The prognostic significance of psychosocial factors in women with breast cancer

One hundred and thirty three recently diagnosed breast cancer patients completed a self-administered questionnaire which measured 16 psychosocial variables. After 4 years, three variables (expressive activities at home, extroversion, low anger) were significant prognostic factors for overall survival independent of clinical and other psychosocial factors; likewise three variables (expressive activities at home, expressive activities away from home, low cognitive disturbance) were significant independent prognostic factors for disease-free survival. These findings support the prognostic importance of the social emotional network.     

Mindfulness yoga during pregnancy for psychiatrically at-risk women: Preliminary results from a pilot feasibility study

Prenatal psychopathology may have an adverse impact on mother and baby, but few women receive treatment. We offered a 10-week mindfulness yoga (M-Yoga) intervention to psychiatrically high-risk pregnant women as an alternative to pharmacological treatment. Participants (N = 18) were primiparous, 12–26 weeks pregnant, and had elevated scores (>9) on the Edinburgh Postnatal Depression Screen at baseline. In addition to a baseline diagnostic assessment, women completed self-ratings on depression, mindfulness, and maternal-fetal attachment before and after M-Yoga. Findings suggest that M-Yoga was feasible, accepted and effective. Symptoms of depression were significantly reduced (p = 0.025), while mindfulness (p = 0.007) and maternal-fetal attachment (p = 0.000) significantly increased. Overall, this pilot study is the first to demonstrate that M-Yoga may be an effective treatment alternative or augmentation to pharmacotherapy for pregnant women at high risk for psychopathology.     

Polyserositis and arthritis due to Escherichia coli in gnotobiotic pigs

Forty gnotobiotic pigs from six litters were exposed orally to Escherichia coli 083:K.:NM at 69 to 148 hours of age, while 17 pigs from the same litters served as unexposed controls. Clinical signs of infection included fever, anorexia, diarrhea, lameness, and reluctance to move.Eighty-four percent of the exposed pigs in four litters died, while only 13% in two litters died. Gross and microscopic lesions included serofibrinous to fibrinopurulent polyserositis in 96% of the exposed pigs in four litters and 33% of the exposed pigs in two litters. A few pigs had gross and/or microscopic lesions of arthritis. Escherichia coli was routinely isolated from the serous and synovial cavities of infected pigs.Anti-hog cholera serum administered orally as a colostrum substitute gave partial protection against E. coli infection.     

Retinal injury induced by near-ultraviolet radiation in aphakic and pseudophakic monkey eyes. A preliminary report

The effect of repeated exposures to low-intensity, near-ultraviolet (UV) radiation on the retinas of phakic, aphakic, and pseudophakic monkey eyes was studied. Ten eyes (4 aphakic eyes, 3 pseudophakic eyes, and 3 normal phakic eyes) of five rhesus monkeys were used. The near-UV radiation was generated by a high-pressure mercury vapor lamp with a total radiance of 14.43 mW/cm2/sr. Exposure regimens were 5 minutes a day for 10 days, 15 minutes a day for 5 days, or 60 minutes a day for 5 days. The retinas of aphakic and pseudophakic eyes were exposed to a daily dose of more than 0.97 J/cm2, or a total dose of more than 4.9 J/cm2 in 5 days at a retinal irradiance of more than 1.0 mW/cm2. Three of four aphakic eyes and one of three pseudophakic eyes showed clinical and pathologic retinal lesions after radiation. None of the three phakic eyes was damaged. The retinal lesions showed mild opalescent thickening ophthalmoscopically and retinal pigment epithelial staining by fluorescein angiography. Histopathologically, the retinal pigment epithelium was the site of primary injury by near-UV radiation.     

Assigning patients with heart failure to observation status: B-type natriuretic peptide, ejection fraction, or physician judgment

It is of clinical and financial importance to identify those heart failure patients who are likely to improve rapidly. The authors evaluated, as predictors of short-term resolution, three clinical variables often used to predict long-term outcome. Consenting patients admitted to the emergency department with dyspnea were examined daily until resolution (symptom reversion to baseline absent worsening clinical signs or x-ray). The authors then compared hours to resolution of heart failure with serum B-type natriuretic peptide (BNP), ejection fraction (EF), and admitting physician prediction. They calculated negative and positive predictive values for EF, BNP, and physician opinion using quintile and published severity standards as cutoffs (for EF and BNP). Among 85 patients, BNP <400 pg/mL and <1000 pg/mL had poor positive predictive values (34% and 22%, respectively), as did EF (21%) and physician opinion (16%-21%, depending on physician confidence). Combining tests did not improve prediction. These results do not support the use of BNP, EF, or clinical assessment in triaging heart failure patients to short-stay status.     

Infant mortality in Sri Lankan households: a causal model

The infant mortality rate in Sri Lanka has fallen precipitiously since World War II, to 44 per 1000 births, a rate that is similar to a number of Western Countries. Yet the aggregated country rate masks wide variations across districts, from a low 21 per 1000 in Jaffna District to a high of 100 per 1000 in Nuwara Eliya District. Such regional variations in infant mortality rates have been shown to be related to a number of social, demographic and intitutional characteristics of each area. To specify such linkages we move, in this paper, from the aggregate level of analysis to the level of individual households in order to look for social, economic and other characteristics associated with infant deaths. Data are derived from a systematic interview of 480 household heads in 12 villages of Sri Lanka, collected in 1980. The most proximate factors, public health or medical variables, that predict infant death in particular households include quality of family nutrition, supervised childbirth, immunization of children and, most significant, whether the family has a sanitary latrine. Yet these medical variables are strongly associated with educational and economic characteristics of the family which, in turn, are predictive of infant mortality. Poor families and poorly educated mothers are less likely to go to hospital for childbirth, have a latrine, etc., and more likely to have had an infant die. Underlying the variations in education and economic status are variations in ethnic group; families with poor sanitation, least education and few economic resources are most likely to be members of the minority communities, Ceylon or Indian Tamils and Muslims. Minority group membership is significantly associated with infant mortality as well. When a set of medical, educational, economic and cultural variables are examined simultaneously within a path model we show that the best causal explanation of infant death in Sri Lankan households says, "Minority group status results in poverty which prevents families from having safe sanitary facilities which causes infant death". Infant mortality in Sri Lanka is thus not simply a medical problem to be dealt with by public health programs, nor is it solely an economic problem that can be solved with creation of jobs, but it is better seen as a problem of the structure of the whole society.