Mutations in the tyrosine kinase domain of the epidermal growth factor receptor in non-small cell lung cancer.

We evaluated somatic genetic alterations in the kinase domain of the EGFR gene in the tumors of 219 non-small cell lung cancer patients of primarily Caucasian and African American origins. We identified 26 patients (12%) whose tumors had a mutation in the EGFR gene, and 11 (5%) patients carried novel genomic variations consistent with germ-line polymorphisms. All but one mutation were identified in Caucasian patients affected with adenocarcinoma. EGFR mutations were more frequent in women and in nonsmokers, but a significant portion of the affected patients were men (12 of 26) and current or past smokers accounted for half of the patients affected (13 of 26). Screening subjects with EGFR mutations may identify patients whose tumors could respond to targeted therapy using tyrosine kinase inhibitors.     

Targeting Lifestyle Behavior Change in Adults with NAFLD During a 20-min Consultation: Summary of the Dietary and Exercise Literature

Non-alcoholic fatty liver disease (NAFLD) is largely linked to poor diet, lack of physical activity/exercise, and being overweight. In the absence of approved pharmaceutical agents, lifestyle modification, encompassing dietary change and increased physical activity/exercise to initiate weight loss, is the recommended therapy for NAFLD. Despite this, the use of lifestyle therapy within clinical settings is lacking with limited guidance available about what it should involve, how it should be delivered, and whether it can be feasibly delivered as part of standard care. This paper highlights the evidence for the use of lifestyle modification in NAFLD. While there is evidence to support use of behavioral strategies to support lifestyle behavior change in other clinical populations, these are yet to be assessed in people with NAFLD. However, there is sufficient evidence to suggest that behavioral intervention targeting diet and physical activity to promote weight loss in general is effective and a number of practical strategies are presented on how this could be achieved.     

Acute and chronic caffeine administration increases physical activity in sedentary adults

Caffeine is a commonly used stimulant thought to have ergogenic properties. Most studies on the ergogenic effects of caffeine have been conducted in athletes. The purpose of this study was to test the hypothesis that caffeine reduces ratings of perceived exertion and increases liking of physical activity in sedentary adults. Participants completed treadmill walking at 60% to 70% of their maximal heart rate at baseline and for 6 subsequent visits, during which half of the participants were given caffeine (3 mg/kg) and half given placebo in a sports drink vehicle. To investigate the potential synergistic effects of acute and chronic caffeine on self-determined exercise duration, participants were rerandomized to either the same or different condition for the last visit, creating 4 chronic/acute treatment groups (placebo/placebo, placebo/caffeine, caffeine/placebo, caffeine/caffeine). Participants rated how much they liked the activity and perceived exertion at each visit. There was a main effect of time on liking of physical activity, with liking increasing over time and an interaction of sex and caffeine treatment on liking, with liking of activity increasing in female participants treated with caffeine, but not with placebo. There was no effect of caffeine on ratings of perceived exertion. Individuals who received caffeine on the final test day exercised for significantly longer than those who received placebo. These data suggest that repeated exposure to physical activity significantly increases liking of exercise and reduces ratings of perceived exertion and that caffeine does little to further modify these effects.     

Perceptual Organisation in Schizophrenia: Evidence of Intact Processing of Configural Stimuli

Although it has been hypothesised that schizophrenia patients have a perceptual organisation deficit, recent work indicates that their ability to process highly configural stimuli with continuous or near continuous contour is intact. To clarify further the range of the perceptual organisation dysfunction in schizophrenia, we assessed, using Kahneman and Neisser's Visual Suffix Task, the ability to process configural stimuli made up of noncontiguous elements. Both acute and chronic schizophrenia patients demonstrated the same degree of responsivity to the grouping manipulations as psychotic nonschizophrenia and nonpatient control groups. These data provide further evidence that schizophrenia patients can perceptually organise configural stimuli, and that their perceptual organisation difficulties are limited to organising nonconfigural sets of stimuli into perceptual wholes. Implications of these data for understanding the attentional difficulties and the underlying structure of the visual system in schizophrenia are discussed.     

Consumer Health Resources for Racial and Ethnic Minority Groups

Culturally appropriate health materials for consumers can be difficult to identify. Many federal resources exist to help support minority health initiatives. In addition, national nonprofit organizations and state agencies provide materials to address the health needs of African Americans, Hispanics/Latinos, Asian Americans, American Indians/Alaska Natives, and Native Hawaiians/Pacific Islanders. This listing offers an initial list of primary resources that librarians can use to address consumer health inquiries from the public.     

Early life predictors of adult leisure-time physical inactivity: prospective findings from the 1958 British Birth Cohort

BackgroundLeisure-time physical inactivity has a high prevalence and associated disease burden. Adult inactivity research ignores earlier life factors from which later life influences can originate. We aimed to establish whether early life factors influence adult inactivity.MethodsThe 1958 British Birth Cohort is a nationwide follow-up study of all births during 1 week in March, 1958. The outcome of the present study was leisure-time inactivity, defined as activity frequency of less than once a week, assessed at ages 33 years, 42 years, and 50 years (n=12 776). Early life factors (birth to 16 years) were categorised into three domains (physical, social, behavioural). We assessed stability of inactivity from 33 years to 50 years and associations with adult inactivity using logistic regression of: factors within domains, the three domains combined (ie, multivariable associations), and allowing for adult factors. Missing values were imputed with multiple imputation chained equations.FindingsAt each adult age, about 32% of participants were inactive (31% at 33 years, 34% at 42 years, and 30% at 50 years). 1189 (9%) were inactive at all three ages. In analysis of the three domains simultaneously, factors related to adult inactivity were: short prepubertal stature, poor hand control or physical coordination, and poor cognition (physical); low class at birth, minimal parental education, poor household amenities, parental divorce, and institutional care (social); and inactivity, average or lower sports aptitude, smoking, and externalising and unsociable behaviours (behavioural). Odds ratios for inactivity at age 33 years ranged from 0·86 per SD increase in cognition (95% CI 0·82–0·91) to 1·41 (1·23–1·61) for average or lower sports aptitude. Associations weakened slightly but were mostly maintained after adjustment for adult covariates. After allowing for adult covariates participants with unskilled manual backgrounds had 23% higher odds of inactivity at 50 years than those from professional or managerial backgrounds.InterpretationOur study, based on self-report, focuses only on leisure-time inactivity. However, to have repeat, prospective data on inactivity spanning several decades in adulthood is rare, and leisure-time inactivity is likely to be amenable to modification. Adult inactivity is only moderately stable, providing opportunities for behaviour change. Factors from early life are associated with adult inactivity, allowing for early identification of groups vulnerable to later inactivity.FundingThis work was supported by the Department of Health Policy Research Programme through the Public Health Research Consortium. The Great Ormond Street and University College London Institute of Child Health was supported in part by the Department of Health's National Institute for Health Biomedical Research Centre.     

Sufentanil versus Fentanyl: Efficacy and Patient Satisfaction with Intrathecal Pain Management

Objectives: This study compared fentanyl vs. sufentanil in intrathecal pain pumps. H1: both reduce patient subjective pain ratings. H2: sufentanil is more effective than fentanyl. H3: overall satisfaction with pain control is greater with sufentanil. Materials/Method: This is an archival study of patients in tertiary pain management (N= 97, mean age = 58.77, standard deviation = 14.88). Pain was measured using the subjective units of discomfort scale. Satisfaction with pain control/relief was measured by asking patients each visit if they are satisfied with pain management and is recorded in a “yes”/ “no” manner. Pain ratings were analyzed with repeated measures analysis of variance and satisfaction was analyzed with chi square. Results/Discussion: Sufentanil was found to be marginally more effective, but both medications controlled a significant degree of variance in pain reduction over time. A significantly greater number of patients maintained on sufentanil were satisfied with care than patients on fentanyl.