Drug abuse risks for acculturating immigrant adolescents: case study of Asian Indians in the United States

Immigrant parents and their U.S.-born children may experience stressful family conflicts over the disparate sociocultural norms of the United States and their country of origin. Such stresses may heighten adolescents' vulnerability to drug abuse. This article documents the extent of drug use in a sample of 200 U.S.-born Asian Indian adolescents. According to the study participants' self-reports on lifetime use, 28 percent had used alcohol on at least one occasion, 16.5 percent had used cigarettes, and 2.5 percent had used marijuana. Adolescents who placed importance on their parents' drug abuse prevention messages tended not to use drugs. The implications of the study's findings for drug abuse assessment, treatment, and prevention are discussed.     

Chemotherapie der Herpes-Infektion mit neuen 5-Alkyluracildesoxyribosiden

Ohne Zusammenfassung     

Masquerade syndrome: sebaceous carcinoma presenting as an unknown primary with pagetoid spread to the nasal cavity

Sebaceous carcinoma of the eyelid is an uncommon tumour with unusual modes of presentation. It can remain occult at the primary site, without producing any mass, masquerading as chronic blepharoconjunctivitis, while setting up metastases in the regional lymph nodes especially in the pre-auricular group. We report here a case that not only masqueraded as chronic blepharoconjunctivitis with nodal metastases from an 'unknown primary' in the neck, but whose tumour spread in a pagetoid manner along the nasolacrimal duct producing a nasal tumour that was believed to be the 'unknown primary'. This case emphasizes the need for ophthalmologists, ENT surgeons and pathologists to keep sebaceous carcinoma in mind while evaluating patients with chronic blepharoconjunctivitis and cervical node metastases from 'unknown primary'. Histological clues for picking up a sebaceous carcinoma at a metastatic site include a tumour with comedo or ductal growth pattern and intracytoplasmic lipid.     

A spatio-temporal absorbing state model for disease and syndromic surveillance

Reliable surveillance models are an important tool in public health because they aid in mitigating disease outbreaks, identify where and when disease outbreaks occur, and predict future occurrences. Although many statistical models have been devised for surveillance purposes, none are able to simultaneously achieve the important practical goals of good sensitivity and specificity, proper use of covariate information, inclusion of spatio-temporal dynamics, and transparent support to decision-makers. In an effort to achieve these goals, this paper proposes a spatio-temporal conditional autoregressive hidden Markov model with an absorbing state. The model performs well in both a large simulation study and in an application to influenza/pneumonia fatality data.     

An epidemiological study of pulmonary function tests in geriatric population of central India

We have studied Pulmonary Function Tests (PFTs) namely Vital Capacity (VC). Forced Vital Capacity (FVC), and Forced Expiratory Volume in First Second (FEV1). Forced Expiratory Flow(FEF 25-50%) in 1200 elderly subjects above 60 years of age of which 570 were females and 630 males. Mean age was 69.22 +/- 5.57 years in males and 68.77 +/- 5.44 in females. The mean value of ventilatory parameters were as follows-1) VC 2.99 +/- 0.5 lt in males and 1.89 +/- 0.29 lt in females. 2) FVC 2.69 +/- 0.58 lt. in males and 1.76 +/- 0.21 lt in females. 3) FEV1/FVC% 83.82 +/- 10.62% in males and 83.37 +/- 11.93% in females. 4) FEF 25-75% was 2.81 +/- 1.20 lt/sec in males and 2.13 +/- 1.27 lt/sec. Physical as well as ventilatory parameters were less in females than for males. The correlation of age with VC and FEV1 was highly significant (P < 0.01) but with FVC was not significant (P > 0.05). The correlation of height, weight and body surface area was not significant with any ventilatory parameter (P > 0.05). Multiple regression equations for VC, FVC and FEV1 were formulated for males and females taking height and age as variables. The predicted values correlated excellently with observed values.     

Patterns of self-reported symptoms in pancreatic cancer patients receiving chemoradiation

Pancreatic cancer is a lethal disease characterized by multiple disease-related symptoms. Chemoradiation therapy is a standard of treatment for locally advanced pancreatic cancer. Although shown to prolong survival, there is little information about treatment-related symptoms or the palliative benefits of chemoradiation. We assessed symptoms of patients with locally advanced pancreatic cancer receiving chemoradiation to determine the prevalence, and co-occurrence, of symptoms and to identify the extent to which symptoms interfered with function. Forty-eight patients were treated with chemoradiation on a Phase I protocol. Patients received radiotherapy (50.4 Gy in 28 fractions), capecitabine (median dose 825 mg/m(2) twice daily), and bevacizumab (2.5-10 mg/kg). Symptom severity and its interference with function were prospectively assessed (at presentation, during, and after chemoradiation) in 43 consenting patients using the M.D. Anderson Symptom Inventory. Results showed that 95% of patients reported at least one of the 13 symptoms assessed at presentation. The most commonly reported symptoms of moderate to severe (>or=5 on a 0-10 scale) intensity at presentation were lack of appetite (24%), pain (19%), fatigue (19%), and sleep disturbance (10%). We observed an increase in patients reporting moderate to severe fatigue, nausea, and sleep disturbance during chemoradiation. McNemar tests for paired binary observations showed the proportion of patients reporting moderate to severe symptoms significantly (P<0.001) decreased after chemoradiation at 94 days follow-up (lack of appetite=7%, pain=7%, fatigue=13%, sleep disturbance=7%). This study demonstrates the feasibility and usefulness of symptom assessment in chemoradiation protocols. Future studies with larger cohorts are needed to further characterize multiple symptoms associated with chemoradiation.     

Multipulse drug permeation across a membrane driven by a chemical pH-oscillator.

Chemical pH-oscillators provide a potential means for modulating the delivery of acidic or basic drugs across lipophilic membranes. Previous attempts to exploit this notion were not completely successful due to quenching of the pH oscillator in the presence of the drug, most likely by a buffering mechanism. Here we show that multiple, periodic pulses of drug flux across a membrane can be achieved when the concentration of drug is sufficiently low. Advantage is taken of a pH oscillator system whose periodicity is slower than that of previously considered oscillators.