Empathy and response to distress in children with Down syndrome

BACKGROUND: Most studies of empathy have focused on young children, and those who are typically developing. Thus, we know little about the emergence and manifestation of empathy in non-normally developing children. METHOD: Empathy and response to distress in others were examined in 30 children with Down syndrome, 22 children with nonspecific etiologies of mental retardation, and 22 typically developing children. RESULTS: Results indicated that compared to the other children, children with Down syndrome responded to distress in others by looking to them more, and offering more comfort in the form of prosocial responses. However, in a hypothetical empathy situation, children with Down syndrome were less likely to feel the same emotion as the protagonist than were the typical children. Children with Down syndrome differed from the children with nonspecific mental retardation only in their response to distress in others. The children with nonspecific mental retardation were more similar to than different from the MA-matched typical children. CONCLUSIONS: These results suggest some etiology-associated differences in empathy and response to distress in children with mental retardation.     

Teaching women’s health skills

OBJECTIVE: This study assesses the readiness of academic general internists to perform and precept a commonly utilized women's health examination, and procedural and management skills. DESIGN: Full-time faculty from divisions of general internal medicine and departments of family practice in 9 states reported their encounter frequency with, comfort precepting, and the importance they ascribe to several examination, procedural, and management skills relevant to women's health care; and their attitudes toward performing the pelvic exam and obtaining a Pap smear. MEASUREMENTS AND MAIN RESULTS: A total of 331 general internal medicine physicians (GIMs) and 271 family medicine physicians (FPs) completed questionnaires, with response rates of 57% and 64%, respectively. More than 90% of GIMs and FPs indicated they were confident precepting the breast and Pap/pelvic examinations. A relatively small percentage of GIMs expressed confidence precepting the management of dysfunctional uterine bleeding (22%), initiating Depo-Provera (21%), and initiating oral contraceptives (45%), while a substantially larger percentage indicated that these skills were important to primary care practice (43%, 44%, and 85%, respectively). Although GIMs indicated they were confident precepting the Pap/pelvic exam, they were less likely than FPs to agree with the following statements: "Performing routine Pap smears is a good use of my time" (GIMs 65%, FPs 84%); "It is a waste of health care dollars for primary care physicians to refer patients to gynecologists for routine Pap/pelvic exams" (GIMs 69%, FPs 90%); "I feel very well trained to do a routine bimanual exam" (GIMs 71%, FPs 98%), and "The clinic where I practice is well equipped to do a Pap smear" (GIMs 78%, FPs 94%). CONCLUSIONS: Although most academic GIMs are confident precepting the breast and pelvic examination, only a minority are confident precepting the management of dysfunctional uterine bleeding, initiating Depo-Provera, and initiating oral contraceptives. These findings suggest that a number of academic GIMs may not be prepared or willing to perform or precept important women's health skills.     

ADAM33 is not associated with asthma in Puerto Rican or Mexican populations

A recent study identified the ADAM33 gene as a promising candidate contributing to asthma. In Puerto Rican and Mexican populations, we have genotyped six single nucleotide polymorphisms (SNPs) that were used in the Genetics of Asthma in Latino Americans Study. We chose to study these two populations because in the United States, Puerto Ricans have the highest asthma prevalence, morbidity, and mortality and Mexicans the lowest. We used the transmission disequilibrium test to analyze associations between the ADAM33 gene variants and asthma, asthma severity, bronchodilator responsiveness, and total IgE levels using single SNPs, two to six SNP combinations, and specific haplotypes in 583 trios (proband with asthma and both biological parents). We also genotyped matched control samples to allow case-control analyses. None of the transmission disequilibrium test or case-control results showed significant association in either population. We found no evidence for association of single SNPs with asthma severity, bronchodilator response, or IgE levels in Mexicans or in the combined population. Two SNPs showed a modest association in Puerto Ricans, insignificant when the number of comparisons was taken into account. We conclude that the ADAM33 gene is not an important risk factor for asthma or for asthma-associated phenotypes in Mexicans or in Puerto Ricans.     

Safety of atorvastatin derived from analysis of 44 completed trials in 9,416 patients

This analysis assessed the safety of atorvastatin in the 10- to 80-mg dose range using pooled data from 44 completed trials comprising 16,495 dyslipidemic patients treated with atorvastatin (n = 9,416), placebo (n = 1,789), and other statins (n = 5,290). A retrospective analysis was conducted and included treatment-associated adverse events, serious adverse events, and musculoskeletal and hepatic adverse events. Only 3% (n = 241) of atorvastatin-treated patients withdrew from studies due to treatment-associated adverse events, compared with 1% of those (n = 16) on placebo and 4% of those (n = 188) receiving other statins; the most frequently reported treatment-associated adverse events were related to the digestive system. Serious adverse events were rare and seldom led to withdrawal. Persistent elevations in hepatic transaminases to >3 times the upper limit of normal (ULN) were experienced by 0.5% (n = 47) of atorvastatin-treated patients. A persistent elevation in creatine phosphokinase (CPK) (>10 x ULN) was observed in only 1 atorvastatin-treated patient and was not associated with myopathy. The incidence of treatment-associated myalgia was low in the atorvastatin (1.9% [n = 181]), placebo (0.8% [n = 14]), and other statin (2.0% [n = 105]) groups, and was not related to the atorvastatin dose. No cases of rhabdomyolysis or myopathy were reported. Thus, the overall incidence of treatment-associated adverse events observed with atorvastatin did not increase in the 10- to 80-mg dose range, and was similar to that observed with placebo and in patients treated with other statins. Specific analysis of musculoskeletal and hepatic adverse events showed that these occurred infrequently and rarely resulted in treatment discontinuation.     

The Canadian celiac health survey – the Ottawa chapter pilot

Background  

Celiac disease may manifest with a variety of symptoms which can result in delays in diagnosis. Celiac disease is associated with a number of other medical conditions. The last national survey of members of the Canadian Celiac Association (CCA) was in 1989. Our objective was to determine the feasibility of surveying over 5,000 members of the CCA, in addition to obtaining more health related information about celiac disease.     

Safety and immunogenicity of three doses of an eleven-valent diphtheria toxoid and tetanus protein – conjugated pneumococcal vaccine in Filipino infants

Background  

An 11-valent pneumococcal conjugate vaccine could provide significantly larger reduction in pneumococcal disease burden than the currently available 7-valent vaccine formulation in many countries.     

"Razoo Health": a community-based nursing education initiative

When statistics depicted a health crisis for people of all ages living in Louisiana, and New Orleans in particular, school of nursing faculty designed and instituted a neighborhood-based initiative to "Razoo Health." This initiative facilitated a paradigm shift from exclusively illness management to include health promotion and disease prevention. "Razoo," a local colloquialism used to claim an opponent's marble during game play, means to snatch or claim. Appropriately, Razoo Health refers to the intent of Louisiana citizens to reclaim and take back the health of the people in the cities' neighborhoods. Working with four inner-city parochial schools and churches as hubs, nursing faculty and students mobilize neighborhood assets, talents, and capacities to form partnerships for healthy change. The Centers for Disease Control and Prevention Coordinated School Health Model is employed within each neighborhood school to provide health care access, decrease absenteeism, raise test scores, and deliver worksite health programming to faculty and staff and to neighbors and parishioners. Nursing students work with citizens and students of other health care professions to learn community assessment skills and deliver primary, secondary, and tertiary services to individuals, families, and the community. Citizens wear crowns of empowered sovereignty as they take back, or razoo, what is rightfully theirs--health.     

High-throughput screening assays for CYP2B6 metabolism and inhibition using fluorogenic vivid substrates

CYP2B6 is a highly polymorphic P450 isozyme involved in the metabolism of endo- and xenobiotics with known implications for the activation of many procarcinogens resulting in carcinogenesis. However, lack of validated high-throughput screening (HTS) CYP2B6 assays has limited the current understanding and full characterization of this isozyme's involvement in human drug metabolism. Here, we have developed and characterized a fluorescence-based HTS assay employing recombinant human CYP2B6 and 2 novel fluorogenic substrates (the Vivid CYP2B6 Blue and Cyan Substrates). Assay validation included testing the inhibitory potency of a panel of drugs and compounds known to be metabolized by this isozyme, including CYP2B6 substrates, inhibitors, and known inducers. Compound rankings based on inhibitory potency in the Vivid CYP2B6 Blue and Cyan Assays matched compound rankings based on relative affinity measurements from previously published data (K(i), K(d), or K(m) values) for the CYP2B6 isozyme. In conclusion, these assays are proven to be robust and sensitive, with broad dynamic ranges and kinetic parameters allowing screening in HTS mode of a large panel of compounds for CYP2B6 metabolism and inhibition, and are a valuable new tool for CYP2B6 studies.