Prevalence of and risk factors for depressive symptoms among young adolescents

OBJECTIVE: To determine the prevalence, risk factors, and risk behaviors associated with depressive symptoms in a nationally representative, cross-sectional sample of young adolescents. DESIGN: A school-based survey collected through self-administered questionnaires in grades 6, 8, and 10 in 1996. SETTING: Schools in the United States. PARTICIPANTS: 9863 students in grades 6, 8, and 10 (average ages, 11, 13, and 15). MAIN OUTCOME MEASURES: Depressive symptoms, substance use, somatic symptoms, scholastic behaviors, and involvement in bullying. RESULTS: Eighteen percent of youths reported symptoms of depression. A higher proportion of females (25%) reported depressive symptoms than males (10%). Prevalence of depressive symptoms increased by age for both males and females. Among American Indian youths, 29% reported depressive symptoms, as compared with 22% of Hispanic, 18% of white, 17% of Asian American, and 15% of African American youths. Youths who were frequently involved in bullying, either as perpetrators or as victims, were more than twice as likely to report depressive symptoms than those who were not involved in bullying. A significantly higher percentage of youths who reported using substances reported depressive symptoms as compared with other youths. Similarly, youths who reported experiencing somatic symptoms also reported significantly higher proportions of depressive symptoms than other youths. CONCLUSIONS: Depression is a substantial and largely unrecognized problem among young adolescents that warrants an increased need and opportunity for identification and intervention at the middle school level. Understanding differences in prevalence between males and females and among racial/ethnic groups may be important to the recognition and treatment of depression among youths.     

Maximizing the right renal vein length in laparoscopic live donor nephrectomy

Laparoscopic donor nephrectomy has become the standard of care at increasing numbers of renal transplant programs worldwide. The majority of laparoscopic living donor kidneys are procured from the left side because of the longer renal vein and improved transplantation. The aim of this article is to report a technique to maximize the right renal vein length by performing a hand-assisted cavotomy.     

Ternatin, a flavonoid, prevents cyclophosphamide and ifosfamide-induced hemorrhagic cystitis in rats

To compare the classical uroprotective efficacy of mesna (2-mercaptoethanesulfonic acid) with ternatin (flavonoid isolated from Egletes viscosa Less.) in cyclophosphamide (CYP) and ifosfamide (IFS) induced hemorrhagic cystitis (HC). Male Wistar rats received an intraperitoneal injection of saline, CYP or IFS and were treated with saline or mesna, 5 min before, 4 and 8 h after CYP or IFS administration. In other animals, 1, 2 or 3 doses of mesna were replaced with ternatin or 3 doses of mesna were replaced with dimethylsulphoxide (DMSO), ternatin diluent. In an additional group, the last 2 doses of mesna were replaced with saline. HC was evaluated 24 h after CYP or IFS administration. CYP or IFS treatment induced marked changes in macroscopic and microscopic evaluation and in bladder wet weight (BWW), and these alterations were significantly inhibited by treatment with 3 doses of mesna, as well as by the replacement of 1 or 2 doses of mesna with ternatin. The replacement of 2 doses of mesna with saline or all doses of mesna with ternatin or DMSO did not prevent HC. In conclusion, the replacement of 1 or 2 doses of mesna with ternatin efficiently blocked CYP- or IFS-induced HC, however mesna is necessary for initial uroprotection.     

Factors associated with adverse reactions to cocaine among a sample of long-term, high-dose users in São Paulo, Brazil

This cross-sectional survey investigates the frequency of adverse cocaine reactions and associated factors among regular cocaine misusers. A sample of 332 cocaine misusers from a range of treatment and nontreatment settings in S?o Paulo, Brazil, were interviewed using a questionnaire that includes the Severity of Dependence Scale (SDS), the General Health Questionnaire (GHQ-28), the CAGE, and an eight-item questionnaire investigating the frequency of specific adverse cocaine reactions. The most commonly described reactions were hot flushes (84%), uncontrollable shaking (76%), and feeling ill (75%). The most severe symptoms and least common were convulsions or fits (18%) and passing out (21%). Frequency of adverse reactions to cocaine was positively associated with out-of-treatment status, severity of cocaine dependence, ever having injected cocaine, using tranquilisers with cocaine, and GHQ score. Adverse reactions to cocaine are common among regular cocaine users. Some of the adverse effects, especially those on the heart and central nervous system, are potentially fatal. Preventive strategies should be developed to reduce the risk of adverse cocaine reactions. The findings are discussed in relation to the type of interventions that might be developed and lines of future research.     

Hypothalamic Y2 receptors regulate bone formation

Neuropeptide Y (NPY) is a downstream modulator of leptin action, possibly at the level of the arcuate nucleus where NPY neurons are known to express both leptin receptors and Y2 receptors. In addition to the well-described role of NPY and leptin in energy balance and obesity, intracerebroventricular administration of NPY or leptin also causes bone loss. Here we show that Y2 receptor-deficient mice have a twofold increase in trabecular bone volume as well as greater trabecular number and thickness compared with control mice. We also demonstrate that central Y2 receptors are crucial for this process, since selective deletion of hypothalamic Y2 receptors in mature conditional Y2 knockout mice results in an identical increase in trabecular bone volume within 5 weeks. This hypothalamus-specific Y2 receptor deletion stimulates osteoblast activity and increases the rate of bone mineralization and formation, with no effect on osteoblast or osteoclast surface measurements. The lack of any changes in plasma total calcium, leptinemia, or hypothalamo-pituitary-corticotropic, -thyrotropic, -somatotropic, or -gonadotropic output suggests that Y2 receptors do not modulate bone formation by humoral mechanisms, and that alteration of autonomic function through hypothalamic Y2 receptors may play a key role in a major central regulatory circuit of bone formation.     

Epidemiological profile of cocaine users on treatment in psychiatrics hospitals, Brazil

OBJECTIVE: To describe the epidemiological profile and patterns of cocaine use among hospitalized drug users. METHODS: A cross-sectional study was carried out among drug users, aged 18 years or more, hospitalized in one out six selected psychiatric hospitals in the metropolitan area of Greater S o Paulo, whose clinical conditions allowed them to reliably answer to a standardized questionnaire and who agreed to participate. Six psychiatric hospitals who attended spontaneously referred public and private patients from all Greater S o Paulo were selected. Data collection was conducted using structured interviews, individually applied by a trained psychologist. Statistical analysis was performed using Student t-test and Chi-square test at p<0.05. RESULTS: There was a predominance of crack use (38.4%) over intravenous drug use (1.6%). Addicts who smoked cocaine had lower education, most were unemployed and had previously lived on the streets, and used higher amounts of drugs. These addicts also had been previously incarcerated more often than addicts who used other routes for drug administration. CONCLUSIONS: Drug use is a serious public health problem in Greater S o Paulo, and this is shown by the great amount of hospital admissions due to drug addiction. Crack users have lower socioeconomic status and more often engage in violence and crimes.