A brief intervention is sufficient for many adolescents seeking help from low threshold adolescent psychiatric services

Background  

There has been a considerable increase in the need for psychiatric services for adolescents. Primary health care practitioners have a major role in detecting, screening and helping these adolescents. An intervention entitled SCREEN is described in this article. The SCREEN intervention was developed to help practitioners to detect and screen adolescent needs, to care for adolescents at the primary health care level and to facilitate the referral of adolescents to secondary care services in collaboration between primary and secondary health care. Secondly, the article presents the background and clinical characteristics of youths seeking help from the SCREEN services, and compares the background factors and clinical characteristics of those patients referred and not referred to secondary care services.     

Latent Autoimmune Diabetes in Adults Differs Genetically From Classical Type 1 Diabetes Diagnosed After the Age of 35 Years

OBJECTIVE

We studied differences between patients with latent autoimmune diabetes in adults (LADA), type 2 diabetes, and classical type 1 diabetes diagnosed after age 35 years.

RESEARCH DESIGN AND METHODS

Polymorphisms in HLA-DQB1, INS, PTPN22, and CTLA4 were genotyped in patients with LADA (n = 213), type 1 diabetes diagnosed at >35 years of age (T1D_>35y; n = 257) or <20 years of age (T1D_<20y; n = 158), and type 2 diabetes.

RESULTS

Although patients with LADA had an increased frequency of HLA-DQB1 and PTPN22 risk genotypes and alleles compared with type 2 diabetic subjects, the frequency was significantly lower compared with T1D_>35y patients. Genotype frequencies, measures of insulin secretion, and metabolic traits within LADA differed according to GAD antibody (GADA) quartiles, but even the highest quartile differed from type 1 diabetes. Having two or more risk genotypes was associated with lower C-peptide concentrations in LADA.

CONCLUSIONS

LADA patients differed genetically and phenotypically from both T1D_>35y and type 2 diabetic patients in a manner dependent on GADA levels.Patients with latent autoimmune diabetes in adults (LADA) have a progressive insulin secretion defect, have less evidence of metabolic syndrome than type 2 patients, and share a genetic predisposition with both type 1 and type 2 diabetic patients (1–5). Whether LADA merely represents older-onset type 1 diabetes or is a distinct subgroup has been debated (6), but studies comparing LADA with classical type 1 diabetes in a comparative age-range are lacking. We investigated 1) whether LADA differed genetically (with respect to genes associated with risk of type 1 diabetes: HLA-DQB1, PTPN22, INS, and CTLA4) and phenotypically (with respect to metabolic syndrome) from type 1 diabetes diagnosed after age 35 years; and 2) whether the observed clinical heterogeneity within LADA depended on GAD antibody (GADA) levels and type 1 diabetes susceptibility genotypes.     

Radiation sensitizing effect of estramustine is not dependent on apoptosis

BACKGROUND: Estramustine is an anti-mitotic cytostatic drug that also enhances the effect of radiotherapy. The mechanism of radiosensitization is not thoroughly known. Since both radiotherapy and estramustine induce apoptosis in prostate cancer cells, we conducted an experiment to show whether radiosensitization is mediated by apoptosis. MATERIALS AND METHODS: DU-145 human prostate cancer cells were xenografted to nude mice and treated with estramustine for 2 weeks and external radiation for 3 to 6 days (18 to 36 Gy). Tumor regression was measured mechanically and the rate of apoptosis defined by the amount of low molecular weight DNA fragmentation. Follow-up time was 1 to 18 days. RESULTS: The tumor size regressed in the group of mice receiving both radiotherapy and estramustine. Four weeks after the treatment, apoptosis was accentuated in the tumors treated with estramustine or radiation but not with their combination. CONCLUSION: Estramustine potentiates radiotherapy, but not by enhancing radiation-induced apoptosis.     

Activation of caspase 9 in a rat model of experimental glaucoma

PURPOSE: We investigated retinal ganglion cell (RGC) death and activation of caspase 9 in rats with experimental glaucoma. METHODS: Elevated intraocular pressure (IOP) was induced in rats using the Morrison model. Surviving backlabeled RGC were counted and TUNEL staining detected apoptosis. Procaspase 9 expression and activated caspase 9 were studied by immunoblot and immunohistochemistry. RESULTS: IOP correlated with surviving RGC. TUNEL-positive RGC were observed in animals with elevated IOP. Procaspase 9 levels increased with IOP intensity. Cleaved caspase 9 was detected by immunoblot only in rats with peak IOP above 35 mm Hg for > or =6 days. Cleaved caspase 9 staining was seen only in the ganglion cell layer of retinas from rats with peak IOP > or =32 mm Hg. CONCLUSIONS: RGC loss is correlated with IOP in experimental glaucoma. These results support activation of caspase 9, the intrinsic caspase cascade, in RGC death in experimental glaucoma.     

Effects of phytosterols on the endocrinology and metabolism of the female raccoon dog (Nyctereutes procyonoides)

Phytosterols (PS) are the analogues of animal cholesterol in various plants. beta-Sitosterol is a PS used in margarines and natural remedies to lower elevated serum cholesterol levels. PS enter the ecosystem via pulp mill effluents. The study investigated the endocrine and metabolic effects of PS on the female raccoon dog (Nyctereutes procyonoides), a canid omnivore. Eight female animals were exposed perorally to 8 mg PS/kg/d for 4 wk with 8 animals in the control group. In the PS-treated females, there was a transitory decrease in the plasma estradiol concentrations with an increase in the plasma follicle-stimulating hormone levels. The plasma triiodothyronine concentrations were higher in the PS group. Serum lipid concentrations decreased in PS-treated and control animals. This probably represents a seasonal adaptation. Most of the cholesterol in raccoon dog serum was high-density lipoprotein cholesterol, unlike that in humans but similar to some other carnivores. Liver and kidney ethoxyresorufin O-deethylase activities were lower in the PS treated females. Data indicate that raccoon dogs may not be a sentinel species for PS effects.     

Physiology: Effects of intermittent antiprogestin RU486 combined with cyclic medroxyprogesterone acetate on folliculogenesis and ovulation

The results of several studies have suggested an inhibitoryeffect of the antiprogestin RU486 on late stages of folliculogenesisand ovulation. To assess the feasibility of using this propertyto inhibit ovulation without losing cycle control, an intermittentadministration of RU486 alternated with medroxyprogesteroneacetate (MPA) was tested in a phase I study. RU486 at a doseof 50 mg/day was given on menstrual cycle days 9–11 and27–29, and 10 mg/day of MPA was given on cycle days 17–26for three consecutive cycles to six Finnish and five Chileanwomen. Blood samples were collected two to three times a weekfor serum progesterone and oestradiol assays in three treatmentcycles. One control cycle and one post-treatment recovery cyclewere also monitored by serum samplings. Ultrasonography wascarried out to measure follicular diameters in the treatmentcycles. In 29 of 32 cycles, bleeding commenced within 3 daysafter the last MPA pill intake. Out of 32 treatment cycles,20 were without luteal activity (serum progesterone <9 nmol/l).Although 12 treatment cycles showed luteal activity (serum progesterone9 nmol/l), a clear rupture of a pre-ovulatory follicle >15mm, verified by ultrasonography, was seen in only one treatmentcycle. During the treatment cycles with luteal activity (serumprogesterone levels 9 nmol/1), serum oestradiol concentrationswere significantly higher on cycle days 9–18 and significantlylower at the end of the cycle compared with the cycles withoutluteal activity. The regimen used in this study disturbed folliculogenesisand ovulation (apparently), and was able to provide good cyclecontrol in the majority of the cycles.