Improving Prenatal Diagnosis of Coarctation of the Aorta

Background

The purpose of the study was to evaluate the association between fetal echocardiographic measurements and the need for intervention (primary coarctation repair, staged coarctation repair, or catheter intervention) in prenatally diagnosed coarctation of the aorta.

History of Articulators: Henry L. "Harry" Page and the Transograph

The intention of this article is to introduce the reader to the Transograph from a historical perspective. The technical data presented are intended to help the reader understand the design of this unique instrument and how it was programmed, but will not provide the reader a thorough understanding of this philosophy. The article seeks neither to defend nor criticize the principles of Transographics.     

A Preliminary Study of Negative Self-Beliefs in Anorexia Nervosa: A Detailed Exploration of Their Content, Origins and Functional Links to “Not Eating Enough” and Other Characteristic Behaviors

Objective: The study explored the semantic content and origins of negative self-beliefs, and their functional links to “not eating enough” and other behaviors, in participants with anorexia nervosa (AN). Method: Fifteen women meeting DSM-IV criteria for AN were compared with 17 dieting and 18 non-dieting women matched on age and number of years of education. The main outcome measure was a semi-structured interview. Results: Six themes were identified in the beliefs of participants with AN. These were, in order of decreasing frequency, powerlessness (present in all but three AN participants), failure, defectiveness, unattractiveness, worthlessness and emptiness. Importantly, powerlessness and failure beliefs were consistently present independent of Beck Depression Inventory-II scores. The negative early life experiences associated with these beliefs had high distress and responsibility ratings. Participants with AN reported that they employed specific behaviors, particularly ‘not eating enough,’ and ‘placating others,’ to try to reduce the cognitive and emotional impact of their negative self-beliefs. Discussion: The findings are discussed in relation to the role of powerlessness and the function of “not eating enough” in cognitive theory and therapy for AN.

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Educating African American men about the prostate cancer screening dilemma: a randomized intervention.

BACKGROUND: Until there is a definitive demonstration that early diagnosis and treatment of prostate cancer reduces disease-related mortality, it is imperative to promote informed screening decisions by providing balanced information about the potential benefits and risks of prostate cancer screening. Within a community/academic collaboration, we conducted a randomized trial of a printed booklet and a videotape that were designed for African American (AA) men. The purpose of the trial was to determine the effect of the interventions on knowledge, decisional conflict, satisfaction with the screening decision, and self-reported screening. METHODS: Participants were 238 AA men, ages 40 to 70 years, who were members of the Prince Hall Masons in Washington, DC. Men were randomly assigned to the (a) video-based information study arm, (b) print-based information study arm, or (c) wait list control study arm. Intervention materials were mailed to men at home. Assessments were conducted at baseline, 1 month, and 12 months postintervention. Multivariate analyses, including ANCOVA and logistic regression, were used to analyze group differences. RESULTS: The booklet and video resulted in a significant improvement in knowledge and a reduction in decisional conflict about prostate cancer screening, relative to the wait list control. Satisfaction with the screening decision was not affected by the interventions. Self-reported screening rates increased between the baseline and the 1-year assessment, although screening was not differentially associated with either of the interventions. In exploratory analyses, prostate-specific antigen testing at 1 year was more likely among previously screened men and was associated with having low baseline decisional conflict. CONCLUSIONS: This study represents one of the first randomized intervention trials specifically designed to address AA men's informed decision making about prostate cancer screening. We have developed and evaluated culturally sensitive, balanced, and disseminable materials that improved knowledge and reduced decisional conflict about prostate cancer screening among AA men. Due to the high incidence and mortality rates among AA men, there is a need for targeted educational materials, particularly materials that are balanced in terms of the benefits and risks of screening.     

A De Novo novel mutation of the EDNRB gene in a Taiwanese boy with Hirschsprung disease.

Hirschsprung disease (HSCR) is a congenital disorder characterized by an absence of ganglion cells in the nerve plexuses of the lower digestive tract. Although mutations in eight different genes (EDNRB, EDN3, ECE1, SOX10, RET, GDNF, NTN, SIP1) have been identified in affected individuals, it is now clear that RET and EDNRB are the primary genes implicated in the etiology of HSCR. All eight genes are involved in the early development of the enteric nervous system, and most act through two distinct biochemical pathways mediated by RET and EDNRB. Mutations in RET and EDNRB account for up to 50% and 5% of HSCR cases in the general population, respectively. Interaction between these two signaling pathways could modify RET expression and, therefore, HSCR phenotype. Here, we report the case of a 1-year-old Taiwanese boy who presented with abdominal distension since birth and bilious vomiting after feeding. HSCR (short-segment type) was diagnosed based on X-ray, lower gastrointestinal series and biopsy findings. Mutation analysis revealed a heterozygous T>C missense mutation in exon 1 of the EDNRB gene, that substitutes the highly conserved cysteine-90 residue in the extracellular domain of the G protein-coupled receptor with an arginine residue (C90R). No RET gene mutation was detected in this patient.     

Social dimensions of mental illness among rural elderly populations

Despite growing concern with rural elderly populations, little attention has focused on their mental health, ways it may correlate with physical health, or how rural mental health patterns compare to urban. Popular wisdom contends that elderly people in general, and rural elderly persons in particular, are at increased risk for mental illness. This article examines these questions. A review of available literature suggests that elderly people may be at only slightly greater risk of mental illness than the population at large, though there are some indications that rates of depression may be somewhat higher among the elderly population. Much of this same literature implies that objective environmental conditions play a significant role in the incidence of depression. Analysis of data gathered in a statewide random poll (N = 743) indicates that while physical health tends to be poorer among rural populations, when health is held constant there is actually an inverse relationship between age and depression. Therefore, rural elderly persons are no more likely to be depressed than their urban counterparts despite harsher living conditions. Both conceptual and policy implications are discussed.     

Growth and development in rats and deficiency of magnesium and pyridoxine

Eight-eight female weanling Sprague-Dawley rats were fed diets containing either 650 or 150 mg magnesium/kg diet and 7.0 or 3.5 mg pyridoxine-HCl/kg diet, in a 2 x 2 factorial arrangement, during growth, gestation, and lactation. The objective of the study was to determine whether concurrent dietary deficiencies of magnesium and pyridoxine were synergistic, additive, or antagonistic with regards to effects on reproductive performance, growth, and development of offspring, and tissue content of magnesium and calcium. Body weight of dams and pups was not different between groups until day 9 of lactation, at which point those animals in either low magnesium group weighed less than the other. Litter size and birth weight were not different. Development, as measured by timing of unfolding of the external ear, opening of both eyes, and clinical emergence of incisors, was delayed in pups from litters in the low magnesium groups. A synergistic effect on delay of onset of ear unfolding by deficiency of both magnesium and pyridoxine was observed. Calcium content of heart and kidney from dams was increased in the low magnesium groups. Renal calcium was not further increased by the level of pyridoxine deficiency in this study. The calcium to magnesium ratio in heart from pups was higher in those from litters in the low magnesium and pyridoxine group than in the others. Results indicate that simultaneous deficiencies of magnesium and pyridoxine may impair function synergistically. Because these two nutrients are often reported to be presented in inadequate amounts in diets of women in their reproductive years, the potential exists for impaired reproductive success.