Improving measurement of injection drug risk behavior using item response theory

Background: Recent research highlights the multiple steps to preparing and injecting drugs and the resultant viral threats faced by drug users. This research suggests that more sensitive measurement of injection drug HIV risk behavior is required. In addition, growing evidence suggests there are gender differences in injection risk behavior. However, the potential for differential item functioning between genders has not been explored. Objectives: To explore item response theory as an improved measurement modeling technique that provides empirically justified scaling of injection risk behavior and to examine for potential gender-based differential item functioning. Methods: Data is used from three studies in the National Institute on Drug Abuse’s Criminal Justice Drug Abuse Treatment Studies. A two-parameter item response theory model was used to scale injection risk behavior and logistic regression was used to examine for differential item functioning. Results: Item fit statistics suggest that item response theory can be used to scale injection risk behavior and these models can provide more sensitive estimates of risk behavior. Additionally, gender-based differential item functioning is present in the current data. Conclusion: Improved measurement of injection risk behavior using item response theory should be encouraged as these models provide increased congruence between construct measurement and the complexity of injection-related HIV risk. Suggestions are made to further improve injection risk behavior measurement. Furthermore, results suggest direct comparisons of composite scores between males and females may be misleading and future work should account for differential item functioning before comparing levels of injection risk behavior.     

Vitamin B12 and its binding proteins in hepatocellular carcinoma and chronic liver diseases

Abstract

Background. The vitamin B₁₂ (B₁₂)-binding protein haptocorrin (HC) has proven to be a potentially useful biomarker in patients with fibrolamellar hepatocellular carcinoma (HCC). Little is known concerning the level of HC and other B₁₂-related proteins in patients with HCC as compared to patients with other chronic liver diseases (CLDs) and healthy controls. We hypothesized that HC could be a biomarker of HCC. Aims. To investigate levels of HC and B₁₂-related proteins in HCC compared to CLDs and healthy controls. Methods. We investigated two patient populations: A cross-sectional cohort of HCC patients (n = 130), CLD patients (n = 102) and healthy controls (n = 46) and a cohort of 38 HCC patients studied at baseline and 1, 4, and 12 weeks following ablative treatment. Patients were evaluated by standard biochemistry, Child–Pugh-score and Barcelona Clinic Liver Cancer (BCLC) classification. We analyzed total B₁₂ by routine methods and HC, transcobalamin (TC), B₁₂ saturated TC (holoTC), and the soluble cell surface receptor for holoTC (sCD320) by in-house enzyme-linked immunosorbent assay. Results. HC showed higher median (range) levels for both HCC (590 [290–5860]) and CLD patients (620 [310–4010]) compared to controls (460 [250–2020]) (p < 0.01). Total B₁₂, TC, holoTC, and sCD320 showed elevated levels in both HCC and CLD compared to controls. Only holoTC changed following treatment, without a concurrent change in TC. Conclusion. B₁₂ and B₁₂-related proteins (total B₁₂, HC, TC, holoTC, and sCD320) show elevations in both HCC and CLD patients compared to controls, suggesting a relation to CLD in general rather than to primary liver cancer. Thus, HC is not useful as a biomarker for HCC.     

术中膀胱黏膜下注射盐酸氮芥、术后即刻丝裂霉素灌注化疗预防膀胱癌复发

目的探讨经尿道膀胱肿瘤电切(TUR-Bt)术中膀胱黏膜下注射盐酸氮芥、术后即刻丝裂霉素(MMC)膀胱灌注化疗预防膀胱癌复发的疗效。方法 112例行TUR-Bt术的膀胱癌患者随机分为2组,对照组56例:行TUR-Bt术后1周给予MMC常规膀胱灌注化疗;治疗组56例:TUR-Bt术中经尿道行膀胱黏膜下注射盐酸氮芥,术后再即刻行MMC膀胱灌注化疗,术后1周再给予MMC常规膀胱灌注化疗。比较观察2组患者术后3、6、12、18、24个月的复发情况。结果治疗组术后3、6、12、18、24个月的复发率低于对照组,比较差异有统计学意义(P<0.05)。结论 TUR-Bt术中膀胱黏膜下注射盐酸氮芥、术后即刻行MMC膀胱灌注化疗能显著提高膀胱癌治疗效果,减少术后复发,且无明显毒副反应。     

Amelioration of pregnancy-associated osteoporosis after treatment with vitamin K2: a report of four patients

Abstract

We demonstrate for the first time therapeutic effects of vitamin K₂ (menatetrenone) on pregnancy-associated osteoporosis with multiple vertebral fractures in four cases. Due to its safety, vitamin K₂ presents itself as a treatment option for women with pregnancy-associated osteoporosis. Desirably, future controlled studies should verify these findings.     

Acceptability of a Reusable Insulin Pen,HumaPen® Ergo,by Patients with Type 1 and Type 2 Diabetes

Summary

A reusable insulin pen (HumaPen® Ergo) was tested for patient acceptability and safety in two multinational studies involving a total of 230 patients with either type 1 (27%) or type 2 (73%) diabetes. Prior to the studies, all patients used other insulin injection pen models. During the 5-7-week studies, the acceptability of HumaPen Ergo was assessed with a questionnaire which was issued to all patients. The HumaPen Ergo was considered easy/very easy with respect to learning to use (97%), reading dose numbers (95%) and correcting dose mistakes (97%), and 62% considered it easy/very easy to hold during use. HumaPen Ergo features considered easier/much easier compared to the previously used model of pen were ease of correcting dose (Study 1/Study 2:89%/93%), ease of reading the dose number (77%/61%) and ease of changing cartridge (54%/68%). At the end of the studies the majority of patients (60%/69%) said that they would continue to use HumaPen Ergo and would recommend it to other patients, even though they had expressed satisfaction with the pen that they had used previously. Health-care professionals evaluated HumaPen Ergo according to the same criteria as the patients and said that they would recommend the HumaPen Ergo owing to ease of dialling back without wasting insulin (80%) and reading dose numbers (74%). The HumaPen Ergo was well accepted by both patients and health-care professionals and provides an important tool to combat the trauma and inconvenience associated with insulin self-injection.     

Zidovudine-induced diaphragmatic contractile dysfunction: impact of an antioxidant diet

OBJECTIVE: Zidovudine (AZT) is a primary drug therapy used to treat HIV-infected individuals. While AZT inhibits replication of HIV, it also induces a drug-specific myopathy resulting in altered muscle mitochondria, increased oxidative stress and muscle contractile dysfunction. The purpose of this study was to assess the impact of an antioxidant diet (high in vitamins C and E) on AZT-mediated diaphragmatic contractile dysfunction in rodents. METHODOLOGY: Adult, Sprague-Dawley rats were assigned to feeding groups: control (CON, n = 9), AZT-treatment (AZT, n = 8), antioxidant diet only (Anti-Ox, n = 6), and AZT + antioxidant diet (AZT + Anti, n = 9). Two costal diaphragm strips were removed from each animal (under surgical anaesthesia) and evaluated for force-frequency relationship, maximal specific tension, and fatigue resistance using an in vitro preparation. RESULTS: Results indicate significant reductions in normalized force production (20-200 Hz), including maximal specific tension, between AZT animals and all other groups. While AZT reduced diaphragm contractility, the addition of an antioxidant diet eliminated this decrease. CONCLUSION: These data suggest that an increase in oxidative stress mediated by AZT may contribute to AZT-induced muscle contractile dysfunction, and that antioxidant vitamin supplementation may help ameliorate this effect.     

丹红注射液对不稳定型心绞痛病人炎症反应物及纤溶活性的影响

目的探讨丹红注射液对不稳定型心绞痛(UA)病人血浆炎症反应物及纤溶活性的影响。方法140例UA病人随机分为常规治疗组(67例)和丹红治疗组(73例),另设正常对照组50名。丹红治疗组于常规治疗基础上加用丹红注射液20mL静脉输注,每日1次,疗程为3周。两组分别于治疗前及结束时测定血清C-反应蛋白(CRP)、白细胞介素-6(IL-6)、纤维蛋白原(FIB)、D-二聚体(DD)浓度和组织型纤溶酶原激活物(t-PA)、纤溶酶原激活物抑制物-1(PAI-1)活性。结果丹红注射液治疗3周后,CRP,IL-6,FIB,DD,PAI-1水平下降(P<0.05或P<0.01),t-PA活性升高(P<0.01)。治疗前UA病人的CRP与IL-6,PAI-1,DD呈正相关(P<0.05或P<0.01),与t-PA呈负相关(P<0.01)。丹红治疗组治疗后CRP与IL-6,PAI-1呈正相关(P<0.05或P<0.01),与t-PA呈负相关(P<0.05)。结论UA病人应用丹红注射液治疗,可能有利于抑制炎症反应,改善内皮功能,提高纤溶活性,稳定斑块。     

In whom and how to prevent glucocorticoid-induced osteoporosis

Glucocorticoid use is widespread in medicine. While it is often life-saving, side-effects are well known. The most common side-effect is osteoporosis. Today we have therapies with proven efficacy for the prevention of vertebral fractures and bone loss. Consequently recognition of glucocorticoid-induced osteoporosis is extremely important given the availability of effective therapy.     

Absorption kinetics of subcutaneously injected insulin

Summary The absorption of subcutaneously injected insulin was examined by injecting semisynthetic [³H] insulin in anaesthetized pigs and subsequently analysing the tissue excised from the injection site. Contrary to previously accepted views, a significant proportion of insulin was degraded at the injection site. The disappearance of intact [³H] insulin from the injection site followed a monoexponential function with a half-time of 59 min.