Identifying Risk Drinking in Expectant Fathers

Abstract: Background: Identification of risk drinking in expectant fathers may be helpful as an important part of efforts to minimize maternal alcohol use, and as an opportunity to inform them about a problematic practice during a critical developmental stage for the couple. The purpose of this study was to evaluate the T‐ACE screening questionnaire, which asks about t olerance to alcohol, being a nnoyed by other's comments about drinking, attempts to c ut down, and having a drink first thing in the morning (“ e ye‐opener”), in the male partners of pregnant women who themselves were T‐ACE positive. Methods: Two hundred fifty‐four male partners were asked to complete the T‐ACE embedded in a health survey, the Alcohol Use Disorders Identification Test (AUDIT), and other questions about their alcohol use in the past 30 days when their pregnant partners had a median gestation of 11.5 weeks (T₁). After delivery, male partners again completed the T‐ACE and quantity‐frequency questions (T₂). The predictive ability of the T‐ACE and AUDIT was compared, using risk drinking (>4 drinks/day or >14 drinks/week) as the criterion standard. Results: A substantial minority of male partners had risk drinking, 31 percent at T₁ and 25 percent at T₂. Although the AUDIT was better than the T‐ACE as an independent predictor of risk drinking, the latter was most accurate when the tolerance threshold exceeded 2 drinks, the same established for pregnant women. The sensitivity (T₁ = 84.6%, T₂ = 82.8%) and specificity (T₁ = 43.8%, T₂ = 51.1%) of the T‐ACE at this threshold compared favorably with those of the AUDIT at the standard cut point of 8. Conclusions: The T‐ACE may be a practical way for clinicians to identify risk drinking in both pregnant women and expectant fathers. (BIRTH 33:2 June 2006)     

Blood markers for early detection of colorectal cancer: a systematic review.

BACKGROUND: Despite different available methods for colorectal cancer (CRC) screening and their proven benefits, morbidity, and mortality of this malignancy are still high, partly due to low compliance with screening. Minimally invasive tests based on the analysis of blood specimens may overcome this problem. The purpose of this review was to give an overview of published studies on blood markers aimed at the early detection of CRC and to summarize their performance characteristics. METHOD: The PUBMED database was searched for relevant studies published until June 2006. Only studies with more than 20 cases and more than 20 controls were included. Information on the markers under study, on the underlying study populations, and on performance characteristics was extracted. Special attention was given to performance characteristics by tumor stage. RESULTS: Overall, 93 studies evaluating 70 different markers were included. Most studies were done on protein markers, but DNA markers and RNA markers were also investigated. Performance characteristics varied widely between different markers, but also between different studies using the same marker. Promising results were reported for some novel assays, e.g., assays based on SELDI-TOF MS or MALDI-TOF MS, for some proteins (e.g., soluble CD26 and bone sialoprotein) and also for some genetic assays (e.g., L6 mRNA), but evidence thus far is restricted to single studies with limited sample size and without further external validation. CONCLUSIONS: Larger prospective studies using study populations representing a screening population are needed to verify promising results. In addition, future studies should pay increased attention to the potential of detecting precursor lesions.     

Gianotti-Crosti-Syndrom nach Impfung

Es wird über 4 Kleinkinder berichtet, bei denen ein Gianotti-Crosti-Syndrom (GCS) mit einer Latenz von 6–8 Tagen nach Impfung auftrat. Nachfolgende Auffrischungsimpfungen wurden problemlos vertragen. W?hrend das Auftreten eines GCS in Assoziation mit einer Virusinfektion gut dokumentiert ist, liegen über das Auftreten eines GCS im Anschluss an eine Impfung nur wenige Mitteilungen vor. Auf einen derartig m?glichen Zusammenhang sollte jedoch bei Vorstellung dieses Krankheitsbildes (GCS) im Rahmen der Anamneseerhebung unbedingt eingegangen werden.     

Effects of 8-OH-DPAT and fluoxetine on activity and attack by female mice towards lactating intruders

1. The impact of the serotoninergic receptor on the attack directed by female mice towards lactating intruders was assessed by studying the effects of 8-OH-DPAT (a serotoninergic agonist) and fluoxetine (an inhibitor of serotonin reuptake) on this paradigm at a range of doses and post-injection durations. 2. The specificity of these drug actions behaviour were examined by studying their effects on wheel running activity and performance in the open field. Non-sedative doses of 200 and 250 micrograms/kg of 8-OH-DPAT reduced attack by resident females on lactating intruders. 3. Higher doses (12-16 mg/kg) of fluoxetine reduced activity measures whereas lower non-sedative doses (up to 8 mg/kg) were without action on this aggression paradigm. 4. Additional studies with specific serotoninergic drugs are needed to clarify the role of this transmitter in attack by female mice on lactating intruders.     

Elective open operation for abdominal aortic aneurysm in octogenarians--survival analysis of 105 patients.

OBJECTIVES: To study early mortality and long-term survival of patients more than 80 years of age having elective open repair for abdominal aortic aneurysm (AAA). DESIGN: Retrospective multicenter cohort study. MATERIAL: One hundred and five patients, 23 women and 82 men, with a median age of 82 years, operated at three Norwegian hospitals during the period 1983-2002. METHOD: Survival analyses were based on data from medical records and the Norwegian Registrar's Office of Births and Deaths. Expected survival was based on mortality rates of the general population, matched by age, sex, and calendar period. Relative survival was calculated as the ratio between the observed and the expected survival. RESULTS: During the study period there has been a 10 fold increase in octogenarians treated with open operation for AAA. Early mortality (30-day) for the whole group of patients was 10.5% (95% confidence interval (95% CI) 5.3-18.0), and similar for both genders. The 5-year survival rate was 47% (95% CI 35.9-57.4), and not significantly different from that of a matched group in the general population. Patients aged 84 years or more had a median survival time of 35 months (95% CI 18.5-51.6). CONCLUSION: The number of AAA operations in octogenarians has increased considerably during 20 years. Octogenarians operated electively for AAA has higher 30-day mortality as compared to younger patients. Their long-term survival appears similar to a matched control group. The benefit of surgery must be carefully considered against the perioperative risk, especially for the oldest octogenarians.     

One-stage versus two-stage lymph node dissection after investigation of sentinel lymph node in cutaneous melanoma: a comparison of complications, costs, hospitalization times, and operation times

The aim of the study was to evaluate whether complication rate, costs, operation times, and hospitalization times differed in two different patient groups: in group 1, frozen section analysis of the sentinel lymph node and lymph node dissection were carried out in the same operation. In group 2, normal investigation of the sentinel lymph node and lymph node dissection were done in a second operation. One hundred thirty-five patients with cutaneous melanoma were included. Hospitalization times, costs, complication rates, and operation times of two-stage and one-stage lymph node dissection of the draining area after detection of metastases in the sentinel lymph node were retrospectively compared. Lymph node metastasis in the sentinel lymph node was found in 23 patients. In 11 patients, removal of the sentinel lymph node and dissection of the lymph node basin was performed in the same operation. In 12 patients, a two-stage procedure was the treatment of choice. Operation times were not different in the two groups (p=0.87) while two-stage operation patients were hospitalized significantly longer (14.2 ± 9.7 vs 23.9 ± 24 days; p=0.01) and costs were significantly higher (7,836.90 ± 2,397.95 Swiss francs vs 5,279.40 ± 1,994.90 Swiss francs). In addition, more complications were found in the two-stage group.     

Plasma lipoprotein distribution, faecal cholesterol excretion, and activities of lipoprotein lipase, hepatic lipase and lecithin:cholesterol acyltransferase in rats fed diets rich in sucrose or sunflower oil

Plasma HDL2 has been suggested to carry cholesterol to the liver for subsequent excretion in the bile and faeces. The enzymes lipoprotein lipase (LPL), hepatic lipase (HL) and lecithin:cholesterol acyltransferase (LCAT) have been implicated in the centripetal cholesterol transport. Activities of these enzymes, the amount of faecal cholesterol excretion and the level of plasma lipoproteins were determined in male rats fed for 4 weeks on purified diets in which the sunflower oil:sucrose ratio was either 0.03 (group a) or 1.01 (group b). Whole plasma triacylglycerols (TG), unesterified cholesterol (UC) and phospholipids (PL) were highest in group (a). The concentration of cholesteryl esters (CE) was similar in the two groups. Protein, TG and UC of VLDL, and TG, UC, CE and PL of HDL2 were higher in group (a) than in group (b). The HDL3-protein and TG were lowest in group (a). Thus, total weight of VLDL and HDL2 were increased, and HDL3 reduced in group (a), which had also increased activities of HL and adipose tissue LPL. Activity of LCAT was lower, and faecal excretion of cholesterol was reduced by about 50% in group (a) compared to group (b). Accordingly, in the rat increased plasma levels of HDL2 are not necessarily indicative of increased faecal cholesterol excretion.