A psychometric study of recovery among Certified Peer Specialists

The recovery model is wielding a welcome influence in the mental healthcare system. Despite its potential impact, systematic studies of the recovery construct as viewed by consumers and former consumers of mental health services have only recently begun to permeate the literature. We have embarked on an ongoing collaboration with the Georgia Mental Health Consumer Network to study the recovery experiences of Certified Peer Specialists (CPSs). As a first step, we evaluated the psychometric characteristics of a new measure of the recovery construct in CPSs. CPSs (N=84) enrolled in the GMHCN completed the Maryland Assessment of Recovery in Serious Mental Illness (MARS) along with measures of resilience, coping styles, community living, social support, internalized stigma, psychopathology, and personality. Recovery as measured by the MARS was associated with resilience, coping behaviors, quality of social support, community living, internalized stigma, and severity of psychopathology. Recovery did not demonstrate a statistically significant association with personality. Recovery appeared to mediate the effect of psychopathology and episodic stressors on community functioning. Our psychometric study supports the psychometric soundness of the MARS and the construct validity of recovery.     

Bridging Hepatocellular Carcinoma to Transplant: Transarterial Chemoembolization Response,Tumor Biology,and Recurrence after Transplantation in a 12-Year Transplant Cohort

PurposeTo evaluate tumor response to transarterial chemoembolization as well as biologic characteristics of the tumor as predictors of recurrence after transplantation in patients with hepatocellular carcinoma (HCC) who were bridged or down-staged to liver transplantation.Materials and MethodsAn institutional review board-approved, Health Insurance Portability and Accountability Act-compliant, single-institution retrospective analysis was performed on all patients with HCC who were treated with the use of conventional transarterial chemoembolization or transarterial chemoembolization with drug-eluting embolics (DEE) over a 12-year period and who subsequently underwent liver transplantation (n = 142). Treatment response was based on modified Response Evaluation Criteria in Solid Tumors (mRECIST) imaging criteria and then correlated with tumor characteristics and recurrence. Of the 142 patients followed after transplantation, 127 had imaging after transarterial chemoembolization but before transplantation. Imaging response and post-transplantation recurrence were correlated with patient demographics, liver function, and tumor morphology. HCC recurred in 9 patients (mean time from transplantation, 526 days). Recurrence was analyzed with the use of univariate and multivariate statistics. Kaplan-Meier recurrence-free survival curves were calculated based on immediate imaging response before transplantation with the use of the log-rank test.ResultsBefore transplantation, 57% of patients (72/127) demonstrated complete response (CR) and 24% (31/127) showed partial response (PR). Complete pathologic necrosis occurred in 54% (39/72) of CR patients and 20% (6/31) of PR patients. Poor treatment response, defined as stable disease (SD) or progressive disease (PD), occurred in 18% of patients (24/127) before transplantation and was present in 67% of cases of recurrence (6/9; P < .001). Post-transplantation recurrence was present in 1.4% of patients (1/71) with CR and in 6.5% of patients (2/31) with PR. In patients with SD after transarterial chemoembolization, HCC recurred in 18.8% of transplant patients (3/16) and in 43% of patients (3/7) with PD. Larger pretreatment tumor size (P = .05), higher Child-Pugh score (P = .002), higher tumor grade at explantation (P = .04), and lymphovascular invasion at explantation (P = .008) also were associated with increased incidence of post-transplantation recurrence.ConclusionsPoor tumor response to transarterial chemoembolization before transplantation identifies patients at increased risk for post-transplantation recurrence.     

CD molecules 2006--human cell differentiation molecules

The Human Leucocyte Differentiation Antigens Workshops (HLDA) have since 1984 provided a forum for the characterization and study of leucocyte surface molecules and antibodies against them. HLDA devised the CD nomenclature, which is sanctioned by IUIS. The HLDA Council reviewed and modified the objectives of HLDA in 2004, and changed the name of the organization to Human Cell Differentiation Molecules (HCDM) to reflect the broader objectives. Workshop studies under the HCDM banner proceeded during 2005 and early 2006, culminating in a meeting in May 2006. At that meeting the Council, acting as Nomenclature Committee, approved a number of new CD designations and changes to some pre-existing CD designations, which are summarized in this report.     

Relationship between Erythrocyte Omega-3 Content and Obesity Is Gender Dependent

Epidemiological evidence of an inverse association between consumption of long-chain omega-3 polyunsaturated fatty acids (LC n-3 PUFA) and obesity has been conflicting, even though studies in animal models of obesity and limited human trials suggest that LC n-3 PUFA consumption may contribute to weight loss. We used baseline data from a convenience sample of 476 adults (291 women, 185 men) participating in clinical trials at our Centre to explore relationships between erythrocyte levels of LC n-3 PUFA (a reliable indicator of habitual intake) and measures of adiposity, viz. body mass index (BMI), waist circumference (WC) and body fat (BF) assessed by dual-energy X-ray absorptiometry. Means ± SD of assessments were BMI: 34 ± 7 and 31 ± 5 kg/m²; WC: 105 ± 16 and 110 ± 13 cm; BF: 48 ± 5 and 35% ± 6% in women and men respectively. Erythrocyte levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) were similar in men and women while docosapentaenoic acid (DPA) was higher and EPA + DHA (Omega-3 Index) slightly lower in men than in women. Both DHA and EPA + DHA correlated inversely with BMI, WC and BF in women while DPA correlated inversely with BF in men. Quartile distributions and curvilinear regression of the Omega-3 Index versus BMI revealed a steep rise of BMI in the lower range of the Omega-3 Index in women, but no association in men. Thus the results highlight important gender differences in relationships of specific LC n-3 PUFA in erythrocytes to markers of adiposity. If these reflect causal relationships between LC n-3 PUFA consumption and risk of obesity, gender specific targeted interventions should be considered.     

Use of a glyphosate-based herbicide-induced nephrotoxicity model to investigate a panel of kidney injury biomarkers

Accidental or intentional ingestion of glyphosate surfactant-based herbicides, like Roundup^®, leads to nephrotoxicity as well as death. In this study, a panel of kidney injury biomarkers was evaluated in terms of suitability to detect acute kidney injury and dysfunction. The Roundup^® intoxication model involved oral administration of glyphosate to rats at dose levels of 250, 500, 1200 and 2500 mg/kg. Urinary and plasma biomarker patterns were investigated at 8, 24 and 48 h after dosing. Biomarkers were quantified by absolute concentration; by normalising to urine creatinine; and by calculating the excretion rate. The diagnostic performances of each method in predicting of acute kidney injury were compared. By Receiver Operating Characteristic (ROC) analysis of the selected biomarkers, only urinary kidney injury molecule-1 (KIM-1) best predicted histological changes at 8 h (best cut-off point > 0.00029 μg/ml). Plasma creatinine performed better than other biomarkers at 24 h (best cut-off point > 0.21 mg/dl). Urinary KIM-1 was the best early biomarker of kidney injury in this glyphosate-induced nephrotoxicity model.