A comparison of Thermo Electron RSV OIA to viral culture and direct fluorescent assay testing for respiratory syncytial virus.

BACKGROUND: Rapid diagnostic methods for respiratory syncytial virus are useful tools available for the clinician. OBJECTIVES: The Thermo Electron RSV OIA (optical immunoassay kit) was prospectively compared with direct immunofluorescent assay and viral culture at Primary Children's Medical Center, Salt Lake City, Utah. STUDY DESIGN: Specimens from three hundred and thirty patients exhibiting respiratory symptoms were collected for testing by the three methods above. Several specimens were positive by both OIA and DFA with a negative culture result. These culture results were verified by RT-PCR analysis. RESULTS: Overall, 107 specimens were positive for RSV by the reference tests (culture or RT-PCR). DFA analysis identified an additional 40 patient specimens positive for other respiratory viruses. Compared to the reference tests the sensitivity, specificity, positive, and negative predictive values of the OIA for detection of RSV were 87.9%, 99.6%, 98.9% and 94.5%, respectively. CONCLUSIONS: The rapid OIA assay format proved to be cost effective, and simple to use in comparison to DFA and viral culture. Negative rapid test results should still be confirmed with a secondary test.     

Epidermolytic hyperkeratosis

A 13-year-old boy presented to the dermatology clinic for treatment of a congenital ichthyosis with a history of generalized erythroderma and trauma related blistering at the time of birth. At the time of presentation he was noted to have red corrugated hyperkeratotic plaques involving the joint flexures, dorsal hands, and neck. Epidermolytic hyperkeratosis is a rare autosomal dominant genodermatosis that presents at birth with generalized erythema, blisters and erosions. In the subsequent months after birth erythema and blistering improves but patients go on to develop hyperkeratotic scaling that is especially prominent along the joint flexures, neck, hands and feet. The disease is caused by mutations in either keratin 1 or keratin 10. Treatment options include urea or alpha-hydroxy acid containing creams as well as topical and systemic retinoids. Epidermolytic hyperkeratosis is also known as bullous congenital ichthyosiform erythroderma (of Brocq) and disorder of cornification type 3.     

Rural Hispanic Populations at Risk in Developing Diabetes: Sociocultural and Familial Challenges in Promoting a Healthy Diet

Type II diabetes affects Hispanic populations disproportionately and is the fifth leading cause of death for Hispanic people in the United States (Smith & Barnett, 2005 Smith, C. A. S. and Barnett, E. 2005. Diabetes-related mortality among Mexican Americans, Puerto Ricans, and Cuban Americans in the United States. Public Health, 18: 381–387. [Web of Science ®] , [Google Scholar]). Risk of diabetes is of great concern throughout the United States and is clearly of epidemic proportions for regions such as the Southwest and Texas where the primary minority populations are Mexican American. We conducted four focus groups with a total of 49 Hispanic participants (23 adults and 26 adolescents) from rural West Texas communities to gain insights about participants' eating habits, knowledge of diabetes, and potential barriers to preventive care. From the data, we identified a three-tiered predisposition or vulnerability to diabetes—heredity; preferences for unhealthy, culturally based food; and temptations from U.S. mainstream fast food culture. These vulnerabilities added to the sociocultural concerns that participants identified—importance of parental and familial modeling; challenges to healthy eating based on a culturally based diet and mainstream fast food culture; and a lack of support from the larger sociocultural networks such as teachers, community leaders, and the media. From these data, we have a better understanding of familial and sociocultural factors that need to be addressed in the development of preventive public awareness and educational plans. We outline implications for practitioners and educators from an integrated cultural biomedical approach.     

Development and application of a mouse intestinal loop model to study the in vivo action of Clostridium perfringens enterotoxin

Clostridium perfringens enterotoxin (CPE) is responsible for causing the gastrointestinal symptoms of C. perfringens type A food poisoning, the second most commonly identified bacterial food-borne illness in the United States. CPE is produced by sporulating C. perfringens cells in the small intestinal lumen, where it then causes epithelial cell damage and villous blunting that leads to diarrhea and cramping. Those effects are typically self-limiting; however, severe outbreaks of this food poisoning, particularly two occurring in psychiatric institutions, have involved deaths. Since animal models are currently limited for the study of the CPE action, a mouse ligated intestinal loop model was developed. With this model, significant lethality was observed after 2 h in loops receiving an inoculum of 100 or 200 μg of CPE but not using a 50-μg toxin inoculum. A correlation was noted between the overall intestinal histological damage and lethality in mice. Serum analysis revealed a dose-dependent increase in serum CPE and potassium levels. CPE binding to the liver and kidney was detected, along with elevated levels of potassium in the serum. These data suggest that CPE can be absorbed from the intestine into the circulation, followed by the binding of the toxin to internal organs to induce potassium leakage, which can cause death. Finally, CPE pore complexes similar to those formed in tissue culture cells were detected in the intestine and liver, suggesting that (i) CPE actions are similar in vivo and in vitro and (ii) CPE-induced potassium release into blood may result from CPE pore formation in internal organs such as the liver.     

Dietary intake, supplement use, and survival among women diagnosed with early-stage breast cancer

Previous studies examining the relationship between micronutrient intakes and survival following diagnosis of breast cancer have reported mixed results. This may be partly due to considerable variance in amounts of micronutrients consumed from diet and supplements across studies. Early-stage breast cancer survivors (N = 3081) completed four 24-h dietary and supplement recalls at the baseline assessment (1995 to 2000) and were followed for a median of 9.0 yr. Mean micronutrient intakes were compared to dietary reference intakes (DRI) to assess micronutrient adequacy for both users and nonusers of supplements. Cox regressions were performed to assess whether intakes of selected micronutrients were associated with all-cause mortality. Four hundred and twelve deaths occurred between baseline and August 2009. Among these women, more supplement users had adequate micronutrient intakes than nonusers for 15 out of 17 micronutrients. Less than 10% of supplement users (<2% of nonsupplement users) reported levels that exceeded the tolerable upper limit for each micronutrient except magnesium. After adjusting for age, tumor characteristics, and health status variables, micronutrient intakes were not significantly associated with all-cause mortality. Dietary supplements may improve overall micronutrient intakes of breast cancer survivors. However, vitamin and mineral intakes were not associated with all-cause mortality.     

The role of attachment style in coping with job loss and the empty nest in adulthood

The current study employed a life events perspective to examine the relationship between attachment style and both adjustment and coping processes in adults during two specific life events involving both the loss of and a renegotiation of an attachment relationship: the launching of children from the family of origin and job loss, which represent both normative and non-normative transitions, respectively. Using median splits for each attachment dimension (closeness, dependency, and anxiety) to define secure, anxious, and avoidant styles, based on the work of Collins and Read, analyses failed to yield a significant multivariate life event by style interaction. However, a statistically significant multivariate main effect for life event and for attachment style was obtained. Additionally, findings suggested that to a certain extent, the impact of attachment style and life events is moderated by gender, wherein a supplemental analysis yielded a significant life event by gender by level of closeness interaction. The data support the notion that securely attached individuals may be more equipped to meet developmental life challenges in adulthood, and extend previous work that is limited to women and to the empty nest.     

Externalizing disorders in the offspring from the San Diego prospective study of alcoholism

OBJECT: Conduct disorder (CD) and attention deficit hyperactivity disorder (ADHD) may be more prevalent in relatives of alcoholics and may predict alcohol and drug problems, but not all studies agree. This paper evaluates these questions in well-educated families of alcoholics and controls. METHODS: Data from 165, 14-25-year-old offspring in the San Diego Prospective Study were used to create Group 1 (n=17) with CD or ADHD and Group 2 (n=148) with no such diagnoses. Correlations and hierarchical logistic regressions evaluated characteristics associated with these disorders, comparing the impact of CD and ADHD. RESULTS: The rates of CD (6.1%) and of ADHD (4.8%) were not strikingly elevated, and did not relate to the family history of alcohol or drug use disorders. Group 1 offspring were more likely to have divorced parents, a relative with bipolar disorder, a higher intake of alcohol and illicit substances, and associated problems.