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PubMed1999

PTEN tumour suppressor is linked to the cell cycle control through the retinoblastoma protein.

The tumour suppressor PTEN, also named MMAC1 or TEP1, is associated with a number of malignancies in human populations. This protein has a dual protein phosphatase activity, being also capable to dephosphorylate phosphatidylinositol 3,4,5 triphosphate. We have studied the mechanism of growth suppression attributable to PTEN. We observed that PTEN overexpression inhibits cell growth in a variety of normal and transformed, human and murine cells. Bromodeoxyuridine (BrdU) incorporation and TUNEL labelling experiments in transiently transfected cells demonstrate that this inhibition is due to a cell cycle arrest rather than induction of apoptosis. Given that PTEN is unable to cause cell growth arrest in retinoblastoma (Rb)-deficient cell lines, we have explored the possible requirement for pRb in the PTEN-induced inhibition of cell proliferation. We found that the co-expression of SV40 antigen, but not a mutant form (which binds exclusively to p53), and cyclin D1/cdk4 are able to overcome the PTEN-mediated growth suppression. In addition, the reintroduction of a functional pRb, but not its relatives p107 or p130, in Rb-deficient cells restores the sensitivity to PTEN-induced arrest. Finally, the hyperphosphorylation of transfected pRb is inhibited by PTEN co-expression and restored by PI-3K co-expression. Accordingly, PTEN gene is mostly expressed, in parallel to Akt, in mid-late G1 phase during cell cycle progression prior to pRb hyperphosphorylation. Finally, we have studied the signal transduction pathways modulated by PTEN expression. We found that PTEN-induced growth arrest can be rescued by the co-expression of active PI-3K and downstream effectors such as Akt or PDK1, and also certain small GTPases such as Rac1 and Cdc42, but not by active Ha-ras, raf or RhoA. Collectively, our data link the tumour suppressor activities of PTEN to the machinery controlling cell cycle through the modulation of signalling molecules whose final target is the functional inactivation of the retinoblastoma gene product.

3T3 Cells↗

PubMed2004

Amphetamines for schizophrenia.

BACKGROUND: It is estimated that between 10% and 65% of people with schizophrenia use illicit drugs such as amphetamines. This group have an increased rate of hospitalisation, homelessness, unemployment and suicide compared with those with schizophrenia who do not abuse drugs. OBJECTIVES: To evaluate the effects of amphetamines for people with schizophrenia in terms of clinically meaningful outcomes, cognitive functioning and physiological tests. SEARCH STRATEGY: We searched the Cochrane Schizophrenia Group's Register (February 2002). SELECTION CRITERIA: We included all randomised controlled trials investigating the effects of amphetamines on people with schizophrenia, compared with a placebo intervention. DATA COLLECTION AND ANALYSIS: Working independently, we selected and critically appraised studies, extracted data and analysed on an intention-to-treat basis. Where possible and appropriate we calculated risk ratios (RR) and their 95% confidence intervals (CI), with the number needed to treat (NNT). For continuous data we calculated Weighted Mean Differences (WMD). MAIN RESULTS: We included four short studies with a total of 83 participants. Data were few and poorly reported. The results indicated a reduction of negative symptoms for people allocated to amphetamines (n = 16, 1 RCT, WMD -3 CI -5.02 to -0.98). No such effect was found for positive symptom change (n = 16, 1 RCT, WMD 0 CI -4.46 to 4.46). Compared with placebo, amphetamines significantly increased metabolism in the left and right cerebellum (n = 23, 1 RCT, WMD 0.12 CI 0.06 to 0.18; n = 23 1 RCT, WMD 0.12 CI 0.06 to 0.18) and left striatum (n = 23, 1 RCT, WMD 0.14 CI 0.00 to 0.28) and also significantly decreased metabolism in the left dorsolateral prefrontal cortex (n = 23, 1 RCT, WMD -0.09 CI -0.17 to -0.01). REVIEWERS' CONCLUSIONS: Understandably amphetamines are rarely formally evaluated in randomised studies and therefore unpublished work in this area is likely to exist. Addition of more studies may clarify reasons why people with schizophrenia persist in taking these harmful stimulants.

Amphetamine-Related Disorders↗

PubMed2004

The effects of prior workplace behavior on subsequent sexual harassment judgments.

A dual processing model of sexual harassment judgments predicted that the behavior of a complainant in a prior case would influence evaluations in an unrelated subsequent case. In the first of two experimental scenarios depicting social-sexual conduct at work, the female complainant's conduct was manipulated to be aggressive, submissive, ambiguous, or neutral. Half of the participants were asked to reflect upon the first scenario after reading it and before answering responsibility questions. The other half simply reviewed the scenario and answered the questions. When the complainant acted aggressively, her behavior in the first scenario caused men who reflected on the fact pattern to find less evidence of harassment. Most interestingly, an aggressive complainant observed in the first scenario caused participants (especially women) to rate lower the likelihood that a neutral complainant in a second independent case was the victim of gender discrimination. Across cases, men found less evidence of harassment than did women.

Behavior↗

PubMed1998

Change in job conditions and change in psychological distress within couples: a study of crossover effects.

In a random sample of 242 full-time employed men and women in dual-earner couples (N = 484), this study estimated the relations between (a) his experiences on the job over time and her distress over time and (b) her experiences on the job over time and his distress over time. In addition, we explored whether the crossover effects were due primarily to experiences with particular job conditions, and whether there were gender differences in the magnitude of these associations. The participants were interviewed 3 times over a 2-year period. After taking into account the relationship between each partner's own job conditions over time and her or his own psychological distress, there were significant associations between both the time-varying and the stable components of each partner's job conditions on the other partner's distress. The findings are discussed within the context of the need to expand the models used to study the job stress-illness relation to include longitudinal and within-couple crossover effects.

Adult↗

PubMed2005

Racial disparities in the receipt of osteoporosis related healthcare among community-dwelling older women with arthritis and previous fracture.

OBJECTIVE: To examine potential racial/ethnic disparities in osteoporosis care among community-dwelling older women with self-reported arthritis and previous fracture. METHODS: We conducted a computer assisted telephone interview using a population based random sample drawn from 6 counties in Alabama, USA. Eligible respondents had self-reported arthritis and were over 50 years of age; 1424 people responded to the survey. Logistic regression was used to examine the association of race/ethnicity with the receipt of dual energy x-ray absorptiometry (DEXA) and prescription osteoporosis treatments (including bisphosphonates, calcitonin, hormone replacement, or selective estrogen receptor modulators) among older women with a history of fracture. RESULTS: Of eligible African American and Caucasian female respondents, 251 (25%) reported a history of fracture after 45 years of age. Women with a history of self-reported fracture were predominantly Caucasian (n = 178, 71%) and had a mean age of 68 +/- 11 years. After multivariable adjustment, African American women with a fracture history were less likely than Caucasian women with a history of fracture to receive a DEXA (OR 0.39, 95% CI 0.19-0.81) or prescription osteoporosis medicines (OR 0.17, 95% CI 0.08-0.37). CONCLUSION: In this population of community-dwelling older women, African American respondents at high risk for fracture were far less likely than Caucasians to receive osteoporosis related healthcare.

Absorptiometry, Photon↗

PubMed2006

Auditory recognition memory, conscious recollection, and executive function in patients with schizophrenia.

BACKGROUND: Dual-process models propose that recognition memory (RM) involves two processes: conscious recollection and familiarity-aware memory. Studies investigating RM in schizophrenia report a selective deficit in conscious recollection and intact levels of familiarity-driven RM for stimuli presented in the visual and olfactory domains. It has been suggested that abnormalities in conscious recollection result from a breakdown in frontal strategic memory processes involved in encoding and retrieval and executive functions linked to reality monitoring and decision making. We investigated three predictions arising from these proposals. Firstly, if conscious recollection abnormalities arise from a central impairment, then these abnormalities should not be domain specific. Secondly, if the deficits in conscious recollection arise from a breakdown in executive processes, deficiencies should be correlated with executive dysfunction. Finally, the conscious recollection deficiencies are likely to be more severe in schizophrenia, a condition associated with marked executive dysfunction relative to Major Depressive Disorder, Recurrent (MDDR), in which executive dysfunction is less marked. METHODS: The remember/know paradigm was used to investigate RM for voices in three groups: patients with schizophrenia (n = 14), patients with MDDR (n = 16), and normal controls (n = 16). Executive function was assessed using the Wisconsin Card Sorting Task. RESULTS: Patients with schizophrenia made significantly fewer remember responses than normal controls (p < 0.01), despite normal levels of discrimination and familiarity-driven auditory RM. Patients with MDDR did not differ significantly from either normal controls or patients with schizophrenia. Executive dysfunction was limited to the schizophrenia group and was not correlated with conscious recollection deficiencies. CONCLUSIONS: Patients with schizophrenia exhibit a deficit in conscious recollection for auditory RM of voices. These findings, when considered alongside remember/know data collected from the same set of patients for olfactory and visual RM, support proposals that abnormalities in conscious recollection stem from a breakdown in central rather than domain-specific processes.

Auditory Perception↗

PubMed2000

PCR detection of granulocytic ehrlichiae in Ixodes ricinus ticks and wild small mammals in western Switzerland.

The presence of granulocytic ehrlichiae was demonstrated by PCR in Ixodes ricinus ticks and wild small mammals in Switzerland in two areas of endemicity for bovine ehrlichiosis. Six ticks (three females and three nymphs) (1.4%) of 417 I. ricinus ticks collected by flagging vegetation contained ehrlichial DNA. A total of 201 small mammals from five species, wood mouse (Apodemus sylvaticus), yellow-necked mouse (Apodemus flavicollis), earth vole (Pitymys subterraneus), bank vole (Clethrionomys glareolus), and common shrew (Sorex araneus), were trapped. The analysis of I. ricinus ticks [corrected] collected on 116 small mammals showed that nine C. glareolus voles and two A. sylvaticus mice hosted infected tick larvae. In these rodents, granulocytic ehrlichia infection was also detected in blood, spleen, liver, and ear samples. Further examinations of 190 small mammals without ticks or with noninfected ticks showed the presence of ehrlichial DNA in spleen and other tissues from six additional C. glareolus, three A. flavicollis, and one S. araneus mammals. This study suggests that A. sylvaticus, A. flavicollis, S. araneus, and particularly C. glareolus are likely to be natural reservoirs for granulocytic ehrlichiae. Partial 16S rRNA gene sequences of granulocytic ehrlichiae from ticks and rodents showed a high degree of homology (99 to 100%) with granulocytic ehrlichiae isolated from humans. In contrast, groESL heat shock operon sequence analysis showed a strong divergence (approximately 5%) between the sequences in samples derived from rodents and those derived from samples from questing ticks or from other published ehrlichia sequences. Dual infections with granulocytic ehrlichia and Borrelia burgdorferi were found in ticks and small mammals.

Animals↗

PubMed2002

Bull exposure and an increased within-day milking to suckling interval reduced postpartum anoestrus in dual purpose cows.

It is hypothesized that the combined effects of suckling and milking in the dual purpose cows is one of the main suppressors of reproductive efficiency in this production system. The experiment described here examined whether managing the interval between milking and suckling could reduce the postpartum anoestrous period and whether the presence of a teaser bull could enhance the effects of these managements. The experiment involved 39 Bos taurus x Bos indicus cows which had an average weight of 523.0 +/- 12.8 kg (mean +/- S.E.M.) and body condition score of 5-7 (scale 1-9) at calving. The cows and calves grazed separate pastures and the cows were supplemented with 2 kg 17% CP concentrates and 1 kg molasses per cow per day. The experiment was conducted over the first 100 days postpartum. Cows were hand-milked once per day in the presence of the calf to stimulate milk release. The factors in the 2 x 2 design were the milking to suckling interval (0 h, control suckling; CS versus 8 h prolonged-delay suckling; PDS) and no exposure versus exposure to a teaser bull (B). Cows were assigned at random within calving date to the four treatments: CS (n = 10), PDS (n = 10), CS-B (n = 9) and PDS-B (n = 10). Cows on treatments CS and CS-B had three-quarters of the udder milked and one-quarter was not milked. The entire udder was milked on those treatments where there was an interval between milking and suckling. The bull was introduced 7 days after calving in treatments where the cows were exposed to a teaser bull. Body weights of cows and calves and cow milk yield were recorded. Weekly blood samples were collected for plasma progesterone assay. Data were analyzed by ANOVA in a 2 x 2 factorial design and by chi(2)-test. There were no statistically significant differences between treatments in cow body weight at calving and at 100 days postpartum, nor in milk yield (overall mean 6.0 +/- 1.1 kg per day). Calf daily gain was 598 +/- 25 g for treatments CS and CS-B in which suckling immediately followed milking and 833 +/- 24 g for treatments PDS and PDS-B (P < 0.001). The proportion of cows ovulating was CS 80.0%, PDS 100.0%, CS-B 88.8% and PDS-B 100.0%. The difference between CS and PDS or PDS-B was significant (P < 0.05). CS-B did not differ significantly from the other three treatments. The calving to first ovulation interval was not improved when the interval between milking and suckling was increased from 0 h (56.5 +/- 5.0 days) to 8 h (64.8 +/- 4.5 days). Exposure to a teaser bull, however, significantly (P < 0.001) reduced this interval from 77.0 +/- 2.7 days (no bull exposure) to 44.4 +/- 2.7 days (exposure to teaser bull). Exposure to a teaser bull significantly reduced the calving to first anoestrus interval. Delaying the start of suckling after milking did not improve the reproductive performance of the cows or alter the effect of bull exposure, however, delaying suckling after milking improved the performance of the calves without affecting milk yield.

Anestrus↗

PubMed2006

Molecular epidemiology of HIV Type 1 in preparation for a Phase III prime-boost vaccine trial in Thailand and a new approach to HIV Type 1 genotyping.

To characterize HIV-1 genotypes in candidate populations for a prime-boost phase III vaccine trial in Thailand, specimens from prevalent and incident HIV-1 infections from a family planning clinic population in Rayong Province and a community cohort in Chon Buri Province, collected from 1998 to 2001, were genotyped. A new multiregion hybridization assay, MHAbce, capable of distinguishing HIV-1 CRF01_AE, subtype B, and subtype C and their recombinants, was developed and applied to prevalent infections. Most incident and selected prevalent infections were studied by complete genome sequencing. By MHAbce, 168 of 194 prevalent infections were genotyped. Of these, 90.5% were CRF01_AE, 2.4% were subtype B, and 7.2% showed discordant or dual probe reactivity, indicative of recombination or dual infection, respectively. Among 23 incident infections, 20 were sequenced. Eighteen CRF01_AE, one subtype B, and one CRF01/B recombinant strains were seen. Two CRF01/B and one CRF01/C recombinant were identified among selected prevalent infections. These results indicate that incident and prevalent HIV-1 infections in Rayong and Chon Buri during 1998-2001 were 90% CRF01_AE, 3% subtype B, and 7% either recombinant or dual. This study frames the genetic diversity of HIV-1 in these cohorts in their preparatory phase for the ongoing ALVACHIV (vCP1521) prime, AIDSVAX B/E boost, phase III vaccine trial and will provide a benchmark for interpretation and analysis.

AIDS Vaccines↗

PubMed2000

Short-term increases in bone turnover markers predict parathyroid hormone-induced spinal bone mineral density gains in postmenopausal women with glucocorticoid-induced osteoporosis.

The purpose of this study was to test the ability of early changes in markers of bone turnover to predict subsequent changes in bone mineral density (BMD) induced by parathyroid hormone fragment, PTH (1-34), in postmenopausal osteoporotic women treated with estrogen and glucocorticoids. Forty-nine postmenopausal women with chronic, inflammatory diseases and BMD T-scores < or = -2.5 at the lumbar spine or femoral neck who were concurrently treated with estrogen > or = 1 year and prednisone 5-20 mg/day for > or = 1 year participated. Subjects were randomized to treatment with human PTH (1-34) 400 IU/day or to a control group for 1 year and followed for an additional year. Serum and urine were collected at baseline and 1, 3, 6, 9, 12, 18 and 24 months for measurement of bone alkaline phosphatase (BAP), osteocalcin (OC) and deoxypyridinoline (DPD). We constructed an Uncoupling Index (UI) from all three markers (UI = [ZBAP + Zoc]/2 -ZDPD, where the Z-score for each marker in each subject was calculated from the mean and standard deviation of the study population at baseline). BMD of the lumbar spine and hip was measured at baseline and every 6 months thereafter by dual-energy X-ray absorptiometry (DXA) and annually by quantitative computed tomography (QCT; spine only). BMD of the spine, but not hip (total, femoral neck or trochanter), and levels of all three markers increased significantly as a result of PTH treatment (p<0.01 compared with controls). The resorption response lagged behind that of formation as evidenced by a significant increase (p < 0.05) in the UI for the first 9 months of treatment. The UI values and changes from baseline to 1, 3 and 6 months in BAP, OC and DPD were correlated with the 12- and 24-month changes in spine BMD measured both with QCT and with DXA (Spearman's rank coefficients <0.76; p<0.05). Most PTH-treated subjects could be identified as biochemical responders by least significant change analysis. Following 1 month of therapy, BAP and OC identified 65% and 81% as responders, respectively. The responder rates were 79%, 79% and 75% for BAP, OC and DPD, respectively by 6 months. Responders exhibited a high level of diagnostic accuracy for predicting a gain in BMD (areas under the receiver operating characteristic curves exceeding 0.79 for QCT and 0.70 for DXA), but not the magnitude of the gain. These data suggest that serial bone marker measurements may be useful in identifying skeletal responders to an anabolic therapy, such as PTH, in estrogen-replete postmenopausal women with glucocorticoid-induced osteoporosis.

Aged↗

PubMed1998

Quantitative ultrasonometry (QUS) for the evaluation of osteoporosis risk: reference data for various measurement sites, limitations and application possibilities.

Osteoporosis is a wide-spread disease characterized by low bone mass, deterioration of bone structure and typical fractures, which lead to pain, disability and high costs for health systems. Quantitative Ultrasonometry (QUS) is a new, non-invasive method to study bone density and structure in vivo. This technique has the following advantages: it is safe; it is easy to use, there is no radiation load on the patient, and instruments can be transported and are relatively cheap, as compared with the substantially more expensive methods of traditional osteodensitometry (dual X-ray absorptiometry = DXA, quantitative computed tomography = QCT). For measuring the osteoporosis risk, QUS has the same value as the conventional radiological osteodensitometry methods (QCT, DXA) The combination ofQUS, DXA and QCT improves the message. At present, there are three measurement sites for QUS measurement at the skeleton: the calcaneus, the tibia and the phalanges. The oldest method is the calcaneus measurement, and instruments with and without a water bath are available for this purpose. QUS might be a screening method for osteoporosis. Currently QUS can already be used in clinical practice. It can, for example, be an aid in decision-making for female patients who do not wish to have a postmenopausal hormone replacement therapy (HRT) or who can only barely tolerate doses with a bone-protective effect. In addition, patients can be examined before and after a glucocorticoid therapy with regard to a possible loss in bone mass. As a third possibility, QUS provides a further opportunity for subdividing into development stages patients with an established osteoporosis resulting in fractures, since there is an indication that by means of QUS it may be possible to account for more structural bone changes than with the traditional DXA or QCT methods. Treatment can also be monitored by means of QUS. As prospective studies have shown, increases in SOS by HRT and alendronate and precision error of QUS are lower than expected changes. Due to the greater practicability of QUS (no radiation load, portable instruments), this method ought to be further used in research and clinical settings, and more experience ought to be collected with this method so that wide-ranging experience can help the management of our patients.

Adult↗

PubMed2004

Experiences with a workstation prototype for softcopy reading within the Bavarian mammography recertification program: workstations and education.

RATIONALE AND OBJECTIVES: In January 2002, the Bavarian Statutory Health Care Administration ("Kassenärztliche Vereinigung Bayerns", KVB) started a recertification program for quality assurance and quality improvement in mammography reading. MATERIALS AND METHODS: All accredited radiologists and gynecologists are asked to prove their qualification every 1-2 years. The recertification program requires the physicians to read 50 cases randomly selected from a larger collection of high-quality test cases. The portion of malignant and benign cases corresponds to the requirements of the German National Association of Statutory Health Insurance Physicians ("Kassenäztliche Bundesvereinig ung", KBV). In order to perform the recertification in a manageable manner a decentralized approach (test at different locations in parallel) was preferred over a centralized one. Therefore, the X-ray films were digitized and converted to DICOM Digital Mammography format to be read on a softcopy device. To verify the applicability of digitized mammograms for recertification purposes, a comparative study with 32 trained radiologists and gynecologists was performed. RESULTS: A system of two high-resolution/high-contrast monitors (2048 X 2560 pixels, > or = 350 cd/m2) in combination with a 5 mega-pixel dual-head graphics adapter with calibrated output was chosen for the mammography workstation. The software was implemented according to the particular requirements of this program. As a result, the comparative study showed that there was no significant difference in the error rate of the reported findings between conventional film and softcopy reading. CONCLUSION: The first intermediate results of this quality initiative are promising. As of 2003, the test is mandatory for all mammography-reading physicians in Bavaria.

Breast Neoplasms↗

PubMed2005

Nigerian HIV type 2 subtype A and B from heterotypic HIV type 1 and HIV type 2 or monotypic HIV type 2 infections.

The presence of HIV-2 in Nigeria has been confirmed serologically, but not genetically. To determine the frequency of HIV-2 infections and the dynamics between HIV-1 and HIV-2 in 35 of 36 Nigerian states, 420 blood samples were collected in 1999. Antibodies to HIV-1 and HIV-2 were detected by EIA and seroreactivity was confirmed with the INNO-LIA HIV Line Assay. The frequency of HIV-2 was 4.3% (18 of 420), with 3.8% (16 of 420) HIV-1 and HIV-2 (HIV-1/2) heterotypic and 0.5% (2 of 420) HIV-2 homotypic infections. The presence of HIV-2 subtype B in the two monotypic HIV-2 infections and subtype A in 11 (68.8%) of 16 HIV-1/2 dually seropositive samples was established by sequencing and phylogenetic analysis. HIV-2 subtype B viruses were not found in any of the HIV-1/2 dual infections, and HIV-2 subtype A strains were not identified in either of the two monotypic HIV-2 infections. Since our sample size was small and represented only convenience samples, larger randomized studies will be needed to better understand the dynamics of infection between HIV-1 and different HIV-2 subtypes and to determine whether significant biological differences exist among the HIV- 2 subtypes.

DNA, Viral↗

PubMed1994

Completeness and accuracy of interview data from proxy respondents: demographic, medical, and life-style factors.

To evaluate the quality of exposure data provided by proxy respondents, we used a dual interview protocol in a case-control study of subarachnoid hemorrhage. All control subjects and their proxy respondents were interviewed (N = 283 control-proxy pairs), as were the cases who were able to provide their own information and their proxy respondents (N = 68 case-proxy pairs). The reliability of proxy-derived data was excellent for demographic and body habitus measures (kappa or intraclass correlation range = 0.86-0.99), and all aspects of cigarette smoking history (range = 0.79-0.93). Proxy reliability was somewhat lower for questions regarding medications and hormone preparations (range = 0.55-0.88), alcohol consumption (range = 0.52-0.82), and recreational physical activity (range = 0.55-0.67). Proxy reliability varied according to the relationship of the proxy to the index subject. Relative to the index subjects, proxy respondents tended to underreport the presence or level of exposure. For most exposures, odds ratios computed with proxy-derived data were similar in magnitude to odds ratios obtained with index subject data; important bias due to differential nonresponse or differential misclassification was suggested only for questions regarding hormone replacement therapy. Epidemiologic studies that rely on proxy respondents may require more subjects to offset the effect of nondifferential nonresponse and misclassification on the precision of effect estimates.

Adolescent↗

PubMed2002

Human immunodeficiency virus type 1 group m protease in cameroon: genetic diversity and protease inhibitor mutational features.

To establish a baseline for monitoring resistance to protease inhibitors (PIs) and examining the efficacy of their use among persons in Cameroon infected with human immunodeficiency virus type 1 (HIV-1), we analyzed genetic variability and PI resistance-associated substitutions in PCR-amplified protease (PR) sequences in strains isolated from 110 HIV-1-infected, drug-naïve Cameroonians. Of the 110 strains, 85 were classified into six HIV-1 PR subtypes, A (n = 1), B (n = 1), F (n = 4), G (n = 7), H (n = 1), and J (n = 7), and a circulating recombinant form, CRF02-AG (n = 64). PR genes from the remaining 25 (23%) specimens were unclassifiable, whereas 2% (7 of 301) unclassifiable PR sequences were reported for a global collection. Two major PI resistance-associated mutations, 20M and 24I, were detected in strains from only two specimens, whereas secondary mutations were found in strains from all samples except one strain of subtype B and two strains of CRF02-AG. The secondary mutations showed the typical PI resistance-associated pattern for non-subtype B viruses in both classifiable and unclassifiable PR genes, with 36I being the predominant (99%) mutation, followed by 63P (18%), 20R (15%), 77I (13%), and 10I or 10V (11%). Of these mutations, dual and triple PI resistance-associated substitutions were found in 38% of all the Cameroonian strains. Compared with classifiable PR sequences, unclassifiable sequences had significantly more dual and triple substitutions (64% versus 30%; P = 0.004). Phenotypic and clinical evaluations are needed to estimate whether PI resistance during antiretroviral drug treatment occurs more rapidly in individuals infected with HIV-1 strains harboring multiple PI resistance-associated substitutions. This information may be important for determination of appropriate drug therapies for HIV-1-infected persons in Cameroon, where more than one-third of HIV-1 strains were found to carry dual and triple minor PI resistance-associated mutations.

Amino Acid Sequence↗

PubMed1993

[Obstetric data processing with a personal computer].

Update computer technology is an increasingly useful tool in medicine for more accurate documentation, avoidance of multiple documentation, improvement of service performance, quicker and easier data processing and evaluation and hence quality assurance. We developed an obstetric data recording programme for an IBM compatible personal computer according to the MS-DOS command programme. A laser printer with dual paper feed is available. The relational database system Clipper is used for programming. The programme comprises at present 179 data fields and is subdivided on the input side into: data on anamnesis and partus, course of puerperium, infant data. This gives the print-outs: birth protocol, adhesive labels for the temperature curves of the mother and of the infant, respectively, birth record book and mother-infant health passport, furthermore, list print-outs: infant record book, transferred/decreased infants, birth lists relating to midwives, and, in addition, physician's report on the mother and the child, and finally, automated monthly and annual statistics. From August 1990 to July 1992, all events were stored by the computer, so that a total of 5,572 data items have been recorded to date. The primary scope of recording was 98.4% already in the first year of full operation of the database. Computer feed-in was affected directly after each data item became available. Application is fully integrated into normal clinical everyday work. To ensure best possible motivation and acceptance, special attention was paid to user friendliness and immediate print-outs whenever required. Attention was also given to the inclusion of infant follow-up data. The computer programme has been accepted for daily operation, and the necessary data quality has been attained by means of proper choice of the appropriate user groups and manifold measures to ensure integration, safe working, continual servicing and creation of suitable working and data feed conditions.

Attitude to Computers↗

PubMed2000

Severe mental illness and substance use disorders among former Supplemental Security Income beneficiaries for drug addiction and alcoholism.

BACKGROUND: Recently enacted federal legislation targeted at curbing perceived abuses of cash benefits for former Supplemental Security Income beneficiaries for drug addiction and/or alcoholism (DA&A) may be creating a residual population that is too seriously impaired to work owing to psychiatric and substance use disorders. METHOD: Data in this report were derived from 1-year follow-up interviews of 204 randomly selected DA&A beneficiaries in Chicago who were initially interviewed between January 1997 and March 1997, immediately following their termination in the Supplemental Security Income DA&A program. Information on subjects' work and benefits status were collected along with DSM-III-R psychiatric and substance use disorder diagnostic information. Urine specimens were also collected and tested for recent use of marijuana, cocaine, opiates, phencyclidine, amphetamines, and methadone. RESULTS: Twenty-six percent had a past-year severe mental illness while 34% met the DSM-III-R criteria for drug dependence. Illegal drug use was also prevalent with about 50% of the sample testing positive for marijuana, cocaine, or opiates. Compared with those working and earning at least $500 a month, unemployed or underemployed subjects who had lost all federal benefits had a much greater likelihood of being dependent on drugs (odds ratio, 5.0; P<.005; 95% confidence interval, 1.6-15.7) and of having 2 or more comorbid psychiatric disorders (odds ratio, 6.9; P<.005; 95% confidence interval, 1.9-24.7). CONCLUSIONS: Those who have lost DA&A disability benefits and who continue to be unemployed or underemployed have elevated rates of drug dependence and psychiatric comorbidities; consequently, helping these cases make the transition from government assistance to sustained employment is increasingly difficult.

Alcoholism↗

PubMed1999

Utilization of mental health and substance abuse services among homeless adults in Los Angeles.

OBJECTIVES: Even though psychiatric disorders are disproportionately present among the homeless, little is known about the extent to which homeless people receive treatment for those problems or the factors that are associated with receiving treatment. This article examines utilization and predictors of mental health and substance abuse treatment among a community-based probability sample of homeless adults. METHODS: The data analyzed here were collected through face-to-face interviews with 1,563 homeless individuals. Bivariate analyses examined differences between homeless men and women in (1) the prevalence of major mental illnesses and substance dependence and (2) utilization of inpatient and outpatient treatment services for those with specific diagnoses. Logistic regression analyses identified predictors of mental health treatment among those with chronic mental illness and substance abuse treatment among those with recent substance dependence. RESULTS: Two-thirds of these homeless adults met criteria for chronic substance dependence, whereas 22% met criteria for chronic mental illness, with substantial overlap between those two disorders: 77% of those with chronic mental illness were also chronic substance abusers. Only one-fifth of each of those two groups reported receiving treatment for those disorders within the last 60 days. Mental health service utilization was predicted largely by factors related to need (eg, diagnosis, acknowledgment of a mental health problem), whereas substance abuse service utilization was predicted by myriad additional factors, reflecting, in part, critical differences in the organization and financing of these systems of care. CONCLUSIONS: More attention must be directed at how to better deliver appropriate mental health and substance abuse services to homeless adults.

Adolescent↗