Clinical and epidemiological findings during a measles outbreak occurring in a population with a high vaccination coverage

Malignant mesothelioma is caused almost exclusively by occupational exposure to asbestos. During the past few years, however, increasing evidence has mounted that background exposure to asbestos could be sufficient to cause mesothelioma. Treatment of malignant mesothelioma remains a big problem. Some new approaches are on their way, and the most exciting ones are local immunotherapy in very early cases. Some success has been reported with local interferon treatment. As for treatment of metastatic pleural disease, the main purpose is symptomatic relief of dyspnea caused by fluid accumulation. The best way to achieve a lasting palliation is pleurodesis, and the most common way to do this, is by chemical means. The drug of choice in the United States has for many years been tetracycline, but since injectable tetracycline is no longer available, some substitute must be found. The substance that will "win" is not yet clear, but the two leading contestants are talc and doxycycline. Bleomycin also has its supporters, and a dark horse is quinacrine, which although not easily available in the United States, has been used in many European centers for decades.     

The risk of measles, mumps, and varicella among young adults: a serosurvey of US Navy and Marine Corps recruits

OBJECTIVES: To assess the risk of epidemic transmission and to guide immunization policy, the seroprevalence of antibody to measles, mumps, and varicella was determined in a group of young adults. METHODS: A cross-sectional study of 1533 US Navy and Marine Corps recruits was conducted in June 1989. Antibody status was determined with commercially available enzyme-linked immunosorbent assays. RESULTS: Direct sex and race adjustment to the 15- to 29-year-old US population resulted in seronegativity rates of 17.8% for measles, 12.3% for mumps, and 6.7% for varicella. Measles and mumps seronegativity rates were higher among Whites whereas varicella seronegativity was higher among non-Whites. Recruits enlisting from outside the 50 US states, especially those from island territories, were more likely to lack varicella antibody. The sensitivity of a positive history of vaccination or disease in predicting antibody status was less than 90% for all diseases. CONCLUSIONS: These results suggest a continued potential for epidemics, especially of measles, and the need for mandatory immunization policies. Immigrants to the United States, especially those from island territories, may be a high-risk group that could benefit from varicella vaccination.     

An outbreak of measles in a highly immunised population: immunisation status and vaccine efficacy

4-Aminopyridine (4-AP) 1 mg.kg-1 sc at the scruff induced a licking response in mice. H1 receptor blockaders, such as diphenhydramine HCl (1, 10 mg.kg-1, sc at the scruff or 40 mg.kg-1, i.p.), chlorphenamine maleate (20 mg.kg-1, i.p.), and astemizole (2 mg.kg-1, i.g.), inhibited the licking response caused by 4-AP. Repeated injections of 4-AP (1 mg.kg-1) reduced the times of lick and the histamine content in the skin of injected site. 4-AP also promoted histamine release from incubated mouse peritoneal mast cells (PMC) in a dose-dependent manner. The results indicate that the licking response may originate from the histamine liberation of mast cells.     

高危性行为与性病艾滋病知识及感染状况调查

目的 了解宜昌市嫖客人群艾滋病相关知识、高危行为方式、艾滋病(AIDS)及性病(STD)感染状况.方法 采用个人访谈的形式对450名嫖客人群进行了相关调查与HIV/STD感染状况检测.结果 450名嫖客中有关艾滋病传播等知识单题知晓率在40.56%～90.37%之间;嫖客中阴道交、口交和二者并存分别占81.11%、5.11%和13.78%,其安全套使用率分别为46.03%、4.35%和33.87%,差异具有显著性意义(x2=17.20,P＜0.01);嫖客中HIV抗体、梅毒和生殖道沙眼衣原体检出阳性率分别为0.44%、4.65%和6.13%,生殖器疱疹和尖锐湿疣现患率分别为5.66%和9.43%,4种性病的未使用安全套暴露组与全程使用安全套对照组的相对危险度RR值在7.46～13.91之间,差异具有极显著性意义(x2值在7.01～11.09之间,P＜0.01).结论 宜昌市嫖客人群中的性传播疾病知识知晓率与安全套使用率相对较低,HIV/STD感染率较高,应加强嫖客与暗娼人群的行为干预.     

中盖艾滋病项目覆盖区域中高危人群干预效果的评价分析

目的 评价高危人群干预措施效果,为制定相关政策和资源分配提供依据.方法 对中盖项目中高危人群和普通人群进行KABP调查,进行对比分析.结果 国家M&E框架知晓率达到87.92%,UNGASS知晓率达到83.33%.对比2次问卷调查结果,高危人群的知晓率有明显提高(P＜0.05).女性涉性人员中"最近一次商业性行为安全套使用率"由2007年的92%提高到2010年的95%,"最近一个月商业性行为安全套使用率"由68%提高到77%;静脉吸毒人群中"最近一次共用注射针具比例"由2007年的17.86%下降到10%,"最近一个月共用注射针具比例"由26.42%下降到15%;男男性行为者中"最近一次与男性伴性行为安全套使用率"由69.1%提高到80%,"最近一个月与男性伴性行为安全套使用率"由45.5%提高到77%.结论 武汉中盖艾滋病项目的展提高了高危人群的艾滋病知识知晓率,改善了他们的高危行为,效果非常明显.     

Marital status, marital satisfaction, and support processes among women at high risk for breast cancer.

This study explored marital status, social support processes, and psychological distress among women at high risk for breast and ovarian cancer who were anticipating genetic testing. In addition to substantive findings, it presents a means of using nonsense coding (J. Cohen & P. Cohen, 1983) to include unmarried persons in regression analyses examining the importance of marital support. These women had mobilized high levels of social support. Married and unmarried women did not differ in distress, but women had to have more satisfying marriages than average to be equivalent to unmarried women. For the married women, husbands were more involved and more influential in decision making than female relatives, even in distressed marriages. Negativity from close relationships, particularly the spouse, had more influence on these women's well-being than did positive involvement. The authors' findings suggest that counseling and education programs need to accommodate the key role that husbands have in decision making concerning genetic testing for risk of breast cancer. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reducing sexual risk behaviors and alcohol use among HIV-positive men who have sex with men: A randomized clinical trial.

This randomized clinical trial (N = 253) evaluated the efficacy of a theory-based intervention designed to reduce both alcohol use and incidence of unprotected sexual behaviors among HIV-positive men who have sex with men with alcohol use disorders. An integrated, manualized intervention, using both individual counseling and peer group education/support, was compared with a control condition in which participants received resource referrals. The intervention was based on the transtheoretical model’s stages and processes of change, and motivational interviewing was used to enhance client readiness for change. Major findings include treatment effects for reduction in number of drinks per 30-day period, number of heavy drinking days per 30-day period, and number of days on which both heavy drinking and unprotected sex occurred. Practitioners employing this intervention may achieve enhanced client outcomes in reduction of both alcohol use and risky sexual behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reflection in preferences under risk: Who and when may suggest why.

In an experiment with 60 undergraduates, the robustness of the reflection effect was examined both within Ss and across Ss differing in risk style for a set of multi-outcome lotteries. Reflection was found to be weak and irregular for all choice pairs except those that included a lottery with a riskless component. The latter were generally preferred for gains but not for losses by both risk-averse and risk-seeking Ss. In all other choices, risk-averse and risk-seeking Ss differed systematically from one another, but in ways that are more complex than pure risk aversion or risk seeking would predict. It is concluded that the findings suggest a general inability of weighted value theories such as the prospect theory described by D. Kahneman and A. Tversky (1979) to adequately describe the pattern of risk preferences over individuals and over the full range of lottery types. Such inadequacy suggests the need for an alternative approach to risk with emphasis on the goals and strategies that individuals bring to the risky choice process. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Infant birth weight among women with or at high risk for HIV infection: The impact of clinical, behavioral, psychosocial, and demographic factors.

The purpose of these analyses was to provide a prospective examination of the impact of HIV on birth weight using clinical, behavioral, psychosocial, and demographic correlates. 319 HIV-positive and 220 HIV-negative pregnant women matched for HIV risk factors (i.e., drug use and sexual risk behaviors) were interviewed during the 3rd trimester of pregnancy and 6 weeks postpartum. Medical chart reviews were also conducted for the HIV-seropositive pregnant women to verify pregnancy-related and birth outcome data. In a logistic regression analysis, controlling for parity and gestational age, women who were HIV seropositive were 2.6 times more likely to have an infant with low birth weight. Black women and those who did not live with their partners were more than 2 times as likely to have infants with low birth weight, and those who smoked were 3.2 times more likely to have infants with low birth weight. Knowing that women with HIV, those who are Black, and those not living with a partner are at highest risk for adverse birth outcomes can help those in prenatal clinics and HIV specialty clinics to target resources and develop prevention interventions. This is particularly important for women with HIV because birth weight is associated with risk of HIV transmission from mother to child. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Experience of non-fatal overdose among heroin users in Adelaide, Australia: circumstances and risk perceptions

AIMS: To ascertain the prevalence and risk factors for non-fatal overdose among heroin users to assist in the development of an effective intervention. DESIGN: Cross-sectional design. SETTING: Community setting, principally metropolitan Adelaide. PARTICIPANTS: Current heroin users (used heroin in the previous six months). MEASUREMENTS: A structured questionnaire including the Severity of Dependence Scale. FINDING: Of 218 current South Australian heroin users interviewed in 1996, 48% had experienced at least one non-fatal overdose their life-time (median: two overdoses), and 11% had overdosed in the previous 6 months. At some time, 70% had been present at someone else's overdose (median: three overdoses). At the time of their own most recent overdose, 52% had been using central nervous system depressants in addition to heroin, principally benzodiazepines (33%) and/or alcohol (22%). The majority of overdoses occurred in a private home (81%) and in the presence of other people (88%). Unrealistic optimism regarding the risk of overdose was evident across the sample. Despite almost half the sample reporting having had an overdose, and the belief expressed by respondents that on average about 50% of regular heroin users would overdose during their life-time 73% had, during the previous 6 months, "rarely" or "never" worried about possibly overdosing. Optimism regarding the possibility of future overdose was reduced in those with recent experience of overdose in comparison to the rest of the sample. A targeted intervention aimed at the reduction of overdose among heroin users is outlined.     

Planes, trains, automobiles--and tea sets: Extremely intense interests in very young children.

[Correction Notice: An erratum for this article was reported in Vol 44(1) of Developmental Psychology (see record 2007-19851-021). The DOI for the supplemental materials was printed incorrectly. The correct DOI is as follows: http://dx.doi.org/10.1037/0012-1649.43.6.1579.supp.] Some normally developing young children show an intense, passionate interest in a particular category of objects or activities. The present article documents the existence of extremely intense interests that emerge very early in life and establishes some of the basic parameters of the phenomenon. Surveys and interviews with 177 parents revealed that nearly one third of young children have extremely intense interests. The nature of these intense interests is described, with particular focus on their emergence, commonalities in the content of the interests, and the reactions of other people to them. One of the most striking findings is a large gender difference: Extremely intense interests are much more common for young boys than for girls. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An outbreak of group C rotavirus gastroenteritis among adults living in Valentim Gentil, S?o Paulo State, Brazil

A comparison among modified and unmodified supercritical fluid extraction (SFE), enhanced-fluidity liquid extraction, and accelerated solvent extraction (ASE) techniques was made for the extraction of polynuclear aromatic hydrocarbons (PAHs) from an aged, spiked lignite coal fly ash. All of the attempted extraction conditions allowed the extraction of the PAHs to some degree, but no single extraction technique proved to be superior for all of the PAHs used. Three groups of PAHs with similar extraction efficiencies were identified. The group with the lowest molecular weights was best recovered using a 90% CO2-10% methanol mixture at 70 degrees C and 238 atm. The group of medium-molecular-weight PAHs was recovered equally well using any of three extraction conditions: SFE (100% CO2, 90 degrees C, and 238 atm), enhanced-fluidity liquid mixture (60% CO2-40% methanol, 70 degrees C, and 238 atm), and a methanol ASE mixture. The group of high-molecular-weight PAHs seemed to be equally well recovered with all of the attempted extraction conditions, but the enhanced-fluidity conditions (60% CO2-40% methanol, 70 degrees C, and 238 atm) had extraction recoveries (> 85%) with the lowest standard deviations (approximately 5%).     

Embryotoxic doses of vitamin A to rabbits result in low plasma but high embryonic concentrations of all-trans-retinoic acid: risk of vitamin A exposure in humans

Retinoid pharmacokinetics were examined in plasma, placenta and embryos of gestational d 12 rabbits following application of an embryotoxic dosing regimen (10 mg retinyl palmitate/kg body wt per day from gestational d 7 to 12). Vehicle-treated or untreated rabbits served as controls. Physiological concentrations of all-trans-retinoic acid (all-trans-RA) and 13-cis-RA in rabbit plasma (5-8.33 nmol/L) were very close to the endogenous levels in human plasma. In addition, we identified endogenous all-trans-RA, 3,4-didehydroretinol and 3,4-didehydroretinoic acid in rabbit embryo. Following the last retinyl palmitate administration, apparent steady-state concentrations of all retinoids were reached in the examined compartments of rabbits. The major polar retinoid in plasma was 9, 13-di-cis-RA, but its embryonic concentrations were only about 6% of those in plasma. In the embryo, retinol and its esters were found at high concentrations; lower amounts of all-trans-4-oxo-RA and the newly identified 14-hydroxy-4, 14-retro-retinol could also be measured. Embryonic concentrations of all-trans-RA were about 100% higher than endogenous levels. The overall exposure of the embryo to this retinoid was, however, substantial. Embryonic area under the concentration time curve values strongly suggest that the embryotoxicity of the applied dosing regimen is mainly due to the action of all-trans-RA. A very remarkable finding of this study is the marginal increase of plasma concentrations of all-trans-RA over their endogenous levels, which is comparable to the human situation after vitamin A intake. This analogy indicates that high vitamin A intake may be associated with a higher risk for teratogenic effects in humans even in the absence of high elevation of plasma all-trans-RA levels.     

Long-term use of the female condom among couples at high risk of human immunodeficiency virus infection in Zambia

A comparison of course and outcome in schizophrenics and patients with unipolar affective disorders revealed significant differences not only between the two groups but also between first hospitalized and rehospitalized patients within each group. While schizophrenics fared worse in almost all parameters at the end of the 14-year follow-up period, within each group overall course and outcome were also poorer for rehospitalized versus first hospitalized patients. The poorest course was shown by rehospitalized schizophrenics. Future studies on course and outcome should differentiate between first and rehospitalized patients.     

Developmental trajectories toward violence in middle childhood: Course, demographic differences, and response to school-based intervention.

Investigated (a) the course of developmental trajectories toward violence over middle childhood, (b) whether and how the course of these trajectories differed by demographic subgroups of children, and (c) how responsive these trajectories were to a universal, school-based preventive intervention. Four waves of data on features of children's social-emotional development known to forecast aggression/violence were collected over 2 yrs for a highly representative sample of 1st to 6th grade children from New York City public elementary schools (N=11,160). Using hierarchical linear modeling techniques, synthetic growth curves were estimated for the entire sample and were conditioned on child demographic characteristics (gender, family economic resources, race/ethnicity) and amount of exposure to components of the preventive intervention. Three patterns of growth--positive linear, late acceleration, and gradual deceleration--characterized the children's trajectories, and these trajectories varied meaningfully by child demographic characteristics. Children whose teachers taught a high number of lessons in the conflict resolution curriculum demonstrated positive changes in their social-emotional developmental trajectories and deflections from a path toward future aggression and violence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

CD46 (membrane cofactor protein of complement, measles virus receptor): structural and functional divergence among species (review)

OBJECT: In this retrospective study, the authors analyzed the frequency, anatomical distribution, and appearance of traumatic brain lesions in 42 patients in a posttraumatic persistent vegetative state. METHODS: Cerebral magnetic resonance (MR) imaging was used to detect the number of lesions, which ranged from as few as five to as many as 19, with a mean of 11 lesions. In all 42 cases there was evidence on MR imaging of diffuse axonal injury, and injury to the corpus callosum was detected in all patients. The second most common area of diffuse axonal injury involved the dorsolateral aspect of the rostral brainstem (74% of patients). In addition, 65% of these patients exhibited white matter injury in the corona radiata and the frontal and temporal lobes. Lesions to the basal ganglia or thalamus were seen in 52% and 40% of patients, respectively. Magnetic resonance imaging showed some evidence of cortical contusion in 48% of patients in this study; the frontal and temporal lobes were most frequently involved. Injury to the parahippocampal gyrus was detected in 45% of patients; in this subgroup there was an 80% incidence of contralateral peduncular lesions in the midbrain. The most common pattern of injury (74% in this series) was the combination of focal lesions of the corpus callosum and the dorsolateral brainstem. In patients with no evidence of diffuse axonal injury in the upper brainstem (26% in this series), callosal lesions were most often associated with basal ganglia lesions. Lesions of the corona radiata and lobar white matter were equally distributed in patients with or without dorsolateral brainstem injury. Moreover, cortical contusions and thalamic, parahippocampal, and cerebral peduncular lesions were also similarly distributed in both groups. CONCLUSIONS: The data indicate that diffuse axonal injury may be the major form of primary brain damage in the posttraumatic persistent vegetative state. In addition, the authors demonstrated in this study that MR imaging, in conjunction with a precise clinical correlation, may provide useful supportive information for the accurate diagnosis of a persistent vegetative state after traumatic brain injury.     

Relationships among HIV risk beliefs, attitudes, and behaviors in sexually active, seronegative gay men

Safer-sex guidelines established during the early days of the HIV/AIDS epidemic have undergone very little revision despite some controversy. Although these guidelines have been widely disseminated in the gay community, many gay men continue to engage in behaviors that are believed to put them at high risk for transmission of HIV. This suggests either that they have not accepted safer-sex guidelines as accurate or that other factors override personal implementation of the guidelines. The study examined seronegative gay men's beliefs about the accuracy of safer sex guidelines and the men's participation in behaviors risky for transmitting HIV. The greatest disagreement between the men's beliefs and behaviors centered on the risk of oral intercourse; this suggests a need for clarification of the safer sex message about this behavior. The findings of this study support the need to reformulate safer-sex guidelines. When unprotected oral and anal sex are classified at the same level of risk, those who engage in unprotected oral sex may proceed to unprotected anal sex with less reservation.     

Infants at social risk: Relations among infant maltreatment, maternal behavior, and infant attachment behavior.

Fifty-six 12-mo-old infants, including 10 maltreated infants, 18 nonmaltreated high-risk infants, and 28 matched low-income controls, were videotaped in naturalistic settings at home with their mothers for 40 min and were observed 2 weeks later in the Ainsworth Strange Situation. Maltreating mothers were rated higher than nonmaltreating mothers on covertly hostile and interfering behaviors toward their infants at home. Maltreated infants were more avoidant of their mothers in the Strange Situation than nonmaltreated infants. Correlations between maternal behaviors at home and infant behaviors in the Strange Situation revealed that mothers whose infants displayed resistant behavior on reunion were rated at home as less verbally communicative and mothers whose infants displayed avoidant behavior on reunion were rated at home as more covertly hostile. Infants showing mixed avoidance and resistance were more likely to have extremely uncommunicative mothers than were infants who showed avoidance alone. Use of the behavioral rating scales for avoidance and resistance produced clearer findings than use of the final attachment classifications. Reasons for the discrepancies between analyses of classifications and analyses of behavior ratings were identified. (PsycINFO Database Record (c) 2010 APA, all rights reserved)