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81.
Objective: Thousands of Americans grieve the sudden death of a loved one each year. These sudden deaths may be the result of violent deaths, as in the cases of homicide, suicide, or fatal accidents, or may occur as the result of natural causes such as heart attacks or strokes. Sudden loss survivors often experience negative mental health outcomes such as depression, prolonged grief disorder, and posttraumatic stress disorder. Survivors may also misuse alcohol for varied reasons after these losses, which can put them at risk for alcohol-related consequences. Thus, the purpose of this study was to explore associations between psychological distress and alcohol-related outcomes among young adults with a history of sudden loss. Methods: A sample of 659 young adults completed a series of self-report measures assessing loss history, psychosocial distress, perceived alcohol-related problems, and drinking motives. Results: Results showed that survivors of sudden, violent losses reported higher rates of past 30-day alcohol use than those who had lost a loved one to a sudden, natural loss or those who reported no loss history. Although there were no statistically significant differences in drinking motives between violent or natural loss survivors, more severe depression symptoms among bereaved individuals were associated with drinking to cope and to conform. Participants experiencing prolonged grief symptoms were also more likely to report drinking to conform. Conclusions: Bereavement-related distress may influence drinking motives among young adults with a history of sudden loss.  相似文献   
82.

Purpose  

The intracorporeal anastomotic procedure is one of the most difficult components in single-incision laparoscopic gastrectomy. We describe a simple surgical technique for intracorporeal circular-stapled Billroth I gastroduodenostomy with transumbilical introduction of the instrument.  相似文献   
83.
Eating disorder researchers have focused more on the etiology and treatment and less on what happens for individuals during the recovery process from an eating disorder. For this qualitative study, we examined how social supports were helpful and hurtful during the eating disorder recovery process and learned about varying experiences with social supports from the perspectives of 22 recovered women. Participants reported that eating disorder recovery is largely influenced by the individual's sense of connection to self and others. In addition, participants shared that the focus of care from providers influenced their recovery process in powerful ways. Clinical implications and future research ideas are presented for clinicians and researchers working in the area of eating disorders.  相似文献   
84.
A 72-year-old male was diagnosed as having a thoracic tumor in the left chest wall five years after resection of primary pancreatic somatostatinoma. The tumor was suggestive of metastasis to the chest wall or to the left lung from the previously resected somatostatinoma based on the abnormally elevated serum somatostatin level. Percutaneous biopsy confirmed that the lesion was an islet cell tumor and thoracotomy demonstrated metastasis to the left third rib without involvement of the left lung. Our case represents a rare documentation of somatostatinoma metastatic to the chest wall for which complete resection was performed.  相似文献   
85.
86.
Chlamydia trachomatis (CT) is a widespread, sexually transmitted disease with potential long-term effects on female reproductive health. The objective of this study was to investigate compliance to treatment, partner notification, and attendance for test-of-cure among Norwegian men diagnosed with CT. We conducted a longitudinal case-series study among 81 CT positive men identified in a cross-sectional study (n = 1032, April-December 2005). Participants were interviewed on partner notification intentions at the treatment visit and on partner notification actions at the test-of-cure visit. Of the 81 patients, 8 (10%) did not meet for treatment, 2 were treated elsewhere, and 6 were treated but not interviewed. At the treatment visit, the 65 interviewed men reported that they intended to notify 100 out of 165 partners (61%). 40 of 71 treated patients attended for test-of-cure (56%). Four men (10%) needed repeated treatment. The 35 men interviewed at test-of-cure visit reported that 63 out of 95 partners (68%) had been notified. In conclusion, men diagnosed with CT infection are relatively open on notifying sexual partners but have low compliance to meeting for test-of-cure.  相似文献   
87.
Rising health care costs have led to an emphasis on identifying factors that contribute to medical service utilization. Previous research has suggested an association between youth psychopathology and service utilization; however, prospective studies among high-risk populations are needed. The current study examined youth psychopathology as a predictor of subsequent medical service utilization among a large sample (N?=?536) of youth entering residential treatment. Youth psychopathology and medical status were assessed at intake, and medical service utilization was tracked across the duration of the residential placement. Results indicated that higher levels of psychopathology predicted greater youth medical service utilization, even after controlling for the presence of a diagnosed medical condition. Internalizing problems was a significant independent predictor of utilization, but externalizing problems was not. These findings highlight the association between mental health and medical service utilization and suggest that effective behavioral health services may be helpful in reducing costly medical service needs.  相似文献   
88.

Purpose

The ability of human melanotransferrin (hMTf) to carry a therapeutic concentration of trastuzumab (BTA) in the brain after conjugation (in the form of trastuzumab-melanotransferrin conjugate, BT2111 conjugate) was investigated by measuring the reduction of the number and size of metastatic human HER2+ breast cancer tumors in a preclinical model of brain metastases of breast cancer.

Methods

Human metastatic brain seeking breast cancer cells were injected in NuNu mice (n?=?6–12 per group) which then developed experimental brain metastases. Drug uptake was analyzed in relation to metastasis size and blood-tumor barrier permeability. To investigate in-vivo activity against brain metastases, equimolar doses of the conjugate, and relevant controls (hMTf and BTA) in separate groups were administered biweekly after intracardiac injection of the metastatic cancer cells.

Results

The trastuzumab-melanotransferrin conjugate (BT2111) reduced the number of preclinical human HER2+ breast cancer metastases in the brain by 68% compared to control groups. Tumors which remained after treatment were 46% smaller than the control groups. In contrast, BTA alone had no effect on reducing number of metastases, and was associated with only a minimal reduction in metastasis size.

Conclusions

The results suggest the novel trastuzumab-melanotransferrin conjugate (BT2111) may have utility in treating brain metastasis and validate hMTf as a potential vector for antibody transport across the Blood Brain Barrier (BBB).
  相似文献   
89.
Sodium and potassium-activated adenosine triphosphatases (Na,K-ATPase) are ubiquitous, participate in osmotic balance and membrane potential, and are composed of α, β, and γ subunits. The α subunit is required for the catalytic and transport properties of the enzyme and contains binding sites for cations, ATP, and digitalis-like compounds including ouabain. There are four known α isoforms; three that are expressed in the CNS in a regional and cell-specific manner. The α2 isoform is most commonly found in astrocytes, pyramidal cells of the hippocampus in adults, and developmentally in several other neuronal types. Ouabain-like compounds are thought to be produced endogenously in mammals, bind the Na,K-ATPase, and function as a stress-related hormone, however, the impact of the Na,K-ATPase ouabain binding site on neurobehavioral function is largely unknown. To determine if the ouabain binding site of the α2 isoform plays a physiological role in CNS function, we examined knock-in mice in which the normally ouabain-sensitive α2 isoform was made resistant (α2(R/R) ) while still retaining basal Na,K-ATPase enzymatic function. Egocentric learning (Cincinnati water maze) was impaired in adult α2(R/R) mice compared to wild type (WT) mice. They also exhibited decreased locomotor activity in a novel environment and increased responsiveness to a challenge with an indirect sympathomimetic agonist (methamphetamine) relative to WT mice. The α2(R/R) mice also demonstrated a blunted acoustic startle reflex and a failure to habituate to repeated acoustic stimuli. The α2(R/R) mice showed no evidence of altered anxiety (elevated zero maze) nor were they impaired in spatial learning or memory in the Morris water maze and neither group could learn in a large Morris maze. These results suggest that the ouabain binding site is involved in specific types of learning and the modulation of dopamine-mediated locomotor behavior.  相似文献   
90.
Helicobacter pylori infection plays a key role in the pathogenesis of H. pylori-associated diseases, including gastroduodenal and non-gastroduodenal diseases. A 71-year-old man was evaluated for a positive fecal occult blood test by upper gastrointestinal endoscopy, which revealed H. pylori infection, two adenocarcinomas and two gastric mucosa-associated lymphoid tissue lymphomas. Hematological examination revealed low platelet-count, elevated platelet-associated immunoglobulin G and anti-H. pylori immunoglobulin G antibodies. We diagnosed H. pylori infection complicated by simultaneous occurrence of gastric cancer, gastric mucosa-associated lymphoid tissue lymphoma, and idiopathic thrombocytopenic purpura. These diseases were successfully treated with laparoscopy-assisted total gastrectomy and splenectomy, and there was no evidence of recurrence for about 2 years. This is the first reported case of H. pylori infection complicated by these three diseases and cured with laparoscopic surgery.  相似文献   
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