Adolescent inhalant use and executive cognitive functioning.

BACKGROUND: This study investigates the association between inhalant use and executive cognitive functioning (ECF) and processing speed (PS) in 754 adjudicated poly-substance users on a series of neuropsychological tests. Poly-substance users who used inhalants (PSI = 262) and poly-substance users who did not use inhalants (PSO = 492) neuropsychological tests scores were compared. Hispanic Americans comprised 72% of the participants; European Americans, African Americans and Asian Americans comprised 28% of the participants. METHODS: Standardized neuropsychological tests were used to assess ECF and PS. Psychosocial and substance abuse standardized surveys were used to assess drug use severity and psychosocial problems associated with substance use. RESULTS: Multiple Analysis of Covariance shows that PSI users who used inhalants performed worse on ECF and PS measures in comparison to non-inhalant poly-substance users (PSO). PSI users were younger, used more drugs and had more psychiatric admissions than PSO users. CONCLUSION: PSI users initiate substances at a younger age and experienced more ECF and PS deficits, and behavioural problems in comparison to PSO users. The results of this study suggest that PS has direct effect on ECF and psychosocial outcomes in PSI users.

Implementation of sepsis management guideline in a community-based teaching hospital - can education be potentially beneficial for septic patients?

OBJECTIVE: To assess clinical outcomes associated with the implementation of the sepsis management guideline in a community-based hospital. In addition, evaluate the utility and effectiveness of a Sepsis Education Program. RESEARCH DESIGN AND METHODS: This is an observational cohort study of patients presenting to the Emergency Department at a community-based teaching centre meeting severe sepsis or septic shock criteria. A quality improvement programme consisting of a comprehensive Sepsis Education Program based on recommendations from the Surviving Sepsis Campaign was implemented and evaluated. Patients were identify by the admission diagnosis and were evaluated over two time periods (7/2003-6/2004 and 7/2005-6/2006) and to show clinical outcomes before and after implementation of the sepsis guideline/quality improvement programme. RESULTS: A total of 96 patients with severe sepsis (34 control group and 62 SSC group) were included. Both groups had similar intensive care unit (ICU)-length of stay (3 vs. 3 days, p = 0.647). Patients who required mechanical ventilation (MV) had similar MV time (4 vs. 3.5 days p = 0.349). A greater percentage of survival was found in the SSC group [45% vs. 73% (p = 0.006)]. Patient received similar care with regards to appropriate early antibiotics (85% vs. 90%, p 0.459). The main difference between the two group was the early fluid resuscitation (2 l vs. 3 l, p = 0.006) over the first 3 h and a difference remained significant at 6 h (4.2 l vs. 6.3 l, p = 0.013). CONCLUSIONS: In a community based teaching hospital, implementing the surviving sepsis campaign guideline through an education programme was feasible and resulted in early therapy with aggressive fluid administration and appropriate antibiotics. The Sepsis Education Program resulted in early therapeutic interventions and contributed to the survival benefits.

An examination of information-processing skills among inhalant-using adolescents.

BACKGROUND: This study investigates the association between inhalant use and information processing (IP) in adjudicated polysubstance users. Polysubstance users who used inhalants (n= 158) were compared with polysubstance users who did not use inhalants (n= 303). Hispanic Americans comprised 72% of the participants; European Americans, African Americans and Asian Americans comprised 28% of the participants. METHOD: Standardized intelligence and achievement tests were used to assess information-processing constructs of working memory and processing speed. Psychosocial and substance abuse standardized surveys were used to assess drug use severity and psychosocial problems associated with substance use. RESULTS: Polysubstance users who used inhalants (PSI users) were younger, used more drugs more frequently and had more psychiatric admissions than non-inhalant polysubstance users (PSO users). Statistical analysis also shows that PSI users performed worse on measures of IP selected tests in comparison with the PSO users. CONCLUSION: Inhalant users begin abusing substances at a younger age and suffer from more verbal and non-verbal processing, behavioural, language and memory problems than non-inhalant users.

Tick-Borne Relapsing Fever in Dogs.

BACKGROUND: In the United States, Tick-Borne Relapsing Fever (TBRF) in dogs is caused by the spirochete bacteria Borrelia turicatae and Borrelia hermsii, transmitted by Ornithodoros spp. ticks. The hallmark diagnostic feature of this infection is the visualization of numerous spirochetes during standard blood smear examination. Although the course of spirochetemia has not been fully characterized in dogs, in humans infected with TBRF the episodes of spirochetemia and fever are intermittent. OBJECTIVES: To describe TBRF in dogs by providing additional case reports and reviewing the disease in veterinary and human medicine. ANIMALS: Five cases of privately-owned dogs naturally infected with TBRF in Texas are reviewed. METHODS: Case series and literature review. RESULTS: All dogs were examined because of lethargy, inappetence, and pyrexia. Two dogs also had signs of neurologic disease. All dogs had thrombocytopenia and spirochetemia. All cases were administered tetracyclines orally. Platelet numbers improved and spirochetemia and pyrexia resolved in 4 out of 5 dogs, where follow-up information was available. CONCLUSION AND CLINICAL IMPORTANCE: TBRF is likely underdiagnosed in veterinary medicine. In areas endemic to Ornithodoros spp. ticks, TBRF should be considered in dogs with thrombocytopenia. Examination of standard blood smears can provide a rapid and specific diagnosis of TBRF when spirochetes are observed.

The role of alcohol in physical assault perpetration and victimization.

OBJECTIVE: This study examines the influence of lifetime alcohol use and drinking-in-the-event on the risk of physical assault perpetration and victimization while controlling for the effects of additional demographic and personality characteristics known to be associated with violence or alcohol use. METHOD: Secondary analyses were performed on data collected for the 1990 National Alcohol Survey, which included in-person interviews with 2,058 adults (58% female) residing within the 48 contiguous United States. RESULTS: Approximately 11.5% of the sample reported having committed a physical assault, and 16.6% of the respondents reported having been the victim of a physical assault, since the age of 12 years. Gender, age, education, lifetime drinking history and an interaction between age and impulsivity were associated with physical assault perpetration. Marital status, impulsivity, and life-time drinking history were associated with physical assault victimization. Analyses performed on the subsample of individuals reporting a physical assault indicated that drinking-in-the-event by both the perpetrator and victim was associated with men's, and not women's, experiences. CONCLUSIONS: The results support a strong and stable relationship between alcohol use and physical assault. Previous findings regarding men and alcohol-related aggression are supported, but the results contradict past conclusions pertaining to alcohol and women's victimization.

Childhood sexual abuse: impact on a community's mental health status.

Epidemiologists have used impact fractions (e.g., attributable fractions) to study the influence of various risk factors on the rates of physical diseases within the community. In this study, impact fractions are applied to a psychiatric epidemiologic problem in order to examine the impact of childhood sexual abuse (CSA) on the mental health status of a community. Analysis of the Los Angeles Epidemiologic Catchment Area (LAECA) data indicate that a history of CSA significantly increases an individual's odds of developing eight psychiatric disorders in adulthood. On the community level, however, it is estimated that 74% of the exposed psychiatric cases (i.e., those with a history of CSA), and 3.9% of all psychiatric cases within the population can be attributed to childhood sexual abuse. Intervention implications are discussed.

Utility of endoscopic biopsies of the duodenum and ileum for diagnosis of inflammatory bowel disease and small cell lymphoma in cats.

BACKGROUND: Endoscopic duodenal biopsies are relatively convenient, minimally invasive tests for infiltrative intestinal disorders of cats. Ileal endoscopic biopsies might not be performed because of technical difficulty and effort required to prepare the colon. It is not known whether or not histopathology of feline duodenal and ileal biopsies for detection of inflammatory bowel disease (IBD) and small cell lymphoma (SC-LSA) provides comparable results. OBJECTIVES: To evaluate the agreement between endoscopic biopsies of duodenum and ileum in cats with IBD and SC-LSA. ANIMALS: Seventy client-owned cats with gastrointestinal disease and adequate duodenal and ileal tissue biopsies obtained endoscopically. METHODS: Retrospective study: Search of medical records of cats with enteropathy and endoscopy. Samples were blinded and re-evaluated by single pathologist (JM) for quality, number of biopsies, and diagnosis according to WSAVA standards. Agreement of IBD and SC-LSA diagnoses among biopsy sites assessed using Cohen's Kappa. RESULTS: Eighteen of 70 cats (26%) were diagnosed with SC-LSA in duodenum, ileum, or both. Of these 18 cats, 7 (39%) were diagnosed with only duodenal SC-LSA, 8 (44%) were diagnosed with only ileal SC-LSA, and 3 (17%) had SC-LSA in both duodenum and ileum. There was poor agreement on diagnosis between duodenal and ileal biopsies (kappa = 0.23). CONCLUSIONS AND CLINICAL IMPORTANCE: Although review by a single pathologist remains a limitation of this study, results suggest that there is a population of cats in which diagnosis of SC-LSA can be found only by evaluation of ileal biopsies. Clinicians should consider performing both upper and lower GI endoscopic biopsies in cats with infiltrative small bowel disease.

Novel splice isoforms of STRADalpha differentially affect LKB1 activity, complex assembly and subcellular localization.

STRADalpha is a pseudokinase that forms a heterotrimeric complex with the scaffolding protein MO25 and the tumor suppressor serine threonine protein kinase LKB1. Mutations in the LKB1 gene are responsible for the Peutz-Jeghers Syndrome (PJS) characterized by a predisposition to hamartomatous polyps and hyperpigmentation of the buccal mucosa. Mutations in LKB1 have also been observed in some sporadic tumours unrelated to PJS. The LKB1/STRAD/MO25 complex is involved in the regulation of numerous signaling pathways including metabolism, proliferation and cellular polarity of human intestinal epithelial cells. Cell polarization, together with tissue-restricted transcription, represents the main feature of enterocyte differentiation. Since a full-length STRADalpha transcript has not been identified thus far in these cells, we evaluated the expression of endogenous STRADalpha in five colorectal cancer cell lines characterized by their diverse ability to differentiate in vitro. We report herein the discovery of several novel splice isoforms of STRADalpha that differentially affect the kinase activity, complex assembly, subcellular localization of LKB1 and the activation of the LKB1-dependent AMPK pathway.

Gene-flow between populations of cotton bollworm Helicoverpa armigera (Lepidoptera: Noctuidae) is highly variable between years.

Both large and small scale migrations of Helicoverpa armigera Hübner in Australia were investigated using AMOVA analysis and genetic assignment tests. Five microsatellite loci were screened across 3142 individuals from 16 localities in eight major cotton and grain growing regions within Australia, over a 38-month period (November 1999 to January 2003). From November 1999 to March 2001 relatively low levels of migration were characterized between growing regions. Substantially higher than average gene-flow rates and limited differentiation between cropping regions characterized the period from April 2001 to March 2002. A reduced migration rate in the year from April 2002 to March 2003 resulted in significant genetic structuring between cropping regions. This differentiation was established within two or three generations. Genetic drift alone is unlikely to drive genetic differentiation over such a small number of generations, unless it is accompanied by extreme bottlenecks and/or selection. Helicoverpa armigera in Australia demonstrated isolation by distance, so immigration into cropping regions is more likely to come from nearby regions than from afar. This effect was most pronounced in years with limited migration. However, there is evidence of long distance dispersal events in periods of high migration (April 2001-March 2002). The implications of highly variable migration patterns for resistance management are considered.

Installing management by objectives in a public agency: a comparison of Black and White managers, supervisors, and professionals.

This paper explores the prediction of King and Bass (1974) that black managers and supervisors may be more reluctant than whites to accept management programs such as management by objectives. Data were collected from 77 black and 61 white managers and professionals of the City of Detroit transportation system (D-DOT), after they had been involved with MBO for almost one year. Analyses of t-test results indicate that blacks assessed MBO as more helpful in their individual jobs and more positive for the organization than their white counterparts. Explanations derived from the racial demographics of the organization, the MBO installation, and characteristics of MBO as a management process in public agencies are given.

A comparison of intermittent and continuous support during labor: a meta-analysis.

Our goal was to contrast the influence of intermittent and continuous support provided by doulas during labor and delivery on 5 childbirth outcomes. Data were aggregated across 11 clinical trials by means of meta-analytic techniques. Continuous support, when compared with no doula support, was significantly associated with shorter labors (weighted mean difference -1.64 hours, 95% confidence interval -2.3 to -.96) and decreased need for the use of any analgesia (odds ratio.64, 95% confidence interval.49 to.85), oxytocin (odds ratio.29, 95% confidence interval.20 to.40), forceps (odds ratio.43, 95% confidence interval.28 to.65), and cesarean sections (odds ratio.49, 95% confidence interval.37 to.65). Intermittent support was not significantly associated with any of the outcomes. Odds ratios differed between the 2 groups of studies for each outcome. Continuous support appears to have a greater beneficial impact on the 5 outcomes than intermittent support. Future clinical trials, however, will need to control for possible confounding influences. Implications for labor management are discussed.

The obstetrical and postpartum benefits of continuous support during childbirth.

The purpose of this article is to review the evidence regarding the effectiveness of continuous support provided by a trained laywoman (doula) during childbirth on obstetrical and postpartum outcomes. Twelve individual randomized trials have compared obstetrical and postpartum outcomes between doula-supported women and women who did not receive doula support during childbirth. Three meta-analyses, which used different approaches, have been performed on the results of the clinical trials. Emotional and physical support significantly shortens labor and decreases the need for cesarean deliveries, forceps and vacuum extraction, oxytocin augmentation, and analgesia. Doula-supported mothers also rate childbirth as less difficult and painful than do women not supported by a doula. Labor support by fathers does not appear to produce similar obstetrical benefits. Eight of the 12 trials report early or late psychosocial benefits of doula support. Early benefits include reductions in state anxiety scores, positive feelings about the birth experience, and increased rates of breastfeeding initiation. Later postpartum benefits include decreased symptoms of depression, improved self-esteem, exclusive breastfeeding, and increased sensitivity of the mother to her child's needs. The results of these 12 trials strongly suggest that doula support is an essential component of childbirth. A thorough reorganization of current birth practices is in order to ensure that every woman has access to continuous emotional and physical support during labor.

Sex differences in hepatic lipids of Toxaphene-exposed juvenile yellowtail flounder (Pleuronectes ferrugineus Storer).

Histochemical and biochemical effects of Toxaphene on liver were investigated in laboratory-bred female and male juvenile yellowtail flounder (Pleuronectes ferrugineus). Fish were fed uncontaminated food, or food contaminated with hexane (the solvent for Toxaphene) or with one of two concentrations of Toxaphene (0.02 or 0.2 microg/g fish/day) for 2 weeks. Males were more advanced in sexual maturity than females, although all were from the same year-class (0(+)). Liver tissue examined histochemically (Sudan black B, oil red O) revealed that Toxaphene affected storage of total and neutral lipids according to sex and dose. The sexes differed in the amount of total and neutral lipids. Neutral lipid droplets were considerably larger in the liver of females. Lipids were extracted and analyzed using the latroscan TLC/FID system. Triacylglycerols comprised the majority of lipids. Animals exposed to the lowest concentration of Toxaphene stored low amounts of total and neutral lipids and high amounts of polar lipids, while animals exposed to a 10 times higher concentration showed the reverse. Sterols were highest in animals exposed to the highest dose. Thus Toxaphene can alter the lipid composition in the liver of yellowtail flounder, which may have consequences for physiological processes involving the liver, such as lipid metabolism and reproduction.

Sugarcane moth borers (Lepidoptera: Noctuidae and Pyraloidea): phylogenetics constructed using COII and 16S mitochondrial partial gene sequences.

Sugarcane moth borers are a diverse group of species occurring in several genera, but predominately within the Noctuidae and Pyraloidea. They cause economic loss in sugarcane and other crops through damage to stems and stalks by larval boring. Partial sequence data from two mitochondrial genes, COII and 16S, were used to construct a molecular phylogeny based on 26 species from ten genera and six tribes. The Noctuidae were found to be monophyletic, providing molecular support for the taxonomy within this subfamily. However, the Pyraloidea are paraphyletic, with the noctuids splitting Galleriinae and Schoenobiinae from the Crambinae. This supports the separation of the Pyralidae and Crambinae, but does not support the concept of the incorporation of the Schoenobiinae in the Crambidae. Of the three crambine genera examined, Diatraea was monophyletic, Chilo paraphyletic, and Eoreuma was basal to the other two genera. Within the Noctuidae, Sesamia and Bathytricha were monophyletic, with Busseola basal to Bathytricha. Many species in this study (both noctuids and pyraloids) had different biotypes within collection localities and across their distribution; however the individual biotypes were not phylogenetically informative. These data highlight the need for taxonomic revisions at all taxon levels and provide a basis for the development of DNA-based diagnostics for rapidly identifying many species at any developmental stage. This ability is vital, as the species are an incursion threat to Australia and have the potential to cause significant losses to the sugar industry.