Improving treatment services for substance abusers with comorbid depression

Early identification of patients with comorbid depression and their subsequent enrollment in an enhanced psychiatric case management (PCM) intervention were examined as an effective way to engage depressed substance abuse patients into psychiatric treatment. Depression was screened using the Global Appraisal of Individual Needs (GAIN) and a DSM-IV checklist. Patients positive on both evaluations were assigned to PCM (n = 10) or to no case management, or treatment as usual (TAU) (n = 10). An examination of outcomes at six weeks indicated that PCM services are feasible and appear to be effective in encouraging use of psychiatric referral by depressed substance abusers.     

Life activity choices by people with aphasia: repeated interviews and proxy agreement

Background: Person-centered rehabilitation requires that meaningful life activities are identified on a case-by-case basis, but the discovery process can be inaccessible for clients with aphasia. Card-sorting methodology addresses core barriers and help clients communicate their preferences.

Aims: To characterize life activities that people with aphasia want to do, to estimate consistency in selections over time, and to replicate previous findings about the ability of family members and friends to identify their loved ones’ activity preferences.

Methods & Procedures: We administered the Life Interests and Values (LIV) Cards to 26 people with aphasia, asking them which of 95 depicted life activities they wanted to do more in their lives. Half the activity cards were presented again one to ten weeks later. Twenty family members or friends responded as proxies by selecting from a questionnaire with the same items.

Outcomes & Results: Participants with aphasia selected diverse activities, though as a group they identified significantly more activities from the “social” activity category than from the “home and community”, “creative and relaxing”, or “physical” categories. Across the repeated interviews, they selected identical activities on average 78% of the time. Item-to-item agreement between people with aphasia and their proxy responders was significantly lower at 69%.

Conclusions: People with aphasia have diverse activity interests and are reliable informants about their preferences. Because significant others have limited ability to predict these choices, their impressions are inadequate substitutes for direct interviews.     

Discovery of Potent Inhibitors of Streptococcus mutans Biofilm with Antivirulence Activity

Dental caries is a bacterial infectious disease characterized by demineralization of the tooth enamel. Treatment of this disease with conventional antibiotics is largely ineffective as the cariogenic bacteria form tenacious biofilms that are resistant to such treatments. The main etiological agent for dental caries is the bacterium Streptococcus mutans. S. mutans readily forms biofilms on the tooth surface and rapidly produces lactic acid from dietary sucrose. Glucosyl transferases (Gtfs) secreted by S. mutans are mainly responsible for the production of exopolysaccharides that are crucial for the biofilm architecture. Thus, inhibiting S. mutans’ Gtfs is an effective approach to develop selective biofilm inhibitors that do not affect the growth of oral commensals. Herein, we report a library of 90 analogs of the previously identified lead compound, G43, and exploration of its structure activity relationships (SAR). All compounds were evaluated for the inhibition of S. mutans biofilms and bacterial growth. Selected compounds from this library were further evaluated for enzyme inhibition against Gtfs using a zymogram assay and for growth inhibition against oral commensal bacterial species such as Streptococcus gordonii and Streptococcus sanguinis. This study has led to the discovery of several new biofilm inhibitors with enhanced potency and selectivity. One of the leads, III_F1, showed marked reduction in buccal, sulcal, and proximal caries scores in a rat model of dental caries.     

The linkage map of the rat

Our genetic knowledge of a species is reflected in the state of its gene map. Although still primitive, relative to the gene map of the mouse, great strides have been made in recent years in developing the gene map of the rat and nine linkage groups have now been defined. Mapping by conventional backcrossing methods has been supplemented with parasexual methods using somatic cell hybrids. Use of recombinant-inbred strains has contributed significantly to the development of the mouse map and the technique holds promise for the future expansion of the rat map. Of great interest are comparative gene mapping and the relationship of linkage groups of the rat to those of other species. At present the linkage groups of the rat and the mouse reflect a high degree of conservation. This is surprising since chromosome banding patterns of the two species show but 40% homology.     

Chromosomal localization of the lysozyme gene cluster in river buffalo (Bubalus bubalis L.)

Lysozyme (LYZ) is an antibacterial enzyme which allows the digestion of bacteria present in tears and saliva. In the true stomach of ruminants LYZ breaks open the bacteria of the foregut, which are subsequently digested by typical mammalian digestive enzymes, allowing the incorporation of nutrients from the bacteria. Southern analysis with a single exon from a cow lysozyme gene revealed that there are about 10 genes in ruminants (Irwin & Wilson 1989), while pig and primates have a single lysozyme gene (Swansonet al. 1991) and camels have two (Irwinet al. 1992). The higher number ofLYZ genes in ruminants is believed to be the result of gene duplication associated with the evolution of foregut fermentation (Irwinet al. 1992). Recently, the genomic organization of the lysozyme gene family has been determined in domestic cattle, and, using a cocktail of genomic clones, the lysozyme gene cluster (LYZ@) was assigned to chromosome (Chr) 5, band 23 by fluorescencein situ hybridization (FISH) (Gallagheret al. 1993). In our continued effort to test the genetic homology of conserved chromosome banding regions between cattle and river buffalo, and to extend the river buffalo physical gene map, we have mapped theLYZ@ by FISH and R-banding.     

Physical activity and sedentary behavior in relation to lung cancer incidence and mortality in older women: The Women's Health Initiative

Physical activity has been associated with lower lung cancer incidence and mortality in several populations. We investigated these relationships in the Women's Health Initiative Observational Study (WHI‐OS) and Clinical Trial (WHI‐CT) prospective cohort of postmenopausal women. The WHI study enrolled 161,808 women aged 50–79 years between 1993 and 1998 at 40 U.S. clinical centers; 129,401 were eligible for these analyses. Cox proportional hazards models were used to assess the association of baseline physical activity levels [metabolic equivalent (MET)‐min/week: none <100 (reference), low 100 to <500, medium 500 to <1,200, high 1,200+] and sedentary behavior with total lung cancer incidence and mortality. Over 11.8 mean follow‐up years, 2,148 incident lung cancer cases and 1,365 lung cancer deaths were identified. Compared with no activity, higher physical activity levels at study entry were associated with lower lung cancer incidence [p = 0.009; hazard ratios (95% confidence intervals) for each physical activity category: low, HR: 0.86 (0.76–0.96); medium, HR: 0.82 (0.73–0.93); and high, HR: 0.90 (0.79–1.03)], and mortality [p < 0.0001; low, HR: 0.80 (0.69–0.92); medium, HR: 0.68 (0.59–0.80); and high, HR: 0.78 (0.66–0.93)]. Body mass index (BMI) modified the association with lung cancer incidence (p = 0.01), with a stronger association in women with BMI < 30 kg/m². Significant associations with sedentary behavior were not observed. In analyses by lung cancer subtype, higher total physical activity levels were associated with lower lung cancer mortality for both overall NSCLC and adenocarcinoma. In conclusion, physical activity may be protective for lung cancer incidence and mortality in postmenopausal women, particularly in non‐obese women.     

Smoking history is related to free-living daily physical activity in claudicants.

PURPOSE: To determine whether smoking history was related to free-living daily physical activity in peripheral arterial occlusive disease (PAOD) patients with intermittent claudication, and whether the effect of smoking history on physical activity level persisted after controlling for group differences in ambulatory function, peripheral circulation, and body composition. METHODS: Patients were separated into three groups: those who never smoked (N = 35), those who had a lower pack-year history of smoking (< or =40 pack-yr; N = 33), and those who had a higher pack-year history (>40 pack-yr; N = 30). Free-living daily physical activity was assessed by activity monitors (an accelerometer and a pedometer) worn on each hip over 2 consecutive weekdays. Patients also were characterized on ambulatory function, peripheral circulation, and body composition because of their relationship with physical activity. RESULTS: A progressive decline (P < 0.001) in free-living daily physical activity with increasing smoking exposure was obtained from the accelerometer in the nonsmokers (482 +/- 36 kcal x d(-1); mean +/- SE), smokers with a lower pack-year history (361 +/- 37 kcal x d(-1)), and smokers with a higher pack-year history (227 +/- 23 kcal x d(-1)). A similar decline was found with the pedometer data (P < 0.001). After controlling for group differences in 6-min walk distance and in calf transcutaneous heating power, group differences in free-living daily physical activity were no longer significant. CONCLUSION: Progressive decrements in free-living daily physical activity with greater levels of smoking exposure in PAOD patients are primarily due to smoking-related impairments in ambulatory function and peripheral circulation.     

食管癌的诊断和治疗

1诊断 1.1普查由于食管早期癌的疗效明显好于进展期癌,加之,内镜下食管粘膜切除术用于无淋巴结转移的表浅食管癌的根治已取得良好疗效,并已逐渐被医患双方所接受,因而普查仍是目前改善食管癌(EC)疗效的肯定手段.我国北方尤其是太行山地区及伊朗里海沿岸居民、有头颈癌肿史者是EC的高发人群.     

Digital pattern recognition-based image analysis quantifies immune infiltrates in distinct tissue regions of colorectal cancer and identifies a metastatic phenotype

Background:

Several studies in colorectal cancer (CRC) indicate a relationship between tumour immune infiltrates and clinical outcome. We tested the utility of a digital pattern recognition-based image analysis (DPRIA) system to segregate tissue regions and facilitate automated quantification of immune infiltrates in CRC.

Methods:

Primary CRC with matched hepatic metastatic (n=7), primary CRC alone (n=18) and primary CRC with matched normal (n=40) tissue were analysed immunohistochemically. Genie pattern recognition software was used to segregate distinct tissue regions in combination with image analysis algorithms to quantify immune cells.

Results:

Immune infiltrates were observed predominately at the invasive margin. Quantitative image analysis revealed a significant increase in the prevalence of Foxp3 (P<0.0001), CD8 (P<0.0001), CD68 (<0.0001) and CD31 (<0.0001) positive cells in the stroma of primary and metastatic CRC, compared with tumour cell mass. A direct comparison between non-metastatic primary CRC (MET−) and primary CRC that resulted in metastasis (MET+) showed an immunosuppressive phenotype, with elevated Foxp3 (P<0.05) and reduced numbers of CD8 (P<0.05) cells in the stroma of MET+ compared with MET− samples.

Conclusion:

By combining immunohistochemistry with DPRIA, we demonstrate a potential metastatic phenotype in CRC. Our study accelerates wider acceptance and use of automated systems as an adjunct to traditional histopathological techniques.