Stigmatizing attributions about mental illness

Work and housing opportunities of persons with psychosis, substance abuse disorder, and other mental illnesses are significantly hampered by societal stigma. Earlier research by Weiner and colleagues (1988) examined stigmatizing attitudes associated with general health disabilities in terms of attributions about the controllability and stability of these disabilities. The relevance of this model for describing attributions about four psychiatric disorders is examined in this study. One hundred and fifty two adults rated four psychiatric groups (cocaine addiction, depression, psychosis, and mental retardation) and two physical health groups (cancer and AIDS) on six items corresponding with controllability and stability attributions. Findings from a factor analysis supported the distinction between controllability and stability factors. Results also suggested that mental health disabilities were rated more negatively on these factors than physical disabilities. Participants clearly discriminated among mental health disabilities, with cocaine addiction rated most negative in terms of controllability and mental retardation rated most negative in terms of stability. Attribution analyses provide useful information for changing the community's reactions to persons with mental illness. © 2000 John Wiley & Sons, Inc.     

Panitumumab Monotherapy in Patients with Metastatic Colorectal Cancer and Cetuximab Infusion Reactions: A Series of Four Case Reports

PurposeMonoclonal antibodies against the epidermal growth factor receptor approved for treating metastatic colorectal cancer (mCRC) include cetuximab (a chimeric antibody) and panitumumab (a fully human antibody). Because these antibodies have differences in protein sequence, patients intolerant to one antibody might still tolerate the other. Four cases are presented from a US panitumumab compassionate-use program in which patients with mCRC who were intolerant to cetuximab received panitumumab.Patients and MethodsEligible patients had failed previous fluoropyrimidine therapy with oxaliplatin- and irinotecan-containing chemotherapy, had cetuximab intolerance (ie, experienced an infusion reaction), and were unable to participate in a panitumumab clinical trial. For each patient, individual Federal Drug Administration-approved single-patient treatment use Investigational New Drug– and Institutional Review Board–approved protocols were used, informed consent was obtained, and data were collected independently by the investigator.ResultsAll 4 patients (2 men, 2 women) had received previous bevacizumab and premedications before cetuximab administration. In response to cetuximab, all 4 patients experienced Common Terminology Criteria for Adverse Events grade 3 or grade 4 infusion-reaction symptoms, which required acute therapy. Time from cetuximab discontinuation to panitumumab administration ranged from 8 days to 5 months. Panitumumab monotherapy was administered at approximately 6 mg/kg every 2 weeks. Two patients received premedications before panitumumab use. No physician reported any infusion reaction to panitumumab. One patient had stable disease, and 3 patients had disease progression.ConclusionThough this small case series provides evidence that patients with mCRC intolerant to cetuximab can receive subsequent panitumumab monotherapy without experiencing infusion reactions, additional clinical testing is needed to definitively examine this finding.     

The history and evolution of hand transplantation

Hand transplantation has proven itself to be a viable treatment option for upper extremity reconstruction. It has grown through advancements in several critical areas: microsurgery, transplant immunology, and hand surgery. The field has also benefited from a global effort with active transplant centers in 3 different continents. The early struggles and breakthroughs of hand transplantation's past have shaped and formed its current state. This article traces the events of the modern era of hand transplantation.     

High-resolution MRI of excised human prostate specimens acquired with 9.4T in detection and identification of cancers: validation of a technique

Purpose:

To evaluate feasibility of high‐resolution, high‐field ex vivo prostate magnetic resonance imaging (MRI) as an aid to guide pathologists' examination and develop in vivo MRI methods.

Materials and Methods:

Unfixed excised prostatectomy specimens (n = 9) were obtained and imaged immediately after radical prostatectomy under an Institutional Review Board‐approved protocol. High‐resolution T2‐weighted (T2W) MRI of specimens were acquired with a Bruker 9.4 T scanner to correlate with whole‐mount histology. Additionally, T2 and apparent diffusion coefficient (ADC) maps were generated.

Results:

By visual inspection of the nine prostate specimens imaged, high‐resolution T2W MRI showed improved anatomical detail compared to published low‐resolution images acquired at 4 T as published by other investigators. Benign prostatic hyperplasia, adenocarcinomas, curvilinear duct architecture distortion due to adenocarcinomas, and normal radial duct distribution were readily identified. T2 was ≈10 msec longer (P < 0.03) and the ADC was ≈1.4 times larger (P < 0.002) in the normal peripheral zone compared to the peripheral zone with prostate cancer.

Conclusion:

Differences in T2 and ADC between benign and malignant tissue are consistent with in vivo data. High‐resolution, high‐field MRI has the potential to improve the detection and identification of prostate structures. The protocols and techniques developed in this study could augment routine pathological analysis of surgical specimens and guide treatment of prostate cancer patients. J. Magn. Reson. Imaging 2011. © 2011 Wiley‐Liss, Inc.     

Hyperthermically induced changes in high spectral and spatial resolution MR images of tumor tissue--a pilot study

This pilot study investigated the feasibility of using MRI based on BOLD (blood-oxygen-level-dependent) contrast to detect physiological effects of locally induced hyperthermia in a rodent tumor model. Nude mice bearing AT6.1 rodent prostate tumors inoculated in the hind leg were imaged using a 9.4 T scanner using a multi-gradient echo pulse sequence to acquire high spectral and spatial resolution (HiSS) data. Temperature increases of approximately 6 °C were produced in tumor tissue using fiber-optic-guided light from a 250 W halogen lamp. HiSS data were acquired over three slices through the tumor and leg both prior to and during heating. Water spectra were produced from these datasets for each voxel at each time point. Time-dependent changes in water resonance peak width were measured during 15 min of localized tumor heating. The results demonstrated that hyperthermia produced both significant increases and decreases in water resonance peak width. Average decreases in peak width were significantly larger in the tumor rim than in normal muscle (p = 0.04). The effect of hyperthermia in tumor was spatially heterogeneous, i.e. the standard deviation of the change in peak width was significantly larger in the tumor rim than in normal muscle (p = 0.005). Therefore, mild hyperthermia produces spatially heterogeneous changes in water peak width in both tumor and muscle. This may reflect heterogeneous effects of hyperthermia on local oxygenation. The peak width changes in tumor and muscle were significantly different, perhaps due to abnormal tumor vasculature and metabolism. Response to hyperthermia measured by MRI may be useful for identifying and/or characterizing suspicious lesions as well as guiding the development of new hyperthermia protocols.     

Comparison of the age-adjusted and clinical probability-adjusted D-dimer to exclude pulmonary embolism in the ED

Background

Diagnosing pulmonary embolism (PE) in the emergency department (ED) can be challenging because its signs and symptoms are non-specific.

Oxidative stress markers in surgically treated patients with refractory epilepsy

OBJECTIVES: This study examines the redox status of drug-resistant epileptic patients and how it is modified after surgical treatment. DESIGN AND METHODS: The activity of antioxidant enzymes (superoxide dismutase, catalase and glutathione peroxidase), and markers of damage to biomolecules (malondialdehyde and advanced oxidation protein products) were determined by spectrophotometric methods in the serum of 9 drug-resistant epileptic patients, before and at different times after surgery, and in 32 control subjects. RESULTS: Pre-surgery, epileptic patients presented increases in markers of oxidative damage and alterations in the activities of antioxidant enzymes. Additionally, patients showed a correlation between advanced oxidation protein products and the evolution time of the illness. After surgery, patients showed a trend to normalization in all the measured variables, except for the superoxide dismutase activity. CONCLUSIONS: Drug-resistant temporal lobe epilepsy is associated with an oxidative stress condition that is favourably modified by the surgical resection of the epileptic foci.