Discrimination Trends and Mental Health Among Native- and Foreign-Born Latinos: Results from National Surveys in 2004 and 2013

Prevention Science - We examined national trends and mental health correlates of discrimination among Latinos in the USA. We used data from two nationally representative surveys based on the...     

Early nephrectomy in neonates with symptomatic autosomal recessive polycystic kidney disease

IntroductionAutosomal recessive polycystic kidney disease (ARPKD) is a rare cause of renal failure with a highly variable clinical course. Patients who are symptomatic early in life frequently require early nephrectomy and peritoneal dialysis. In these patients there are little data to guide clinicians on whether to select unilateral nephrectomy or bilateral nephrectomy at the initial operative intervention. We review our experience with this disease process.MethodsA retrospective review was performed of 11 patients at our institution with ARPKD symptomatic within the first month of life. Charts were reviewed for relevant clinical data, and patients were divided into groups based on undergoing either unilateral or bilateral nephrectomy at their initial intervention. The decision for unilateral versus bilateral nephrectomy was decided by the clinical team without any available guidelines.ResultsOf the 11 patients reviewed, two patients died within the first two weeks from other complications. The remaining 9 all required nephrectomy, with 5 undergoing synchronous bilateral nephrectomy, and 4 undergoing initial unilateral nephrectomy. All four patients required removal of their contralateral kidney, a median of 25.5 days later. There was no difference in mortality, ventilator free days, or time to full feeds between the two groups, although the group undergoing initial unilateral nephrectomy had more TPN days than their counterparts (28 vs 17 days, p = 0.014).ConclusionsIn our cohort, there were few significant differences between the groups based on choice of initial unilateral or bilateral nephrectomy, and all children ultimately required removal of both kidneys. These data suggest that anesthetic exposures and other clinical outcomes might be optimized by initial bilateral nephrectomy.Level of evidenceIII.     

Cellular Delivery of Nucleoside Diphosphates: A Prodrug Approach

Purpose. This study is concerned with cellular delivery/generation of 2′-azido-2′-deoxyuridine and -deoxycytidine diphosphate (N₃UDP or N₃CDP), potent inhibitors of ribonucleotide reductase. It characterizes the phosphorylation steps involved in the conversion of 2′-azido-2′-deoxyuridine (N₃Urd) and 2′-azido-2′-deoxycytidine (N₃Cyd) to the corresponding diphosphates and explores a prodrug approach in cellular delivery of the inhibitor which circumvents the requirement of deoxynucleoside kinases. Methods. Cell growth of CHO and 3T6 cells of known deoxycytidine kinase level was determined in the presence of N₃Urd and N₃Cyd. Activity of ribonucleotide reductase was determined in the presence of the azidonucleosides as well as their mono- or di-phosphates in a Tween 80-containing permeabilizing buffer. A prodrug of 5′-monophosphate of N₃Urd was prepared and its biological activity was evaluated with CHO cells as well as with cells transfected with deoxycytidine kinase. Results. N₃Urd failed to inhibit the growth of both cell lines, while N₃Cyd was active against 3T6 cells and moderately active against CHO cells. These results correlate with the deoxycytidine kinase levels found in the cells. Importance of the kinase was further established with the finding that the nucleoside analogs were inactive as reductase inhibitors in a permeabilized cell assay system while their mono- and di-phosphates were equally active. The prodrug was active in cell growth inhibition regardless of the deoxycytidine kinase level. Conclusions. The azidonucleosides become potent inhibitors of the reductase by two sequential phosphorylation steps. The present study indicates that the first step to monophosphate is rate-limiting, justifying a prodrug approach with the monophosphate.     

Effect of ionizing radiation on wild-type and mutant mouse leukemia L1210 cells

Wild-type (WT) mouse leukemia L1210 cells express steady-state levels of p53 mRNA and protein. However, the p53 expressed by the wild-type L1210 cells was found to be a mutant form of p53 (relative to normal mouse fibroblast p53 sequence) having a point mutation in the DNA binding domain of p53. A deoxyadenosine-resistant L1210 cell line (Y8) derived from the parental WT cells had previously been shown to lack the expression of p53 but to respond to cycloheximide (CHX) treatment by superinduction of p53 mRNA. The mRNA for p53 induced by CHX had the same sequence as the p53 from normal mouse fibroblasts. Although the Y8 cells had no constitutive levels of p53 mRNA or protein, the Y8 cells expressed constitutive levels of WAF1 mRNA and protein. Gadd45 mRNA was also present in the Y8 cells. Subjecting the WT or Y8 cells to ionizing radiation did not result in a G0/G1 cell cycle block; the cells blocked in G2/M. The Y8 cells were much more sensitive to the irradiation treatment than the WT cells, resulting in marked increases in apoptosis in the Y8 cells. Although radiation treatment induced p53 mRNA, but no p53 protein, in the Y8 cells, WAF1 mRNA was induced in the Y8 cells. These data indicate that there are p53-independent pathway(s) that may still involve WAF1 and Gadd45 with respect to cell cycle control and apoptosis.     

Contemporary Health-Related Decision Aids: Tools for Social Work Practice

The escalating complexity in health-related decisions that people face have important implications for social work interventions. This article explores the nature of these implications within the context of decisional conflict, shared decision making, and the use of decision aids. In addition, the authors present the findings of a content analysis of 29 contemporary health-related decision aids. Emergent categories from this analysis are presented as a resource for social workers as they encounter, adapt, and create decision aids in their work to help address the health-related needs of their clients.     

Legal factors associated with change in alcohol use and partner violence among offenders

Intimate partner violence (IPV) is a pervasive social concern that may be exacerbated by high rates of alcohol dependence among perpetrators. Society has attempted to combat IPV through various legal interventions, but the effects of specific legal factors on behavioral change and treatment compliance remain largely unexamined. The primary focus of the current study was to comprehensively evaluate the impact of various legal factors (i.e., judicial mandate, judicial monitoring, stage of change, and stake in conformity) on mandatory treatment compliance and behavioral change over a 12 week post-adjudication period among a high-risk sample of alcohol dependent IPV offenders (N = 60). Growth curve analyses revealed effects of judicial monitoring and stage of change such that participants reporting low perceived judicial monitoring and early stages of change reported higher initial levels and a more rapid reduction in IPV than those reporting high perceived judicial monitoring and late stages of change, who reported consistently low IPV. Although we found that legal factors were poor predictors of treatment compliance and alcohol use during treatment, the association between alcohol and IPV was moderated by the legal factors. Stake in conformity was negatively associated with IPV among low alcohol users and positively associated among high alcohol users whereas stage of change was negatively associated with IPV among high alcohol users. The current results suggest that pretreatment legal factors may represent an important consideration in reducing IPV among alcohol dependent offenders. Further research is required to determine the efficacy of legal factors in isolation of treatment as well as methods of manipulating these factors to optimally compliment a prescribed course of treatment.