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PubMed2005

Hormonal aspects in the causation of human breast cancer: epidemiological hypotheses reviewed, with special reference to nutritional status and first pregnancy.

Epidemiology of breast cancer has identified early age at menarche, late first pregnancy, low parity and late menopause as risk factors, but in addition genetic factors, height, weight and living in western countries play a significant role. The international variation in incidence is almost exclusively due to non-genetic factors. Hypotheses in prevention-oriented research are reviewed: 1. obesity-related oestrogen production as a stimulus of the tumour in postmenopausal women; 2. nutritional status and energy expenditure during puberty and adolescence, developed for fertility and fecundity and extended later to breast cancer; 3. reproductive life during early adulthood, age at first pregnancy and its specific effects on breast tissues. The message of preventability of breast cancer is that mammary epithelial differentiation should come early. Our insight concerning events in puberty and early adulthood can be consolidated in one concept on the risk of extended proliferation of breast epithelium during early adulthood in the absence of full differentiation induced by pregnancy. The combined effects of Western-type nutrition, lack of exercise and Western-type women's emancipation sets the stage for breast cancer already at a young age. Since it is unlikely that emancipated women in affluent societies will return to the original life-style of getting pregnant as soon as it is biologically possible, a novel daring way of protection has to be considered. Could a "Breast Differentiation Pill" be developed to offer protection?

Age Factors↗
PubMed2006

Gene dosage in the developing and adult brain in a mouse model of 22q11 deletion syndrome.

We evaluated the consequences of heterozygous chromosome 22q11 deletion - a significant genetic risk for schizophrenia - for expression levels and patterns of a subset of 22q11 genes implicated in schizophrenia and other phenotypes in mouse models of 22q11 deletion syndrome (22q11DS). In deleted embryos, expression levels of at least nine 22q11 orthologues decline by 40-60% in the frontonasal mass/forebrain and other 22q11DS phenotypic sites (branchial and aortic arches, limb buds); however, coincident expression patterns of 22q11 and Snail genes - diagnostic for neural crest-derived mesenchyme - are unchanged, and Snail1 expression levels do not decline. Subsequently, 22q11 mRNA levels are reduced by 40-60% in the brains of developing, adolescent and adult deleted mice without altered expression patterns, dysmorphology or reduced cell density. Apparently, in deleted individuals, 22q11 gene expression declines across otherwise stable cell populations, perhaps disrupting individual cell function via diminished dosage. Such changes might contribute to schizophrenia vulnerability in 22q11DS.

Age Factors↗
PubMed1978

Sexual precocity in a male due to thoracic polyembryoma.

A 7-year-old boy with sexual precocity of recent onset was found to have elevated levels of chorionic gonadotropin, alpha fetoprotein, and testosterone. Removal of a retropleural, posterior mediastinal mass with an intraspinous epidural extension was followed by prompt declines in the plasma concentrations of the tumor markers and cessation of adolescent development. The neoplasm proved to be a polyembryoma, unusual in the multiplicity of its embryoid bodies and extra gonadal location. Following local irradiation and two years of systemic chemotherapy, the patient, now 13 years of age, has done well except for evidence of testicular tubular insufficiency.

Child↗
PubMedDate not supplied

Adolescent health.

Explore the source record for details and available documents.

Adolescent↗
PubMedDate not supplied

Ethnicity, culture, and neuropsychiatry.

The purpose of this paper is to review the research on the relationships among ethnicity, culture, neuropsychiatric diagnosis, and treatment. Psychiatric nurses provide care to an ethnically and culturally diverse group of clients. Knowledge of ethnic and cultural differences are essential to diagnosis and treatment. Ethnic diversity affects psychiatric diagnosis. Cross-ethnic differences in genetics, diet, environmental exposure, and fetal, childhood, and adolescent development may result in varied experiences of psychiatric illness among ethnic groups. Ethnic diversity also affects psychiatric treatment. There are dramatic ethnic differences in the metabolism of psychotropic medications and the effects of drugs on target organs. These differences are again due to genetic variation, exposure to different diets and environments, and other medications in use. Cultural diversity influences both diagnosis and treatment. Cultural forces shape symptom formation and the expression of distress, creating many sources for misdiagnosis based on DSM-IV criteria. The culture-bound syndromes represent unique illness forms with a natural history distinct from DSM classification. Culture also influences treatment expectations, therapeutic compliance, family involvement, and the interpretation of side effects, all of which help determine whether or not treatment will be effective. Neuropsychiatric nurses can contribute to research by studying cross-ethnic differences and similarities in biological markers of mental illness. A second significant area for research is that of ethnicity and psychotropic drug metabolism and pharmacodynamics.

Attitude to Health↗
PubMedDate not supplied

A comparison of two groups of women with bulimia nervosa on symptom onset.

Bulimia nervosa (BN) is a significant mental health problem for women. Both children and adolescents develop risk factors for BN that are identifiable. An important role for psychiatric-mental health nurses is the prevention of psychiatric disorders through risk factor identification and intervention for early symptoms. The purpose of this study was to extend recent research on the sequencing of risk factors and symptoms in the development of bulimia nervosa. Symptom history was collected on 71 women who agreed to participate in research on eating disorders (EDs). Women were divided into two groups based on whether their first symptom manifested was bingeing (BF) or dieting (DF). The groups were compared on age of symptom onset, weight history, and history of diagnosis. There were significant differences between the groups, and the present findings contradict some of the important conclusions from three previous studies. The results are discussed and implications for strategies for early detection and prevention are presented.

Adult↗
PubMed1990

A case study of lead in drinking water: protocol, methods, and investigative techniques.

A comprehensive study was performed to determine whether lead (Pb) in drinking water exceeded acceptable levels at a manufacturing and research site. Recent research indicates the possibility of abnormal adolescent development if the mother's blood lead levels exceed 15 micrograms lead per dL of whole blood. Using Environmental Protection Agency (EPA) estimates of average consumption and ratios correlating the amount of lead consumed to blood lead levels, a level of 10 micrograms/L of lead in water was determined to be acceptable. Water samples were collected from each type of water cooler and from faucets in every bathroom on site. Samples were collected that represented worst case exposures. Novel methods were used to identify the source of lead at those locations that exceeded the acceptable limit for lead. Control techniques are discussed. A laboratory study was performed to determine if lead could be prevented from leaching into drinking water from existing plumbing systems by treating the system with carbon dioxide gas.

Colorado↗
PubMed1992

To be or not be a woman: anorexia nervosa, normative gender roles, and feminism.

This paper reviews the characteristics of anorexia nervosa described in the DSM-III-R, relates them to normative gender roles and adolescent development, and critiques those roles on feminist grounds. Two apparently contradictory explanations for the irrational pursuit of thinness are considered: a) the anorexic thus attempts to conform to a socially defined feminine ideal; b) the anorexic thus attempts to avoid the appearance and consequences of mature womanhood. I propose that both explanations are applicable, together emplifying the ambiguity that Simone de Beauvoir considers characteristic of female experience. Because both explanations suggest a gender identity disorder, I question the fact that the DSM-III-R fails to indicate this linkage. I argue further that therapeutic considerations require efforts to alter the socialization factors that are implicative in anorexia nervosa.

Anorexia Nervosa↗
PubMed2005

Adolescent medicine in paediatric practice.

Adolescents are a growing area in paediatric practice in both hospital and community settings. They make up around one quarter of the practice of many paediatricians. Yet until recently there has been little formal interest in young people's health in the UK. The situation is now changing, particularly following the publication of the "National Service Framework for children, young people and maternity services", which places a major emphasis on adolescent health. Given that this area is relatively new to many paediatricians, this article aims to provide an overview of the range of health problems that affect young people, to provide practical advice for working with this group in paediatric practice, and to outline current and future opportunities for training in adolescent health in the UK.

Adolescent↗
PubMed1998

Response of proximal tubules to angiotensin II changes during maturation.

The renin-angiotensin system changes with age, but it is unclear how renal responses to angiotensin II (Ang II) evolve as an animal matures. We hypothesized that Ang II exerts a greater effect on proximal nephron volume absorption (Jv), blood pressure (BP), renal blood flow (RBF), and renal vascular resistance (RVR) in young compared with adult rats. To test this hypothesis, we investigated the effects of Ang II on proximal nephron fluid absorption in response to 10(-10) mol/L Ang II in rats from three age groups: young (4 to 5 weeks old), intermediate (6 weeks old), and adult (7 weeks old). In proximal straight tubules from 7 young rats, Jv was 0.64+/-0.05 nL/mm per minute. Ang II in the bath increased Jv by 69+/-18% to 1.05+/-0.07 nL/mm per minute (P<.005). In tubules from five intermediate-aged rats, Jv was 0.60+/-0.10 nL/mm per minute and increased by 34+/-5% to 0.83+/-0.16 nL/mm per minute after Ang II (P<.02). In five adult rats, Jv was 0.69+/-0.06 nL/mm per minute and increased 20+/-6% to 0.85+/-0.13 nL/mm per minute after Ang II (P<.05). Next we tested whether the exaggerated effect of Ang II on proximal tubular Jv in young rats was due to Ang II-induced changes in cAMP. cAMP content of proximal tubules from eight young rats was 24.8+/-7.6 fmol/mm and fell by 29.7+/-9.8% (P<.025) after treatment with Ang II. In contrast, cAMP content of proximal tubules from nine adults was only 9.8+/-4.5 fmol/mm, 40% of baseline in young rats, and was unchanged by Ang II (9.2+/-4.5 fmol/mm). We finally determined whether the increased sensitivity to Ang II in tubules of young rats is mimicked by renal hemodynamics. Eleven adult rats had BP of 115+/-5 mm Hg, RBF of 6.99+/-0.42 mL/min per g kidney weight (kw), RVR of 16.82+/-0.95 mm Hg/mL per minute per g kw (resistance units), and plasma renin activity (PRA) of 11.2+/-2.3 ng Ang I/mL per hour. Seven young rats had BP of 98+/-7 mm Hg, 17 mm Hg lower than adults (P<.025). RBF was 4.94+/-0.23 mL/min per g kw, and RVR was 20.30+/-1.19 RU, 20% greater than in adults (P<.025). PRA was 9.2+/-2.2 ng Ang I/mL per hour. There were no differences between groups with regard to increased BP, decreased RBF, or increased RVR with graded doses of 8, 40, and 200 fmol Ang II/g body weight. Thus, Ang II increased Jv more in young rats but had a lesser effect in adults. This was coupled with a greater effect of Ang II on tubular cAMP in young rats, but no differences in systemic or renal hemodynamic responses to Ang II between adults and young. We conclude that during adolescent development, Ang II may be an important factor in the regulation of salt and water metabolism, but not renal hemodynamics.

Absorption↗
PubMedDate not supplied

The association between athletic training time and the sagittal curvature of the immature spine.

Strenuous physical activity is known to cause structural abnormalities in the immature vertebral body. Concern that exposure to years of intense athletic training may increase the risk for developing adolescent hyperkyphosis in certain sports, as well as the known association between hyperkyphosis and adult-onset back pain, led us to examine the association between cumulative hours of athletic training and the magnitude of the sagittal curvature of the immature spine. A sample of 2,270 children (407 girls and 1,863 boys) between 8 and 18 years of age were studied. An optical raster-stereographic method was used to measure the mid-sagittal curvatures of the surface of the back while the subject was in the upright standing position to quantify the angles of thoracic kyphosis and lumbar lordosis. These data were then correlated with self-reported hours of training measured by interview and questionnaire. The possible effects of age, sex, sport, and upper and lower body weight training were investigated. The results in these young athletes showed that larger angles of thoracic kyphosis and lumbar lordosis were associated with greater cumulative training time. Gymnasts showed the largest curves. Lack of sports participation, on the other hand, was associated with the smallest curves. Age and sex did not appear to affect the degree of curvature.

Adolescent↗
PubMed2005

Age at first sexual assault and current substance use and depression.

This article explores how the association between sexual violence and substance use and mental health differs by race and life course stage. Analyses are based on data (n = 8,000) from the Violence and Threats of Violence against Women and Men in the United States Survey, 1994-1996 (NVAWS). Although sexual violence does not heighten the risk of problem drinking for White women, minority women victimized in adulthood are significantly more likely to engage in problem drinking and use illicit drugs. This suggests that for minority women the effects of recent victimization experiences result in immediate and potentially long-lasting consequences. The findings with respect to the association between sexual violence and depression are consistent with the child and adolescent development literature. It is Hispanic women who are more likely to suffer depression as a consequence of child sexual assault.

Adult↗
PubMed2002

Small group experience for socially withdrawn girls.

Social competence is the effectiveness of social interaction behavior. Given its link to mental health outcomes, it is an important consideration in child and adolescent development. Social withdrawal is associated with depression. Socially withdrawn children make few social initiations and tend to be isolated in their play, further limiting their social involvement. To develop effective social behavior, experiences must be provided to learn relationship skills. This practice improvement project provided a small group experience for five socially withdrawn school-age girls. Weekly group meetings provided a social situation in which conversations could occur around a shared snack and craft project. The school nurse facilitated self-assertion and the expression of prosocial behavior in a socially safe (nonrejecting) environment and promoted social problem solving. On completion of the program, the participants not only showed more effective social reasoning and social skills, but developed friendships with each other that lasted beyond the life of the group.

Child↗
PubMed2003

Child and familial pathways to academic achievement and behavioral adjustment: a prospective six-year study of children with and without ADHD.

This longitudinal study examined familial and child predictors of academic achievement and behavioral adjustment. Participants included 115 children with ADHD and 59 normative comparisons. Data analyses spanned three assessment waves from elementary- through secondary-school grades. We evaluated the degree to which child and familial factors present during middle school mediated relationships between childhood ADHD, subsequent academic achievement, and behavioral adjustment during high school. We found that emotional and behavioral well-being of ADHD children during middle school mediated relations between childhood ADHD and adverse academic and behavioral outcomes during high school. In addition, familial factors in middle school years predicted the behavioral adjustment of children in both the ADHD and non-ADHD groups. Academic achievement during high school was strongly associated with previous achievement levels. Our results provide support for tailoring preventive interventions to the unique needs of children with ADHD and their parents at various stages of adolescent development.

Attention Deficit Disorder with Hyperactivity↗
PubMed1997

Four-year remission of transsexualism after comorbid obsessive-compulsive disorder improved with self-exposure therapy. Case report.

BACKGROUND: There has been no report of comorbid transsexualism and obsessive-compulsive disorder (OCD) or of their differential course over follow-up. METHOD: Such comorbidity and follow-up are documented in a case report. RESULTS: A man who had been transsexual and homosexual since early adolescence developed severe OCD at age 40 as he became depressed when his mother, to whom he was very close, died. Two years later he was referred for his OCD. He refused treatment for his transsexualism. As his OCD and mood improved with self-exposure therapy, his transsexualism and homosexuality remitted also. Four years later depression and transsexualism recurred and remained to six-year follow-up despite full remission in OCD continuing throughout. CONCLUSIONS: The sequence is like that in other cases in whom unusual sexual behaviour remitted for years after comorbid disorders improved with various treatments, or after circumstances changed.

Humans↗
PubMed2000

Anisomastia associated with interstitial duplication of chromosome 16, mental retardation, obesity, dysmorphic facies, and digital anomalies: molecular mapping of a new syndrome by fluorescent in situ hybridization and microsatellites to 16q13 (D16S419-D16S503).

Anisomastia is a common problem among developing adolescent girls. We recently evaluated a 22-yr-old female patient who had severe anisomastia (which had been repaired by surgery), associated with moderate to severe mental retardation, a stocky body habitus with mild obesity, dysmorphic facies (prominent, upslanting palpebral fissures, beaked nose, and a prominent philtrum), webbed neck, low hairline, and severe bilateral clinodactyly of the third, fourth, and fifth fingers with acral (but not large joint) flexion contractures. A peripheral blood high resolution karyotype revealed additional chromosomal material within the long arm of chromosome 16. Densitometric analysis of amplified polymorphic sequence-tagged sites (STS) mapping to 16q suggested that the duplication is defined by the noninvolved markers D16S419 [16q12-cen, 66 centimorgan (cM) from 16p terminus] and D16S421 (16q13-q21, 84.4 cM), encompassing a maximum of 18.4 cM of genetic distance. The STS analysis showed that the duplication was on the maternally derived chromosome 16, resulting in two maternal (and one paternal) copies of that region of chromosome 16. The location was further confirmed by bacterial artificial chromosomes (BACs) that were obtained from a commercially available library, labeled, and used for fluorescence in situ hybridization. The BACs containing STSs D16S408, D16S3137, and D16S3032 (markers that correspond to 16q13) showed two regions of hybridization, indicating that these sites were duplicated, whereas a BAC containing the STS D16S512 (which corresponds to 16q21-q22) revealed one hybridization signal per 16q, indicating that the corresponding region was not involved in the duplication. The distance between the probe signals suggested a tandem duplication. We conclude that even though trisomy 16 is the most common autosomal trisomy in spontaneous abortions, few patients with unbalanced chromosome 16 abnormalities survive to adulthood; in this report we describe one such patient with an interstitial chromosome 16 duplication (at 16q13), who had a specific phenotype associated with abnormal breast size. There are clinical similarities between this patient and patients with other 16q abnormalities, although the breast findings were unique. Molecular cytogenetics, including fluorescence in situ hybridization and densitometric analysis of amplified STSs, provided useful tools for the precise mapping of the syndrome to 16q13, where the gene(s) responsible for this phenotype might be localized.

Adult↗
PubMed2002

Hepatitis C virus and human immunodeficiency virus-1 co-infection in former heroin addicts in methadone maintenance treatment.

OBJECTIVES: To investigate hepatitis C (HCV) and human immunodeficiency virus (HIV-1) prevalence in former opiate or heroin addicts currently in methadone maintenance treatment (MMT). METHODS: Retrospective chart review for patients (n = 342) currently attending two MMT clinics affiliated with New York Presbyterian Hospital (Adolescent Development Program, ADP: n = 106, median age 30 years; Adult Clinic, AC: n = 236, median age 45 years), as of May 2000. RESULTS: Overall seroprevalence of those tested was 67% for HCV (ADP, 44%; AC, 80%), and 29% for HIV-1 (ADP, 13%, AC, 39%). Co-infection was present in 26% of patients (ADP, 13%; AC, 35%). Prevalence of HCV reached 92% in the 45-49 year old group (n = 53). The greatest HIV-1 prevalence (45%) was in the 35-39 year old group (n = 33). There was a linear relationship between infection seroprevalence and age at admission into MMT. CONCLUSIONS: The high prevalence of HCV and HIV-1 infections in MMT patients varies both by current age and by age at admission to MMT. This population needs risk reduction education and treatment for HCV and HIV- 1.

Adult↗