Adolescent exposure to and perceptions of environmental tobacco smoke

Environmental tobacco smoke (ETS) poses an underappreciated risk to adolescent health. This study examined perceptions of adolescents (n = 574) regarding ETS. About one half (54%) were exposed to ETS the previous week, and one third (30%) were exposed to 3 or more hours of ETS the past week. Concurrently, 29% believed that breathing someone else's cigarette smoke had little or no effect on their health. Most adolescents (56%) believed that smoking should not be allowed in restaurants without bars but were less supportive of prohibiting smoking in restaurants with bars (20%) or in bars (14%). Two thirds (69%) of adolescents believed that the government should be involved in making laws that protect the health of people who work in bars and restaurants. Almost one half (49%) believed that the government should be involved in passing laws that make it illegal for people to smoke in public places. Odds ratios revealed that females, nonwhites, younger students, nonsmoking students, and students who believed that ETS exposure had a moderate or major effect on health were statistically significantly more likely to support clean indoor air ordinances in select locations compared to males, whites, older students, students who smoke, and students who perceived that ETS exposure has little to no effect on health.     

Maternal estimates of mental age in developmental assessment

Objective: To examine the accuracy and clinical utility of maternal estimates of mental age in young children referred for developmental assessment.Methods : Mothers of 100 children aged 16 to 60 months referred for developmental evaluation to psychology services of Department of Pediatrics of a tertiary care teaching hospital were asked to estimate the mental age of their child. Maternal estimates were converted to intelligence quotient (IQ) and were compared to results from developmental tests of cognitive and adaptive behavior functioning which were administered to all children.Results : Maternal estimate IQ was highly correlated with IQ calculated from Developmental Profile II (r=.83, p<.001) and social quotient (SQ) calculated from Vineland Social Maturity Scale (r=.81, p<.001). Maternal estimate IQ was 82% sensitive to cognitive delay and 81% specific in identifying children likely to have normal development. Twenty seven percent of the maternal estimates were within ±5 IQ points of actual IQ. Mothers were more likely to overestimate their child’s functioning. Maternal IQ (Mean=62.1, S.D. =25.8) was significantly higher (t=2.93, p<.004) than the actual IQ (Mean=57.9, S.D.=21.9). Step-wise multiple regression analysis revealed that the child’s IQ and SQ explained 10% of the variance (F=6.40, p<.001) in maternal accuracy. The lower the SQ and IQ of the child, more accurate the estimates.Conclusion : Maternal estimates of mental age provide an accurate measure of developmental functioning in young children and may be used as a screening technique to identify a subset of children who need more detailed evaluation.     

Enhanced retrieval of DNA from human fecal samples results in improved performance of colorectal cancer screening test

Colorectal cancer accounts for more than 10% of all cancer deaths but is curable, if detected early. We reported previously on a stool-based screening test in which DNA from stool samples is subjected to genome analysis; sensitivity of the test has been limited in part by inefficiency of retrieving DNA from stool. Our aim was to test the impact of a new purification method that would increase the yield of human DNA from stool. DNA from 86 cancer and 100 non-cancer subjects (diagnosed by colonoscopy) were purified from stool with a new method for DNA recovery based on sequence-specific capture with acrylamide gel immobilized capture probes as well as with a previously developed magnetic bead-capture procedure. The new purification method gives an average 5.4-fold increase in the quantity of human DNA that can routinely be retrieved from fecal samples. The increased recovery of DNA corresponds with an increase in assay sensitivity from 53% (CI: 42 to 64%) to 70% (CI: 59 to 79%); P = 0.0005 (by McNemar's test), with no change in specificity. The newly developed sample preparation method mitigates a major problem in detecting rare cancer-associated genetic changes in heterogeneous clinical samples such as stool.     

Percutaneous radiofrequency ablation of pulmonary malignancies: combined treatment with brachytherapy

OBJECTIVE: The purpose of this article is to report the clinical experience and technical feasibility of percutaneous radiofrequency ablation in conjunction with brachytherapy, a novel approach in the treatment of lung neoplasms. Data from three patients with lung malignancies illustrate the expanding therapeutic indications of this minimally invasive intervention. CONCLUSION: Percutaneous radiofrequency ablation in conjunction with brachytherapy is a promising minimally invasive combination modality. It may be a treatment option for patients with primary, recurrent, or metastatic malignancies of the lung that are not amenable to surgery or further external beam radiation therapy.     

Antisaccade performance is abnormal in schizophrenia patients but not in their biological relatives

Numerous studies have replicated the finding that schizophrenia patients make an increased number of errors on an antisaccade task. Some studies have reported that relatives of schizophrenia patients also make an increased number of antisaccade errors, a finding that has been interpreted to support the usefulness of compromised antisaccade performance as an index of genetic liability for schizophrenia. We examined performance on an antisaccade task in schizophrenia patients, nonpsychiatric controls, first-degree relatives of schizophrenia patients and first-degree relatives of nonpsychiatric controls. Schizophrenia patients made significantly more errors than did nonpsychiatric controls, but relatives of schizophrenia patients did not differ from relatives of controls or from all controls. Increased antisaccade errors on the standard version of the antisaccade task are associated with schizophrenia, but do not seem to be a co-familial trait for schizophrenia.     

Multivitamin use among multi-ethnic, low-income adults

There has been growing interest in the protective health benefits of multivitamin use (MVU). Relatively little research has investigated the factors associated with MVU among adults across a broad age range, particularly among lower-income, racially/ethnically diverse adults. In light of standing MVU recommendations and documented health benefits for certain groups, as well as ongoing studies evaluating the potential health benefits of multivitamins, vitamin D, and calcium, research among this understudied population is warranted. The aims of this paper were to assess the association between MVU and (1) sociodemographic, (2) preventive/health, and (3) patient/provider factors among a racially and ethnically diverse adult sample of over 1,500 low-income housing residents living in Boston, Massachusetts (USA). Bivariate and multivariable logistic regression models were the primary analytic strategy for investigating these associations. In multivariable analyses, sociodemographic factors (female gender, older age, and White or Other race/ethnicity) were significantly associated with regular MVU (p ≤ .05). Preventive/health variables (health status, physical activity, and body mass index) and characteristics of patient/provider relationships (having a regular provider, last provider visit, decision-autonomy, and quality of relationship) were not significantly associated with MVU. While more evidence is needed to understand the benefits of MVU, future studies should address low use of MVU among lower-income, multi-ethnic populations, particularly in light of health disparities.     

Neonatal Sporotrichosis

Abstract:  Sporotrichosis is caused by the dimorphic fungus, Sporothrix schenckii . Classically, infection occurs after implantation of the organism into the skin by abrasion of a puncture wound by contaminated thorns, hay, or sphagnum moss. Cats are also a commonly recognized source of sporotrichosis. In children, fixed cutaneous lesions are more common than lymphocutaneous lesions, and the face is a frequent location for infection. We present a neonate with a fixed cutaneous facial lesion and both pre-auricular and cervical lymphadenopathy who developed signs of infection at 3 weeks of age. This patient is currently the youngest reported case of sporotrichosis in the literature. The patient's family denied any trauma and denied contact with flowers, gardens, and cats; thus, the source of infection remains unknown.     

Clinical and polysomnographic predictors of severe obstructive sleep apnea in the South Indian population

Background:With the emergence of lifestyle diseases in epidemic proportions, obstructive sleep apnea (OSA) is being increasingly recognized in less developed countries as well.Aim:We sought to study the demographic, clinical, and polysomnographic (PSG) predictors of OSA severity in a cohort of South Indian patients.Results:There were 152 (119 males and 33 females) subjects with a mean age of 53.8 years and body mass index (BMI) of 29.31. Mean AHI was 36.2/h (range: 5.1-110) and 66 subjects had severe OSA. Around 12% had the presenting complaint as insomnia, mainly of sleep maintenance. Of the subjects, 35% had witnessed apneas and 67% had excessive daytime sleepiness (EDS); 40% of patients had ≥2 risk factors. PSG parameters showed short sleep onset latency with a high arousal index. Mean apnea duration was 24.92 s. We found that age >55 years, BMI >25 kg/m², witnessed apneas, EDS, hypertension, dyslipidemia, reduced slow wave sleep duration, mean apnea duration >20 s, and desaturation index >10/h correlated well with OSA severity while the arousal index, sleep latency and efficiency, and exposure to smoking and alcohol showed no association.Conclusions:Older subjects with witnessed apneas are likely to have more severe OSA. Even though overall sleep architecture was similar between the groups, severe OSA had shorter slow wave sleep, longer apneas, and higher nocturnal hypoxemia.