Examining Couple Functioning and Alcohol use Among Latino Couples: A Dyadic Data Analysis

Background: Prior research suggests that Latinos are at higher risk of alcohol use as compared to their counterparts (NSDUH, 2014). However, little work has been conducted to understand alcohol use among Latinos systemically and more research is needed to better understand the impact of couple functioning on alcohol use among Latino couples. Objectives: The current study aimed to examine how each partner's perception of couple functioning impacted alcohol use in Latino dyads.

Methods: Using data from 329 Latino dyads from the Building Strong Families (BSF) Project, a structural equation model examining the actor-partner interactions between partner perceptions of couple functioning and each person's alcohol use was analyzed. Results: Correlation analysis revealed that the dyad's perceptions of couple functioning were positively correlated. Results from the APIM model indicated male's perceptions of couple functioning was positively associated with his own alcohol use, whereas female's perceptions of couple functioning was not significantly related to either partner's alcohol use. Conclusions/Importance: The findings may help clinicians, researchers, and policy makers to better conceptualize how couple functioning may impact alcohol use among Latino dyads.     

Adequacy of anticoagulation in patients with atrial fibrillation: effect of various parameters

BACKGROUND: Despite reported evidence of the vital importance of appropriate anticoagulation in patients with chronic atrial fibrillation for stroke prevention, this treatment modality still lags behind optimal requirements. HYPOTHESIS: Our objectives were to evaluate various doctor or patient-related factors that influence quality of control and to assess the adequacy of anticoagulation provided by physicians in the community. METHODS: In a retrospective study, International Normalized Ratio (INR) values obtained immediately on admission to hospital were considered representative of previous long-term control. RESULTS: Only 42% of the relevant 385 patient population fell within the protective anticoagulation range of INR 1.91-4.1. The respective figures for patients with poor (INR < 1.5) or suboptimal (INR 1.51-1.9) control, as well as those whose INR values risked bleeding (INR > 4.1), were 28.3, 14.1, and 15.6%. Patient involvement in treatment positively influenced quality of control. By contrast, age 70-80 years or absence of congestive heart failure negatively affected quality of anticoagulation [p = 0.07, odds ratio (OR), 1.7 (95% confidence interval. 0.94-3.08), p = 0.014, OR, 2.06 (95% confidence interval, 1.15-3.7) respectively]. The percentage of patients admitted with stroke who had been adequately anticoagulated was significantly lower than that of patients who had no stroke (21 vs. 44.4%). Adequacy of anticoagulation in patients with cardiac prosthetic valves was superior compared with the rest of the patient population (56.7 vs. 42% with optimal, and only 14.5 vs. 28.3% with poor anticoagulation, respectively), indicating that under the same conditions a better quality of treatment could be achieved. CONCLUSIONS: Adequacy of anticoagulation in patients with atrial fibrillation lags behind actual recommendations. Better control is required and achievable.     

Isolation of Chlamydia Pneumoniae from Serum Samples of the Patients with Acute Coronary Syndrome

BACKGROUND: Limited body of evidence suggests that lipopolysaccharide of C. pneumoniae as well as C. pneumoniae-specific immune complexes can be detected and isolated from human serum. The aim of this study was to investigate the presence of viable elementary bodies of C.pneumoniae in serum samples of patients with acute coronary syndrome and healthy volunteers.MATERIAL AND METHODS: Serum specimens from 26 healthy volunteers and 56 patients with acute coronary syndrome were examined subsequently by serological (C.pneumoniae-specific IgA and IgG), PCR-based and bacteriological methods. Conventional, nested and TaqMan PCR were used to detect C.pneumoniae genetic markers (ompA and 16S rRNA) in DNA from serum specimens extracted with different methods. An alternative protocol which included culturing high-speed serum sediments in HL cells and further C.pneumoniae growth evaluation with immunofluorescence analysis and TaqMan PCR was established. Pellet fraction of PCR-positive serum specimens was also examined by immunoelectron microscopy.RESULTS: Best efficiency of final PCR product recovery from serum specimens has been shown with specific C. pneumoniae primers using phenol-chloroform DNA extraction protocol. TaqMan PCR analysis revealed that human serum of patients with acute coronary syndrome may contain genetic markers of C. pneumoniae with bacterial load range from 200 to 2000 copies/ml serum. However, reliability and reproducibility of TaqMan PCR were poor for serum specimens with low bacterial copy number (<200 /ml). Combination of bacteriological, immunofluorescence and PCR- based protocols applied for the evaluating HL cells infected with serum sediments revealed that 21.0 % of the patients with acute coronary syndrome have viable forms C.pneumoniae in serum. The detection rate of C.pneumoniae in healthy volunteers was much lower (7.7%). Immunological profile of the patients did not match accurately C.pneumoniae detection rate in serum specimens. Elementary bodies of C.pneumoniae with typical ultrastructural characteristics were also identified in serum sediments using immunoelectron microscopy.Conclusions: Viable forms C. pneumoniae with typical electron microscopic structure can be identified and isolated from serum specimens of the patients with acute coronary syndrome and some healthy volunteers. Increased detection rate of C. pneumoniae in serum among the patients with an acute coronary syndrome may contribute towards enhanced pro-inflammatory status in cardiovascular patients and development of secondary complications of atherosclerosis.     

Use of Structural Family Therapy With an Individual Client Diagnosed With Intermittent Explosive Disorder: A Case Study

While significant contributions have been made in analyzing the efficacy of the systemic approach with individual clients, debate on the subject continues to cast a shadow of doubt on the practice. In this article, the author presents the use of Structural Family Therapy with an individual adult client, diagnosed with intermittent explosive disorder. The use of the systemic approach as the foundation for the treatment plan was shown to be effective, as demonstrated by the client’s reduction in hostility and improved overall well-being. The outcomes revealed this approach to be effective in improving the individual client’s functioning, without working directly with the entire relational system.     

Clinical characteristics of neuroleptic-induced parkinsonism

Summary. In order to characterize the clinical spectrum of neuroleptic-induced parkinsonism (NIP), we studied a population of consecutive psychiatric in-patients treated with neuroleptics for at least two weeks, who were diagnosed by their psychiatrist as having parkinsonism. Parkinsonism was confirmed by a movement disorders specialist who performed neurological assessment including the motor examination and the activities of daily living (ADL) sections of the Unified Parkinson's Disease Rating Scale (UPDRS), and the Hoehn and Yahr (H&Y) staging. Seventy-five patients (54 males), aged 46 ± 13 years (range 21 to 73 years) were included in the analysis. The mean duration of neuroleptic therapy was 15 ± 12 years, while 61% were treated for more than 10 years. Most of the patients (n = 66, 88%) were scored as H&Y stage 2.5 or less. Rest tremor was present in 44% of the patients, and usually persisted in action. Forty-one patients (61%) had symmetrical involvement. Parkinsonian signs were significantly more common and pronounced in the upper in comparison with the lower limbs (p = 0.0001). Gait disturbances were mild and freezing of gait was very rare (n = 2). Neither age nor duration of therapy or their interaction affected the total motor score or any of the motor sub-scores. In conclusion, NIP differs from PD for more bilateral involvement with relative symmetry, and by affecting upper limbs more often than the lower ones. NIP tends to be associated with the triad of bradykinesia, tremor and rigidity while PD tends to involve gait and posture more often. NIP develops unrelated to duration of neuroleptic treatment or age of the patient, suggesting an individual predisposition to blockage of the dopaminergic receptors. Received May 8, 2001; accepted June 10, 2001     

Efficiency of Immunological Methods in the Diagnosis of Active Tuberculosis in Children

Nowadays, no clear diagnostic criteria for tuberculosis in children exist as absolute majority of tuberculosis cases in childhood have no bacterial excretion, unlike adults where bacterial excretion is observed not rarely. This fact leads to necessity to implement immunological methods in diagnostic complex in children. Tuberculin test is a routine one which is used for diagnosis of tuberculosis, However, there are a number of factors which interfere with the diagnostic value of tuberculin test. This study helped to ascertain the superiority ofDST （Diaskintest） and QFT-G （QuantiFERON-TB Gold IT） with respect to the wealth of information they provide when compared with the TST （tuberculin screening test） in determining the activity of tuberculosis infection in children. The evaluation parameters of diagnostic value （DSS （diagnostic sensitivity）, the DSC （diagnostic specificity）, PPV （positive predictive value） and NPV （negative predictive value）, and DE （diagnostic efficiency）） with DST, QFT and TST （tuberculin skin test） were： DSS--84.3%, DSC--59.1%, PPV--61.9%, NPV--82.7%, DE--71.7%） with QFT （DSS--78.4%, DSC--68.2%, PPV--57.7%, NPV--85.1%, DE--73.3%） were significantly higher than with TST （DSS--91.5%, DSC--15.7%, PPV--74.4%, NPV--45.8%, DE--53.6%）. New immunologic methods DST and QFT-G have higher specificity and diagnostic value in comparison with TST that makes their implementation in the diagnosis of TB in children essential.     

Pallidal Activity in Cervical Dystonia with and Without Head Tremor

The relationship between two common movement disorders, dystonia and tremor, is controversial. Both deficits have correlates in the network that includes c     

Increased number of peripheral blood CD34+ cells in lithium-treated patients

Eight adult patients with bipolar disorder were prospectively examined to find whether lithium carbonate increased their peripheral blood CD34⁺ haemopoietic stem cells. Following lithium therapy for 3–4 weeks their neutrophil counts increased by a mean of 88% (from 4625 ± 1350 × 10⁹/l, mean ± SD pretreatment, to a peak of 8300 ± 3910 × 10⁹/l). Concommitantly, there was a significant increment in their CD34⁺ cells (from 0.11 ± 0.01% to a peak of 0.18 ± 0.08%). There was a significant correlation between the rise in neutrophil count and that of the CD34⁺ cells ( r  = 0.795, P  = 0.019). Lithium therapy may be used to mobilize peripheral blood CD34⁺ cells for marrow transplantation.     

Sulpiride versus metoclopramide in nononcologic patients with vomiting or nausea.

Metoclopramide, a benzamide substitute, is used frequently as an antiemetic drug. Sulpiride, another benzamide substitute, was investigated and found to be safe and effective in a handful of studies involving only oncologic or other severely symptomatic patients. In this investigation the authors compared prospectively the antiemetic efficacy of sulpiride versus metoclopramide in a double-blind, randomized study involving 36 nononcologic patients with transient vomiting or nausea of various etiologies. Each group of 18 patients received oral metoclopramide or sulpiride (10 mg or 50 mg respectively) every 8 hours for a total of three doses each (24 hours of treatment). A 5-point score was used to evaluate symptomatic relief. Efficacy of the two drugs proved similar, and at the end of the study, 14 and 13 of 18 patients on sulpiride or metoclopramide respectively were asymptomatic. Only transient, minor side effects were reported in one patient in each group. The authors conclude that sulpiride is an effective and safe antiemetic drug that can be adopted legitimately in such cases as a first choice, or serve as an equipotent alternative to metoclopramide in patients sensitive to the latter.