Habitat degradation and fishing effects on the size structure of coral reef fish communities.

Overfishing and habitat degradation through climate change pose the greatest threats to sustainability of marine resources on coral reefs. We examined how changes in fishing pressure and benthic habitat composition influenced the size spectra of island-scale reef fish communities in Lau, Fiji. Between 2000 and 2006 fishing pressure declined in the Lau Islands due to declining human populations and reduced demand for fresh fish. At the same time, coral cover declined and fine-scale architectural complexity eroded due to coral bleaching and outbreaks of crown-of-thorns starfish, Acanthaster planci. We examined the size distribution of reef fish communities using size spectra analysis, the linearized relationship between abundance and body size class. Spatial variation in fishing pressure accounted for 31% of the variation in the slope of the size spectra in 2000, higher fishing pressure being associated with a steeper slope, which is indicative of fewer large-bodied fish and/or more small-bodied fish. Conversely, in 2006 spatial variation in habitat explained 53% of the variation in the size spectra slopes, and the relationship with fishing pressure was much weaker (approximately 12% of variation) than in 2000. Reduced cover of corals and lower structural complexity was associated with less steep size spectra slopes, primarily due to reduced abundance of fish < 20 cm. Habitat degradation will compound effects of fishing on coral reefs as increased fishing reduces large-bodied target species, while habitat loss results in fewer small-bodied juveniles and prey that replenish stocks and provide dietary resources for predatory target species. Effective management of reef resources therefore depends on both reducing fishing pressure and maintaining processes that encourage rapid recovery of coral habitat.

Phagocytic function of polymorphonuclear leukocytes in rheumatic diseases.

Phagocytosis of yeast particles by peripheral blood and synovial fluid neutrophils was compared in the sera and synovial fluids from 16 osteoarthritis, 23 rheumatoid arthritis, and 12 miscellaneous arthritis patients. Phagocytosis by normal peripheral blood neutrophils was decreased equally and significantly in all synovial fluids. All synovial fluid neutrophils demonstrated decreased phagocytic capacity in all media. Rheumatoid arthritis synovial fluid neutrophils showed significantly less phagocytosis than miscellaneous arthritis synovial fluid neutrophils. Normal peripheral blood neutrophils which in vitro had previously ingested monosodium urate crystals or oil red O, subsequently exhibited a normal yeast phagocytic capacity. Normal peripheral blood neutrophils, which had ingested preformed immunoglobulin G-rheumatoid factor complexes exhibited significantly less yeast phagocytic capacity than control cells or cells preincubated with the individual complex components. There was a significant correlation between the log of the reciprocal of the rheumatoid factor titer in sera used to produce complexes and the phagocytic capacity exhibited by test neutrophils. Ingestion of immunoglobulin G-rheumatoid factor complexes may be important in the production of the cellular phagocytic defect which this study has demonstrated in rheumatoid arthritis synovial fluid neutrophils.

Fenoprofen, aspirin, and gold induction in rheumatoid arthritis.

Fenoprofen calcium (2,400 mg/day) or aspirin (3,900 mg/day) was administered in double-blind fashion to 20 rheumatoid patients during 6 months of gold induction therapy, and to 20 rheumatoid patients not receiving gold. Among both the gold-treated and nongold-treated patients, the fenoprofen and aspirin groups improved equally in all but one parameter of disease activity. Fenoprofen and aspirin did not differ significantly in the observed prevalences of abdominal discomfort, guaiac-positive stools, or peptic ulcers. Aspirin was associated with significantly higher mean serum glutamic oxaloacetic transaminase (SGOT) levels than fenoprofen, but only among patients undergoing gold induction. Comparison of efficacy parameters between patients treated with gold and patients treated with oral drugs alone revealed significant differences favoring gold.

Pirprofen and aspirin in the treatment of rheumatoid arthritis.

Pirprofen (800 mg/day) or aspirin (3,600 mg/day) was administered in double-blind fashion for up to one year to 40 adult outpatients with rheumatoid arthritis, after a short, single-blind placebo period. There were no statistically significant differences in efficacy between pirprofen and aspirin, as evidenced by patient opinion, observer opinion, grip strength, walking time, number of tender joints, number of swollen joints, or erythrocyte sedimentation rate. Clinically significant pain of gastrointestinal origin occurred in an equal number of patients from each group. Audiologic evaluation revealed 3 pirprofen-treated patients and 5 aspirin-treated patients in whom sensorineural hearing loss progressed during therapy and required either discontinuation or reduction of drug dosage. Ophthalmologic evaluation disclosed a high prevalence of lesions, the most common being decreased visual acuity and cataracts not explained by previous antiarthritic therapy. The high prevalence of audiologic and ophthalmologic pathology reported in the literature in patients with rheumatoid arthritis makes it difficult to establish in our study whether pirprofen or aspirin affected these organ systems.

Selective alteration of personality and social behavior by serotonergic intervention.

OBJECTIVE: The authors sought to test the causal hypothesis that serotonergic function modulates aspects of the normal spectrum of individual differences in affective experience and social behavior in humans. METHOD: A selective serotonin reuptake inhibitor (SSRI), paroxetine, 20 mg/day (N = 26), or placebo (N = 25) was administered to normal volunteers in a double-blind manner for 4 weeks, and personality variables and social behavior were assessed at baseline and at weeks 1 and 4 of treatment. RESULTS: Relative to placebo, SSRI administration reduced focal indices of hostility through a more general decrease in negative affect, yet did not alter indices of positive affect. In addition, SSRI administration increased a behavioral index of social affiliation. Changes in both negative affect and affiliative behavior were significantly related to volunteers' plasma SSRI levels at the end of the experiment. CONCLUSIONS: Central serotonergic function may modulate a dimension of normal personality characterized by reduced negative affective experience and increased affiliative behavior. SSRI administration has significant and detectable effects on these measures even in the absence of baseline clinical depression or other psychopathology.

Nabumetone: a single-center three-week comparison with placebo in the treatment of rheumatoid arthritis.

Forty-six patients with definite or classical rheumatoid arthritis were entered into a three-week, double-blind, randomized, parallel study of nabumetone, 1,000 mg at bedtime, compared with placebo. Fifteen nabumetone-treated and 12 placebo-treated patients were evaluated for efficacy variables including physician's opinion of rheumatoid arthritis activity, patient's opinion of rheumatoid arthritis activity, articular index, morning stiffness, 50-foot walking time, grip strength, and acetaminophen consumption. Between-group analysis of improvement over baseline was significantly (p less than 0.05) greater for nabumetone-treated patients for six of the seven variables. Nabumetone was significantly favored over placebo in three global evaluations and significantly more placebo-treated (75 percent) than nabumetone-treated (20 percent) patients withdrew from the study due to an unsatisfactory therapeutic response. Of the 38 patients receiving the study medication, 22 percent of nabumetone-treated and 5 percent of placebo-treated patients reported adverse experiences either related to treatment or for which the relationship to treatment was unknown. No patients were withdrawn from the study as a result of these experiences and no long-term sequelae or clinically significant laboratory abnormalities were reported.

Evaluation of nabumetone in the treatment of active adult rheumatoid arthritis.

The safety and efficacy of nabumetone and placebo were compared in a three-week, multicenter, double-blind, randomized, parallel evaluation involving patients with class II or III definite or classical rheumatoid arthritis. No patient received concomitant treatment with other nonsteroidal anti-inflammatory agents; however, disease-modifying agents (gold, steroids) were permitted. Of the 139 patients who entered the double-blind phase of the study, all were evaluable for safety, and 113 were evaluable for efficacy. Sixty-one patients received 1,000 mg of nabumetone per day at bedtime, and 50 were given placebo tablets; patients in both groups were permitted up to 3,250 mg of acetaminophen per day as needed for pain. After three weeks, nabumetone-treated patients exhibited a greater degree of improvement from baseline than did the placebo-treated patients, and the degree of improvement was statistically significant for four of seven variables.

Comparison of diflunisal and aspirin in long-term treatment of patients with rheumatoid arthritis.

A multicenter, open-label clinical trial evaluated the efficacy and tolerability of diflunisal given twice daily and aspirin given four times daily in the long-term treatment of patients with rheumatoid arthritis. Patients who successfully completed a 12-week, double-blind, parallel study comparing diflunisal (500 to 750 mg daily) with aspirin (2.6 to 3.9 gm daily) continued on the same medication in a 40-week, open-label segment of the study. The dosage of diflunisal could be increased to a maximum of 1 gm daily during the open-label phase. Both regimens were effective during the 40-week study. Diflunisal was better tolerated than aspirin as judged by the overall incidence of clinical adverse experiences. Patients treated with diflunisal had significantly fewer adverse experiences involving the digestive system and organs of special sense than did those treated with aspirin.

Pain behavior of rheumatoid arthritis patients enrolled in experimental drug trials.

OBJECTIVE: This study examined the sensitivity of a behavioral observation method for the assessment of arthritis pain as an outcome measure in clinical drug trials. METHODS: The subjects were 33 rheumatoid arthritis patients who were receiving either an active experimental drug or a placebo. Disease activity measures, self-reports of pain, and pain behavior observations were completed for each subject prior to drug initiation, 6 weeks after drug initiation, and 12 weeks after drug initiation. RESULTS: Significant reductions in measures of disease activity and self-report of pain were found for the subjects who received an active drug, relative to those who received the placebo. The pain behavior scores produced by both groups of subjects remained relatively stable during the study. CONCLUSION: The lack of change in pain behavior suggests that arthritis pain behavior may lack sensitivity to short-term changes accompanying drug therapy.

Observation of pain behavior in rheumatoid arthritis patients during physical examination. Relationship to disease activity and psychological variables.

This study examined the reliability and validity of a behavioral observation method for the assessment of arthritis pain in a clinical practice setting. Trained observers measured the occurrence of seven pain behaviors in a group of 61 rheumatoid arthritis patients undergoing physical examinations. These observations were compared with videotaped observations of the patients in a laboratory setting. Significant differences were found between the pain behavior frequencies observed during the examinations and those observed during videotaped sessions. Total pain behavior scores obtained in both settings were significantly correlated with patients' self-reports of pain and with disease activity measures. Pain behavior observed during the exams was significantly associated with patients' self-reports of anxiety and depression.

Autonomy, relatedness, and the initiation of health risk behaviors in early adolescence.

This study examined the relationships among sociodemographic characteristics, family processes, and the initiation of health risk behaviors in early adolescence. Subjects were 189 6th and 7th graders from a public middle school. A path-analytic model was used to analyze data. Results showed that students who received autonomy support from parents were less likely to initiate sexual intercourse. Students who were emotionally detached from their parents were more likely to fight and use substances. Those who were emotionally detached tended to come from families with low levels of cohesion and acceptance. Sociodemographic variables, such as family structure, gender, and ethnicity, had both direct and indirect effects on health risk behaviors, but the indirect effects were quite small.

Initiation of substance use in early adolescence: the roles of pubertal timing and emotional distress.

Two hypotheses regarding the effects of pubertal timing on substance use were tested in a prospective study of 221 young adolescents. A maturational-deviance hypothesis predicted that early-maturing girls and late-maturing boys would experience heightened emotional distress, which in turn would influence initiation and use of substances. Alternatively, an early-maturation hypothesis predicted that early-maturing girls would engage in more substance use than all other groups, independent of emotional distress. Early-maturing adolescents reported more substance use within 1 year. Adolescents experiencing elevated levels of negative affect also reported greater substance use within the next year. However, pubertal timing was not related to emotional distress. Results support the early-maturation hypothesis for girls and suggest its extension to boys.

Diflunisal 500-750 mg versus aspirin 2600-3900 mg in the treatment of rheumatoid arthritis.

Diflunisal was compared to aspirin in a 12-week, double-blind, parallel, multicenter rheumatoid arthritis study. One hundred twenty-six (126) patients received diflunisal and 123 patients received aspirin. Both treatment groups demonstrated significant improvement from baseline in joint pain, morning stiffness, grip strength, walking time and painful and swollen joint scores. For these parameters, the only statistically significant difference between the groups was that diflunisal was more effective than aspirin for overall joint pain at week 2. The overall evaluation by patients and by investigators showed significantly better responses in those treated with diflunisal at weeks 1 and 12. Diflunisal produced significantly less gastrointestinal pain and tinnitus than aspirin. Neither drug showed unusual frequency of adverse effects as determined in the laboratory. Long-term studies using a higher-dose regimen are suggested to further define the efficacy and tolerability of diflunisal in the treatment of patients with rheumatoid arthritis.

Alterations in arachidonic acid metabolism and chemotactic response in polymorphonuclear leukocytes from patients with rheumatoid arthritis.

This study examines the interrelationship between arachidonic acid (AA) metabolism and chemotactic potential of human peripheral blood neutrophils from both normal donors and patients with rheumatoid arthritis (RA). We demonstrate that there is a significant inverse relationship between the neutrophil's metabolic capability to produce [3H]LTB4 in response to ionophore A23187 stimulation versus the cell's chemotactic potential to optimal concentrations (i.e., 20 nM) of the chemotactic peptide f-Met-Leu-Phe as determined by leading front (r = 0.567, p = 0.009), mean depth (r = 0.458, p = 0.042), and population ratio (r = 0.471, p = 0.036) analyses. Subsequent Percoll density gradient studies revealed several RA neutrophil subpopulations exhibiting significantly enhanced (p less than 0.05) [3H] AA metabolism over corresponding density normal cells. Based on these results, we speculate that RA peripheral blood neutrophils have been "processed" to become less chemotactically-responsive yet more metabolically-active cells, and that the increased ability to produce LTB4 through both increased phospholipase A2 and lipoxygenase activities are part of the increased metabolic capabilities of the cell.

Phospholipase activity in synovial fluid from patients with rheumatoid arthritis, osteoarthritis and crystal-associated arthritis.

Phospholipase activity was assayed in cell-free synovial fluid (SF) from patients with rheumatoid arthritis (RA, n = 28), osteoarthritis (OA, n = 10), and crystal-associated arthritis (C, n = 7) by measuring the release of either [14C]oleic acid or [3H]arachidonic acid from radiolabeled E. coli phospholipids. Activity measured by oleic acid release was not significantly different between the three groups of patients (RA = 571 +/- 43.3, OA = 460 +/- 54.7 and C = 718 +/- 162.6 pmol/min/mg). Arachidonic acid release was significantly (p less than 0.005) less in OA (31 +/- 7.3) than RA (61 +/- 4.7) which was similar to C (58 +/- 17.6 pmol/min/mg). Arachidonic acid release correlated significantly with the SF white blood cell count (r = 0.483, p less than 0.01). This study shows the importance of the type of substrate used to measure phospholipase activity and indicates that differences in the capacity to release arachidonic acid may exist between RA and OA disease states.

Clinical evaluation of radiographic progression in rheumatoid arthritis.

Four rheumatologists and 2 radiologists utilized 3 reading techniques to evaluate clinical radiographic progression in selected serial hand and wrist films from 5 rheumatoid arthritis patients. The carpometacarpal radio determinations were the most internally consistent; global assessment and total erosion + joint space narrowing scores showed the best between-method correlations; and the erosion + joint space narrowing scores depicted most sensitively the progression over time which was not affected by immunomodulating agent or non-steroidal anti-inflammatory agent therapy. In this study, instructed, non-experienced readers detected rheumatoid radiographic progression utilizing readily available scoring techniques.

Inhibition of neutrophil phagocytosis and enzyme release by hyaluronic acid.

Hyaluronic acid at a concentration found in normal joints (4 mg/ml) inhibited the uptake of aggregated IgG by human peripheral blood polymorphonuclear leukocytes, but concentrations of hyaluronic acid found in inflammatory joints (1 mg/ml) did not. Similarly, hyaluronic acid at 4 mg/ml, but not 1 mg/ml, inhibited the release of lysozyme from aggregated IgG stimulated polymorphonuclear leukocytes. beta-Glucuronidase release was inhibited by both concentrations of hyaluronic acid. Physiological concentrations of hyaluronic acid inhibit this model system for the fluid phase of rheumatoid arthritis and hyaluronic acid may be an important immunomodulating substance in the rheumatoid joint.

Decreased production of suppressive-B-cell factor by synovial membrane B-lymphocytes in rheumatoid arthritis.

Suppressive-B-cell factor (SBF) is an autoregulatory B-cell lymphokine produced by heat-aggregated-IgG stimulated B-lymphocytes which suppresses polyclonal immunoglobulin production. SBF production by rheumatoid arthritis (RA) patients' peripheral blood B-lymphocytes inversely correlates with disease activity and in vitro rheumatoid factor production. To further define the role of SBF in the pathogenesis of RA, the present study measured SBF production by surgically-obtained synovial membrane mononuclear leukocytes. SBF production by RA synovial leukocytes was similar to the levels previously described for RA peripheral blood leukocytes. Both RA and osteoarthritis (OA) synovial leukocytes produced significantly less SBF than leukocytes obtained from otherwise healthy patients with plica. OA patients produced less SBF than RA patients, but the difference was not statistically significant. SBF values for combined RA patients and controls with OA or plica correlated with the degree of histological plasma cell infiltration providing further evidence for SBF production by cells of the B-lymphocyte lineage. Depletion studies also demonstrated that synovial SBF was produced by B-lymphocytes. The molecular weight (34,000) of synovial SBF was similar to the molecular weight of peripheral blood SBF. Decreased SBF production by RA synovial B-lymphocytes is a functional abnormality in RA which may contribute to the perpetuation of synovial rheumatoid factor production and chronic synovial inflammation.

The roles of constructive thinking and optimism in psychological and behavioral adjustment during pregnancy.

This study examined the impact of constructive thinking on the anxiety, positive states of mind, and substance use of 221 women during pregnancy and the influence of optimism and perceived stress on these relationships. Participants were interviewed both early and late in pregnancy. Constructive thinking predicted both psychological and behavioral adjustment later in pregnancy, independent of age and social desirability. Subsequent path analyses indicated that constructive thinking mediated the impact of optimism on anxiety, positive states of mind, and substance use during pregnancy. In turn, the effect of constructive thinking on women's adjustment during pregnancy was itself mediated by their perceived stress. Implications for constructive thinking and optimism as independent constructs relevant to adjustment and their potential importance for future research and clinical applications are discussed.

Psychological approaches to the management of arthritis pain.

The present review examines the literature regarding the efficacy of cognitive-behavioral and other self-control interventions in helping arthritis patients reduce their pain and functional disabilities. The evidence indicates that self-control interventions have produced significant and positive changes in the pain and functional disabilities of patients with rheumatoid arthritis and arthritis secondary to hemophilia. However, the literature suffers from deficiencies with regard to the use of small subject samples; inadequate control procedures and follow-up assessments; failure to demonstrate that positive outcomes are related to changes in subjects' covert experiences or control of physiological variables; and reliance upon self-report measures of outcome. The review is followed by a description of a multidisciplinary study of the efficacy of a biofeedback-assisted, cognitive-behavioral group therapy program for rheumatoid arthritis patients that features several methodological improvements relative to previous investigations. The preliminary outcome data show that the cognitive-behavioral intervention is associated with reductions in pain behavior and self-reports of pain and disability. It is concluded that, although the self-control interventions have shown promising results, psychologists must demonstrate positive and reliable outcomes among large numbers of arthritis patients over extended periods of time if the interventions are to be viewed as credible by rheumatologists.