BACKGROUND: The CAGE and the Brief MAST questionnaires are widely used to screen for alcohol problems. We tested the performance of these instruments in 2 population-based groups: a high-risk sample composed of relatives of alcoholic subjects and a community sample consisting of families not selected for alcoholism (ie, alcohol dependence disorder). METHODS: A total of 3435 relatives of alcoholics and 795 control subjects were interviewed with the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA) semistructured interview in a multicenter collaborative study on the genetics of alcoholism. The performance of "CAGE" and "Brief MAST" equivalent items in the SSAGA was characterized by their positive predictive value, sensitivity, specificity, and percentage of the sample who screened positive. RESULTS: Both questionnaires performed well in the highrisk sample, where the base rate of alcoholism was 35%. However, in the community sample, where the 16% rate of alcoholism was comparable to that of the US population (14%), an acceptable positive predictive value could be achieved only through a substantial reduction in sensitivity. Results were similar when men were compared with women and when lifetime alcoholics were compared with current alcoholics. CONCLUSION: The "Brief MAST" and "CAGE" can be effective instruments to screen for significant alcohol problems in both community and high-risk patients; as expected, their positive predictive value increases with the base rate of alcoholism in the population being screened.

Alcoholism↗

PubMedDate not supplied

The association between punitive childhood experiences and hyperactivity.

This study compared the abuse histories and home environments of adult males who had been referred for Attention Deficit-Hyperactivity Disorder (ADHD) with that of their nonADHD siblings. Probands and brothers did not differ in their reporting of physical punishment, discipline, parental rejection, or positive parental contact, nor did they differ in their perception of the general atmosphere of their home environments. These findings were generally replicated in a larger sample of ADHD probands, nonADHD brothers and a group of classmate controls. In addition, the relation between severity of hyperactive and aggressive symptoms and degree of abuse was examined within an ADHD sample. Neither the degree of hyperactive symptoms, the degree of aggressive symptoms, nor the interaction of the two was associated with the amount of physical punishment reported. These data challenge the "scapegoat" or "target child" hypothesis prevalent in the child abuse literature by suggesting that punitive parenting may not be significantly controlled by the behavioral characteristics of ADHD children.

Adult↗

PubMedDate not supplied

Diagnosis of human coronary atherosclerosis by morphology-based Raman spectroscopy.

BACKGROUND: Recent studies have shown that chemical composition and morphology, rather than anatomy (degree of stenosis), determine atherosclerotic plaque instability and predict disease progression. Current clinical diagnostic techniques provide accurate assessment of plaque anatomy, but have limited capability to assess plaque morphology in vivo. Here we describe a technique for a morphology-based diagnosis of atherosclerosis in the coronary arteries using Raman spectroscopy that can potentially be performed in vivo using optical fiber technology. METHODS: Raman tissue spectra were collected from normal and atherosclerotic coronary artery samples in different stages of disease progression (n=165) from explanted transplant recipient hearts (n=16). Raman spectra from the elastic laminae (EL), collagen fibers (CF), smooth muscle cells (SMC), adventitial adipocytes (AA) or fat cells, foam cells (FC), necrotic core (NC), cholesterol crystals (CC), beta-carotene containing crystals (beta-C), and calcium mineralizations (CM) were used as basis spectra in a linear least squares-minimization (LSM) model to calculate the contribution of these morphologic structures to the coronary artery tissue spectra. RESULTS: We developed a diagnostic algorithm that used the fit-contributions of the various morphologic structures to classify 97 coronary artery samples in an initial calibration data set as either nonatherosclerotic, calcified plaque, or noncalcified atheromatous plaque. The algorithm was subsequently tested prospectively in a second validation data set, and correctly classified 64 (94%) of 68 coronary artery samples. CONCLUSIONS: Raman spectroscopy provides information about the morphologic composition of intact human coronary artery without the need for excision and microscopic examination. In the future, it may be possible to use this technique to analyze the morphologic composition of atherosclerotic coronary artery lesions and assess plaque instability and disease progression in vivo.

Adipocytes↗

PubMedDate not supplied

Raman microspectroscopy of human coronary atherosclerosis: biochemical assessment of cellular and extracellular morphologic structures in situ.

BACKGROUND: We have previously shown that Raman spectroscopy can be used for chemical analysis of intact human coronary artery atherosclerotic lesions ex vivo without tissue homogenization or extraction. Here, we report the chemical analysis of individual cellular and extracellular components of atherosclerotic lesions in different stages of disease progression in situ using Raman microspectroscopy. METHODS: Thirty-five coronary artery samples were taken from 16 explanted transplant recipient hearts, and thin sections were prepared. Using a high-resolution confocal Raman microspectrometer system with an 830-nm laser light, high signal-to-noise Raman spectra were obtained from the following morphologic structures: internal and external elastic lamina, collagen fibers, fat, foam cells, smooth muscle cells, necrotic core, beta-carotene, cholesterol crystals, and calcium mineralizations. Their Raman spectra were modeled by using a linear combination of basis Raman spectra from the major biochemicals present in arterial tissue, including collagen, elastin, actin, myosin, tropomyosin, cholesterol monohydrate, cholesterol linoleate, phosphatidyl choline, triolein, calcium hydroxyapatite, calcium carbonate, and beta-carotene. RESULTS: The results show that the various morphologic structures have characteristic Raman spectra, which vary little from structure to structure and from artery to artery. The biochemical model described the spectrum of each morphologic structure quite well, indicating that the most essential biochemical components were included in the model. Furthermore, the biochemical composition of each structure, indicated by the fit contributions of the biochemical basis spectra of the morphologic structure spectrum, was very consistent. CONCLUSIONS: The Raman spectra of various morphologic structures in normal and atherosclerotic coronary artery may be used as basis spectra in a linear combination model to analyze the morphologic composition of atherosclerotic coronary artery lesions.

Biomarkers↗

PubMedDate not supplied