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[Texas revised inventory of grief: adaptation to Spanish, reliability and validity].

OBJECTIVES: To adapt into Spanish the Texas Revised Inventory of Grief (TRIG) of Faschinbaguer et al (1977, 1981) and to examine its reliability and validity. DESIGN: Two stages: a) cross-culture adaptation of a questionnaire, and b) cross-sectional study of reliability and validity. SETTING: Primary care teams in Vizcaya, north of Spain. PARTICIPANTS: 118 people who had been widowed between 3 months and 3 years before the study. MAIN MEASUREMENTS AND RESULTS: Cross-culture adaptation: the TRIG was translated from American English, then back-translated and finally compared with the version in American Spanish by Grabowski & Frantz (1993). Reliability: the Cronbach's alpha coefficients (internal consistency) of the 2 TRIG scales were 0.75 and 0.86. Factorial validity: all items except one threw saturation >0.40 on the 2 factors extracted from the varimax rotation. Validity by hypothesis: the TRIG scales showed differences (P<.05) between the grieving in terms of the expected or unexpected character of death, the place where death occurred and time elapsed since the death. The scores on the adapted TRIG were similar to scores on the American Spanish TRIG for Latins and higher than those on the original TRIG and the American Spanish TRIG for Anglo-saxons. Convergent validity: the 2 TRIG scales correlated positively (P<.05) with all the clinical scales on the Inventory of Grief Experiences of Sanders et al (1985) and García García et al (2001). CONCLUSIONS: In the evaluation of grief due to the death of the spouse, the TRIG adapted to Spanish is as reliable and valid as the original version.

Aged↗

Perceptions of Mexican American clients receiving genetic services in South Texas.

OBJECTIVES: The objectives of this study were to assess the perceptions among medically indigent Mexican American clients in South Texas receiving genetic services, and the effects of these perceptions on the utilization of genetic services. METHODS: Using a qualitative ethnographic approach, 16 caretakers of children with genetic conditions and 7 prenatal clients were interviewed. Interview data were analyzed using the NUD*IST 4 computer program. RESULTS: Clients reported challenges with understanding and utilizing genetic services due to language and communication barriers, poverty, cultural differences, and system issues. CONCLUSION: Client perceptions of genetic services were influenced by experiences with other biomedical providers and traditional healers, and by anxieties precipitated by unfamiliar concepts and approaches to medical care. Recommendations are made to improve provision of genetic services.

Journal Article↗

Testing neonate-infant membrane oxygenators with the University of Texas neonatal pulsatile cardiopulmonary bypass system in vitro.

Neurologic complications are already well documented after cardiopulmonary bypass (CPB) procedures in neonates and infants. Physiologic pulsatile flow CPB systems may be the alternative to the currently used steady-flow CPB circuits. In addition to the pulsatile pump, a membrane oxygenator should be chosen carefully, because only a few membrane oxygenators are suitable for physiologic pulsatile flow. We have tested four different types of neonate-infant membrane oxygenators for physiologic pulsatility with The University of Texas neonate-infant pulsatile CPB system in vitro. Evaluation criteria were based on mean ejection time, extracorporeal circuit (ECC) pressure, and upstroke of dp/dt. The results suggested that the Capiox 308 hollow-fibre membrane oxygenator produced the best physiologic pulsatile waveform according to the ejection time, ECC pressure, and the upstroke of dp/dt. The Minimax Plus and Masterflo Infant hollow-fibre membrane oxygenators also produced adequate pulsatile flow. Only the Variable Prime Cobe Membrane Lung (VPCML) Plus flat-sheet membrane oxygenator failed to reach the criteria for physiologic pulsatility. Depending on the oxygenator used, the lowest priming volume of the infant CPB circuit was 415 ml and the highest 520 ml.

Brain Diseases↗

Spectra and fluorescence lifetimes of lissamine rhodamine, tetramethylrhodamine isothiocyanate, texas red, and cyanine 3.18 fluorophores: influences of some environmental factors recorded with a confocal laser scanning microscope.

We report on the spectra and fluorescence lifetimes of four commonly used fluorophores: lissamine rhodamine (LRSC); tetramethyl rhodamine isothiocyanate (TRITC); Texas Red; and cyanine 3.18 (Cy-3). Fluorescence lifetime recordings revealed that these spectrally overlapping fluorophores can be individually detected by their lifetimes, indicating that at least four fluorophores can be individually identified in discrete tissue domains by confocal microscopy. A further advantage of lifetime recordings is that fluorophores that emit light within the same wavelength band can be used and chromatic aberrations are therefore circumvented, thereby improving the spatial accuracy in imaging of multiple fluorophores. Low and high pH, respectively, tended to influence fluorophore emission spectra and fluorescence lifetime. IgG conjugation of the fluorophores tended to shift the spectra towards longer wavelengths and to change the fluorescence lifetimes. The IgG-conjugated form of the fluorophores may, when applied to tissue specimens, change the emission spectrum and lifetime. In addition, different tissue embedding procedures may influence fluorescence lifetime. These observations emphasize the importance of spectral and lifetime characterization of fluorescent probes within the chemical context in which they will be used experimentally. Changes in spectra and fluorescence lifetimes may be a useful tool to gain information about the chemical environment of the fluorophores.

Animals↗

Treatment-related leukemia in breast cancer patients treated with fluorouracil-doxorubicin-cyclophosphamide combination adjuvant chemotherapy: the University of Texas M.D. Anderson Cancer Center experience.

PURPOSE: Adjuvant chemotherapy for breast cancer has been the routine practice in the past decade. A number of studies have observed an increased incidence of treatment-related leukemias following chemotherapy with alkylating agents and/or topoisomerase II inhibitors. We evaluated the incidence of treatment-related leukemias in breast cancer patients treated in four adjuvant and two neoadjuvant chemotherapy trials at The University of Texas M.D. Anderson Cancer Center. PATIENTS AND METHODS: Between 1974 and 1989, 1,474 patients with stage II or III breast cancer were treated in six prospective trials of adjuvant (n = 4) or neoadjuvant (n = 2) chemotherapy with fluorouracil, doxorubicin, and cyclophosphamide (CTX) (FAC) with or without other drugs. The median observation time was 97 months. In 1,107 patients, FAC chemotherapy was given postoperatively; 367 patients received induction chemotherapy, as well as postoperative chemotherapy. Eight hundred ten patients had surgery followed by radiotherapy and chemotherapy; 664 patients had surgery and chemotherapy only. Patients in two adjuvant and one neoadjuvant study received higher cumulative doses of CTX compared with those in the other studies. RESULTS: Fourteen cases of leukemia were observed. Twelve of these patients had received radiotherapy and chemotherapy, and two had received chemotherapy only. Six of the reported patients with leukemia were treated with a cumulative CTX dose of greater than 6 g/ m2. Five of these patients had received both radiotherapy and chemotherapy. The median latency period in the 14 patients was 66 months (range, 22 to 113). Six of 10 patients with adequate cytogenetic analyses had abnormalities that involved chromosomes 5 and/or 7. The rest of the patients had nonspecific cytogenetic abnormalities or lacked cytogenetic information. The 10-year estimated leukemia rate was 1.5% (95% confidence interval [CI], 0.7% to 2.9%) for all patients treated, 2.5% (95% CI, 1.0% to 5.1%) for the radiotherapy-plus-chemotherapy group, and 0.5% (95% CI, 0.1% to 2.4%) for the chemotherapy-only group; this difference was statistically significant (P = .01). The 10-year estimated leukemia risk for the higher-dose (> 6 g/m2) CTX group was 2% (95% CI, 0.5% to 5.0%) compared with 1.3% (95% CI, 0.4% to 3.0%) for the lower-dose group, a difference that was not statistically significant (P = .53). CONCLUSION: These data illustrate that patients treated with adjuvant FAC chemotherapy plus radiotherapy have a slightly increased risk of leukemia. This information needs to be considered in the treatment plans for patients with breast cancer. However, for most patients, the benefits of adjuvant therapy exceed the risk of treatment-related leukemia.

Adult↗

Prey snapping and visual distance estimation in Texas horned lizards, Phrynosoma cornutum.

Captive Texas horned lizards were high-speed videotaped while feeding on ants in order to study the role of vision in facilitating tongue-protrusion capture of prey. Analysis of tongue movements revealed that prey snapping in these lizards is not a typical fixed-action pattern. By contrast, it is variable in performance and duration. Lizards adjusted head and tongue direction during the strike, within a few milliseconds, in response to movements of the prey. The duration of a typical tongue strike was 100-150 ms. The strike duration was prolonged after ophthalmic lenses were placed in front of one or both eyes. These lenses were used to investigate whether horned lizards use accommodation to judge prey distance. Focal changes of negatively powered ophthalmic lenses (employed monocularly) induced a clear underestimation of prey distance by the lizards, confirming the hypothesized expectation that accommodation is used for depth perception. The effect of the lenses was different in the two animals tested with monocular restriction. This, together with the lack of difference in responses by the lizards when untreated and when both eyes were lens covered (binocular treatment of equal power, -9 D), illustrates that horned lizards also use other visual parameters for depth perception.

Accommodation, Ocular↗

Some psychometric properties of the Texas Grief Inventory adjusted for miscarriage.

The psychometric properties of an adjusted version of the Texas Grief Inventory (Zisook, Devaul & Click, 1982) were evaluated in a sample of 207 women following an early pregnancy loss. Factor structure of the Inventory was examined, and the validity was assessed by comparing the level of grief in women who became pregnant following a miscarriage and those who did not. Factor analysis resulted in a three-factor solution that was theoretically interpretable. The identified subscales were: pure grief, grief-related emotions and perceived adjustment and functioning since miscarriage. Significantly lower levels of grief-related behaviours and feelings were reported in women who became pregnant, which was suggestive of the construct validity of the Inventory. The high reliability coefficient (Cronbach's alpha = .90) obtained with this 17-item version of the Grief Inventory suggests it to be a reliable instrument for the assessment of grief after early miscarriage.

Abortion, Spontaneous↗

What's up, Billy Jo? Deaf children and bilingual-bicultural instruction in east-central Texas.

Seven deaf children attended a bilingual-bicultural (bi-bi) prekindergarten, kindergarten, and first grade from 1993 to 1996 in an east-central Texas public school. The children had diverse backgrounds (African American, Hispanic, White) and various intellectual, cognitive, and linguistic abilities. We detail the backgrounds of the seven children and their families and describe three bi-bi classrooms. We present standardized test scores on cognition (Bracken Test of Basic Concepts) and academic achievement (Stanford Achievement Test, 9th edition, and Woodcock-Johnson Psycho-Educational Battery). When, with one exception, the children completed first grade, they all tested at grade level. (The exception was a younger child who had only completed kindergarten but who nonetheless tested at the first-grade level). We interpret our findings in light of theories of first- and second-language acquisition and discuss the feasibility of establishing bi-bi programs in areas where no large Deaf community exists. We also note our plans to evaluate the seven children again, at the end of second grade in spring 1997.

Child↗

Fluorescence properties of fluorescein, tetramethylrhodamine and Texas Red linked to a DNA aptamer.

We report the picosecond time-scale fluorescence dynamics of a dye-labeled DNA oligonucleotide or "aptamer" designed to bind specifically to Immunoglobulin E. Comparison of the photophysics of Texas Red (TR), fluorescein and 5'-carboxytetramethylrhodamine (TAMRA)-labeled aptamers reveals surprising differences with significant implications for measurements of oligonucleotide structure and dynamics. The fluorescence decay of the TR-aptamer is a simple single exponential with a weak temperature dependence. The fluorescence decay of the fluorescein-aptamer (fl-aptamer) is pH dependent and displays a complex temperature dependence with significant changes on melting of the aptamer tertiary structure. Despite its similarities to TR, TAMRA is strongly quenched when conjugated to the aptamer and displays complex fluorescence kinetics best described by a distributed rate model. Using the maximum entropy method, we have discovered two highly temperature-dependent fluorescence lifetimes for the TAMRA-aptamer. One of these lifetimes is similar to that of free TAMRA and displays the same temperature dependence. The other lifetime is quenched and displays a temperature dependence characteristic of a charge transfer reaction. These data set TR apart as an attractive alternative to TAMRA and fluorescein for studies such as fluorescence polarization and fluorescence resonance energy transfer, where environmental sensitivity of the probe is not desired.

DNA↗

A comparison of two diabetic foot ulcer classification systems: the Wagner and the University of Texas wound classification systems.

OBJECTIVE: In this study the following two ulcer classification systems were applied to new foot ulcers to compare them as predictors of outcome: the Wagner (grade) and the University of Texas (LT) (grade and stage) wound classification systems. RESEARCH DESIGN AND METHODS: Ulcer size, appearance, clinical evidence of infection, ischemia, and neuropathy at presentation were recorded, and patients were followed up until healing or for 6 months. RESULTS: Of 194 patients with new foot ulcers, 67.0% were neuropathic, 26.3% were neuroischemic, 1.0% were ischemic, and 5.7% had no identified underlying factors. Median (interquartile range [IQR]) ulcer size at presentation was 1.5 cm2 (0.6-4.0). Lower-limb amputations were performed for 15% of ulcers, whereas 65% healed [median (IQR) healing time 5 (3-10) weeks] and 16% were not healed at study termination; 4% of patients died. Wagner grade (P < 0.0001), and UT grade (P < 0.0001) and stage (P < 0.001) showed positive trends with increased number of amputations. For UT stage, the risk of amputation increased with infection both alone (odds ratio [OR] = 11.1, P < 0.0001) and in combination with ischemia (OR = 14.7, P < 0.0001), but not significantly with ischemia alone (OR = 4.6, P = 0.09). Healing times were not significantly different for each grade of the Wagner (P = 0.1) or the UT system (P = 0.07), but there was a significant stepwise increase in healing time with each stage of the UT system (P < 0.05), and stage predicted healing (P < 0.05). CONCLUSIONS: Increasing stage, regardless of grade, is associated with increased risk of amputation and prolonged ulcer healing time. The UT system's inclusion of stage makes it a better predictor of outcome.

Adult↗

Comparison of F1 Bos indicus x Hereford cows in central Texas: II. Udder, mouth, longevity, and lifetime productivity.

Postpartum udder characteristics, aged mouth condition scores, and cow survival, longevity, and productivity were evaluated for 15 yr on F1 cows in central Texas (temperate winters and subtropical summers). The cows (n = 116) were progeny of Angus, Gray Brahman, Gir, Indu-Brazil, Nellore, and Red Brahman sires and Hereford dams. Crossbred cows sired by Nellore had smaller (P < 0.05) postpartum teat length than cows of all other crossbred groups and smaller (P < 0.10) postpartum teat diameter than Indu-Brazil and Red Brahman crossbreds. The Nellore crossbred cows had larger (P < 0.10) postpartum udder support scores (more well-supported udders) than Gir, Indu-Brazil, and Red Brahman crossbreds. As 14-yr-old cows, Angus crossbreds had lower (P < 0.05) mouth scores (indicative of one or more missing incisors) than Bos indicus crossbreds. Under actual and artificial (records were removed) culling procedures, Nellore crossbreds had the highest cow survival to age 14 and the highest longevity. Indu-Brazil crossbreds tended to be the lowest for both survival and longevity. Curves were fitted by nonlinear regression procedures to the adjusted frequencies of cows remaining at each age; scale and shape parameters were estimated and compared for the different breed groups. Breed group cow survival rates, calf crop weaned, and calf weaning weights were used 1) to construct population projection and production matrices for each breed group and 2) to generate breed group vectors containing projected age distributions and production information. Cows sired by Nellore and Gir were projected to require the fewest purebred cows to generate replacement heifers and to have the most calves and the largest total calf weight sold per year.

Animals↗

Location of tumour cells in colon tissue by Texas red labelled pentosan polysulphate, an inhibitor of a cell surface protease.

Pentosan polysulphate (PPS), a highly negatively charged polysaccharide, is a significant inhibitor of an isoenzymic form of a cell surface protease referred to as guanidinobenzoatase GB, associated with colonic carcinoma tissues in frozen sections and free GB in solution, in a concentration-dependent manner. However PPS failed to recognise and bind to the isoenzymic form of GB associated with normal colon epithelial cell surfaces. Texas red labelled PPS (TR-PPS) binds to the tumour cell surfaces of colonic carcinoma and colonic polyps and these cells fluoresce red, whilst the normal colon cell surfaces failed to bind the TR-PPS, and hence lacked red fluorescence. Polysulphonated suramin also selectively recognised and inhibited the colonic carcinoma GB isoenzyme. The kinetic data indicated that this inhibition was not caused by a mere polyanionic effect, since highly sulphated heparin failed to show a significant inhibition of colonic carcinoma GB, however trypan blue did show 50% inhibition. Kinetic studies have also shown that PPS is a non-competitive, reversible inhibitor of colonic carcinoma GB, with an apparent Km 6.8 x 10(-7) M. Gel analysis has shown that PPS binds to another site, distinct from the active centre, and after binding PPS changed the conformation of GB. These studies suggest that TR-PPS is a potent inhibitor of colonic carcinoma GB, and can be used as a novel fluorescent probe for the location of tumour cells in frozen sections of human colon tissues. PSS could also have potential as a vehicle for the transport of cytotoxic compounds to carcinoma cells of the colon.

Carboxylic Ester Hydrolases↗

Texas Scottish Rite Hospital rod instrumentation for thoracic and lumbar spine trauma.

The authors present their experience with 28 patients who had incurred unstable thoracic or lumbar spine fractures and who were intraoperatively stabilized with the Texas Scottish Rite Hospital (TSRH) universal instrumentation system. These patients were treated over a 1-year period and reflect an evolving insight into the treatment of thoracic and lumbar spine trauma with universal instrumentation. The TSRH instrumentation system appears equivalent to the more established Cotrel-Dubousset system in most respects. The construct design of the TSRH system facilitates the safe application of a rigid spinal implant. No cases of instability or pseudoarthrosis were observed during an average follow-up period of 9 months, (minimum 3 months). As the surgical treatment plan evolved, shorter and more compact constructs were increasingly utilized. There were no cases of instrumentation failure, regardless of the number of spinal levels fused or the number of levels instrumented. The value of using short rods when possible is emphasized: they may decrease the incidence of delayed instability and discomfort related to loosening at the hook/bone interface compared to that observed when long-rod systems are used in association with short spine fusions causing a fusion/instrumentation mismatch.

Adolescent↗

Posterior stabilization of unstable sacroiliac injuries with the Texas Scottish Rite Hospital spinal instrumentation.

This article describes a new alternative technique for stabilization of unstable sacroiliac injuries using the Texas Scottish Rite Hospital (TSRH) instrumentation. The TSRH instrumentation was applied in 14 consecutive patients with unstable posterior pelvic ring disruptions. All patients underwent follow-up for an average of 29 months. Clinical results, using the rating system of d'Aubigne, were good in 9 and satisfactory in 5 patients. No pressure sores, infection, significant loss of correction, or hardware failures were observed postoperatively. The use of the TSRH instrumentation for stabilization of sacroiliac injuries offered sufficient stabilization of the posterior pelvic ring and permitted early mobilization without loss of correction.

Adult↗

Macracanthorhynchus ingens from a child in Texas.

Nine acanthocephala recovered over a two-month period from the stools of a 10-month-old child in Texas were identified as Macracanthorhynchus ingens, a common intestinal parasite of the raccoon, Procyon lotor.

Acanthocephala↗

Immobilization of wild ocelots with tiletamine and zolazepam in southern Texas.

Telazol was used to immobilize nine wild ocelots (Leopardus pardalis) captured in box-traps in southern Texas (USA) between May 1997 and April 1998. Mean (+/- SD) intramuscular dosage rate of 5.05 (+/- 0.76) mg/kg produced an induction time of 3.7 +/- 1.8 min. Duration of cataleptic anesthesia was 67.4 +/- 19.8 min and ocelots stood 50.0 +/- 30.7 min after emergence from cataleptic anesthesia. Ocelots recovered to their preinjection condition 129.7 +/- 28.8 min after first standing and 250.8 +/- 55.1 min after initial injection. We observed no adverse reactions to Telazol aside from minor loss of thermoregulatory control. Telazol administered at 5 mg/kg was an effective and safe immobilizing agent for wild ocelots.

Anesthetics, Dissociative↗

Confocal analysis of phosphatidylserine externalization with the use of biotinylated annexin V revealed with streptavidin-FITC, -europium, -phycoerythrin or -Texas Red in oxysterol-treated apoptotic cells.

OBJECTIVE: To analyze externalization of phosphatidylserine via annexin V on apoptotic cells by laser scanning confocal microscopy and factor analysis of biomedical image sequences (FAMIS). STUDY DESIGN: Streptavidin-fluorescein isothiocyanate (FITC), -europium (Eu), -phycoerythrin (PE) and -Texas Red (TR) were chosen to reveal the binding of biotinylated annexin V on apoptotic U937 human leukemic cells and ECV-304 human endothelial cells induced under treatment with 7-ketocholesterol or 7 beta-hydroxycholesterol. Excitation of each fluorochrome was obtained by selection of specific lines (351 + 364 nm, 488 nm) of the argon laser of a confocal microscope. Temporal and spectral series were performed to characterize each fluorochrome. FAMIS was applied to these series to estimate images corresponding to stains. RESULTS: Each fluorochrome was clearly distinguished, and images showed localization of phosphatidylserine, which was improved by image analysis. CONCLUSION: On apoptotic cells it is possible to analyze differences in the improved visualization of phosphatidylserine in series processed by FAMIS with the use of biotinylated annexin V revealed with streptavidin-FITC, -Eu, -PE or -TR.

Annexin A5↗