A phenomenological study of breastfeeding WIC recipients in South Carolina

The purpose of this phenomenological study was to describe the phenomenon of breastfeeding in a low-income group of mothers and to determine its meaning to the mothers. Eleven mothers who had breastfeeding experience were interviewed. The focal meaning of support as related to breastfeeding emerged during data analysis from the participants' lived experience. In all participant interviews the recurring concept was support. Major themes included informational support, emotional support, and instrumental support. The article suggests implications for advanced practice.     

Symptoms versus a diagnosis of depression: Differences in psychosocial functioning.

In studies of clinical depression, individuals who demonstrate elevated levels of symptoms but do not meet interview-based diagnostic criteria are typically labeled as false positive and eliminated from further consideration. However, the implicit assumption that false-positive participants differ in important ways from true-positive (i.e., diagnosed) participants has not been tested systematically. This study compared the functioning of true-positive, false-positive, and true-negative adolescents on clinical and psychosocial functioning. Although the false-positive participants manifested higher levels of current and future psychopathology than did the true-negative participants, they did not differ significantly from the true-positive participants on most of the measures of psychosocial dysfunction. "False positive," therefore, is not a benign condition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Lithium in depression: a biochemical study

Two groups of depressed subjects, one with a history of recurrent depression, the other with a history of persistent apathy, were given lithium carbonate 1,200 mg q.i.d. and supplementart potassium 1,200 mg t.d.s. for 1 week. Measurements were made before and after the lithium treatment of total body water (tritium space), extracellular fluid (sulphate space), total exchangeable sodium (Nae) and total exchangeable potassium (Ke) using sodium-24 and potassium-42 multiple isotope dilution techniques. Prior to treatment when compared with a group of normal subjects, both depressed groups showed changes in body fluid volumes and electrolyte levels. Total body water, intracellular fluid and intracellular potassium were lowered, while electrolyte levels. Total body water, intracellular fluid and intracellular potassium were lowered, while intracellular sodium was raised. After treatment with lithium the values in the apathetic group showed little change but the group with recurrent depression showed a significant increase in intracellular fluid (p less than 0.025), Ke (p less than 0.001), intracellular potassium (p less than 0.025) and a significant decrease in Nae (p less than 0.05). There was a marked increase in mood in the group with recurrent depression but not in the apathetic group following lithium treatment. These findings suggest that recurrent depression, both in clinical improvement, mood and also correction of water and also correction of water and electrolyte disturbances arise, but not in patients with long-standing apathy.     

The natural history of eosinophilia-myalgia syndrome in a tryptophan-exposed cohort in South Carolina

BACKGROUND: In a previous study, we did follow-up on 418 patients who were exposed to tryptophan in 1989, of whom 47 (11%) had definite and 63 (9%) possible eosinophilia-myalgia syndrome (EMS). METHODS: We assessed mortality and clinical spectrum of illness since 1989 for 242 (58%) of the 418 tryptophan-exposed patients from the original study. To assess outcomes, we used hospital and death records, interviewer-administered questionnaires, physical examinations, and laboratory tests. RESULTS: During the follow-up interval, mortality from all causes was 19% in those with definite EMS, 7% in possible EMS, and 3% in those who were not ill. The age- and sex-adjusted mortality in those with definite EMS was more than 3 times that of the general population or of tryptophan users in the practice who were not ill. Six deaths (66%) among the definite EMS case patients occurred during the 18 months immediately after symptom onset. Compared with the tryptophan users who were not ill, survivors with definite EMS continued to report excess morbidity for 6 major EMS symptoms (myalgia, arthralgia, weakness, rash, alopecia, and sclerodermiform skin changes), but they also reported that the symptom number and severity diminished with time. None of the tryptophan users who were not ill in 1989 developed a symptom complex suggesting new EMS during the follow-up interval. CONCLUSIONS: This study assessing a tryptophan-exposed population found those persons who developed EMS during the 1989 epidemic were at increased risk for death, particularly early after disease onset. Survivors reported improvement or resolution of major symptoms, suggesting that the severity of EMS diminishes with time. We found no evidence of delayed onset of EMS in tryptophan users who were not ill in 1989, regardless of the brand used.     

Health outcomes of women exposed to household alcohol abuse: a Family Practice Training Site Research Network (FPTSRN) study

A systematic haplotype and sequencing analysis of the HLA-DR and -DQ region in patients with narcolepsy was performed. Five new (CA)n microsatellite markers were generated and positioned on the physical map across the HLA-DQB1-DQA1-DRB1 interval. Haplotypes for these new markers and the three HLA loci were established using somatic cell hybrids generated from patients. A four-marker haplotype surrounding the DQB1(*)0602 gene was found in all narcolepsy patients, and was identical to haplotypes observed on random chromosomes harboring the DQB1(*)0602 allele. Eighty-six kilobases of contiguous genomic sequence across the region did not reveal new genes, and analysis of this sequence for single nucleotide polymorphisms did not reveal sequence variation among DQB1(*)0602 chromosomes. These results are consistent with other studies, suggesting that the HLA-DQ genes themselves are among the predisposing factors in narcolepsy.     

Frequency of Discharge Causing Abutment Scour in South Carolina

The purpose of this study is to evaluate the adequacy of the 100-year discharge along with the Froehlich bridge abutment scour equation adopted by the U.S. Federal Highway Administration (FHwA) in predicting abutment scour for bridge design purposes in South Carolina streams. The analysis utilized bridge properties, stream cross-sectional and hydraulic data, local flood frequency equations, a one-dimensional steady river flow computer model (WSPRO), and procedures recommended by the FHwA for predicting abutment scour. A method was developed to identify the single stream-discharge at each bridge that can cause the abutment scour that was observed at 73 bridge abutments. Analysis of the results revealed that for one-third of the abutments in the sandy soil region of South Carolina, the flow rates required to produce the observed scour depths had return periods greater than 100?years. Although for bridges in the region dominated by clay soil, the return periods were significantly smaller than 100?years.     

Diabetes research in South Carolina: past, present, and future

Medical investigators in South Carolina have been on the "cutting edge" of diabetes research for a number of decades. Despite this fact, our state ranks second in the nation in diabetes prevalence, and diabetes complications are more severe here than anywhere else. It is from the efforts of these investigators that our hope for a brighter future comes. Through a concerted effort toward prevention, improvements in care, and investigation of the pathophysiology of diabetes and its complications, researchers may reduce the substantial burden of diabetes in our state and throughout the world.     

Practice patterns for the outpatient treatment of depression in a case-managed delivery system: A utilization study.

Have you ever wondered how long it takes the average outpatient provider to treat a patient with a depression-related diagnosis? This article provides baseline data by diagnostic categories for women treated for depression. As a managed behavioral health care company, ValueOptions partnered with the Virginia Academy of Clinical Psychologists to study how providers use various treatment modalities. Furthermore, this study investigated average length of treatment by diagnostic category. The authors hope this information generates discussion regarding appropriate expectations for treatment and, thus, improves the quality of care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Symptoms of depression and anxiety in pediatric epilepsy patients

The XPF and ERCC1 proteins form a tight complex and function as an endonuclease to incise on the 5'-side of pyrimidine dimers in DNA. Levels of both proteins are extremely low in group F xeroderma pigmentosum (XP-F) cells. We transfected XP-F cells with the plasmids expressing XPF or ERCC1 and examined levels of both proteins in the cells. Although XP-F cells are sensitive to UV and mitomycin C (MMC), cells overexpressing XPF expressed ERCC1 as well and resistance to UV and MMC was restored to the normal level. In contrast, cells overexpressing ERCC1 did not express XPF and were still sensitive to UV and MMC. These results indicate that both the XPF and ERCC1 proteins are required to repair UV- and MMC-induced DNA damage. Even though a high level of ERCC1, which has been presumed to be a catalytic subunit of the endonuclease, is stably present in XP-F cells, ERCC1 protein alone cannot carry out excision repair completely.     

Symptoms of depression in elderly Korean immigrants: narration and the healing process

This paper explores ways in which depressive symptoms are expressed by elderly Korean immigrants in the USA. Depressed elderly Korean immigrants in the Washington DC area were interviewed in depth to explore their conceptualizations of depression in terms of explanatory models and semantic networks. The expressions of depressive symptoms were influenced by linguistic and psycho-socio-cultural factors, therapeutic behaviors, and efficacy of treatment. The data were interpreted in terms of traditional Korean medical principles, cosmological, socio-cultural, and religious influences, and an individual's family structural changes and acculturation. Findings indicate the construction of somatization among Korean elders is more complex than is generally reported: in most cases, a dynamic, holistic blend of processes appears to operate simultaneously, instead of as somatization in isolation. Informants placed different degrees of emphasis on psychologization or somatization, or the two combined. The roles of personality, value orientation, intellect, emotion, economic status, degree of acculturation, degree of dependence on children, living situation (with or not with children), and self-will or self-confidence are important influences on the depression symptoms in the psychologization-somatization continuum. The more self-directed the informants are, the more they psychologize; the more other-directed, the more they seem to somatize. Names and symptoms of depression (a Western concept) and popular illnesses (traditional Korean concepts) were used interchangeably by the informants. When informants were asked to explain the signs and symptoms of depression and sadness, some described symptoms similar to the criteria of major depression in DSM-III (American Psychiatric Association), while others gave different symptoms and ways of expressing them. Some informants believed that symptoms and signs of depression can be concealed from others if one chooses to do so. Many felt that manifestations of depression can be controlled by willpower, personality, and self-care.     

Mercury levels in freshwater fish of the state of South Carolina

Samples of fish from freshwater sources of rivers, lakes and ponds all over the state of South Carolina were collected during the Summer of 1974 and 1975. The fish collected were Bass, Bluegill, Redbreast, Catfish, Shad, Carp, Crappie, Mudfish and Pike. Samples were analyzed using the flameless atomic absorption procedure outlined by Hatch and Ott, and Uthe et al as modified for use with Perkin-Elmer, Coleman MAS-50 mercury analyzer. Triplicate samples of fish tissue were analyzed by wet digestion method. The mean mercury levels in ppb were determined for baseline mercury levels. A significant finding of this report is that those species for which fish of widely differing weights were analyzed, larger fish had higher mercury levels. Mercury levels exceeding the U.S. Food and Drug Administration guideline of 500 ppb for fish tissues have been found in the Mudfish from Edisto River and Pike fish from Lake Murray. Higher levels of mercury occurred in the highly vascularized blood tissues of liver and kidney than in muscle. Carnivorous and bottom-feeding fishes are the most reliable indicators of mercury pollution.     

Lifetime use of alternative therapy: a study of Florida residents

OBJECTIVE: To determine the bacteriologic efficacy of ceftriaxone in nonresponsive acute otitis media in children. METHODS: In a prospective study 92 patients ages 3 to 36 months (median, 11 months) with culture-proved nonresponsive acute otitis media were studied from January, 1995, through August, 1997. The patients were treated with intramuscular ceftriaxone (50 mg/kg/l/day) for 3 days. Middle ear fluid was aspirated for culture by tympanocentesis on day of enrollment (Day 1); a second tap was performed on Days 4 to 10. Additional middle ear fluid cultures were obtained if clinical relapse occurred. Bacteriologic failure was defined by positive culture on Days 4 to 10. Patients were followed until Day 17+/-2. Susceptibility was measured by E test. RESULTS: The main drugs administered before enrollment were amoxicillin (38%), amoxicillinclavulanate (25%) and cefaclor (20%). Organisms recovered (n=105) were: Haemophilus influenzae, 54; Streptococcus pneumoniae, 47; Moraxella catarrhalis, 2; and Streptococcus pyogenes, 2. Thirty-four (72%) of the 47 S. pneumoniae isolates were intermediately resistant to penicillin (MIC 0.1 to 1.0 microg/ml), but all were susceptible to ceftriaxone (MIC < 0.5 microg/ml). Bacteriologic eradication was achieved in 100 of 105 (95%) cases: 54 of 54 (10O%) H. influenzae, 43 of 47 (92%) S. pneumoniae, 1 of 2 (50%) M. catarrhalis and 2 of 2 (100%) S. pyogenes. Bacteriologic success (with no relapse) occurred in 13 of 13 (100%) penicillin-susceptible S. pneumoniae vs. 28 of 34 (82%) S. pneumoniae intermediately resistant to penicillin (4 cases of bacteriologic failure and 2 cases of relapse). CONCLUSION: A 3-day intramuscular ceftriaxone regimen is efficacious for the treatment of nonresponsive acute otitis media. The optimal duration of treatment in cases of nonresponsive acute otitis media and whether ceftriaxone is efficacious for the treatment of nonresponsive otitis media caused by S. pneumoniae highly resistant to penicillin is yet to be determined.     

Treatment of depression by obstetrician-gynecologists: a survey study

OBJECTIVE: We performed an exploratory survey of depression diagnosis, treatment, and patient referral patterns by Fellows of ACOG. We also examined obstetrician-gynecologists' professional training in the management of clinical depression. METHODS: We sent a questionnaire to a total of 1370 ACOG Fellows. Sixty percent of the surveys were returned. RESULTS: As a group, obstetrician-gynecologists reported diagnosing an average of four new cases of depression per month. Within the overall sample, the number of new diagnoses of depression made each month was significantly greater for those defining themselves as primary care physicians than for those defining themselves as specialists. When treating depression pharmacologically, obstetrician-gynecologists reported that they overwhelmingly (74% of the time) chose selective serotonin reuptake inhibitor antidepressants. Ninety-five percent of obstetrician-gynecologists reported that they referred severely depressed patients to a mental health professional. A majority of respondents neither received residency training (80%) nor completed a continuing medical education course (60%) on the treatment of clinical depression in women. CONCLUSION: Obstetrician-gynecologists who describe themselves as primary care physicians make significantly more diagnoses of depression than those considering themselves specialists. Studies further to assess obstetrician-gynecologists' management of depression and better to define needs for professional education are warranted.     

Major depression in the elderly: a population study in Helsinki

The aim of the study was to estimate the prevalence of major depression and to evaluate associated features in random age cohorts of 75, 80, and 85 years (N = 651). A clinical examination was made by experienced health center physicians, and major depression was diagnosed according to DSM-III criteria. The prevalence increased with age and was 1% to 4% in the age groups of 75 and 80 years, but 13% at the age of 85 years. No sex difference was found. The frequency of major depression was fourfold among institutionalized patients (16%) as compared to those living at home (4%). Major depression was strongly associated with objective health, intellectual functioning, and functional capacity. Depression was most common in subjects suffering from poor vision, urinary incontinence, or Parkinson's disease (odd ratios 4.2 to 4.9). Depression was also correlated with musculoskeletal disorders, coronary heart disease, and cerebrovascular diseases (odd ratios 2.5 to 3.4). The survey suggests that major depression is quite rare in healthy elderly people but common in disabled institutionalized patients.     

Group treatment for postpartum depression: a pilot study

OBJECTIVE: There are few reports on the efficacy of treatment programs for women with postpartum depression, despite the long-term nature of this disorder. This study describes a pilot evaluation of a treatment program with educational, social support and cognitive-behavioural components. METHOD: Ten women with persistent depression originating in the postpartum period were offered a 10-week group treatment program and compared to a wait-list control group. RESULTS: Following treatment, a significant improvement in depression was demonstrated on the Edinburgh Post-Natal Depression Scale, Beck Depression Inventory, and Profile of Mood States. Several common factors in women suffering from postpartum depression were also identified, as were drop-out characteristics. CONCLUSION: These results are encouraging and suggest that a cognitive-behavioural group program might be effective as a treatment for depression in the postpartum period. However, further detailed studies are required to conform this pilot study.