Stroke and use of low-dose oral contraceptives in young women: a pooled analysis of two US studies

BACKGROUND AND PURPOSE: The available data on low-dose oral contraceptive pill (OCP) use and stroke risk in US women are limited by small numbers. We sought more precise estimates by conducting a pooled analysis of data from 2 US population-based case-control studies. METHODS: We analyzed interview data from 175 ischemic stroke cases, 198 hemorrhagic stroke cases, and 1191 control subjects 18 to 44 years of age. RESULTS: For ischemic stroke, the pooled odds ratio (pOR) adjusted for stroke risk factors for current use of low-dose OCPs compared with women who had never used OCP (never users) was 0.66 (95% confidence interval [CI], 0.29 to 1.47) and compared with women not currently using OCPs (nonusers) the pOR was 1.09 (95% CI, 0.54 to 2.21). For hemorrhagic stroke, the pOR for current use of low-dose OCPs compared with never users was 0.95 (95% CI, 0.46 to 1.93) and compared with nonusers the pOR was 1.11 (95% CI, 0.61 to 2.01). The pORs for current low-dose OCP use and either stroke type were not elevated among women who were >/=35 years, cigarette smokers, obese, or not receiving medical therapy for hypertension. pORs for current low-dose OCP use were 2.08 (95% CI, 1. 19 to 3.65) for ischemic stroke and 2.15 (95% CI, 0.85 to 5.45) for hemorrhagic stroke among women reporting a history of migraine but were not elevated among women without such a history. Past OCP use (irrespective of formulation) was inversely related to ischemic stroke but unrelated to hemorrhagic stroke. CONCLUSIONS: Women who use low-dose OCPs are, in the aggregate, not at increased risk of stroke. Studies are needed to clarify the risk of stroke among users who may be susceptible on the basis of age, smoking, obesity, hypertension, or migraine history.     

When and how perfectionism impedes the brief treatment of depression: Further analyses of the National Institute of Mental Health Treatment of Depression Collaborative Research Program.

Perfectionism has previously been identified as having a significant negative impact on therapeutic outcome at termination in the brief (16-week) treatment of depression (S. J. Blatt, D. M. Quinlan, P. A. Pilkonis, & T. Shea, 1995) as measured by the 5 primary outcome measures used in the National Institute of Mental Health Treatment of Depression Collaborative Research Program (TDCRP). The present analyses of other data from the TDCRP indicated that this impact of perfectionism on therapeutic outcome was also found in ratings by therapists, independent clinical evaluators, and the patients and that this effect persisted 18 months after termination. In addition, analyses of comprehensive, independent assessments made during the treatment process indicated that perfectionism began to impede therapeutic gain in approximately 2/3 of the sample, in the latter half of treatment, between the 9th and 12th sessions. Implications of these findings are discussed, including the possibility that more perfectionistic patients may be negatively impacted by anticipation of an arbitrary, externally imposed termination date. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Structural instability of uniaxially compressed α-quartz

We report a molecular dynamics simulation study of stress–strain response of single crystal α-quartz under uniaxial compression using the interatomic potential of van Beest et al. [Phys. Rev. Lett. 64 (1990) 1955]. The results at 1073 K shows an abrupt onset of large deformation of 14 GPa and subsequent time-dependent evolution of an “amorphous” structure with near-planar character. We regard this to be a lattice instability leading to structural failure, to be distinguished from a similar instability observed under hydrostatic loading which results in a phase change. The simulation results allow us to suggest new interpretations of experimental observations with regard to the formation of thin zones of isotropic (glassy) material along faults and a possible mechanism for planar fracture.     

Differential signaling and hierarchical response thresholds induced by an immunodominant peptide of myelin basic protein and an altered peptide ligand in human T cells

Changes in peptide antigen concentration or structure can have a profound effect on T cell responsiveness by inducing selected T cell effector functions. In this study, we have compared the biological responses of an MBP83-99-specific human Th0 T cell clone (TCC) stimulated with increasing concentrations of native peptide or an altered peptide ligand (APL). Our results show that the hierarchy of response thresholds for proliferation and cytokine secretion is similar for native peptide and APL. However, because a much higher concentration of the APL is required to evoke the same degree of response, the cytokine profile is shifted towards a Th2-like response relative to the same concentration of native peptide. In addition, we observed qualitative differences in TCR signal transduction triggered by native peptide and a weak agonist APL even at concentrations that elicit similar biological responses. Thus, the relationship between TCR signaling and biological responses may be more complex than previously recognized.     

Developmental differences in error-related ERPs in middle- to late-adolescent males.

Although there are some studies documenting structural brain changes during late adolescence, there are few showing functional brain changes over this period in humans. Of special interest would be functional changes in the medial frontal cortex that reflect response monitoring. In order to examine such age-related differences, the authors analyzed event-related potentials following errors in a visual flanker task and a go/no-go task in adolescent males, 15-16 and 18-20 years old. Response times and accuracy were comparable between groups on each task, but the younger group made more go/no-go errors, suggesting this task was more difficult. Error-related negativity, thought to be generated in the anterior cingulate cortex (ACC), had greater amplitude for the older adolescents on both tasks; thus the increased errors are not simply due to performance level differences. Results from this study suggest that the ACC, which supports response monitoring, is late to mature due to age-related structural or neurochemical changes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Internship recruitment and the VA Psychology Training Program.

A survey of 13 accredited and 12 nonaccredited VA internship centers indicates a flexible and varied administration of the program at the local level as to stipends, training hours, and training rotations. Responses to an anonymous questionnaire by 115 intern applicants who rejected VA internship offers indicated that the rejecting interns had a positive image of the VA, but they wanted a more heterogeneous patient population and a greater academic atmosphere for their internship than they thought the VA could provide. (PsycINFO Database Record (c) 2010 APA, all rights reserved)