecting drug users (IDUs) were revised in 1993. This paper examines efforts by IDUs in NSW prisons to adopt the revised guidelines in 1994. Consecutive inmates (229) nearing release were visited and asked to call a toll free number for an interview once released. Respondents (102) did not differ from non-respondents (127). Many respondents (64%) reported ever injecting and many of these reported injecting (58%), sharing (48%) and syringe cleaning (46%) when last in prison. Some (23%) respondents reported adopting the revised syringe cleaning guidelines. Tattooing (38%) was reported more often than sexual activity in prison (4%). A new methodology for prison research was found to be feasible in this study. The potential for HIV to spread in prison still poses major public health challenges.     

Drug addiction among physicians. The Virginia experience

Drug addiction among physicians appears to be an occupational hazard, with chronic pain, depression, and the easy availability of drugs major factors leading to addiction. In this study of 46 cases of physician addicts handled by the Virginia State Board of Medicine, meperidine hydrochloride (Demerol) was the most frequent addictive agent. The Virginia disciplinary and therapeutic plan for addicted physicians was effective in successfully rehabilitating and returning to medical practice 72% of the 46 physician addicts reported to the board from 1949 to 1974.     

Permanent glaucomatous visual loss after photorefractive keratectomy

Non-convulsive status epilepticus (NCSE), a neurological emergency, is reported to account for approximately 25% of patients presenting in status epilepticus. Diagnosis of NCSE can be delayed or missed because of its often subtle presentation. Hypocalcemia has rarely been reported as a precipitator of NCSE and thus should be considered in the differential. We report the case of a 46-year-old man with idiopathic hypoparathyroidism who presented in NCSE secondary to hypocalcemia. As in patients with convulsive status epilepticus, rapid diagnosis and treatment of patients in NCSE is critical to prevent permanent neurological damage.     

Plasma insulin-like growth factor-I and its binding proteins 1 and 3 during continuous nonoral and oral combined hormone replacement therapy

French and American consensus conferences on hepatitis C confirmed the burden of that disease, especially in high risk populations. In France, the seroprevalence of HCV is about 20% among haemodialysed patients. This study aimed at describing the French screening practices in haemodialysed patients. In 1995, 1213 self-administered questionnaires were sent to nephrologists working in 715 dialysis units. The response rate was 48% (585/1213) and 485 questionnaires were analysed. In 98% of questionnaires nephrologists answered that they prescribed screening test. Routine screening with alanine amino-transferase (ALT) was reported in 98% of questionnaires, usually once a month (57%) or four times a year (23%). Routine anti-HCV serology was reported by 96%, usually once (28%) or twice (46%) a year. The two main annual strategies combining ALT and anti-HCV serology were 12 ALT and 2 serologies (21%), or 12 ALT and 1 serology (14%) per year. HCV RNA detection was reported mainly in the case of positive anti-HCV serology (70%). The study suggested heterogeneity in screening practices and revealed the need to determine the cost-effectiveness ratios of the various strategies.     

Constitutional mosaicism for a chromosome 9 inversion resulting in recombinant aneusomy in an offspring

We report on a case of constitutional mosaicism for a large pericentric inversion of chromosome 9 in a man whose daughter had recombinant aneusomy resulting in partial 9q duplication and partial 9p deletion. At age 6 months, the girl was evaluated because of congenital anomalies [corrected] and developmental delay. Chromosomal analysis on this infant showed a derivative chromosome 9 which was later determined to be a recombinant chromosome with trisomy of 9q34.1-->qter and monosomy of pter-->9p24. Chromosomal analysis in her father showed the presence of two cell lines; 75% of lymphocytes had a 46,XY pattern, and 25% had a 46,XY,inv(9)(p24q34.1) karyotype. The infant's physical findings represent a composite of the reported cases of both trisomy 9q34.1-->qter and monosomy pter-->9p24. The infant's father was phenotypically and cognitively normal. This case broadens the spectrum of reported cases of mosaicism for an autosomal structural rearrangement generating unbalanced gametes, and further supports the tenet that constitutional mosaicism has clinical relevance for genetic counseling.     

Outcome of femoral shaft fractures in the elderly

Published literature on fractures of the femoral shaft has reported results of treatment stratified by fracture type or treatment type. The current study analyzes the outcome of fractures of the femoral shaft in elderly patients. One hundred thirty-eight patients older than the age of 65 years sustained femoral shaft fractures. Ten percent of the patients had associated injuries. The majority of the patients had significant prefracture medical problems. Nonsurgical treatment was used in 29 cases. Surgical treatment in 109 patients consisted of cerclage wires in 13 cases, plates and screws in 58 cases, intramedullary nails in 26 cases, and long stem prostheses in 12 cases. Complications of treatment occurred in 46% of patients. The type of treatment did not influence the frequency of complications. Twenty percent of patients died within 6 months of the fracture. There was a significant difference in the age of the patients who survived compared with those who did not survive. The mental status of the patient was also a major determinant of survival. Alert and oriented patients had a much better chance of survival. The outcome of fractures of the femoral shafts cited in the literature is different from the results seen in this population of elderly patients. The observed complication rate of 46% and mortality rate of 20% in this series is similar to those reported for intertrochanteric fractures and femoral neck fractures. Age and mental status are important determinants in the survival of the patient regardless of the treatment administered.     

Kikuchi''s histiocytic necrotizing lymphadenitis associated with ruptured silicone breast implant

Mortality rates and injuries requiring medical treatment associated with sports and exercise are generally low. However, higher injury rates are reported for athletes and members of sports clubs. This study focuses on the sport- and exercise-related injury rate for various age and sex groups in the general population and how sport and exercise injury rates compare with those for other activities. The data presented are based on telephone interviews. Of the participants (N = 6,596), 335 (5.1%) reported having sustained an injury in the previous month; 46% of injuries among males and 14% of those among females were sport or exercise related. The data show a downward trend in sport- and exercise-related injury rates with increasing age. It is concluded that, as a proportion of all injuries sustained, the sport- and exercise-related injury rate is high, particularly among males. Possible future research on sport- and exercise-related injuries is discussed.     

Fluoxetine as a treatment for post-stroke emotionalism

OBJECTIVES: To review the experience at a children's hospital of lipoblastoma and liposarcoma and to identify any factors that would differentiate one type of tumour from the other. DESIGN: A retrospective case series. SETTING: British Columbia's Children's Hospital a tertiary-care pediatric centre. PATIENTS: All patients with a pathological diagnosis of lipoblastoma and liposarcoma recorded over 12 years. MAIN OUTCOME MEASURES: The frequency of lipoblastoma and liposarcoma, identified from biopsy specimens of pediatric adipose tumours. The clinical, pathological and cytogenetic variables between lipoblastoma and liposarcoma. RESULTS: One hundred and forty-nine adipose tumours were recorded. Seven (4.7%) were lipoblastomas and 2 (1.3%) were liposarcomas. All tumours presented as asymptomatic, slow-growing, soft-tissue masses. The children with lipoblastoma tended to be younger, but 29% were over 3 years of age. The liposarcoma patients were aged 9 and 14 years. One liposarcoma was of myxoid type and the other was a round cell variant. Karyotypes were reported for 1 lipoblastoma and 1 liposarcoma. The myxoid liposarcoma karyotype was 46,XY,t(12;16)(q13;p11), and the lipoblastoma was reported as 46,XY,der(8)?t(8q;?),+mar. CONCLUSIONS: Lipoblastoma is an unusual childhood neoplasm and liposarcoma is very rare in children. Both tumours may present in a similar fashion, and differentiating them histologically can be difficult. Age cannot be relied upon to accurately predict their behaviour. The tumour karyotype is very helpful in differentiating these neoplasms.     

N-acetylcysteine prevents development of the hyperdynamic circulation in the portal hypertensive rat

Infective endocarditis, defined as pathologically or clinically definite by the Duke criteria, was observed in 14 transplant recipients at our institutions. In addition, we reviewed 32 previously reported cases in solid organ transplant recipients. The spectrum of organisms causing infective endocarditis was clearly different in transplant recipients than in the general population; 50% of the infections were due to Aspergillus fumigatus or Staphylococcus aureus, but only 4% were due to viridans streptococci. Fungal infections predominated early (accounting for six of 10 cases of endocarditis within 30 days of transplantation), while bacterial infections caused most cases (80%) after this time. In 80% (37) of the 46 cases in transplant recipients, there was no underlying valvular disease. Seventy-four percent (34) of the 46 cases were associated with previous hospital-acquired infection, notably venous access device and wound infections. Three patients with S. aureus endocarditis had had an episode of S. aureus bacteremia > 3 weeks prior to the diagnosis of endocarditis and had received treatment for the initial bacteremia of < 14 days' duration. The overall mortality rate was 57% (26 of 46 patients died), with 58% (15) of the 26 fatal cases not being suspected during life. Endocarditis is an underappreciated sequela of hospital-acquired infection in transplant recipients.     

Effects of natriuretic peptides and dopamine on single-unit activity of dorsomedial arcuate neurons in rat brain slices

The effects of atrial natriuretic peptide (ANP) and C-type natriuretic peptide (CNP) on single-unit activity of dorsomedial arcuate (DM-ARC) neurons were reported. The modulatory effect of CNP on dopamine's (DA) action was also studied. ANP alone in 0.05-0.5 nmol doses induced 26% inhibition and 14% excitation of 37 DM-ARC neurons; the majority (60%) were not responsive. CNP, however, inhibited 46% and excited 4% of 74 DM-ARC neurons. Dose-dependent inhibitory effects of CNP were also observed. In 71 neurons tested with both CNP and DA, more neurons were inhibited by DA (66%) than those by CNP (46%). About one-third (34%) of them were inhibited by both. Furthermore, in 41 neurons inhibited by DA, more than half (54%) of their responses were potentiated by co-administration of CNP. In conclusion, CNP by itself exhibited a predominantly inhibitory action on DM-ARC neurons; and it also potentiated the inhibitory effect of DA on these neurons.     

RAP46 is a negative regulator of glucocorticoid receptor action and hormone-induced apoptosis

RAP46 was first identified by its ability to bind the glucocorticoid receptor. It has since been reported to bind several cellular proteins, including the anti-apoptotic protein Bcl-2, but the biological significance of these interactions is unknown. Here we show that RAP46 binds the hinge region of the glucocorticoid receptor and inhibits DNA binding and transactivation by the receptor. We further show that overexpression of RAP46 in mouse thymoma S49.1 cells inhibits glucocorticoid-induced apoptosis. Conversely, glucocorticoid-induced apoptosis and transactivation were enhanced after treating S49.1 cells with the immunosuppressant rapamycin, which down-regulates cellular levels of BAG-1, the mouse homolog of RAP46. The effect of rapamycin can, however, be overcome by overexpression of RAP46. These results together identify RAP46 as a protein that controls glucocorticoid-induced apoptosis through its negative regulatory action on the transactivation property of the glucocorticoid receptor.     

Prevalence of G-to-T transversions among K-ras oncogene mutations in human colorectal tumors in Yugoslavia

Human colorectal carcinoma tissue sampled from 37 patients, routinely graded into Dukes' stages A, B and C and histologically examined for the level of differentiation, were analyzed for the presence of point mutations in the K-ras oncogene. Seventeen cases out of the 37 analyzed were found to have a mutation in either the 12th or the 13th codon of the K-ras gene, giving an overall frequency of mutation of 46%. The incidence of mutations in Dukes' stages A, B and C was 33, 46 and 58% respectively. Although the frequency of mutation appears to be similar to that reported for the USA population, the spectrum of point mutations in codons 12 and 13 of the K-ras gene in the Yugoslav population appears to differ significantly. G-to-T transversions make up 77% of all mutations present, with the distribution as follows: 18% at the first base and 59% at the second base of codons 12 and 13. G-to-A transitions at the second base is the only other mutation identified, occurring mainly in codon 13 in colorectal tumors of all 3 stages.     

46,XX/69,XXX diploid-triploid mixoploidy with hypothyroidism and precocious puberty

We report a 20 month old female patient with diploid-triploid mixoploidy (46,XX/69,XXX) syndrome with hypothyroidism and precocious puberty. The triploid cell line was only expressed in the fibroblast culture and comprised the majority (95%) of the cells. Chromosome analysis of the fetal blood sample and peripheral blood sample were normal. The patient shows typical features of full triploidy (growth and severe mental retardation, cranial and facial dysmorphism, complete syndactyly of fingers 3/4, partial syndactyly of toes 2/3) and facial but no body asymmetry. At the age of 5 months central hypothyroidism and precocious puberty were diagnosed. Thin pigmented streaks were visible on the wrists and legs of the patient at the age of 16 months. This is the first patient reported so far with 46,XX/69,XXX mixoploidy suffering from hypothyroidism and precocious puberty.     

Pseudomemory in hypnotized and task-motivated subjects.

Highly hypnotizable hypnotized (HYP; n?=?16) and task motivated (TM; n?=?13) Ss received pseudomemory suggestions (M. T. Orne, 1979). TM Ss reported being more awake and motivated than did HYP Ss and were more likely to pass the target noise suggestion. However, 69% of Ss in both conditions who passed the noise suggestion reported pseudomemories. Pseudomemory rate (69% for HYP Ss and 46% for TM Ss) was not reduced by informing Ss that they could distinguish reality and fantasy in a state of deep concentration. At final inquiry, after deep concentration, pseudomemories remained stable (75% for HYP Ss and 54% for TM Ss). As predicted, HYP Ss reported more unsuggested noises and more pseudomemories of novel noises than did TM Ss. Ss who reported pseudomemories were more confident in the accuracy of their memories than were Ss who reported that the suggested noises were imagined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Record sales for Toyota

Toyota has reported its best-ever first-half sales in the US, 46 years after it first entered the US market. The company reported sales of 903 142 units, up 3.5 per cent from last year's record first six months.This is a short news story only. Visit www.metal-powder.net for the latest metallurgy industry news     

Vagal paraganglioma: a review of 46 patients treated during a 20-year period

BACKGROUND: Vagal paragangliomas (VPs) arise from paraganglia associated with the vagus nerve. Approximately 200 cases have been reported in the medical literature. Because of their rarity, most information regarding these tumors has arisen from case reports and small clinical series. OBJECTIVE: To detail the clinicopathologic features of 46 patients with VP with an emphasis on the role of a multidisciplinary skull base team in both the successful extirpation and rehabilitation. DESIGN: Retrospective review of 46 patients with VP managed by a single skull base team. SETTING: An academic tertiary medical center. RESULTS: Forty-six patients were treated over a 20-year period (1978-1998). Ten (22%) demonstrated intracranial extension. There was a history of familial paragangliomas in 9 (20%) of the patients. The incidence of multicentric paragangliomas was 78% in patients with familial paragangliomas vs 23% in patients with nonfamilial paragangliomas. Management of this group of 46 patients consisted of surgery (n = 40), radiation therapy (n = 4), and observation (n = 2). The operative approach consisted of a transcervical excision often combined with a transtemporal or lateral skull base approach as dictated by the tumor extent. Postoperative cranial nerve deficits were common, and, as such, aggressive rehabilitation was a vital component in the management of these tumors. CONCLUSIONS: The management of VP and its associated cranial nerve deficits remains a difficult clinical problem. Options for treatment include surgical resection, radiation therapy, and, in selected cases, observation. Surgical extirpation requires a multidisciplinary skull base team to achieve complete tumor resection. Radiation therapy is reserved for elderly patients and patients at risk for bilateral cranial nerve deficits. Rehabilitation of cranial nerve deficits is an integral part of the management of VP.     

The role of surgical therapy in patients with nonmetastatic Ewing's sarcoma of the limbs

Of 131 patients with primary Ewing's sarcoma (ES) with extremity locations, treated between April 1972 and May 1987, 13 had amputation; 56 had a local resection with 31 (55%) requiring radiation therapy (RT) as an adjuvant to local therapy. Sixty-two of 131 patients (47%) had RT only. Local recurrences were reported in 5% of patients treated with surgery alone, 1% of the group treated with surgery and radiation therapy, 24% of patients treated with radiation therapy alone (46% for cesium-radiation therapy, and 12% with cobalt-radiation therapy).