Structural differentiation of self-reported depression and anxiety in late life

Research has shown impressive support for tripartite models of anxiety and depression that include a common factor of negative affect, and the unique factors positive affect and arousal. It is not clear whether this structure extends into later life. The current study used confirmatory factor analysis to model the structural relationship of anxiety and depression in two samples of older adults: a large probability sample (N = 1429) and a smaller convenience sample (N = 210). Across all analyses, a correlated, two-factor, psychometric model was most parsimonious. The tripartite model could be fit to the data, but added no explanatory power; in some cases a one-factor model also fit. The results suggest that there is a unitary factor of "distress" that incorporates anxiety and depression, but that the structure is not consistent with factor structures found in younger samples. Instead, the broad constructs may be represented in a more complex manner among older adults, and are less easily differentiated.     

Treating hypertension in diabetic nephropathy

OBJECTIVE: Control of hypertension in patients with diabetic nephropathy improves mortality and slows progression to end-stage renal disease. However, blood pressure is difficult to treat; multiple drug combination therapy is required and treatment algorithms to establish this are lacking. We used a stepped-care algorithm, centered on maximum doses of an ACE inhibitor or angiotensin II receptor blocker, to treat hypertension according to American Diabetes Association recommended blood pressure target goals (<130/80 mmHg) in patients with diabetic nephropathy. RESEARCH DESIGN AND METHODS: We treated 49 consecutive patients with diabetes (13 with type 1 and 36 with type 2), diabetic nephropathy, and proteinuria > or =500 mg/24 h with a stepped-care blood pressure treatment algorithm. The level of blood pressure control achieved at most recent follow-up was assessed. RESULTS: Patients were followed for a median of 18 months (range 9-48). Mean blood pressure achieved was 140/75 +/- 23/14 mmHg in patients with type 1 diabetes and 146/76 +/- 22/14 mmHg in patients with type 2 diabetes. Target blood pressure was reached in 16 (33%) patients, 6 of 13 patients with type 1 diabetes and 10 of 36 patients with type 2 diabetes, whereas systolic blood pressure remained above the target level in the remaining patients. There was no difference in baseline blood pressure, proteinuria, or serum creatinine level between patients who were treated to target and those who were not. CONCLUSIONS: Levels of blood pressure control similar to those achieved in clinical trials in diabetic nephropathy were obtained with a stepped-care algorithm. However, in most patients, systolic blood pressure was difficult to control to target despite the use of multiple drug combination therapy.     

Models have real value

Those of you who have kept tropical fish will almost certainlyhave had the Zebrafish (Daneo rerio) in your menagerie. Youmay not know that this fish is now perhaps the most importanttool in the investigation of normal development and in the identificationof candidate genes that play a determining role in human malformationsyndromes. A deliberate programme of chemical mutagenesis has identifiedhundreds of mutations that affect vertebrate development affectingthe form of the embryo, the generation of the germ layers, organogenesis,differentiation, the cytoarchetectonics of the brain and     

Misplaced

In a recent trial of gene therapy for an immunodeficiency state(X-linked severe combined immunodeficiency disorder), two ofeleven children developed leukaemia. The haematopoetic stemcells of the patents, from the bone marrow, had been transducedwith a vector based on an onco-retrovirus, the murine leukaemiavirus (MLV). The vector expressed the common gamma chain ofthe interleukin receptor. In the two leukaemic children, theleukaemic clone contained vector DNA that had integrated inthe     

Autoimmune inner ear disease: diagnostic and therapeutic approaches in a multidisciplinary setting

Autoimmune Inner Ear Disease (AIED) is a clinical syndrome of uncertain pathogenesis. It is associated with bilateral rapidly progressive hearing loss. The hearing loss may be associated with vestibular symptoms. Autoimmunity has been proposed as the pathogenesis of this sort of hearing loss, although the mechanism of the disease is poorly understood. It is well accepted that the endolymphatic sac is an immunocompetent organ and circulating autoantibodies against inner ear antigens have been reported, as have viral antigens in the endolymph, although the sensitivity, specificity, and roles of those antibodies in a disease process are poorly defined. We will describe the clinical aspects of the disease, the histopathology, the immunologic indicators, the types of presentation, both from the audiologic and vestibular point of view, clinical trials for treatment and the follow-up. One of our conclusions is that many of these patients respond favorably to the treatment Methotrexate.     

Myocardial expression of baculoviral p35 alleviates doxorubicin-induced cardiomyopathy in rats

The clinical use of doxorubicin, one of the most effective antitumor drugs, is limited by its cardiotoxicity, which results in irreversible cardiomyopathy and congestive heart failure. This study aimed to evaluate a gene therapy approach using adenovirus-mediated expression of p35, a baculoviral antiapoptotic gene, for alleviating doxorubicin-induced cardiomyopathy. In cultured neonatal rat cardiomyocytes, transduction with a recombinant adenoviral vector expressing p35 (Ad2/CMVp35) but not a control adenoviral vector expressing no transgene (Ad2/CMVEV) significantly inhibited doxorubicin-induced increase in cellular reactive oxygen species (ROS), the activity of caspases 8 and 3, cytochrome c release, and apoptosis. Direct injection of Ad2/CMVp35 into the left ventricular wall inhibited myocardial caspase 3 activity and apoptosis and improved left ventricular performance in rats treated with doxorubicin, whereas the same dose of Ad2/CMV beta gal encoding beta-galactosidase had no effect. These results suggest that adenovirus-mediated expression of p35 protects cardiomyocytes against doxorubicin cardiotoxicity, possibly by inhibiting caspase activity and by reducing cellular ROS levels. Localized delivery of gene transfer vectors expressing an antiapoptotic protein such as p35 to the myocardium may represent a therapeutic approach to alleviate doxorubicin-induced cardiomyopathy.     

The treatment of multiple sclerosis in Los Angeles and the United States, 1947-1960

Two sets of multiple sclerosis (MS) patient records located in Los Angeles County from the 1940s and 1950s were analyzed within the historical perspective and biomedical context of the time. It was found that there were divergent treatment patterns, and a continuum of therapeutic activism in the treatment of MS: some physicians attempted to intervene aggressively in an attempt to prevent relapses or lessen the severity of attacks, while others adopted milder interventions, basing their therapeutic decisions on their knowledge of the pathology of MS. As long as a physician had a reasonable theory of the pathogenesis of the disease, it was thought permissible to experiment with therapies, despite equivocal evidence, as long as no harm was done. Indeed, for physicians faced with declining and suffering patients, there was a strong emotional imperative to attempt treatments without waiting for an agreed-upon proof of efficacy. This was sustained, in part, by pressure to treat from many patients who shared their physicians' willingness to experiment with treatments.     

Zoophilia in Men: A Study of Sexual Interest in Animals

This article presents a study of 114 self-defined zoophile men who were researched primarily through the use of an on-line questionnaire. We describe how the participants acquired the identity label of zoophile, what it meant to them, and their relationships among themselves. Also examined are how they eroticized animals and how human and feral characteristics combined to form this object choice. Finally, participants' sexual profiles with animals and humans, and how the balance of animal and human desires creates different forms of zoophilia, are described.     

Potential association of pseudoexfoliation syndrome (PEX) with age-related macular degeneration (ARMD)

PURPOSE: Authors report an unexpected association between PEX and ARMD. It was an additional result of a study, that analysed possible systemic symptoms of pseudoexfoliation material in visceral organs. They reviewed literature data for both, concerning epidemiology and physiopathogeny. MATERIAL AND METHODS: We conducted an age-and sex matched study of 142 patients in Brittany, 71 PEX and 71 controls, 31 men and 40 women in the 2 groups. The statistical study was performed with Epi Info 6.0 software using the X2 of Mantel-Haenszel Test. RESULTS: Statistical positive relation was found between PEX and ARMD (p=0.02), both increasing with age. DISCUSSION AND CONCLUSION: Part of epidemiology seems to be similar in PEX and ARMD, especially environment role (particularly solar radiations), individual factors, and genetic predisposition. For the first time, in may 1999, a genetic localization of PEX was discovered on the chromosome II, and nearly of one loci of ARMD multiple localizations.