Psychosocial Adjustment to Illness Scale in family caregivers of patients with Parkinson’s Disease: Spanish validation study

Psychosocial adjustment to a complex and disabling long-term condition like Parkinson´s disease is a complex, dynamic, cyclical and interactive process. Family caregivers, face multiple challenges that require a significant effort in terms of psychosocial adjustment, which must be considered by healthcare professionals in order to provide a holistic care. The patients’ self-report version of the Psychosocial Adjustment to Illness Scale (PAIS-SR), which has been validated in Spain for use in Parkinson's disease, is designed to evaluate the psychosocial adjustment of patients. Our purpose was to validate the Spanish PAIS-SR version for caregivers of patients with Parkinson's disease. An open, national cross-sectional study with one point-in-time evaluation and retest was carried out in 450 family caregivers of patients with Parkinson's disease. Data were collected in Spain from April 2016 to September 2017. The psychometric analysis performed showed that the Spanish version of the PAIS-SR for caregivers presents adequate indicators of reliability, internal and external validity, and is structured according to the seven-domain model proposed by the author of the instrument.     

Renal tubular acidosis in the Silver-Russell syndrome

Several patients with the Silver-Russell syndrome (SRS) attending our Genetics Clinic were diagnosed as having persistent metabolic acidosis. Since this abnormality has not been reported previously in the SRS, we reexamined 33 SRS patients to evaluate the frequency and type of metabolic acidosis, the clinical and laboratory findings, and the growth pattern in SRS patients with and without metabolic acidosis. Among them, 14 had a consistent decrease in HCO levels. Renal studies in acidotic patients showed urine pH of 5.8 and 24 h urine calcium of <2.4 mg/kg/24 h; serum creatinine, excretion of glucose, and aminoacids were normal, as were renal ultrasound and excretory urography findings. These data supported the diagnosis of renal tubular acidosis, probably type II; the patients were treated with oral bicarbonate and acidosis was corrected successfully. Clinical manifestations were similar in acidotic and non-acidotic patients. The nutritional indices at diagnosis and at last evaluation (at least 8 months after diagnosis) were abnormally low in all patients; however, acidotic patients, treated with bicarbonate, showed an improvement of nutritional status particularly in the weight/height index, although the difference between groups after follow-up did not reach statistical significance. We suggest that metabolic acidosis due to renal tubular acidosis, probably type II, may occur in children with the SRS and should be looked for and treated in all patients. © 1995 Wiley-Liss, Inc.     

Tobacco use among Australin secondary students in 1996

OBJECTIVES: To estimate smoking prevalence among Australian secondary students in 1996 and to examine trends in smoking prevalence since 1984. METHOD: A randomly selected representative sample of 434 secondary schools from across Australia participated in the study. At each school 80 randomly selected students completed a pencil-and-paper questionnaire anonymously. Data from 29,850 students aged between 12 and 17 years are reported. RESULTS: Current smoking (smoking in the week before the survey) was 8% in boys and 7% in girls aged 12, and rose to a peak prevalence among 17 year olds of 28% for boys and 34% for girls. The mean number of cigarettes smoked per week among current smokers rose from 11 for boys and six for girls aged 12 to 37 for boys and 34 for girls aged 17. Comparisons across survey years showed that while fewer 12 to 15 year olds were current smokers in 1996 than in 1984, the proportion in 1996 was greater than that in 1987 or 1990. Among 16 and 17 year olds, the proportion of current smokers in 1996 was greater than that seen in 1987 or 1990. An aggregate measure of tobacco involvement suggested that involvement with tobacco had remained stable since 1993 among 12 to 15 year olds. CONCLUSION: The decline in adolescent smoking seen in the late 1980s has stopped. IMPLICATIONS: Extrapolating from this survey, we estimate that more than 276,000 12-17 year old students were current smokers in 1996. If they all continue to smoke, 138,000 would die prematurely.     

c-Fos expression in the auditory pathways related to the significance of acoustic signals in rats performing a sensory-motor task

Neuronal activity was established in the auditory pathways in relation to behavioural response and cognitive information processing during a sensory-motor acoustic learning. Rats were trained in three consecutive phases. The first phase was an association between an auditory stimulus and a food reward; the second phase a simple discrimination between two sounds of different frequency components, and the third phase a more complex discrimination involving both spectral and spatial sound dimensions. Auditory stimuli were bursts of complex sounds lasting 500 ms. Neuronal activity related to the behaviourally relevant stimuli was established in 20 "learning" rats undergoing this protocol, which were progressively sacrificed at the beginning, middle and end of each phase. For comparison, activity was also established in four "control" rats exposed to the same stimuli delivered pseudo-randomly, thus carrying no behavioural meaning. Neuronal activity was assessed immunocytochemically using the functional marker Fos. To establish a baseline, two rats were unexposed to controlled acoustic stimulation ("unstimulated" rats). In the superior olivary complex (SOC), inferior colliculus (IC) and medial geniculate body (MGB), the number of Fos-like immunopositive cells was comparable in "learning" and "control" animals, but higher than in the "unstimulated" rats. In the auditory cortex (AC), most prominently in the secondary area Te2, the number of Fos-like positive cells differed between "learning" and "control" rats, suggesting that the auditory cortical areas may be involved in the encoding of the behavioural significance of the acoustic stimuli.     

Cervical Cancer among Asian American Women: A Neglected Publica Health Problem?

PURPOSE OF THE PAPER: Relatively little attention has been paid to cervical cancer control in Asian American populations. We summarize available cervical cancer incidence and mortality dat, present information on levels of Pap testing use, and review factors that may be associated with cervical cancer screening participation. METHODS: We reviewed the literature pertaining to cervical cancer and Pap testing among Asian populations in North America. PRINCIPAL FINDINGS: Cancer registry data suggest that women from Southease Asia have a nearly five­fold increased risk of invasive cervical cancer (when compared to non­Hispanic White women). Filipino and Korean populations also have elevated risks. The excess invasive cervical cancer burden appears to be concentrated among women aged 40 and older. Pap testing use by Asians is less than for all toher racial/ethnic groups in the U.S., and recent studies suggest that over one­third of Vietnamese immigrants have never been screened. Barriers to Pap testing participation by less acculturated Asian women include a lack of familiarity with Western preventive concepts, a lack of knowledge concerning cervical cancer, embarrassment in association with gynecologic exams, the role of women in some Asian cultures, the cost of health care, and language difficulties. CONCLUSIONS: There is a considerable need for ethnoculturally appropriate cervical cancer control programs targeting Asian American populations. RELEVANCE TO ASIAN PACIFIC ISLANDER AMERICAN POPULATIONS: This paper is relevant to Asian American women from East, South, Southeast, and Island Asia.     

Variations in Prkdc and susceptibility to benzene-induced toxicity in mice.

Benzene, a carcinogen that induces chromosomal breaks, is strongly associated with leukemias in humans. Possible genetic determinants of benzene susceptibility include proteins involved in repair of benzene-induced DNA damage. The catalytic subunit of DNA-dependent protein kinase (DNA-PKcs), encoded by Prkdc, is one such protein. DNA-PKcs is involved in the nonhomologous end-joining (NHEJ) pathway of DNA double-strand break (DSB) repair. Here we compared the toxic effects of benzene on mice (C57BL/6 and 129/Sv) homozygous for the wild-type Prkdc allele and mice (129/SvJ) homozygous for a Prkdc functional polymorphism that leads to diminished DNA-PK activity and enhanced apoptosis in response to radiation-induced damage. Male and female mice were exposed to 0, 10, 50, or 100 ppm benzene for 6 h/d, 5 d/week for 2 weeks. Male mice were more susceptible to benzene toxicity compared with females. Hematotoxicity was evident in all male mice but was not seen in female mice. We observed similar, large increases in both micronucleated erythrocyte populations in all male mice. Female mice had smaller but significant increases in micronucleated cells. The p53-dependent response was induced in all strains and genders of mice following benzene exposure, as indicated by an increase in p21 mRNA levels in bone marrow that frequently corresponded with cell cycle arrest in G2/M. Prkdc does not appear to be a significant genetic susceptibility factor for acute benzene toxicity. Moreover, the role of NHEJ, mediated by DNA-PK, in restoring genomic integrity following benzene-induced DSB remains equivocal.     

Outcomes of a randomized trial of hyperfractionated cranial radiation therapy for treatment of high-risk acute lymphoblastic leukemia: therapeutic efficacy and neurotoxicity.

PURPOSE: We evaluated 8-year survival and late neuropsychologic toxicity in children with acute lymphoblastic leukemia treated in a randomized clinical trial to test whether hyperfractionated (twice daily) cranial radiation therapy (CRT) can reduce incidence and severity of late toxicities associated with 18 Gy of CRT. PATIENTS AND METHODS: Between 1987 and 1995, 369 children treated on two consecutive Dana-Farber Cancer Institute Consortium protocols for high-risk acute lymphoblastic leukemia were randomly assigned to conventionally fractionated CRT (CFX) or hyperfractionated CRT (HFX) to a total dose of 18 Gy. Neuropsychologic testing was completed for 125 of 287 children in continuous complete remission. Event-free and overall survival, as well as neuropsychologic function, were compared for the two arms of the protocol. RESULTS: Eight-year event-free survival (+/- SE) was 80% +/- 3% for children randomly assigned to CFX and 72% +/- 3% for HFX (P =.06). Overall survival was 85% +/- 3% for CFX and 78% +/- 3% for HFX (P =.06). CNS relapses occurred in 2.8% of patients receiving CFX and 2.7% receiving HFX (P =.99). Cognitive function for both groups was solidly in the average range, with no group differences in intelligence, academic achievement, visuospatial reasoning, or verbal learning. Children on the HFX arm exhibited a modest advantage for visual memory (P <.05). CONCLUSION: HFX provides no benefit in terms of cognitive late effects and may compromise antileukemic efficacy. HFX should not be substituted for conventionally dosed CRT in children who require radiation therapy for treatment of acute lymphoblastic leukemia.