Hope Index Scale: An Instrument for the Objective Assessment of Hope

Although many clinical observations suggest that Hope influences the onset, duration, prognosis, and recovery from mental and physical illnesses, a lack of direct scientific proof persists because no method exists for the objective assessment of hope. We have now constructed the Hope Index Scale, a testing instrument for the measurement of this rather elusive human attribute. Upon testing control and experimental subjects, it was found that score distribution on the Hope Index Scale correlates negatively with Beck''s Hopelessness Scale (Pearson r = −.88, P <.001) and is independent of age, race, or sex. It is concluded that this tool can help identify individuals with varying degrees of psychosocial problems and that scores of 150 or below are indicative of pathologic hope deficit often associated with suicide.     

A comparison of tenocytes and mesenchymal stem cells for use in flexor tendon tissue engineering

PURPOSE: Tissue-engineered tendon grafts will meet an important clinical need. To engineer tendons, we used acellularized allogeneic tendon as scaffold material. To determine the ideal cell type to seed the scaffolds, we studied in vitro characteristics of epitenon tenocytes, tendon sheath fibroblasts, bone marrow-derived mesenchymal stem cells (BMSCs), and adipoderived mesenchymal stem cells (ASCs). Subsequently, we implanted reseeded acellularized tendons in vivo as flexor tendon grafts. METHODS: Tenocytes, sheath fibroblasts, BMSCs, and ASCs were obtained from adult rabbits. For all cell lines, collagen 1, 2, and 3 immunocytochemistry was performed, and proliferation was assessed by hemacytometry and senescence by beta-galactosidase staining. Flexor tendons were acellularized after harvest. Tendons were assessed by histology after in vitro reseeding with each of the cell types after 1, 4, and 8 weeks. Finally, reseeded tendons and controls were implanted in a flexor profundus tendon defect. After 6 weeks, the reseeded tendons were harvested and assessed by histology. Statistical analysis for cell proliferation was performed using analysis of variance and t-tests with Bonferroni correction. RESULTS: All cell types had similar collagen expression. Cell proliferation was higher in ASCs in late passage compared with early passage and in ASCs compared with epitenon tenocytes at late passage. The other cell types were similar in growth characteristics. No senescence was detected. In vitro assessment of reseeded constructs showed the presence of cells on the construct surface. In vivo assessment after implantation showed viable cells seen within the tendon architecture in all cell types. CONCLUSIONS: This study suggests that the four cell types may be successfully used to engineer tendons. Adipoderived mesenchymal stem cells proliferate faster in cell culture, but the cell types were similar in other respects. All could be used to successfully repopulate acellularized tendon in vivo as flexor tendon grafts.     

Prevalence of sexually transmitted infections among pregnant women attending antenatal clinics in West Coast Region of The Gambia

BackgroundSexually Transmitted Infections (STI) are the second most common cause of healthy life years lost by women in the 15 – 44 years age group in Africa.Aim/ObjectiveTo determine the prevalence of STIs among pregnant women attending antenatal care (ANC) clinics in the West Coast Region of The Gambia.Materials and MethodsBlood, urine, and high vaginal swabs samples from 280 pregnant women attending ANC in Brikama District Hospital, Brikama, and Bandung Maternity and Child Health Hospital, Bandung were examined. Serum samples were tested for HIV using western blot technique and for syphilis using the Venereal Disease Research Laboratory (VDRL) test, and rapid plasma regimen. Candida albicans, Group B Streptococcus and Neisseria gonorrhoea were identified using Analytical Profile Index (API). Direct urine microscopy was used to identify C. albicans and Trichomonas vaginalis while Chlamydia trachomatis was identified using Direct Fluorescent Antibody (DFA) test.ResultsThe overall prevalence of STIs was 53.6%. The pathogenic agents isolated were Candida albicans (31.8%), Streptococcus agalactiae (15.0%), Treponema pallidum (6.8%), HIV (5.7%), Trichomonas vaginalis (3.9%), Neisseria gonorrhoea (1.8%) and Chlamydia trachomatis (0.7%). STIs were more prevalent among women in the younger age group of 15 – 24 years (54.7%), unemployed (54.0%), Primipara (62.3%), and in the third trimester of pregnancy (72.7%).ConclusionA high prevalence of STIs was found among pregnant women attending ANC in the West Coast region of The Gambia. Public health intervention programmes should be strengthened to promote the sexual and reproductive health of pregnant women in The Gambia.     

Prognostic index for patients with parotid carcinoma

BACKGROUND:

Prognostic indices for recurrence‐free interval in patients with parotid carcinoma were developed and validated in a nationwide database. International validation would increase generalizability.

METHODS:

In a Belgian‐German database that contained 237 consecutive patients with parotid carcinoma, a pretreatment prognostic index (PS1) and a post‐treatment prognostic index (PS2) were validated by calculating both indices for each patient, comparing coefficients, constructing survival curves, calculating the concordance measure C, and performing Wald tests for scale and weight optimization of included variables and for the possible inclusion of new variables.

RESULTS:

Sixty‐nine percent of patients (standard error, 5%) were disease free at 5 years. The defined cutoff points for PS1 resulted in 5‐year disease‐free rates from 94% (PS1 = 1) to 42% (PS1 = 4), and the cutoff points for PS2 resulted in 5‐year disease‐free rates from 93% (PS2 = 1) to 40% (PS2 = 4). Concordance measure C was good with 0.74 for both PS1 and PS2. Neither index could be improved statistically using this international database. There was some evidence that additional inclusion of the variable ‘number of positive lymph nodes in the neck dissection specimen’ could enhance the prognostic power of PS2.

CONCLUSIONS:

The prognostic indices performed adequately in this validation sample. Prospective generalized use seems to be well supported. Cancer 2009. © 2009 American Cancer Society.     

Assessing the WHO 50% Prevalence Threshold in School-Aged Children as Indication for Treatment of Urogenital Schistosomiasis in Adults in Central Nigeria

Preventive chemotherapy with praziquantel is recommended in adults by the World Health Organization when prevalence of schistosomiasis in school-aged children (SAC) is ≥ 50%. This study ascertained the value of this threshold in predicting prevalence and intensity of Schistosoma hematobium (SH) infection in adults in central Nigeria. We evaluated urogenital schistosomiasis prevalence in 1,164 adults: 659 adults in 12 communities where mean hematuria among SAC in 2008 was 26.6% and 505 adults in 7 communities where the mean hematuria among SAC in 2008 was 70.4%. No statistically significant differences were found between the two groups of adults in prevalence of hematuria, prevalence of SH eggs, or intensity of infections. We conclude that, in this setting, the SAC threshold is not useful for treatment decisions in adults. Given the increased risk of subtle morbidity or urogenital schistosomiasis as a risk factor for human immunodeficiency virus (HIV), more liberal treatment of adults with praziquantel is warranted.