Watch, Discover, Think, and Act: a model for patient education program development

In this report we describe the development of the Watch, Discover, Think and Act asthma self-management computer program for inner-city children with asthma. The intervention focused on teaching two categories of behaviors--asthma specific behaviors such as taking preventive medication and self-regulatory processes such as monitoring symptoms and solving asthma problems. These asthma self-management behaviors were then linked with empirical and theoretical determinants such as skills and self-efficacy. We then further used behavioral science theory to develop methods such as role modeling and skill training linked to the determinants. We matched these theoretical methods to practical strategies within the computer simulation and created a culturally competent program for inner-city minority youth. Finally, we planned a program evaluation that linked program impact and outcomes to the theoretical assumptions on which the intervention was based.     

Food availability affects behavior but not circulating gonadal hormones in maternal Belding's ground squirrels

We tested predictions of hypotheses suggesting that the steroid hormones, testosterone (T), progesterone (P), and estradiol (E2), contribute to the energetic regulation of behaviors associated with rearing young in free-living female Belding's ground squirrels (Spermophilus beldingi). We provisioned some female S. beldingi with food rich in fat and calories, and used unprovisioned females as controls. We observed the behavior of females throughout the reproductive cycle, and regularly collected blood samples to measure plasma hormone concentrations. Circulating concentrations of T, P, and E2 were similar in provisioned and unprovisioned females, as were temporal patterns of variation in these hormones. Peaks in rates of nest maintenance and aggressive behavior occurred during gestation and were associated with elevated concentrations of circulating T, P, and E2, raising the possibility that one or more of these hormones mediates behaviors that help females establish maternal nest sites and territories after mating. Temporal patterns of variation in behavior were similar among provisioned and unprovisioned females; however, rates of resting, vigilance, and aggression were higher among provisioned females, whereas unprovisioned females devoted significantly more time to feeding and locomotion. Thus, our data suggest that in maternal S. beldingi, gonadal steroids play a role in mediating behavior associated with raising offspring, but do not facilitate changes in rates of behavior associated with increased energy availability.     

Scintigraphy with In-111-labeled monoclonal antitumor antibodies: kinetics, biodistribution, and tumor detection

The purpose of this study was to evaluate and compare the kinetics, biodistribution, and tumor-depicting properties of three intact indium-111-labeled murine monoclonal antibodies (MoAb) and to determine if use of In-111-labeled F(ab')2 fragments of one of them had advantages over its intact counterpart for immunoscintigraphy. Ten patients with prostate cancer were studied with an anti-prostatic acid phosphatase MoAb (PAY-276), with a resultant tumor detection rate of 15%. Twenty-eight patients with melanoma were studied with ZME-018, a MoAb that targets the KD-240 melanoma antigen. Forty-three percent of the known lesions were detected. Forty patients with carcinoembryonic antigen (CEA)-producing tumors were studied, 24 with intact ZCE-025, and anti-CEA MoAb, and 16 with its F(ab')2 fragment. With use of intact ZCE-025, 34% of known lesions were detected versus 83% with its F(ab')2 fragment. The distribution of each MoAb appears unique unto itself with regard to kinetics, normal tissue distribution, and response to MoAb mass.     

Origins of cerebral palsy

Analyses were undertaken to determine the causes of cerebral palsy in a prospective study of 43,437 full-term children. Presumed causes were found for about 71% of the 34 quadriplegic and 40% of the 116 nonquadriplegic patients with cerebral palsy. Risk estimates based on predictive models, adjusted for multiple factors, suggest that 53% of the quadriplegic patients with cerebral palsy could be attributed to congenital disorders, 14% to birth asphyxia, and 8% to other identified disorders. Thirty-five percent of the nonquadriplegic patients with cerebral palsy could be attributed to congenital disorders and 6% to other disorders. In the victims of cerebral palsy, characteristic consequences of birth asphyxia were more often the result of nonasphyxial disorders. These included meconium in the amniotic fluid, low 10-minute Apgar scores, neonatal apnea spells, seizures, persisting neurologic abnormalities, and slow head growth after birth.     

Hepatic pseudocyst as the first presentation of squamous cell carcinoma of uterine cervix

We describe a patient with diffuse polycystic disease of the liver. The patient's polycystic liver disease was found to be due to liver metastases from squamous cell carcinoma of the uterine cervix. No evidence of discrete masses was found in the liver using abdominal CT scan. Pseudocystic formation in the liver secondary to squamous cell carcinoma is very rare and has not previously been reported as a first presentation of a cervical cancer. Metastatic neoplasms need to be considered in the differential diagnosis of hepatic cysts.     

Modified enzyme immunoassay for detecting Neisseria gonorrhoeae antigens

A commercial modification of an enzyme immunoassay (EIA) (Gonozyme; Abbott Laboratories, North Chicago, Ill.) for detection of Neisseria gonorrhoeae antigens was compared with conventional culturing. Specimens from males and females were collected at a sexually transmitted disease clinic; additional female specimens were collected at an obstetrics and gynecology clinic. EIA sensitivity and specificity for males were 100 and 98.6%, respectively (68 negative, 34 positive, 1 false-positive, and 0 false-negative). EIA sensitivity and specificity for female sexually transmitted disease clinic patients were 74.4 and 95.7%, respectively (66 negative, 29 positive, 3 false-positive, and 10 false-negative) EIA sensitivity and specificity for obstetrics and gynecology clinic patients were 100 and 99.2%, respectively (6 positive, 119 negative, 1 false-positive, and 0 false-negative). In female patients from whom multiple swab specimens were collected, the sequence of specimen collection and subsequent EIA analysis affected sensitivity.