24-h Monitoring of plasma norepinephrine, MHPG, cortisol, growth hormone and prolactin in depression

Depression is associated with alterations in hormone and catecholamine circadian rhythms. Analysis of these alterations has the potential to distinguish between three neurobiological models of depression, the catecholamine model, the phase advance model and the dysregulation model. Although a number of studies of 24-h rhythms have been reported, inconsistencies among the findings have complicated efforts to model the chronobiology of depression. The present study takes advantage of frequent plasma sampling over the 24-h period and a multioscillator cosinor model to fit the 24-h rhythms. METHOD: Plasma levels of norepinephrine, cortisol, prolacatin and growth hormone were sampled at 30-min intervals, and MHPG at 60-min intervals, over a 24-h period in 22 patients with major depressive disorder and 20 healthy control volunteers. RESULTS: The depressed patients had phase advanced circadian rhythms for cortisol, norepinephrine and MHPG, phase advanced hemicircadian rhythms for cortisol and prolactin, and a phase advanced ultradian rhythm for prolactin compared to healthy control subjects. In addition, the rhythm-corrected 24-h mean value (mesor) of norepinephrine was lower in the depressed patients compared to the healthy controls. There also was a poorer goodness-of-fit for norepinephrine to the circadian oscillator in the depressed patients relative to the healthy controls. CONCLUSIONS: These findings provide partial support for the dysregulation model of depression and are consistent with those studies that have found phase advances in cortisol, norepinephrine and MHPG rhythms in depression.     

Key articles and guidelines in pharmacotherapeutic management of arrhythmias

Clinical studies are among the most important literature published in the area of cardiovascular pharmacotherapy and are the basis of many of the standards of practice today. We compiled a list of these clinical trials, as well as well-written, up-to-date review articles and important treatment guidelines, that focus on pharmacotherapeutic management of arrhythmias. This list should be useful not only to practitioners and trainees in cardiovascular pharmacotherapy, but also to other clinicians as an update.     

Body mass index and age at menarche in an adolescent clinic population

Body fatness as a determinant of menarche has been studied extensively, but limited to underweight females. Adolescent female patients were measured and interviewed. Subjects were divided into three groups based on body mass index (BMI) standard deviation score (SDS). Average age at menarche was 11.87 +/- 1.1 years in the obese group, 12.14 +/- 0.9 years in the overweight group, and 12.20 +/- 1.3 years in the normal weight group. Pearson correlation factor between BMI SDS and age at menarche was -0.24 (p < 0.01). These findings suggest an important role of increased body fatness on menarche that extends beyond underweight girls.     

Congenital hypopituitarism as a cause of undetectable estriol levels in the maternal triple-marker screen

We are reporting a child with congenital panhypopituitarism, in whom deficient fetal steroidogenesis was suspected prenatally because of undetectable estriol levels measured in the maternal triple-marker screen. No fetal abnormalities were detected by ultrasonography. Amniocentesis demonstrated a normal 46,XX karyotype. Measurement of maternal urinary steroids failed to show elevation in the excretion of the major precursor for estriol, 16 alpha-hydroxydehydroepiandrosterone, indicating that the fetus did not have steroid sulfatase deficiency (placental sulfatase deficiency), the most common genetic cause of extremely low estriol. The steroid analysis excluded other rare single gene defects, including aromatase deficiency and 17 alpha-hydroxylase deficiency. We therefore suspected that the cause of low estriol in this fetus was adrenal insufficiency. Postnatal evaluation was consistent with panhypopituitarism, characterized by deficiency of all anterior pituitary hormones. Because this screen is now offered to more than half the pregnant women in the United States, reports of low estriol levels have become increasingly common. Therefore, it is essential that physicians be familiar with the various etiologies, perform the appropriate antenatal evaluation to determine the specific cause, and closely monitor both mother and child ante- and postnatally.     

Australian nurses' and midwives' knowledge of computers and their attitudes to using them in their practice

BACKGROUND: The introduction of a new information retrieval system for the use of health service staff at a large tertiary referral hospital provided an excellent opportunity for nurses to make greater use of evidence to inform their practice. However, the extent to which nurses were able to access the resource was unknown. AIM: The aim of the study was to obtain this information and to test nurses' knowledge of computers and their attitudes to using them in their practice. METHODS: During October 2001 a computer use questionnaire was attached to the pay advice slips of all nursing staff at the Royal Brisbane and Royal Women's Hospital (n = 1708). Staff were asked to return their completed questionnaire in a preaddressed return envelope. To encourage this, a prize (a Gold Class cinema pass for two) was offered. RESULTS: Of the 1708 questionnaires distributed, 590 were returned, giving a 34.5% response rate. Computer use was influenced by education, nursing seniority, age, and length of time in the service and, to a lesser extent, gender. CONCLUSIONS: Information from the study has assisted planners and educators to identify clusters of nurses to target for interventions in this area. Results will also be used to assess the success of any interventions.     

Reporter gene assays and their applications to bioassays of natural products

Medicinal plants represent precious resources from which bioactive compounds can be isolated and developed into invaluable therapeutic agents. With the advent of modern drug discovery technologies such as combinatorial chemistry and high-throughput drug screening platforms, there is an increasing interest in utilizing medicinal plants as a source of drug leads. A wide spectrum of bioassays can be employed for the detection of bioactivity in extracts, fractions, as well as purified compounds of herbal origin. Amongst the different types of bioassays, reporter gene assays are highly versatile and reliable. The present review provides an overview of the most popular reporter genes in terms of their basic methodology, capacities and limitations. The different types of intracellular and extracellular reporter gene products and their potential applications in bioassays of natural products are also discussed.     

American Cancer Society guidelines for breast cancer screening: update 2003

In 2003, the American Cancer Society updated its guidelines for early detection of breast cancer based on recommendations from a formal review of evidence and a recent workshop. The new screening recommendations address screening mammography, physical examination, screening older women and women with comorbid conditions, screening women at high risk, and new screening technologies.