Methods for assessing sleep in children with autism spectrum disorders: A review

A literature review completed by Bauer and Blunden (2008) determined that compared to objective measures, subjective assessments of sleep for typically developing children (e.g., parental reports) were of limited utility. No comparable literature review has been undertaken to determine whether subjective measures are appropriate for assessing sleep in children with autism spectrum disorders (ASD). Such a review is necessary as children with ASD have more sleep problems than typically developing children and children's sleep difficulties can negatively affect the child and other family members. It is, therefore, important to have measures of sleep for children with ASD that can reliably detect sleep problems and track improvements in sleep. This literature review described frequently used measures of children's sleep and evaluated their utility for assessing sleep in children with ASD. It was determined that, with the exception of sleep latency, parents’ reports of children's sleep are not consistently associated with objective measures of children's sleep. This was true for single-item parent-reports and for a widely used multi-item parent-report measure of children's sleep. Limitations of objective sleep measures (e.g., polysomnography, actigraphy), including the inability of children with ASD to tolerate such methods, are described.     

Condom use and other factors affecting penile human papillomavirus detection in men attending a sexually transmitted disease clinic

BACKGROUND AND OBJECTIVES: Human papillomavirus (HPV) is the primary cause of cervical, anal, and other anogenital cancers, but risk factors for penile HPV detection in men have not been well-characterized. GOAL: The goal of this study was to identify correlates of penile HPV detection in ethnically diverse men attending a sexually transmitted disease clinic. STUDY: A cross-sectional investigation was conducted among 393 men. Participants completed a risk-factor questionnaire and underwent testing for penile HPV DNA. Presence of HPV DNA was assessed using polymerase chain reaction with PGMY primers and reverse line blot genotyping. Logistic regression analyses were conducted to identify variables associated with any-type, oncogenic, and nononcogenic HPV. RESULTS: Circumcision was associated with reduced risk for oncogenic, nononcogenic, and overall HPV. Regular condom use was associated with reduced risk for oncogenic and overall HPV. CONCLUSION: These findings, if confirmed by other studies, could impact public health practices and messages regarding HPV.     

Rituximab in chronic lymphocytic leukemia

Rituximab (Rituxan®; iogen Idec, San Diego, CA, USA) is a human-mouse chimeric monoclonal antibody specific for CD20, a surface glycoprotein expressed on B lymphocytes. Administration of rituximab as a single agent to patients with chronic lymphocytic leukemia (CLL) has limited clinical activity, but generally does not eradicate leukemia from the marrow. However, when administered in combination with chemotherapy, rituximab can improve the survival of patients relative to those treated with chemotherapy alone. As a result of this, the US Food and Drug Administration approved the use of rituximab in previously untreated and previously treated CD20-positive CLL in combination with fludarabine monophosphate and cyclophosphamide. The results of clinical studies evaluating the activity of rituximab when used alone or in combination with other antileukemia agents for the treatment of this disease are reviewed here.     

Analysis of CLLU1 expression levels before and after therapy in patients with chronic lymphocytic leukemia

Objective: Chronic lymphocytic leukemia (CLL) is incurable, but therapy leading to eradication of minimal residual disease (MRD) in CLL is associated with improved clinical outcomes. CLL upregulated gene 1 (CLLU1) is solely upregulated in CLL patient samples. We hypothesized that CLLU1 could be used to monitor for residual disease in CLL patient samples after therapy. Methods: We examined whether the CLLU1 real‐time quantitative PCR (RQ‐PCR) could detect small numbers of CLL cells in mixtures of normal peripheral blood mononuclear (PBMC) cells. We then performed a retrospective analysis on time‐matched cryo‐preserved specimens from patients who achieved MRD‐negative remissions that underwent serial marrow biopsies for evaluation of residual disease by 4‐color flow cytometry. RNA from PBMC samples collected at the time of the marrow assessments was analyzed for CLLU1. Nine patients underwent a total of 46 paired blood and marrow evaluations (median 5 assessments per patient). Results: CLLU1 RQ‐PCR on PBMCs of healthy donors reconstituted with varying amounts of CLL cells demonstrated leukemia cells could be reliably detected with high sensitivities depending on the CLLU1 expression level. Analysis of time‐matched samples assessed for CLLU1 levels in the blood by RQ‐PCR and residual disease of the marrow determined by 4‐color flow cytometry revealed a correlation coefficient of 0.96 (P < 0.0001). Conclusion: The CLLU1 RQ‐PCR is a sensitive and specific assay for detecting residual CLL cells after therapy. Assessment of blood CLLU1 levels can be used as a reliable marker of tumor burden and has the potential to complement currently used techniques for MRD monitoring in patients with CLL.     

Impact of renin-angiotensin-aldosterone system gene variants on the severity of hypertension in patients with newly diagnosed hypertension

BACKGROUND: The severity of hypertension has prognostic significance. Previous studies have assessed the relationship between renin-angiotensin-aldosterone system (RAAS) genotype and the severity of hypertension in either treated patients or those who have only recently discontinued treatment. METHODS: We assessed the impact of RAAS genotype on ambulatory and office blood pressure (BP) in 231 newly diagnosed hypertensive patients of African ancestry who had never received therapy. Subjects were genotyped for variants of the angiotensin-converting enzyme (insertion/deletion), angiotensinogen (M235T, -20A-->C), and aldosterone synthase (CYP11B2)(-344C-->T) genes. RESULTS: The CYP11B2 gene polymorphism was associated with systolic BP (SBP). In comparison to subjects with at least one copy of the -344C allele (n = 75), patients who were homozygous for the -344T allele (n = 156) had both higher ambulatory SBP (150 +/- 1 v 144 +/- 1 mm Hg, P =.002 before and P =.01 after adjusting for multiple genotyping) and office SBP (163 +/- 2 v 156 +/- 2 mm Hg, P =.01 before and P =.05 after adjusting for multiple genotyping). Neither the angiotensin-converting enzyme insertion/deletion nor the angiotensinogen gene polymorphisms were associated with ambulatory or office SBP or diastolic BP (DBP). The CYP11B2 gene variant also did not affect DBP. CONCLUSION: A variant within the CYP11B2 locus has a clinically important impact on the severity of SBP changes in individuals with newly diagnosed hypertension who are of African ethnicity.     

The accuracy of double-contrast arthrographic evaluation of the anterior cruciate ligament. A retrospective review of one hundred and sixty-three knees with surgical confirmation

In a retrospective review of 163 knees, the double-contrast arthrogram proved to be an accurate method of evaluating the anterior cruciate ligament. The status of the ligament was examined arthrographically with two stress lateral projections: a horizontal cross-table radiograph and a fluoroscopic spot radiograph. The condition of the ligament was interpreted as being normal, lax but intact, torn with intact synovial tissue, or torn or absent. The status of the ligament was subsequently determined at either arthrotomy or arthroscopy by inspection, palpation, and judgment of the degree of tension under stress. The arthrographic diagnosis was found to be 91.4 per cent accurate within the individual subclassifications and 95 per cent accurate in confirming the ligament to be either intact or abnormal. Injury to the anterior cruciate ligament frequently occurs in association with meniscal tears. In our series, 138 of the 163 knees had either a meniscal or a cruciate lesion, or both. Of these, forty-one (30 per cent) had a meniscal lesion, thirty-four (25 per cent) had a cruciate lesion, and sixty-three (45 per cent) had both. We have found the double-contrast arthrogram to be an accurate method of determining the condition of both the anterior cruciate ligament and the menisci in a single outpatient examination.     

Pap smear screening among women >/=40 years residing at the United States-Mexico border

Invasive cervical cancer is a preventable disease due to screening for precursor lesions using the Papanicolaou cytological testing (Pap smear). Participants were assessed regarding their access to and utilization of health care services, prevention orientation, history of chronic disease screening, and reproductive health history. Factors independently positively associated with Pap smear screening were age, clinical breast exam (CBE) in the last year, doctor recommendation of a Pap test, living in the United States, and checkup in the past year. Having a regular source of health care, as well as a doctor's recommendation for a Pap smear, appears to have a positive effect on women's Pap smear screening rates in U.S.-Mexico border communities.