Women in addictions treatment: comparing VA and community samples

Despite increasing awareness of gender issues in substance use treatment, women with substance use disorders (SUD) and gender-specific treatment remain understudied. This study examines differences, including identification of comorbid issues and patients' perceived treatment needs, between women in different SUD treatment settings: an intensive VA outpatient program (VA; N = 76) and a private residential/outpatient program (Residence XII; N = 308). In both settings the Addiction Severity Index (ASI) was administered at intake; ASI data were collected from retrospective chart review. Results support previous findings that women entering SUD treatment endorse high rates of psychiatric and medical comorbidity, and past abuse. Women in VA SUD treatment experienced more impairment on indices of medical, psychiatric, and employment issues whereas the private agency sample had higher alcohol and family/social composite scores. The differences between and similarities among the two treatment groups have implications for design of women-specific SUD treatment programs.     

The norepinephrine transporter gene and attention-deficit hyperactivity disorder

The adrenergic system plays a known role in attentional systems and a suspected causal role in attention-deficit hyperactivity disorder (ADHD), based on evidence from pharmacological interventions and animal models. The efficacy of the highly selective noradrenergic reuptake inhibitor, tomoxetine, in treating ADHD symptoms supports the system's role in ADHD and points to the norephinephrine transporter as a candidate gene. This study tested the gene for the norepinephrine transporter (NET1) as a susceptibility factor in ADHD using three polymorphisms located in exon 9, intron 9, and intron 13. We examined the inheritance of these polymorphisms in a sample of 122 families with a total of 155 children with ADHD identified through an ADHD proband. Use of the transmission disequilibrium test failed to show significant evidence for biased transmission of any of the alleles or the haplotypes of these polymorphisms. We further investigated this gene by screening the probands for five known amino acid variants to determine if they contributed to the ADHD phenotype but observed only one (Thr99Ile) in our sample. Since the frequency of this variant (1.8%) was similar to that previously reported in a control sample (2.2%), it is unlikely that this variant is related to the ADHD phenotype. Our results do not support the NET1 gene as a major genetic susceptibility factor in ADHD.     

Milk of calcium in the breast: appearance on prone stereotactic imaging

Abstract: Microcalcifications discovered by mammography require careful analysis, occasionally leading to core biopsy to exclude associated breast cancer. We report unrecognized milk of calcium layering on small field of view prone digital stereotactic images. We illustrate important features on prone digital images attributed to milk of calcium which can exclude breast neoplasm, suggest this diagnosis, and prevent unnecessary biopsy.     

Children and youth with special healthcare needs: there is no place like (a medical) home

PURPOSE OF REVIEW: This review highlights the importance, components, and outcomes of the medical home for children and youth with special healthcare needs. Relevant work supporting the medical home concept for this vulnerable group is highlighted for healthcare providers. RECENT FINDINGS: Developing a medical home model is garnering support from many national organizations and agencies. Having a medical home for children and youth with special healthcare needs is associated with favorable impacts on healthcare utilization and family-centered care. Achieving family-centered care is associated with increases in satisfaction and linkages to specialists, decreases in school absences and unmet medical needs. Consistent insurance coverage is important for children and youth with special healthcare needs to thrive. Further, lack of access to informational resources minimizes families' knowledge of available public programs. SUMMARY: Children and youth with special healthcare needs constitute a vulnerable population in need of comprehensive and accessible care. Provision of care via a medical home can be efficient and effective in this population of children and their families. Due to the relatively high cost of providing fragmented care to these children and youth, advances in coordinating access to services will have a cost-effective outcome.     

Noninvasive imaging of melanoma with reflectance mode confocal scanning laser microscopy in a murine model

A reflectance-mode confocal scanning laser microscope (rCSLM) was developed for imaging early-stage melanoma in a living mouse model without the addition of exogenous contrast agents. Lesions were first located by surveying the dorsum with a polarized light camera, then imaged with the rCSLM. The images demonstrated two characteristics of melanoma in this animal model: (1) melanocytes and apparent tumor nests in the epidermis at the stratum spinosum in a state of pagetoid spread and (2) architectural disruption of the dermal-epidermal junction. The epidermal melanocytes and apparent tumor nests had a high melanin content, which caused their reflectance to be fivefold greater than the surrounding epidermis. The rCSLM images illustrate the difference between normal skin and sites with apparent melanoma. This imaging modality shows promise to track the progression of melanoma lesions in animal models.     

Social-cognition and the broad autism phenotype: identifying genetically meaningful phenotypes

BACKGROUND: Strong evidence from twin and family studies suggests that the genetic liability to autism may be expressed through personality and language characteristics qualitatively similar, but more subtly expressed than those defining the full syndrome. This study examined behavioral features of this 'broad autism phenotype' (BAP) in relation to performance on a measure of social-cognition in an attempt to tease out this complex clinical picture and identify markers of underlying neuropsychological systems of genetic significance to autism. We hypothesized that mild social-cognitive impairment would be associated with clinically defined social characteristics of the BAP (aloof personality style, lower quality social relationships, and impaired pragmatic language use). METHOD: Forty-eight parents of individuals with autism (13 of whom were identified as 'aloof'), and 22 control parents, were administered the 'Eyes Test', a social-cognitive measure that taps the ability to read complex psychological states from viewing only the eye region of faces. RESULTS: Whereas social-cognitive ability was unimpaired among parents of autistic children in general, the subgroup of parents defined as 'aloof' displayed significant social-cognitive deficits on the 'Eyes Test'. Impaired social-cognitive ability was associated with low quality of friendships and problems with pragmatic language use, associations which mirror those documented in autism. CONCLUSIONS: Findings suggest that social-cognitive impairments co-segregate with conceptually related personality, social, and language features that constitute the BAP, and point towards performance on the Eyes Test as a genetically meaningful endophenotype.