Evaluation of Mental Health First Aid training with members of the Vietnamese community in Melbourne, Australia

Background  

The aim of this project was to investigate in members of the Vietnamese community in Melbourne the impact of Mental Health First Aid (MHFA) training on attitudes to people with mental illness and on knowledge about mental disorders. Our hypotheses were that at the end of the training participants would have increased knowledge of mental disorders and their treatments, and decreased negative attitudes towards people with mental disorders.     

Evaluation of sexual function in hypertensive men receiving treatment: a review of current guidelines recommendation

IntroductionIt has been suggested that some classes of antihypertensive drugs may induce or exacerbate sexual and/or erectile dysfunction (ED) more than others. Sexually related side effects of antihypertensive treatment may compromise patient's and partner's quality of life. Often, these side effects can lead to withdrawal or poor compliance with therapy resulting in abnormal blood pressure and associated morbidity.AimThe aim of this study was to evaluate whether hypertension clinical practice guidelines (CPGs) address ED and/or other sexual issues as either an adverse outcome of chosen therapy or as a factor to consider in treatment decision.MethodsHypertension CPGs were identified by searching PubMed (from 2000 to current), the World Wide Web, bibliographies of retrieved guidelines, and official home pages of major medical societies.Main Outcome MeasuresThe main outcome measures used for this study were guidelines assessment using a set of author‐determined survey questions.ResultsTwelve CPGs were identified and analyzed. From these 12, only three emphasized the importance of assessing sexual function prior to initiation and/or follow‐up of antihypertensive therapy; only five described potential sexual side effects associated with some drugs; only two provided specific management recommendations on commencing antihypertensive therapy in sexually active men or those with preexisting ED and address the timeline of the potential drug‐induced impairment of sexual function.ConclusionsOnly a minority of CPGs for the treatment of hypertension consider ED or other sexual issues as either an adverse outcome or as a factor to consider in treatment. Sexual function is an important aspect of quality of life for both the individual and his partner. It is therefore imperative to select therapy with the least possible potential for causing sexual sequelae and enable the best achievable balance between therapeutic efficacy, quality of life, and therapeutic compliance. Based on these results, our proposed algorithm attempts to effectively apply available evidence to clinical practice. Karavitakis M, Komninos C, Theodorakis PN, Politis V, Lefakis G, Mitsios K, Koritsiadis S, and Doumanis G. Evaluation of sexual function in hypertensive men receiving treatment: A review of current guidelines recommendation. J Sex Med 2011;8:2405–2414.     

Substrate overlap between Mrp4 and Abcg2/Bcrp affects purine analogue drug cytotoxicity and tissue distribution

The use of probe substrates and combinations of ATP-binding cassette (ABC) transporter knockout (KO) animals may facilitate the identification of common substrates between apparently unrelated ABC transporters. An unexpectedly low concentration of the purine nucleotide analogue, 9-(2-(phosphonomethoxy)ethyl)-adenine (PMEA), and up-regulation of Abcg2 in some tissues of the Mrp4 KO mouse prompted us to evaluate the possibility that Abcg2 might transport purine-derived drugs. Abcg2 transported and conferred resistance to PMEA. Moreover, a specific Abcg2 inhibitor, fumitremorgin C, both increased PMEA accumulation and reversed Abcg2-mediated PMEA resistance. We developed Mrp4 and Abcg2 double KO mice and used both single KOs of Abcg2 and Mrp4 mice to assess the role of these transporters in vivo. Abcg2 contributed to PMEA accumulation in a variety of tissues, but in some tissues, this contribution was only revealed by the concurrent absence of Mrp4. Abcg2 also transported and conferred resistance to additional purine analogues, such as the antineoplastic, 2-chloro-2'-deoxyadenosine (cladribine) and puromycin, a protein synthesis inhibitor that is often used as a dominant selectable marker. Purine analogues interact with ABCG2 by a site distinct from the prazosin binding site as shown by their inability to displace the substrate analogue and photoaffinity tag [(125)I]iodoarylazidoprazosin. These studies show that Abcg2, like Mrp4, transports and confers resistance to purine nucleoside analogues and suggest that these two transporters work in parallel to affect drug cytotoxicity and tissue distribution. This new knowledge will facilitate an understanding of how Abcg2 and Mrp4, separately and in combination, protect against purine analogue host toxicity as well as resistance to chemotherapy.     

Validated LC–MS/MS method for simultaneous determination of SIM and its acid form in human plasma and cell lysate: Pharmacokinetic application

Simvastatin (SIM) is a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor widely used in hyperlipidemia therapy. SIM has recently been studied for its anticancer activity at doses higher than those used for the hyperlipidemia therapy. This prompted us to study the pharmacokinetics of high-dose SIM in cancer patients. For this purpose, an LC–MS/MS method was developed to measure SIM and its acid form (SIMA) in plasma and peripheral blood mononuclear cells (PBMCs) obtained from patients. Chromatographic analyte separation was carried out on a reverse-phase column using 75:25 (% v/v) acetonitrile:ammonium acetate (0.1 M, pH 5.0) mobile phase. Detection was performed on a triple quadrupole mass spectrometer, equipped with a turbo ion spray source and operated in positive ionization mode. The assay was linear over a range 2.5–500 ng/mL for SIM and 5–500 ng/mL for SIMA in plasma and 2.5–250 ng/mL for SIM and 5–250 ng/mL for SIMA in cell lysate. Recovery was >58% for SIM and >75% for SIMA in both plasma and cell lysate. SIM and SIMA were stable in plasma, cell lysate and the reconstitution solution. This method was successfully applied for the determination of SIM and SIMA in plasma and PBMCs samples collected in the pharmacokinetic study of high-dose SIM in cancer patients.     

MCM-based microlaboratory for simultaneous measurement of several biochemical parameters by spectrophotometry

This paper reports on the concept, fabrication and characterization of a multi-chip module microlaboratory. The application is in the spectrophotometric analysis of human physiological fluids in a clinical setting. The system is composed of three stacked parts: (1) a central microfluidic system die containing the microchannels, which is fabricated by applying MEMS techniques to an SU-8 layer, (2) an optical filtering system on the top side, fabricated using a dielectric thin-films multilayer and (3) a detection and readout system on the bottom side, which is fabricated in a CMOS microelectronic process. The system modularity and emphasis on microfabrication provides potential for low unit cost. The application is the simultaneous and quantitative measurement of the concentration of four biochemical parameters in human physiological fluids by spectrally selective optical absorption. The intensity of the light transmitted through the physiological fluid results in an electrical output signal in the form of bit streams, which allows simple computer interfacing. A simple white light source is used for illumination, due to the optical filtering system, which makes the microlaboratory portable. The quantitative measurement of chloride, creatinine, total protein and uric acid in urine is successfully demonstrated.     

Dermatophytosis due to Trichophyton rubrum in northern Greece during the decade 1981-1990.

During the years 1981-1990 Trichophyton rubrum was the most frequent causative agent of dermatophytic infections in Northern Greece, especially in cases of tinea pedis, cruris, corporis, and unguium, as well as dermatophytosis of the hands. Between sexes there was a prevalence in women in tinea pedis and toenail infections. Men were particularly infected in the groin, the hands and the face. The chronic follicular dermatophytosis in the lower legs was also presented in women, but tinea corporis and fingernail infections showed no significant differences between the sexes. Also studied were the age of the patients, the inflammatory component of the lesions and the morphotypes of T. rubrum isolated.     

Dermatomyositis sine myositis in five cases

Background A small subset of patients with dermatomyositis develop the characteristic cutaneous manifestations without muscle involvement, the so-called dermatomyositis sine myositis or amyopathic dermatomyositis. Whether systemic treatment of skin disease can prevent the development of myositis remains controversial. Objective The purpose of this study was to evaluate the development of the disease in terms of the onset of muscle symptoms under systemic treatment with corticosteroids or antimalarials. Methods Five patients with dermatomyositis sine myositis were included in this study. All skin biopsy specimens had features consistent with dermatomyositis. Muscle enzymes, electromyograms and muscle biopsies did not reveal any abnormality. Results Corticosteroids were given in three patients and hydroxychloroquine in two. Both regimens proved to be effective in the treatment of skin symptoms. Four patients, three on corticosteroids and one on hydroxychloroquine, did not develop muscle disease 4–7 years after presentation. One patient on hydroxychloroquine showed laboratory evidence of myositis 6 years after initiation of treatment. Conclusion It seems that muscle disease may appear within long periods of time after the onset of the cutaneous manifestations. The term dermatomyositis sine myositis can be used as a provisional diagnosis. Our observations suggest that systemic treatment of skin disease with corticosteroids is successful and may alter the disease course. Hydroxychloroquine may be helpful in some cases.