Craniosynostosis: image quality, confidence, and correctness in diagnosis

The authors used the diagnosis of craniosynostosis to compare subjective evaluation of image quality with objective diagnostic utility. They studied in detail the responses of one observer, who read plain radiographs, computed tomographic (CT) scans, and three-dimensional reconstructions of CT scans (obtained with three different methods) for 82 patients with this diagnosis. The observer rated image quality and certainty in diagnosis made from each image. Subjective and objective performances were found to be strongly linked. High-quality images served as the basis for more accurate diagnoses than low-quality images. The increase in diagnostic performance results primarily from increased specificity, a fact that suggests that specificity and the concomitant diagnosis of normalcy are the focus of attention when image quality is evaluated.     

Recent developments in the medicinal chemistry of cannabimimetic indoles, pyrroles and indenes

During the development of new nonsteroidal anti-inflammatory agents, it was discovered that 1-aminoalkyl-3-aroylindoles have affinity for the cannabinoid brain (CB(1)) receptor. This has led to the development of over 100 cannabimimetic aminoalkylindoles, and the development of SAR for these compounds. Later work demonstrated that the aminoalkyl moiety was not necessary, and could be replaced by a four- to six-membered alkyl chain without loss of affinity. Investigation of these indoles led to the discovery of a CB(2) selective ligand, 3-(1-naphthoyl)-N-propylindole. Subsequent work has provided several additional CB(2) selective indoles. On the basis of a proposed pharmacophore for the cannabimimetic indoles, a series of pyrroles and indenes were developed, some of which are potent cannabinoids. SAR for several series of pyrroles have been developed. Two groups have described cannabimimetic indenes, which have been employed as rigid models for the receptor interactions of cannabimimetic indoles with the CB(1) receptor. There is some evidence that the indoles bind to a somewhat different site on the receptor than traditional cannabinoids, and interact with the receptor primarily by aromatic stacking.     

Synthesis and biological evaluation of 10-oxa-11-deoxyprostaglandin E1 and 10-nor-9,11-secoprostaglandin F1 and their derivatives

Three 10-oxa-11-deoxyprostaglandin E1 and two 10-nor-9,11-secoprostaglandin F1 analogues were prepared. The compounds were evaluated for pregnancy interruptions, oxytocin-like activity (uterine strip), and antiprostaglandin activity. One of the 10-nor-9,11-secoprostaglandin F1 analogues displayed activity as a PGE2 antagonist in the gerbil colon smooth muscle preparation.     

Health Status in Patients with Alzheimer’s Disease: An Investigation of Inter-rater Agreement

Objective: The purpose of the present study was to examine the level of agreement between health status ratings provided by patients with Alzheimer’s disease and by their proxies. Background: Because proxy-completed responses are often necessary in assessing health outcomes for the elderly, it is necessary to determine the feasibility and potential limitations of using proxies as a patient substitutes. Methods: To assess the potential utility of proxy responses on health status when subjects present a cognitive impairment, this study compared the responses of 70 subjects with Alzheimer‘s disease and those of their family and/or care provider proxy using the SF-36. Agreement between proxies and patients was measured by intraclass correlation coefficients (ICCs). Results: The proportion of exact agreement between patients and proxies on the 36 items ranged from 3.3 to 41.7%. Results reveal poor to moderate agreement between patient and proxy reports. Proxy reliability varied according to the relationship of the proxy to the index subject. Agreement decreased significantly with increasing severity of dementia and with increasing severity of Physical status (Katz ADL). Agreement was better for measures of functions that are directly observable and relatively poor for more subjective measures. Conclusions: Our results confirm the importance of the information source used for patient health status.     

Provider recognition of psychosocial problems in low-income Latino children

The purpose of this study was to determine the frequency of identification of psychosocial problems in Latino children by primary care providers (PCPs). This was a cross-sectional study of 269 low-socioeconomic status (SES), Latino children, ages 2-16 years, seen at a community clinic for well-child care. Primary care providers completed a World Health Organization checklist, which organized provider assessment of child psychosocial problems. Clinicians identified one or more psychosocial problems in 39.8% of children. Clinicians recognized only 20% of children with clinically significant aggression symptoms, 18% of children with clinically significant attention/hyperactivity symptoms, and none (0%) of the children with clinically significant anxiety/depression symptoms with clinical data from parent-completed child-behavior checklists used as the benchmark. Despite high rates of identification of psychosocial problems in a low-SES, Latino population, PCPs still miss symptoms of mental health difficulties, especially anxiety and depression. Since symptoms of anxiety and depression are likely to be more pronounced in Latino populations, there is a continued need for improvement in detection of mental health concerns among these children.     

Increased susceptibility of the lungs of hyperthyroid rats to oxidant injury: specificity of effects

Results from previous studies indicate that hyperthyroidism increases the risk of ozone-induced lung toxicity. This observation raised the possibility that pulmonary damage from other oxidant substances might be greater in a hyperthyroid state. To address this hypothesis, pulmonary responses to crystalline silica, a particulate with oxidant properties, were evaluated in normal or hyperthyroid adult male rats. To induce a hyperthyroid condition, time-release pellets containing thyroxine were implanted subcutaneously; control rats received placebo pellets. After 7 days, the animals were exposed to saline or silica (0.1mg/100g BW or 1.0mg/100g BW) by intratracheal instillation. Following silica treatment, there was a dose-related increase in bronchoalveolar lavage (BAL) albumin levels and neutrophil numbers. However, the effects of silica were similar in both normal and hyperthyroid rats. These findings were confirmed and contrasted with those regarding ozone (1ppm, 4h inhalation) in a subsequent experiment. The results indicated that, although exposure to either ozone or silica resulted in increases in BAL albumin levels and neutrophil numbers, only responses to ozone were enhanced in hyperthyroid rats. These findings suggest that specificity exists in regards to the modulation of oxidant-induced lung damage and inflammation by thyroid hormones.     

The impact of deployment length and experience on the well-being of male and female soldiers

This study examined the effects of stressor duration (deployment length) and stressor novelty (no prior deployment experience) on the psychological health of male and female military personnel returning from a peacekeeping deployment. The sample consisted of men (n = 2,114) and women (n = 1,225) surveyed for symptoms of depression and posttraumatic stress. The results confirmed the hypotheses. Longer deployments and 1st-time deployments were associated with an increase in distress scores. However, the relationship between deployment length and increased distress was found only for male soldiers. The findings demonstrate the importance of considering the impact of exposure to long-term occupational stressors and confirm, in part, previous research that has demonstrated a different stress response pattern for men and women.