Raloxifene and estrogen effects on quality of life in healthy postmenopausal women: a placebo-controlled randomized trial

OBJECTIVE: To assess the effects of raloxifene, estrogen, and placebo on quality of life in healthy, asymptomatic, postmenopausal women. METHODS: In a multicenter, double-blind, 12-month study, 398 women were assigned randomly to one of four groups: raloxifene HCl, 60 (n = 97) or 150 mg/day (n = 100); conjugated equine estrogens, 0. 625 mg/day (n = 96); or placebo (n = 105). The Women's Health Questionnaire, a validated quality-of-life instrument for perimenopausal and postmenopausal women, was administered at baseline and 3-month intervals. RESULTS: Overall, quality of life from baseline to end point was preserved equally in all treatment groups. Six domains (depressed mood, somatic symptoms, memory/concentration, sexual behavior, sleep problems, and perceived attractiveness) were unchanged in all groups. Three domains (menstrual symptoms, vasomotor symptoms, and anxiety/fears) were statistically significantly different among groups. Mean scores for menstrual symptoms significantly worsened and vasomotor symptoms significantly improved from baseline to end point in the estrogen group. Mean scores for vasomotor symptoms did not worsen at any point in the raloxifene 60 mg/day group. Mean anxiety/fears scores improved significantly during raloxifene 60 mg/day administration throughout treatment (P <.05), irrespective of previous hormone replacement therapy, baseline estradiol (E2) levels, or years postmenopause. CONCLUSION: Most quality-of-life domains were not affected by treatment with estrogen or raloxifene. Estrogen provided relief from vasomotor symptoms but caused menstrual symptoms. Raloxifene 60 mg/day improved anxiety levels in postmenopausal women.     

Laparoscopy: is it replacing clinical acumen?

One thousand sixty-one laparoscopic procedures (80% for diagnostic indications and 20% for therapeutic indications) performed during a 51-month period were reviewed to assess the effectiveness of laparoscopy in improving clinical diagnosis and avoiding major surgery. The error in preoperative clinical assessment as compared to postlaparoscopic diagnosis was approximately 50%: disease was suspected more often than found. Pelvic inflammatory disease, endometriosis, and ovarian cyst were the entities most often confused. Tubal coagulation was the most common procedure performed for therapeutic reasons. The complication rate for all laparoscopies and associated procedures was 2.6%.     

Dural infolding during C1-2 myelography

Inward buckling of the dura at C1-2 may occasionally occur with hyperextension of the neck and can result in a difficult or unsuccessful puncture when the posterior lateral C1-2 approach is used for cervical myelography. In this circumstance, placement of the head in a neutral or slightly flexed position may widen the posterior subarachnoid space and facilitate the needle puncture.     

Total insulinlike growth factor 1 and insulinlike growth factor binding protein levels, functional status, and mortality in older adults

OBJECTIVES: To assess the association between total insulinlike growth factor (IGF)‐1, IGF binding protein‐1 (IGFBP‐1), and IGFBP‐3 levels and functioning and mortality in older adults. DESIGN: Cohort study. SETTING/PARTICIPANTS: One thousand one hundred twenty‐two individuals aged 65 and older without prior cardiovascular disease events participating in the Cardiovascular Health Study. MEASUREMENTS: Baseline fasting plasma levels of IGF‐1, IGFBP‐1, and IGFBP‐3 (defined as tertiles, T1‐T3) were examined in relationship to handgrip strength, time to walk 15 feet, development of new difficulties with activities of daily living (ADLs), and mortality. RESULTS: Higher IGFBP‐1 predicted worse handgrip strength (P‐trend_T1‐T3<.01) and slower walking speed (P‐trend_T1‐T3=.03), lower IGF‐1 had a borderline significant association with worse handgrip strength (P‐trend_T1‐T3=.06), and better grip strength was observed in the middle IGFBP‐3 tertile than in the low or high tertiles (P=.03). Adjusted for age, sex, and race, high IGFBP‐1 predicted greater mortality (P‐trend_T1‐T3<.001, hazard ratio (HR)_T3vsT1=1.48, 95% confidence interval (CI)=1.15–1.90); this association was borderline significant after additional confounder adjustment (P‐trend_T1‐T3=.05, HR_T3vsT1=1.35, 95% CI=0.98–1.87). High IGFBP‐1 was associated with greater risk of incident ADL difficulties after adjustment for age, sex, race, and other confounders (P‐trend_T1‐T3=.04, HR_T3vsT1=1.40, CI=1.01–1.94). Neither IGF‐1 nor IGFBP‐3 level predicted mortality or incident ADL difficulties. CONCLUSION: In adults aged 65 and older, high IGFBP‐1 levels were associated with greater risk of mortality and poorer functional ability, whereas IGF‐1 and IGFBP‐3 had little association with these outcomes.     

Negative charge distribution and density on the surface of oxygenated normal and sickle red cells

Negative charges on the external surface of red cells were visualized by colloidal iron hydroxide labelling of 50% of the membrane area after osmotic hemolysis and glutaraldehyde fixation. Counts were made over randomly selected areas on electron micrographs at 350,000 x magnification. Statistical analyses showed that at the 95% level of confidence there was no significant difference between oxygenated normal (AA) and sickle (SS) cells in either the distribution or the density of negative charges.     

Evaluation of methoprene (Altosid XR) sustained-release briquets for control of culex mosquitoes in urban catch basins.

A sustained-release, briquet formulation of methoprene (Altosid XR), applied at a rate of one briquet per catch basin in Saginaw, Michigan, provided ca. 70% reduction in emergence of Culex pipiens and Cx. restuans adults, compared with nontreated catch basins, during a period of 15 wk in the summer of 1990. In a parallel study using one briquet per 10.5 liter bucket, there was 99% reduction in adult emergence of these species for a period of 12 weeks. The difference between catch basins and buckets may be attributable to water movement through the catch basins with each rainfall, causing a dilution of methoprene through time. However, both studies indicated that the briquets released methoprene for 12-15 wk, suggesting that this formulation may offer season-long control of Culex mosquitoes from urban catch basins in Michigan, with a single treatment of insecticide.     

The Prevalence of Cryptosporidium spp. in Children,Taiz District,Yemen

Background

This is the first work done on cryptosporidiosis among the children in Taiz, Yemen.

Methods

A number of 712 samples were collected from children of different ages (ranging from 1 month to 12 years) from Dec 2006 to Aug 2007. The collected samples were examined by Sheather''s sugar floatation and Modified Ziehl- Neelsen stain as well as ELISA methods. The test results were statistically analyzed by SPSS software.

Results

The overall positive percentage was 43.7%. The higher incidence (36.2%) was occurred in males while the lowest incidence (32.7%) was observed in females (r=0.876; P=0.001). The correlation between infected cases and the type of drinking water was r =0.121. Among the cases examined by ELISA (92 cases), 26.1% were infected. The correlation between seropositivity and gender was r=0.652 (P=0.031).

Conclusion

Cryptosporidium spp. is a significant pathogen among children at Taiz. Fresh water supplies, education, eating habits and domestic animals are considered the main sources for transmission of cryptosporidiosis.     

Treatment Foster Care Pre-service Trainings: Changes in Parenting Attitudes and Fostering Readiness

Background

Pre-service training of treatment parents is a requirement for all foster care models to ensure safety and well-being of children in care. Researchers theorize treatment parents benefit more from enhanced pre-service trainings; however, no rigorous studies exist indicating the effectiveness of these trainings for treatment parents.

Objective

This quasi-experimental study aimed to determine if an enhanced pre-service training developed for treatment parents (n = 71) is more effective than a basic pre-service training (n = 81) in increasing their parenting attitudes, personal dedication and willingness to provide foster care, and licensing rates.

Methods

Secondary data analyses were performed on an archival dataset that included demographic information and training participant scores from three standardized measurements before and after pre-service trainings: Adult-Adolescent Parenting Inventory (AAPI-2), Personal Dedication to Fostering Scale, and Willingness to Foster Scale. Licensing status as a treatment parent at the end of the pre-service training was also available in the dataset.

Results

Pre/post analyses revealed enhanced pre-service training participants experienced significantly more change in two parenting constructs, and basic pre-service training participants experienced significantly more change in one parenting construct. There were no significant differences between groups in changes in personal dedication or willingness to provide foster care. Enhanced pre-service training participants were significantly more likely to become licensed as treatment parents than basic pre-service training participants.

Conclusions

The findings suggest an enhanced pre-service training may have potential impact on changing some parenting attitudes and an increased licensing status as a treatment parent.

     

维生素D_3对报告载体荧光素酶表达的作用

目的：　研究１,２５－二羟维生素Ｄ３ 对结肠癌细胞系Ｃａｃｏ－２ 细胞中报告基因表达的作用,并探讨在报告载体ｐＧＬ２ 序列中存在潜在的抑制性维生素Ｄ应答元件（ＶＤＲＥ）的可能性。方法：　采用磷酸钙沉淀法将报告载体转染入Ｃａｃｏ－２ 细胞。Ｃａｃｏ－２细胞经不同浓度１,２５－二羟维生素Ｄ３ 处理后测定细胞裂解液中表达的荧光素酶活性。结果：　应用ｐＧＬ２ 报告载体时,当用ｐＳＧ５－ＶＤＲ表达载体共转染后,１,２５－二羟维生素Ｄ３显著地抑制Ｃａｃｏ－２ 细胞荧光素酶的表达（Ｐ＜ ０．０５）;而未使用该表达载体共转染则无抑制作用（Ｐ＞ ０．０５）。应用ｐＧＬ３ 报告载体时,不同浓度的１,２５－二羟维生素Ｄ３ 对ｐＬＧ３转染后Ｃａｃｏ－２ 细胞表达的荧光素酶活性均无显著抑制作用（Ｐ＞ ０．０５）,该作用不依赖是否存在有ｐＳＧ５－ＶＤＲ表达载体共转染。结论：１,２５－二羟维生素Ｄ３ 对报告载体ＰＧＬ２ 荧光素酶表达具有抑制作用,而对ｐＧＬ３ 则否;类似人类ＰＴＨ基因中的潜在抑制性ＶＤＲＥ存在于报告载体ｐＧＬ２,在ｐＧＬ３ 中该ＶＤＲＥ业已改变。