Relationship of race and poverty to lower extremity function and decline: findings from the Women's Health and Aging Study

Race- and poverty-related disparities in physical function are well documented, though little is known about effects of race and poverty on functional decline and the progression of disability. We examined cross-sectional and longitudinal relationships between race, poverty and lower extremity function using data from moderately to severely disabled women in the U.S. Women's Health and Aging Study. Severity of lower extremity functional limitation was determined from scaled responses of reported difficulty walking (1/4) mile, walking across a room, climbing stairs, and stooping, crouching or kneeling. Usual walking speed assessed over 4m was our objective measure of function. Of the 996 women who described themselves as black or white, 284 (29%) were black and 367 (37%) were living at or below 100% of the federal poverty level. Independent of demographic and health-related factors, among white women, the poor exhibited consistently worse lower extremity function than the non-poor; this association, however, was not observed in black women. Among the non-poor, black women had slower walking speeds, and reported more limitation in lower extremity function than their non-poor white counterparts, even after adjusting for demographic variables and health-related characteristics. After 3 years, accounting for baseline function, demographic and health-related factors, race and poverty status were unrelated to functional decline. Thus, while race and poverty status were associated with functional deficits in old age, they do not appear to impact the rate of functional decline or progression of disability over 3 years.     

Callous-unemotional traits and the emotional processing of distress cues in detained boys: testing the moderating role of aggression, exposure to community violence, and histories of abuse

Callous-unemotional (CU) traits in antisocial youth have been associated with deficits in the processing of emotionally distressing stimuli in a number of past studies. In the current study, we investigated moderators of this association in a sample of 88 ethnically diverse detained boys (mean age = 15.57, SD = 1.28). Overall, emotional processing of distressing stimuli using a dot-probe task was not related to CU traits and there was no moderating effect of ethnicity. However, CU traits were related to deficits in emotional processing in youth high on aggression and youth high on exposure to community violence. Further, youth high on CU traits but with enhanced orienting to distressing stimuli had stronger histories of abuse, supporting the possibility that there may be environmentally influenced pathways in the development of these traits.     

Estradiol-induced enhancement of object memory consolidation involves NMDA receptors and protein kinase A in the dorsal hippocampus of female C57BL/6 mice

This study examined the role of dorsal hippocampal NMDA receptors and PKA activation in 17 beta-estradiol (E2)-induced enhancement of object memory consolidation. Mice explored two identical objects during training, after which they immediately received intraperitoneal injections of 0.2 mg/kg E2, and bilateral dorsal hippocampal infusions of Vehicle, the NMDA receptor antagonist APV (2.5 microg/side), or the cAMP inhibitor Rp-cAMPS (18.0 microg/side). Retention was tested 48 hours later. The enhanced object memory and increased ERK phosphorylation observed with E2 alone was reduced by APV and Rp-cAMPS, suggesting that estrogenic enhancement of object memory involves NMDA receptors and PKA activation within the dorsal hippocampus.     

Breast cancer incidence and mortality in a Caribbean population: comparisons with African-Americans

We describe breast cancer incidence and mortality in the predominantly African-origin population of Barbados, which shares an ancestral origin with African-Americans. Age-standardized incidence rates were calculated from histologically confirmed breast cancer cases identified during a 45-month period (July 2002-March 2006). Mortality rates were estimated from death registrations over 10-years starting January 1995. There were 396 incident cases of breast cancer for an incidence rate of 78.1 (95% confidence interval (CI) 70.5-86.3), standardized to the US population. Breast cancer incidence in African-Americans between 2000 and 2004 was 143.7 (142.0-145.5) per 100,000. Incidence peaked at 226.6 (174.5-289.4) per 100,000 among Barbadian women aged 50-54 years, and declined thereafter, a pattern in marked contrast to trends in African-American women, whose rates continued to increase to a peak of 483.5 per 100,000 in those aged 75-79 years. Incidence rate ratios comparing Barbadian and African-American women showed no statistically significant differences among women aged>or=55 years (p相似文献   

Free flap survival improved by prostacyclin analogues

Free flap transplantations and replantations of extremities are threatened by venous occlusion in the postoperative course. In rats, free autogenous groin flaps were transplanted to the neck using microsurgical techniques. On the first postoperative day, the draining vein of the flap was temporarily clamped. In the control group there was always a total loss of the flaps by haemorrhagic necrosis. The intraarterial flap perfusion by lloprost during the clamping was able to diminish the ischaemic effects; 80% of the flaps survived. The systemic application of lloprost by intravenous infusion reduced the ischaemic effects in a similar way. Serious complications such as intraabdominal bleeding or bleeding in the donor area were seen after intravenous administration. Cicaprost had a similar protective effect on flap ischaemia after intravenous infusion. Flap survival was comparable to lloprost. Severe complications seemed to be less. Prostacyclin analogues were able to diminish damage of secondary ischaemia caused by venous occlusion. © 1993 Wiley-Liss Inc.     

Histologic Subtype of Metastatic Renal Cell Carcinoma Predicts Response to Combined Immunochemotherapy with Interleukin 2, Interferon α and 5-Fluorouracil

ObjectivesCombined immunochemotherapy with interleukin 2 (IL-2), interferon α (IFN-α), and 5-fluorouracil (5-FU) is an established first-line therapy for metastatic renal cell carcinoma (RCC). However, data on histologic parameters predictive of clinical benefit are rare. In this study, we evaluated the response to immunochemotherapy in the main histologic subtypes of renal cell carcinoma and performed a subgroup analysis of inoperable patients.MethodsFrom 164 patients treated with one or two cycles of combined immunochemotherapy, radical nephrectomy had revealed 22 cases of papillary RCC (pRCC; 13.4%) and 131 cases of clear cell RCC (ccRCC; 79.9%). In the remaining 11 (6.7%) their disease was inoperable. The overall response rates were evaluated according to World Health Organization criteria.ResultsFor ccRCC and inoperable disease, responses of 34.4% and 27.3% after one cycle and 28.8% and 16.7% after two cycles, respectively, were noted. In contrast, no patient with pRCC showed any response after two cycles of combined immunochemotherapy.ConclusionsNo objective response was seen in patients with pRCC. Hence, the use of immunotherapeutic agents must be questioned in this histologic subtype.     

An ontogenic study of histamine and mast cells in the fetal rhesus monkey

This study was designed to determine the presence of cell-bound histamine and mast cells, if any, in the lung and skin of nonhuman primate fetuses and neonates. The results indicate that cell-bound histamine can be detected in both tissues of the rhesus monkey fetus by 60 days of gestation, the earliest age examined, at levels that are 2% to 3% of levels present in yearling animals. Levels increase markedly during the last life mo of gestation; however, at birth, levels are only 12% to 46% of those observed in the yearling and are lower than levels observed at 150 days of gestation. Mast cell numbers in lung and skin of the fetus closely parallel histamine content.     

Scintigraphic visualization of myocardial infarcts in baboons using thallium-201 and technetium-99m pyrophosphate.

4 baboons with myocardial infarcts were evaluated using thallium-201 for myocardial imaging and 99Tcm pyrophosphate for infarct visualization. Scintiphotographic findings were compared with the size of myocardial infarcts calculated from measurements of the activity of MB isoenzymes of creatine kinase (CK-MB) in serum and in the myocardium at autopsy, as described by Sobel's method. Lack of thallium-201 accumulation was noted in left ventricular infarcts of 3 of the 4 baboons. These same areas localized 99Tcm pyrophosphate administered 24--30 h after infarction.     

Evaluation of retroperitoneum with computerized tomography and ultrasonography in patients with testicular tumors.

Results of CT and US examinations in 24 patients with testicular tumors yielded similar sensitivity and specificity in the diagnosis of enlarged retroperitoneal lymph nodes found at laparatomy. Therefore, the choice of either imaging modality may be influenced by other factors such as presence of abundant bowel gas, post-operative wounds, surgical clips in the abdomen, cachexia or obesity.