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Providing clinical opportunities for youths affected by HIV.

Individual counseling, as invaluable as it is for HIV-affected youth, is just one forum in which young people can receive clinical assistance. The youth-centered programs noted previously and others carried out in various agencies around the country offer HIV-affected youth an opportunity to receive clinical experiences while focusing on their strengths and interests. A nonthreatening atmosphere in which many children are invited to participate is essential for helping young people feel comfortable and connected to the agency. When children develop friendships through the agency, they can begin to feel less alone in their situation and more willing to reach out to others--clinicians and peers--for help. An increased trust in the agency can help HIV-affected young people maintain an ongoing connection to services and open the door to traditional counseling. As children become more engaged in the agency and begin to develop a sense of ownership, they may want to take on more responsibility. Leadership programs that focus on young people's skills and talents can help establish the agency as a place that is safe for youths on their own terms. That may involve activities such as older children serving as mentors for younger ones, performing community projects in their neighborhoods, doing outreach to help connect more people to the programs, or designing and running their own conferences for youth. Collaboration with other agencies for special projects can help link children to additional programs and to other youth, thus decreasing their isolation. Childhood and adolescence is a time of rapid changes accompanied by emotional fluctuations. Young people feel emotions intensely, but often lack the cognitive ability necessary to articulate them. When a young person is coping with the illness or death of a parent from AIDS in addition to all the pressures and changes in life, the experience of growing up is even more difficult and complicated. The emotional flux, confusion, and life transitions can lead to impulsive and self-destructive behavior. But childhood and adolescence is also a time of heightened energy, creativity, resilience, and hope. Programs for HIV-affected youth need to balance the attention paid to the challenges they face and the strengths they possess. When allowed to grow and shine, affected young people may begin to express some of their emotional needs. Caring workers can then help them make sense of their experiences and mature into the successful adults they all have the potential to become.

Adolescent↗

Bonding to caries-affected dentin using self-etching primers.

PURPOSE: To evaluate resin bond strengths to caries-affected versus normal dentin using three self-etching primer adhesive systems. MATERIALS AND METHODS: Carious lesions were excavated and then bonded with one of three self-etching primer adhesive systems (Clearfil Liner Bond 2, Clearfil Liner Bond 2V, A.R.T. Bond). A crown was then built up using a resin composite to a height of 4 mm. Five to six serial slabs approximately 0.7 mm thick were sectioned perpendicular to the bonded surface. The bonded caries-affected or normal dentin areas were isolated to create an hourglass configuration with a cross-sectional area of approximately 1 mm2. The specimens were subjected to tensile stress at a crosshead speed of 1.2 mm/min. The bonded interfaces to caries-affected and normal dentin were examined with an SEM. RESULTS: Clearfil Liner Bond 2 and Clearfil Liner Bond 2V produced high bond strengths to normal dentin, but significantly lower bonds than to caries-affected dentin. (P < 0.05). For A.R.T. Bond, there was no statistically significant difference between types of dentin. All three bonding systems produced thin (+/- 0.5-1.5 microns) hybrid layers in normal dentin. When used on caries-affected dentin, all self-etching primer systems produced hybrid layers that were twice as thick as those produced in normal dentin.

Acid Etching, Dental↗

Serotonergic function, behavioral disinhibition, and negative affect in children of alcoholics: the moderating effects of puberty.

BACKGROUND: Serotonergic (5-HT) dysfunction has been implicated in both behavioral disinhibition and negative affect in adults. Although our group's previous work found decreased whole blood 5-HT in high versus low behavior problem children of alcoholics, some child/adolescent studies report conflicting results, and 5-HT's role in negative affect has been largely unexamined. Age-related developmental factors may play a role in these relationships. METHODS: This report is from an ongoing prospective study of the development of risk for alcohol abuse/dependence and other problematic outcomes in a sample of families subtyped by father's alcoholism classification. The present study extends previous work and examines relationships between whole blood 5-HT and both child behavioral disinhibition (an aggression index from the Child Behavior Checklist) and negative affect (Child Behavior Checklist Anxious/Depressed scale) in offspring from 47 families (N = 45 boys and 17 girls; mean age = 10.88+/-2.03 yr). RESULTS: The most important finding was that puberty moderated relationships between 5-HT and both behavioral disinhibition and negative affect with a relationship for pubescent children (n = 14, r = -0.54, p = 0.05: r = -0.57,p = 0.04, respectively) but no relationship for prepubescent children (n = 48, r = 0.05, p = 0.75; r = -0.15, p = 0.31, respectively). CONCLUSIONS: The moderating effects of puberty may help clarify inconsistencies in child/adolescent literature. Furthermore, there appears to be a relationship between 5-HT and negative affect which parallels that between 5-HT and behavioral disinhibition. Pubertal status may be an important variable to evaluate as a moderator in relation to the developmental context of the role 5-HT dysfunction may play in various models of behavior related to alcoholism over the early life course.

Adolescent↗

[Can we determine which coronary artery is affected by the localization of ST depression? Comparison of ergometric and coronarographic results].

The authors evaluated retrospectively 206 patients with ischaemic heart disease. These patients were subjected to an ergometric loading test on a bicycle ergometer followed by angiography of the coronary arteries. With regard to the site of the ST depressions during the loading test the patients were divided into 7 groups which were further subdivided according to the coronographic finding. The authors investigated the hypothesis that patients with depressions of the ST segment above the anterior wall suffer from an affection of the ramus interventricularis anterior, patients with depressions of ST above the lateral wall from affection of the ramus circumflexus and patients with depressions above the lower wall have an affection of the right coronary artery. From the work ensues that no site of the ST depression correlates significantly with the coronary finding. The correlation is not statistically significant even when we compare the site of ST depressions with the affection of one artery regardless of the affection of the other coronaries.

Coronary Angiography↗

[Parkinson's disease, side affected and depression].

INTRODUCTION: Depression is a state of mind often associated with Parkinson's disease, which is not correlated with the stage of the disease or the response to treatment with L-dopa. It has been suggested that patients with right-sided Parkinsonism have more depression than those with left-sided. OBJECTIVE: To assess whether patients whose dominant side is affected primarily have more depression than those whose non-dominant side is affected; and to evaluate whether when the dominant side is more affected this is accompanied by greater deterioration on the scale of everyday activities (ADLS) and on the motor part of the unified scale for evaluation of Parkinsonism (UPDRSm). PATIENTS AND METHODS: The study group was formed of 63 patients with Parkinsonism at stage 1 or 1.5 (Hoehn and Yahr), with an average age of 66.17 years. They were divided into two groups. Those who received L-dopa (Dopa group) and those who were newly-diagnosed patients (Naive group). They were evaluated on the Hamilton test, UPDRSm and ADLs scale. We used Wilcoxon's nonparametric sum of ranges test taking p < 0.01 as significant. RESULTS: The indexes of depression were greater, in both groups, in the patients whose dominant side was affected (p < 0.001). There were no differences in UPDRSm or ADLs. CONCLUSIONS: The patients with Parkinson's disease whose dominant side is primarily affected have worse depression. The depression seems originate in the dominant hemisphere.

Aged↗

Search for a shared segment on chromosome 10q26 in patients with bipolar affective disorder or schizophrenia from the Faroe Islands.

Previous linkage studies have suggested a new locus for bipolar affective disorder and possibly also for schizophrenia on chromosome 10q26. We searched for allelic association and chromosome segment and haplotype sharing on chromosome 10q26 among distantly related patients with bipolar affective disorder or schizophrenia and controls from the relatively isolated population of the Faroe Islands by investigating 22 microsatellite markers from a 35 cM region. We used a combined approach with both assumption free tests and tests based on genealogical relationships. The 6.5 cM region between D10S1230 and D10S2322, which has been implied in previous linkage analyses, received some support. A search for segment sharing yielded empirical P-values around 0.02 among patients with bipolar affective disorder and around 0.03 for patients with schizophrenia. For both disorders combined allelic association yielded empirical P-values around 0.003 at marker D10S1723. A haplotype data mining approach supported haplotype sharing in this region. In another, more distal, 11.5 cM region between markers D10S214 and D10S505, which has received support in previous linkage studies, increased haplotype sharing in patients with bipolar affective disorder was supported by Fisher's exact test, tests based on genealogy and by haplotype data mining. Our findings yield some support for a risk gene for bipolar affective disorder and possibly also for schizophrenia.

Alleles↗

Assortative mating in primary affective disorder.

Psychiatric illness in spouses of patients with primary affective disorder was determined and compared to psychiatric illness in spouses of a nonpsychiatrically ill control group. An increase in affective illness in wives of bipolar male patients with affective disorder was found. There was no increase in affective illness among husbands of female patients. Marital status of these patients was evaluated and the percentages of patients who had never married or who had married but had ever been divorced or separated were similar to control data. Several of the marriages were quite stable over long time periods in spite of the severe recurrent affective illness experienced by these patients.

Adaptation, Psychological↗

Zone between plaque and attached periodontal tissues on chronic periodontitis-affected teeth: an SEM study.

The zone between plaque and attached periodontal tissues on chronic periodontitis-affected teeth was examined by a combined macroscopic and scanning electron microscopy (SEM) approach. Examined were 27 teeth with chronic periodontitis (chronic periodontitis-affected group) and three healthy teeth with no evidence of periodontal disease (control group). Both groups were collected immediately after extraction, fixed in 2% glutaraldehyde, and post-fixed in 1% osmium tetroxide. Then, teeth were macroscopically examined to identify their stained zones. Teeth were dehydrated, critical-point dried, gold coated, and examined in an SEM. Both healthy and chronic periodontitis-affected teeth showed a very similar staining pattern on their surfaces. An unstained band with a belt-like appearance was observed around the teeth, delimited by two osmium-stained zones. Some weakly stained areas were frequently observed inside the unstained band. The SEM examination showed four different regions in both groups. These regions appeared in the following coronoapical sequence: dental plaque, plaque-free zone, junctional epithelium, and attached periodontal tissues. A dental cuticle covering the cementum surface from the plaque border to the junctional epithelium was detected on chronic periodontitis-affected teeth. Some aspects of this particular zone may be involved in the pathogenesis of inflammatory periodontal disease and therefore may have some influence on treatment for chronic periodontitis-affected teeth.

Chronic Disease↗

The affective Auditory Verbal Learning Test.

The study of emotion is hindered by the lack of tests for affect perception or comprehension. One solution is to develop affective versions of well-known tests. Using an index of word norms (Toglia & Battig, 1978), positively and negatively valenced word lists were developed as alternate forms of the affectively neutral Auditory Verbal Learning Test (RAVL; Rey, 1964). Participants (N=102) received either the original RAVL list, the positively valenced list, or the negatively valenced list. Results are depicted across acquisition trials and location within the list for comparison of primacy and recency effects. Each word list yielded comparable patterns of acquisition. Participants receiving the negative list evidenced an enhanced primacy effect, while participants receiving the positive list evidenced an enhanced recency effect. The positive and negative lists may prove useful in the evaluation of individuals with affective disorders and may provide an alternative for affect induction through an active learning paradigm.

Journal Article↗

Motor evoked potentials in patients with spinal disorders: upper and lower motor neurone affection.

Motor evoked potentials (MEP) following magnetoelectric stimulation allow for detection and quantification of a lesion of the central and peripheral motor pathways. MEP latency is a very sensitive parameter, irrespective whether the lesion affects the upper motor neurone, e.g. in cervical myelopathy, or the lower motor neurone e.g. in cervical or lumbar radiculopathy. However, an increase of MEP latency alone does not allow for a distinction of either upper motor neurone or lower motor neurone affection. We have therefore scrutinized MEP latency and MEP waveform (amplitude, duration, and number of phases) in normal subjects, as well as in patients with cervical myelopathy (upper motor neurone affection: UMNA) and in patients with radiculopathies (lower motor neurone affection, LMNA). The increase of central motor latency compared to normal values was significantly higher in UMNA than in LMNA. MEP following transcranial magnetoelectric stimulation were split up and their duration in relation to M-wave duration was significantly increased in patients with UMNA, yet normal in patients with LMNA. MEP amplitude in relation to M-wave amplitude was significantly decreased in patients with UMNA, yet normal in patients with LMNA. We conclude that cervical myelopathy and cervical or lumbar radiculopathies lead to changes of MEP waveform, which are specific for either upper or LMNA. The analysis of amplitude, duration, and number of phases of MEP following transcranial stimulation increases the diagnostic value of MEP in disorders of the spine affecting the central or proximal peripheral motor pathways.

Adolescent↗

[Family functioning in patients with schizophrenia, bipolar affective disorder and epilepsy].

OBJECTIVE: To evaluate the impact of illness progression on the family functioning of patients with schizophrenia, bipolar affective disorder and epilepsy showing chronic relapsing progress and affecting functionality. METHOD: A total of 75 patients who were diagnosed according to DSM-IV criteria as having schizophrenia (n: 25), bipolar affective disorder (n: 25) or epilepsy (n: 25) and their 134 family members were included in the study. A socio-demographical data form was completed by consulting the patient and family members, and a Family Assessment Device (FAD) was used. RESULTS: The general functionality level was low in patients with schizophrenia. Families of patients with bipolar affective disorder had healthier functioning than families of patients with schizophrenia and epilepsy. Subscales of "communication" and "behavioral control" were reported as highly ineffective by the schizophrenia patients. The epilepsy patients have family dysfunction in "behavioral control" and "roles" subscales. The families of bipolar affective disorder patients evaluated their "problem solving" and "general functioning" as problematic. CONCLUSION: The family's experience of disease and adaptation is a dynamic and ongoing process. Our data suggest that chronic psychiatric and neurological diseases may cause some specific difficulties in family functions.

Adult↗

[Increased accumulated incidence of allergic rhinitis in adolescents of Morelia, Michoacán, and its relation to satisfaction of vital and affective needs].

OBJECTIVE: To determine the incidence (preliminary) of allergic rhinitis in a population-based sample of adolescents and its relation on how they meet basic and affective need satisfaction. MATERIAL AND METHODS: We used ISAAC survey to assess rhinitis-related symptoms in a population-based sample of adolescents from Morelia, Michoacán, Mexico. Some items were added to the survey to evaluate how they meet basic and affective needs. Random sample included 1,333 adolescents aged 11-16 years from several schools of Morelia, Michoacán. Allergic rhinitis impact on basic and affective need satisfaction was assessed. Relative risk (RR) and 95% confidence interval (CI) were estimated. RESULTS AND DISCUSSION: Until 2003, such disease was diagnosed in 12% of cases; however, the number went up after the survey: rhinitis-related symptoms were seen in 46% of those polled, of which prevalence, sensitivity and specificity rates were 27, 90, 70%, respectively. More symptoms were reported from July through December. Sixty percent of adolescents with allergic rhinitis reported sleep disturbances, with adverse effects on bed rest period (RR 2.64) [1.01-6.94]. Well-balanced diet was seen in 62% of adolescents with such disease (RR 1.56) [1.34-1.79]. Sixty-seven percent of such teenagers said that the disease does no interfere with their performance in school (RR 1.41) [0.61-3.24] and 22% felt unaccepted (RR 1.8) [0.795-16.63]. CONCLUSIONS: The estimation of incidence of allergic rhinitis found in this study is higher than in other reports. Basic and affective need satisfaction was affected; thus, implementation of psychotherapy within a multi-disciplinary approach is required.

Adolescent↗

[Factors affecting on the surgery of polyp of vocal cord].

OBJECTIVE: To analyze the factors affecting on the surgery of polyp of vocal cord so as to enhance the success rate of surgery and improve the treatment effect. METHOD: Two thousands seven hundreds and ninety-two cases with polyp of vocal cord were summarized retrospectively according to the types of surgery they received. The factors affecting on the three kinds of surgery were analyzed which including the differences of patients, the types of polyp, the skill of surgeons, the instrument and the anaesthesia. RESULT: The unsuccessful rates in group A, group B and group C were 6.46%, 4.12% and 1.53% respectively. The occurrence rates of complications in three groups were 0.19%, 0 and 1.16% respectively. The proportion of the factors affecting on the surgeries in group A, B, C were the differences of patients 61.77%, 6.67%, 85.71%; the types of polyp 27.94%, 60.00%, 0; the skill of surgeons 30.88%, 46.67%, 0%; the instrument 8.82%, 13.33%, 14.29% and the anaesthesia 16.18%, 33.33%, 0%. CONCLUSION: The main factor affecting the surgery of polyp of vocal cord in group A, C is the differences of patients. The main factor inducing to the complications of surgery is the anaesthesia. All factors affecting on the surgeries should be considered carefully before operation and the necessary measures to avoid the complications must be took.

Adolescent↗

Beyond cognition: the role of disordered affective states in impairing competence to consent to treatment.

Most of the criteria for competence in current use emphasize cognitive rather than affective dimensions. Our clinical experience indicates that affective disorders may impair competence in a detectable and identifiable way. In particular, patients with major affective disorders can retain the cognitive capacity to understand the risks and benefits of a medication, yet fail to appreciate its benefits. A case study of a pathologic grief reaction is introduced to illustrate how cognitive and affective impairments may coexist and require separate remedial strategies for restoration. Further empirical work on the role of affective disorder in impairing competence is warranted and planned.

Aged↗

The psychic costs of intense positive affect.

Recent research indicates that happiness, or affective well-being, is related primarily to the frequency, not to the intensity, of positive affect (PA). The question arises as to why intense positive affect (PI) is not a larger contributor to subjective well-being. Whether processes that yield PI also produce intense negative affect was examined. Studies 1 and 2 suggested that cognitive mechanisms that amplify or dampen affect can carry over from positive to negative events. Study 3 demonstrated that, because of judgment mechanisms, an extremely positive event can make other events less positive. Study 4 revealed that naturally occurring intensely positive experiences are often preceded by negative ones. Study 5 suggested that the more persons valence success at a task, the happier they will be if they succeed, but unhappier if they fail. The 5 studies reveal that intense positive experiences may sometimes have costs that counterbalance their desirable nature.

Adaptation, Psychological↗

Immunodominant proteins of Sarcocystis cruzi bradyzoites isolated from cattle affected or nonaffected with eosinophilic myositis.

Sarcocystis cruzi sarcocysts were isolated from eosinophilic myositis (EM)-affected and nonaffected bovine hearts. Isolates were ruptured and used to prepare a bradyzoite antigen extract from each heart. The nonaffected heart from one newborn calf contained no apparent sarcocysts when examined histologically and was used to prepare Sarcocystis-negative control antigen. Blood samples were taken from the heart approximately 20 minutes after slaughter. Serum was obtained and evaluated, using a radioimmunoassay to measure Sarcocystis-specific IgG and IgE titers. Sarcocystis cruzi extract from a heart without EM lesions was used for antigen in the radioimmunoassay. Sarcocystis-specific IgG titer ranged between 1:1,280 and 1:2,560 in EM-affected cattle and was 1:640 in non-affected cattle. Sarcocystis-specific IgE titer ranged between 1:640 and 1:1,280 in EM-affected and nonaffected cattle. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and protein (western) immunoblot analysis were used to compare antigen extracts and serum samples from EM-affected vs nonaffected cattle. Twenty protein bands, ranging from approximately 22 to 215 kD, were detected consistently on bradyzoite blots probed with anti-bovine IgG after incubation with serum samples. Seven of these bands, 37, 44, 53, 57, 94, 113, and 215 kD, were also detected consistently on bradyzoite blots probed with monoclonal anti-bovine IgE. One additional band, 61 kD, was detected consistently on bradyzoite blots probed for IgE, but was seldom recognized when probed for IgG. Sixteen protein bands were evident in silver-stained gels of S cruzi-negative, newborn calf antigen, but none were recognized by antisera on western blots.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Linkage strategies for genetically complex traits. II. The power of affected relative pairs.

The power to detect disease-susceptibility loci through linkage analysis using pairs of affected relatives and affected-unaffected pairs is examined. Allelic identity by descent (ibd) for a completely polymorphic marker for sibling, uncle-nephew, grandparent-grandchild, half-sib, and first-cousin pairs is considered. Affected-unaffected pairs generally represent a poor strategy. For single-locus models, ibd depends on lambda R, the risk ratio for type R relatives compared with population prevalence, and the recombination fraction theta. The ibd for grandparent-grandchild pairs is least affected by recombination, followed by sibs, half-sib, uncle-nephew, and first-cousin pairs. For diseases with large lambda values and for small theta values, distant relatives offer greater power. For larger theta values, grandparent-grandchild pairs are best; for small lambda values, sibs are best. Additive and multiplicative multilocus models are considered. For the multiplicative model, the same formulas as in the single-locus model apply, except that lambda iR (for the ith contributing locus) is substituted for lambda R. For the additive model, the deviation from null expectation for ibd is divided among all contributing loci. Compared with the multiplicative model, for an additive model there is usually greater advantage in distant relationships. Multipoint analysis using linked marker loci for affected relative pairs is described. Simultaneous use of multiple markers diminishes the effect of recombination and allows for localization of the disease-susceptibility locus.

Alleles↗

Developmental delay in offspring of parents with affective disorders and depression: psycho-social sequels or a constitutional state?

At an early age, offspring of parents with affective disorders and long-lasting depression exhibited elevated rates of psychomotor and language delay, behavior problems and a greater need for somatic psychiatric care compared to matched control children (Harjan 1988, I, II, III). The present report analyses the problem of these children regarding psychomotor and language delay (PMLD) seen in a great number of children and somewhat more often in boys compared with those without this handicap. The study shows that children with PMLD of parents with affective disorders and long-lasting depression differ from those without PMLD with respect to early behavior problems, need for child psychiatric care during latency, and they are loaded by more broken homes and longer stay in pediatric wards. The two groups are similar in aspects of low social standing, mean parental age, perinatal risk factors, delayed somatic growth, incidence of psychiatric registrations and rate and nature of somatic disorders. The developmental delay may be a hereditary disturbance either related to affective disorder or to a concomitant factor, or the developmental delay may relate to the adverse environmental situation. It is also obvious that simultaneous parental illness, social breakdown and genetic constitution form a critical multifactoral loading on the child. The high rate of developmental delay among offspring of parents with affective disorders stresses the importance of giving attention to the children of parents with affective disorders and long-lasting depression. The developmental delay per se is an important disorder for early behavior problems and need for child and youth psychiatric care.

Adolescent↗