Steady (daily, continuous) versus nonsteady (binge, episodic, bout, intermittent) drinking pattern have been influential Jellinek's (1960) formulation of delta and gamma drinkers, and are used as variables in various typological systems and drinker profiles. However, definitions of drinking patterns vary widely across studies, and most studies rely on one self-report item to establish a subject's pattern. To systematize and empirically test drinking-pattern schemas, we developed detailed definitions of binge, episodic, sporadic, and steady drinking patterns. A computer algorithm was written in SAS to classify 94 male alcoholics participating in outpatient conjoint therapy, using 6-month pretreatment drinking data from the Timeline Followback Interview. The final classification was: 3 (3%) binge, 33 (35%) episodic, 12 (13%) sporadic, and 40 (43%) steady drinkers. Six (6%) were unclassifiable (due to too few drinking days or too many interruptions to the pattern) by the computer. Episodic, sporadic, and steady drinkers did not differ in demographics, alcohol-related consequences, global psychological distress, or marital satisfaction. Steady drinking was associated with later onset of drinking problems (> 25), while episodic and sporadic drinking were associated with earlier onset. These results are contrary to current use of "binge drinking" as a variable associated with Type 1 alcoholism. Predictive validity analyses indicated that steady drinkers continued to drink more frequently than episodic and sporadic drinkers during treatment and 6 months posttreatment. Also, preliminary data indicate that pretreatment drinking pattern may be predictive of similar within-treatment urge-to-drink patterns. Implications for research and treatment are discussed.

Adult↗

PubMedDate not supplied

Observations on the American malpractice dilemma.

Explore the source record for details and available documents.

Humans↗

PubMedDate not supplied

Caprine uterine and placental osteopontin expression is distinct among epitheliochorial implanting species.

Osteopontin (OPN) is the most highly up-regulated extracellular matrix/adhesion molecule in the uterus of humans and domestic animals as it becomes receptive to implantation. Studies in sheep and pigs have shown that OPN is a component of ovine and porcine histotroph characterized by a complex temporal and spatial pattern of uterine and conceptus expression involving immune, epithelial, and stromal cells. It is proposed that these expression events are orchestrated to contribute to conceptus attachment and placentation. However, differences in OPN expression between sheep and pigs have been detected that relate to differences in placentation. Therefore, this study examined OPN expression in the caprine uterus and conceptus to gain insight into mechanisms underlying OPN function(s) during pregnancy through comparative analysis of differences in placentation between pigs, sheep, and goats. Goats were hysterectomized (n = 5/day) on Days 5, 11, 13, 15, 17 or 19 of the estrous cycle, and Days 5, 11, 13, 15, 17, 19 or 25 of pregnancy. Slot-blot hybridization showed increases in endometrial OPN mRNA beginning on Day 17 of the estrous cycle and Day 19 of pregnancy. In situ hybridization localized OPN mRNA to endometrial glandular epithelium (GE), Day 25 myometrium, and cells scattered within the placenta hypothesized to be immune. Immunofluorescence microscopy detected OPN protein on the apical surface of endometrial lumenal epithelium (LE), in GE, and on conceptus (Tr). Western blot analysis detected primarily the native 70-kDa OPN protein in endometrial extracts from the estrous cycle and pregnancy, as well as in uterine flushings from pregnant goats. Co-induction of OPN and alpha-smooth muscle actin, but not desmin proteins, was observed in uterine stroma by Day 25 of pregnancy. OPN in cyclic GE, Day 25 myometrium, and desmin-negative endometrial stroma is unique and reflects subtle differences among superficial implanting species that correlate with the depth of Tr invasion.

Animals↗

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Acute toxicity of ethylene glycol mono-n-butyl ether in the guinea pig.

Acute toxicity values, such as oral and percutaneous LD50s, are often used as the basis for classifying chemicals into toxicity categories, and their subsequent regulation. Such values obtained for ethylene glycol mono-n-butyl ether (EGBE; 2-butoxyethanol) in rats and rabbits indicate that it is moderately toxic. However, the cause of death in these acute studies appeared to be secondary to acute intravascular haemolysis, an effect for which guinea pigs and humans are much less sensitive than rats, mice and rabbits. Recently-conducted acute toxicity studies in the guinea pig resulted in an acute oral LD50 of 1400 mg/kg, an acute percutaneous LD50 of greater than 2000 mg/kg, and a 1-hr LC50 greater than 633 ppm. These data are compared with published acute toxicity values, and indicate that the predicted acute toxicity of EGBE in humans, based on data from the guinea pig, would be less than that observed in other animal species. Based in part on the guinea pig data, EBGE is no longer classified as a poisonous substance by either the United Nations or US Department of Transportation.

Administration, Inhalation↗

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Advance directive decision making among medical inpatients.

Per the Patient Self-Determination Act of 1991, hospitals are required to ascertain whether patients have an advance directive (AD). At this point, factors prompting patients to issue ADs have not been studied. The purpose of this study was to describe patients' understanding of ADs as well as the process patients used to arrive at their decisions to implement an AD. A stratified random sample of 26 patients from two intensive care units, one general medical unit, one general cardiac unit, and one acquired immunodeficiency unit were selected for participation. Patients were asked a series of open-ended questions to determine their knowledge and understanding of ADs. The constant comparative method was used to review the transcripts. It was found that only 31 per cent of patients had issued an AD, and 20% had learned of ADs for the first time during their hospitalization. Response analysis showed four phases of AD decision making: evaluation of illness, establishment of priorities, consideration of implications of the directives, and selection or rejection of directives. In conclusion, patients continue to have limited understanding of ADs and their implications. Continued investigation will elucidate the best strategies to educate patients about this topic.

Advance Directives↗

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Joining of V kappa to J kappa gene segments in a retroviral vector introduced into lymphoid cells.

V kappa to J kappa recombination occurred within a DNA construct introduced into cells in the form of a defective retrovirus. Analysis of one recombinant demonstrated that V kappa-J kappa joining can occur via inversion with a net loss of a few base pairs.

Animals↗

PubMedDate not supplied

Metacarpophalangeal pattern profile analysis of a sample drawn from a North Wales population.

Sexual dimorphism and population differences were investigated using metacarpophalangeal pattern profile (MCPP) analysis. Although it is an anthropometric technique, MCPP analysis is more frequently used in genetic syndrome analysis and has been under-used in the study of human groups. The present analysis used a series of hand radiographs from Gwynedd, North Wales, to make comparisons, first, between the sexes within the sample and then with previously reported data from Japan. The Welsh sexes showed MCPP analyses that indicated size and shape differences but certain similarities in shape were also evident. Differences with the Japanese data were more marked. MCPP analysis is a potentially useful anthropometric technique but requires further statistical development.

Adolescent↗