Trends of probable post-traumatic stress disorder in New York City after the September 11 terrorist attacks

The authors investigated trends in probable post-traumatic stress disorder (PTSD) prevalence in the general population of New York City in the first 6 months after the September 11 terrorist attacks. Three random digit dialing telephone surveys of adults in progressively larger portions of the New York City metropolitan area were conducted 1 month, 4 months, and 6 months after September 11, 2001. A total of 1,008, 2,001, and 2,752 demographically representative adults were recruited in the three surveys, respectively. The current prevalence of probable PTSD related to the September 11 attacks in Manhattan declined from 7.5% (95% confidence interval: 5.7, 9.3) 1 month after September 11 to 0.6% (95% confidence interval: 0.3, 0.9) 6 months after September 11. Although the prevalence of PTSD symptoms was consistently higher among persons who were more directly affected by the attacks, a substantial number of persons who were not directly affected by the attacks also met criteria for probable PTSD. These data suggest a rapid resolution of most of the probable PTSD symptoms in the general population of New York City in the first 6 months after the attacks. The psychological consequences of a large-scale disaster in a densely populated urban area may extend beyond persons directly affected by the disaster to persons in the general population.     

“Bird biting” mosquitoes and human disease: A review of the role of Culex pipiens complex mosquitoes in epidemiology

The transmission of vector-borne pathogens is greatly influenced by the ecology of their vector, which is in turn shaped by genetic ancestry, the environment, and the hosts that are fed on. One group of vectors, the mosquitoes in the Culex pipiens complex, play key roles in the transmission of a range of pathogens including several viruses such as West Nile and St. Louis encephalitis viruses, avian malaria (Plasmodium spp.), and filarial worms. The Cx. pipiens complex includes Culex pipiens pipiens with two forms, pipiens and molestus, Culex pipiens pallens, Culex quinquefasciatus, Culex australicus, and Culex globocoxitus. While several members of the complex have limited geographic distributions, Cx. pipienspipiens and Cx. quinquefasciatus are found in all known urban and sub-urban temperate and tropical regions, respectively, across the world, where they are often principal disease vectors. In addition, hybrids are common in areas of overlap. Although gaps in our knowledge still remain, the advent of genetic tools has greatly enhanced our understanding of the history of speciation, domestication, dispersal, and hybridization. We review the taxonomy, genetics, evolution, behavior, and ecology of members of the Cx. pipiens complex and their role in the transmission of medically important pathogens. The adaptation of Cx. pipiens complex mosquitoes to human-altered environments led to their global distribution through dispersal via humans and, combined with their mixed feeding patterns on birds and mammals (including humans), increased the transmission of several avian pathogens to humans. We highlight several unanswered questions that will increase our ability to control diseases transmitted by these mosquitoes.     

Prevention by (+/-)-8-hydroxy-2-(di-n-propylamino)tetralin of both catalepsy and the rises in rat striatal dopamine metabolism caused by haloperidol.

1. The influence of (+/-)-8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT) on haloperidol-induced increases in the dopamine metabolites, 3,4-dihydroxyphenylacetic acid (DOPAC) and 4-hydroxy-3-methoxyphenylacetic acid (HVA), was measured in three microdissected brain regions of the rat following a quantitative assessment of catalepsy. 2. Haloperidol alone (2.66 mumol kg-1, i.p.) caused a robust cataleptic response. Given 30 min after haloperidol, 8-OH-DPAT (76 or 760 nmol kg-1, s.c.) prevented catalepsy in 30% and 100% of rats, respectively. 3. Haloperidol significantly increased the DOPAC (by 2 to 4 fold) and HVA (by 3 to 7 fold) contents of the caudate-putamen, nucleus accumbens and medial prefrontal cortex. Given alone, only the lower dose of 8-OH-DPAT caused a significant biochemical change, a doubling of cortical DOPAC. 4. In the cases where catalepsy was prevented by either dose of 8-OH-DPAT, the haloperidol-induced increases in DOPAC and HVA were consistently lower in the caudate-putamen. This pattern was true for the rise in cortical HVA but only in response to the lower dose of 8-OH-DPAT. In contrast, neither dose of 8-OH-DPAT was able to influence the haloperidol-induced rises in cortical DOPAC. In the nucleus accumbens, 8-OH-DPAT did not affect the haloperidol-induced increases in the dopamine metabolites, irrespective of the dose employed or the resulting behaviour. When catalepsy was not prevented, 8-OH-DPAT did not alter the neurochemical responses to haloperidol in any region. 5. These results suggest that part of the mechanism by which 8-OH-DPAT prevents haloperidol-induced catalepsy is reflected by a reversal of the compensatory increase in meso-striatal and/or meso-cortical dopamine neuronal activity that normally accompanies postsynaptic dopamine receptor blockade with haloperidol.     

Variability of lipids in patients with Type 2 diabetes taking statin treatment: implications for target setting

Aims To determine the biological variability of lipids in patients with Type 2 diabetes (T2DM) who are on statin treatment and then to assess any implications for current lipid targets. Methods A cross‐over study of biological variation of lipids in 26 patients with T2DM taking either simvastatin 40 mg or atorvastatin 10 mg. After 3 months on one statin, fasting lipids were measured on 10 occasions over a 5‐week period. Following 3 months on the other statin, 10 further samples were taken over 5 weeks. The main outcome measures were biological variability of total cholesterol (TC), low‐density lipoprotein (LDL) cholesterol, high‐density lipoprotein (HDL) cholesterol and triglycerides. Results The coefficient of variation (CV) of TC, LDL, HDL and triglycerides on simvastatin was 8.17, 13.11, 7.95 and 12.06%, respectively, whereas the CV on atorvastatin was 6.92, 10.30, 5.13 and 19.71%, respectively, with no statistically significant differences between statins. Treating to sustain a target TC < 5.0 mmol/l or LDL < 3.0 mmol/l means needing to maintain a mean TC of 4.3–4.4 mmol/l or LDL of 2.4–2.5 mmol/l. Treating to consistently achieve an LDL < 2.0 mmol/l means aiming for a mean of only 1.5–1.6 mmol/l. Conclusion In patients with T2DM taking either simvastatin or atorvastatin, the mean TC and LDL concentrations needed to consistently remain below a target are much lower than the target value itself. This means that guideline target limits extrapolated from the mean values of patients participating in clinical studies may overestimate the lipid reductions required.     

Surgical oncology in university departments of surgery in the United States

Data on surgical oncology and multidisciplinary cancer program activity were obtained from 124 of 126 university surgery departments in the United States. Most of these institutions have American College of Surgeons-approved cancer programs (84%) as well as divisions of medical (95%), radiation (94%), pediatric (76%), and gynecologic (79%) oncology. Only 47 departments (38%) have formal divisions of surgical oncology. There are no major staffing or activity differences in surgical departments with or without such divisions, but multidisciplinary cancer program activity is greater in those institutions with a surgical oncology focus. Peer-reviewed cancer research grants are more frequent in departments of surgery with a surgical oncology division (68% vs 47%). The activities of the existing 47 divisions of surgical oncology are mainly operative, with breast cancer, melanoma, and soft-tissue sarcomas being the major clinical responsibilities. Chemotherapy is also frequent (81%). Cancer education for undergraduate and postgraduate surgical trainees is a major responsibility of most divisions, but only a small proportion (28%) have postresidency surgical oncology training programs. In contrast to the growth of some oncologic specialties, the establishment of surgical oncology within university departments has been slow, and the manpower needs appear modest.     

Selection of Rabbit Single-chain Fv Fragments against the Herbicide Atrazine using a New Phage Display System

A convenient new bacteriophage display vector, pSD3, has been constructed and used to generate rabbit monoclonal anti-pesticide antibody fragments. Following amplification of immunoglobulin light chain, and heavy chain variable region gene libraries, restriction enzymes Sfi I and PflM I are used to assemble scFv libraries in pSD3. This allows the number of stages involving the polymerase chain reaction and restriction enzyme digestion to be minimized to optimize maintenance of the original diversity of the variable region genes in the libraries. The vector also incorporates an amber codon, a 6xHis tag and a c-myc epitope to facilitate soluble single-chain Fv production detection and purification. Using the pSD3 system two anti-atrazine single-chain Fvs were isolated from a library derived from the spleen cells of a rabbit immunized with bovine serum albumin-atrazine conjugate. Characterization of single-chain Fvs by competition and equilibrium ELISA indicated good specificity and affinity to atrazine.     

Characterisation of sodium-dependent uptake of 5-hydroxytryptamine into guinea-pig brain

The uptake of 5-hydroxytryptamine (5-HT) was studied using isolated nerve endings (synaptosomes) prepared from the corpus striatum of the guinea pig. Analysis of temperature-dependent uptake revealed that two processes were involved, a sodium-dependent and sodium-independent mechanism. Kinetic studies indicated that the affinity of 5-HT (Ku) and the transport capacity (Vu) of the uptake process were dependent upon the external concentration of sodium. The transport capacity increased linearly with increasing concentrations of sodium up to 140 mmol/l, whereas the affinity for 5-HT was enhanced at concentrations of sodium up to 100 mmol/l, but reduced at 130 mmol/l sodium. The findings of this study suggest that uptake of 5-HT occurs as a result of a mobile carrier transport system which, depending upon the external concentration of sodium proceeds by a single or double displacement mechanism.     

Effect of tolcapone, a catechol-O-methyltransferase inhibitor, on striatal dopaminergic transmission during blockade of dopamine uptake.

To examine the mechanisms of tolcapone in the central nervous system (CNS), we analyzed alterations in parameters of striatal dopamine transmission induced by this drug (30 mg/kg) co-administered with the selective dopamine uptake inhibitor, GBR 12909 (10 mg/kg). Using microdialysis in freely moving rats, it was determined that combined administration of tolcapone with GBR 12909 resulted in a further increase of dopamine levels over that obtained without the catechol-O-methyltransferase inhibitor, while tolcapone alone failed to change dopamine levels. Fast-scan cyclic voltammetric monitoring of electrically evoked dopamine did not show any changes in dopamine release after the combination of the drugs, but there was a pronounced decrease in the rate of dopamine clearance after GBR 12909 alone and when co-administered with tolcapone. These data indicate that in rat striatum, a tolcapone-induced increase in extracellular dopamine is not observed because of the presence of uptake. These results also support the hypothesis that under normal conditions, uptake, rather than metabolism, control extracellular levels of dopamine.     

Spondylometaphyseal dysplasia, corner fracture type: a heritable condition associated with coxa vara

The authors present the radiographic features of a previously incompletely delineated bone dysplasia, which they call spondylometaphyseal dysplasia, corner fracture type. This is a dominant heritable condition associated with short stature and developmental coxa vara. The progressive hip deformity usually causes significant disability requiring surgical correction. Developmental coxa vara, simulated corner fractures of long tubular bones, and vertebral body abnormalities result in a diagnostic constellation. Knowledge of these distinctive radiologic features allows accurate diagnosis, which in turn should lead to appropriate genetic counseling and possibly to earlier, more efficacious surgical treatment of the coxa vara.     

Role of Ca 125 as tumor marker in ovarian carcinoma

Thirty-three healthy women (group 1), 20 patients with a history of ovarian carcinoma but no manifest disease at the time of the study (group 2), and 45 patients with surgically demonstrable ovarian cancer (group 3) were studied to establish guidelines for the use of the ovarian cancer antigen Ca 125 in monitoring the course of ovarian carcinoma. Ninety-nine percent of all Ca 125 titers of patients in groups 1 and 2 were less than or equal to 25 U/mL. By contrast, 96% of patients with manifest ovarian cancer had Ca 125 levels greater than 25 U/mL. Ca 125 values rising from the normal range to greater than 25 U/mL predicted recurrent disease in all of ten patients, provided benign causes (four cases) for titer elevations such as bowel obstruction could be ruled out. Seven of ten patients with recurrent cancer had elevated antigen levels two to five months before the diagnosis could be made clinically. In patients with Ca 125 values greater than 25 U/mL, titer changes of greater than or equal to 50% compared with reference values predicted tumor response or progression in 41 of 43 patients (95%) with antigen positive tumors. Antigen levels less than or equal to 25 U/mL did not exclude the presence of tumor at second look operation in six of 13 patients (46%). It is concluded that the Ca 125 is useful for the detection of persistent and recurrent disease, and for the evaluation of treatment responses.(ABSTRACT TRUNCATED AT 250 WORDS)