Assessment of female sexual arousal: Response specificity and construct validity

Specificity of vaginal pulse amplitude and vaginal blood volume in reaction to visual sexual stimuli was investigated by comparing responses to sexual, anxiety-inducing, sexually threatening, and neutral film excerpts. Subjective sexual arousal, body sensations, emotional experience, skin conductance, and heart rate were monitored along with the genital measures. Self-report data confirmed the generation of affective states as intended. Results demonstrated response specificity of vaginal vasocongestion to sexual stimuli. In terms of both convergent and divergent validity, vaginal pulse amplitude was the superior genital measure. Skin conductance discriminated among stimuli only to a small degree, whereas heart rate failed to discriminate among stimuli altogether.     

Achieving irreducibility of the Markov chain Monte Carlo method applied to pedigree data

Markov chain Monte Carlo (MCMC) methods have been explored byvarious researchers as an alternative to exact probability computationin statistical genetics. The objective is to simulate a Markovchain with the desired equilibrium distribution. If the transitionkernel is aperiodic and irreducible, then convergence to theequilibrium distribution is guaranteed; realizations of theMarkov chain can thus be used to estimate desired probabilities.Aperiodicity is easily satisfied, but, although it has beenshown that irreducibility is satisfied for a diallelic locus,reducibility is a potential problem for a multiallelic locus.This is a particularly serious problem in linkage analysis,because multiallelic markers are much more informative thandiallelic markers and thus highly preferred. In this paper,the authors propose a new algorithm to achieve irreducibilityof the Markov chain of interest by introducing an irreducibleauxiliary chain. The irreducibility of the auxiliary chain isobtained by assigning positive probabilities to a small subsetof the genotypic configurations inconsistent with the data,to bridge the gap between the irreducible sets.     

ORAL STEROIDS AS BRIDGE THERAPY IN RHEUMATOID ARTHRITIS PATIENTS STARTING WITH PARENTERAL GOLD. A RANDOMIZED DOUBLE-BLIND PLACEBO-CONTROLLED TRIAL

The efficacy of oral prednisone as bridge therapy in rheumatoidarthritis (RA) was studied. Forty patients starting aurothioglucosewere randomized to receive either prednisone or placebo for18 weeks. The dose was 10 mg/day in the first 12 weeks, 7.5mg/day in weeks 13 and 14, 5 mg/day in weeks 15 and 16, and2.5 mg/day in weeks 17 and 18. Patients were followed for 44weeks. We found that disease activity was significantly lowerin the prednisone group as early as week 1 and continued upto week 12. Response to prednisone was noticed in 60% of thepatients. After tapering prednisone, a rebound deteriorationwas noticed at weeks 20 and 24 in 58% of the responders. Nosignificant differences in X-ray progression were found betweenthe two groups. We concluded that oral prednisone (10 mg/day)significantlyreduces short-term disease activity in 60% of patients withactive RA. The rebound deterioration after tapering the dosemeans that bridge therapy with prednisone using this dose-reductionscheme is not recommended. KEY WORDS: Rheumatoid arthritis, Prednisone, Efficacy     

IMMEDIATE NONALLERGIC PSYCHOTIC REACTION TO INTRAMUSCULAR PROCAINE PENICILLIN

Background. Though little known by medical personnel, an immediate nonallergic psychotic reaction to intramuscular procaine penicillin has been reported occasionally from many countries since 1951. Materials and Methods. A case report describes a patient whose violent behavior, provoked by this reaction, resulted in legal action taken against him. Two other nonviolent cases are presented and are followed by a review of the literature. Results. Signs and symptoms of this reaction that appears to be to the procaine component resemble a pressor response and are therefore contrary to the signs and symptoms of an anaphylactic reaction. Anxiety, hallucinations, hypertension, and tachycardia are characteristic. The reaction is self-limited. Long-term psychologic sequelae might be averted by adequate reassurance. Conclusions. The importance of procaine penicillin as an essential drug in many parts of the world should not be diminished; however, recognition of acute nonallergic psychotic reactions is of paramount importance to assure proper patient management and to avoid misinterpretation of aggressive behavior.     

Competent kids: children and adolescents with a chronic illness

The social and personal competence of children and adolescents with a seizure disorder or an orthopaedic condition was assessed by parents and teachers. The contributions to these assessments of characteristics of the child, the intensity of the illness, and the child's temperament were explored using a hierarchical regression model. Parents and teachers rated all children as functioning fairly well. Children with a seizure disorder were perceived as significantly less competent than were their healthy peers (P less than 0.05). Across health status groups, children received higher competence scores from their parents than they did from their teachers (P less than 0.05). Competence scores did not differ according to the age of the child. The patterns of variables that predicted ratings of competence differed according to illness type and rater. Indicators of illness intensity explained a larger share of the variance in competence ratings for children with a seizure disorder (25%) than for children with an orthopaedic condition (5%). For children in this latter group, temperament explained a much larger proportion of the variance in both parents' (29%) and teachers' (42%) ratings of competence than did the illness intensity variables.     

The DIET Study: Long-term Outcomes of a Cognitive-behavioral Weight-control Intervention in Independent-living Elders

Objective to describe the long-term outcomes of a cognitive-behavioral weight-control intervention implemented in a community-based sample of independent-living, older adults.Design A quasi-experimental design was used to compare an intervention community with a wait-listed control community. Comparisons between the communities were made at 40 weeks (J Am Diet Assoc. 1994;94:37-42). The controlled trial ended at 40 weeks; then both communities received 2 years of intervention. Two-year data from both communities were combined and are presented in this article. Three-year outcome data from the initial intervention community were available and are also presented.Subjects A total of 247 overweight (>4.5 kg of age-adjusted weight), older (mean AGE=71 years) adults in 2 independent-living retirement communities participated in the study.Intervention The Dietary Intervention: Evaluation of Technology (DIET) study consisted of an intensive 10-week psychoeducational approach focused on lifestyle change, followed by a less intensive 2-year phase focusing on relapse prevention and maintenance of lifestyle changes.Outcome measures Physiologic and behavioral variables were analyzed at baseline and at 2 years after baseline. This article reports the combined 2-year outcome data from both retirement communities. Results of an additional follow-up 1 year after intervention was withdrawn are reported for the initial intervention community.Statistical analysis A within-subjects repeated measures analysis of variance design was used to test for significant changes in weight and lipid values over time.Results At 2 years, 70% of those who started the intervention remained actively enrolled. This group showed significant decreases in body mass index (−1.2, P<.001) and glucose level (−0.80 mmol/L, P<.001). Although high-density lipoprotein cholesterol (HDL-C) levels had increased at 40 weeks after baseline, this was not maintained at 2 years. At the 3-year follow-up, changes in body mass index and glucose level were maintained.Applications/conclusions The purpose of this article was to describe the long-term outcomes of a community-based weight-reduction intervention for older adults. The findings may be of interest to clinicians who design community or worksite weight-reduction programs. Although the intervention was designed to be a low-intensity program, attrition over the length of the study was still problematic. Nevertheless, our follow-up study indicates that this intervention was efficacious in maintaining reductions in weight and glucose levels for overweight older adults for 3 years. J Am Diet Assoc. 1998;98:1276–1281.     

Approaches to Document the Efficacy and Safety of Microdermabrasion Procedure

BACKGROUND: Microdermabrasion is a popular cosmetic procedure for skin rejuvenation, which is achieved by mechanical abrasion of the skin at a superficial level. OBJECTIVE: The objective was to study the efficacy of microdermabrasion in photoaging and to investigate the compatibility of a cleanser and a lotion with microdermabrasion. METHODS: Sixteen women underwent microdermabrasion to the face once a week for a total of six treatments. Subjects were also given a personal skin care regimen (cleanser and lotion). Colorimetry values as well as investigator and patients ratings for safety and efficacy were analyzed at various time points and compared to baseline. RESULTS: There were no significant changes in safety and tolerance variables throughout the study. Clinical efficacy variables (fine wrinkles, dullness, pigmentation, and large pores) significantly improved by the third treatment, with further improvement by the end of the study (six treatments). Subjects perceived improvement in facial photoaging variables. Colorimetry showed increased brightness and decreased yellowness of target skin sites on the face throughout the study. CONCLUSION: Multiple microdermabrasions were effective in significantly improving various facial photoaging variables. The personal skin care regimen used was well tolerated by the subjects.