bluuebunny/crossref_metadata_2025 huggingface dataset:
Decreasing requirement for lithium carbonate therapy in bipolar affective disorder (hypomanic type) following the onset of chronic renal insufficiency
Authors: Pandita-Gunawardena R. , Donaldson D.
Published: September 2007

The importance of regular monitoring of both serum lithium and creatinine levels, together with thyroid function assessment, in a patient taking lithium carbonate therapy for bipolar affective disorder (hypomanic type) is emphasised. In this case it was the gradual rise of serum creatinine that alerted the physician to the onset of insidiously progressive renal impairment. In the absence of any evidence for another aetiology, it was concluded that a possible cause for the renal problem was the lithium therapy itself. By reducing the dosage it was found that serum lithium levels were maintained within the reference range, thus avoiding the potential psychiatric consequences of high concentrations — which could well have occurred had the former dosage been continued during the period of deteriorating renal function. The situation is currently being carefully monitored in case another cause for renal disease, other than that of a side-effect of therapy, emerges at a later date.
Burden of Illness Review of Obesity: Are the true costs realised?
Authors: McIntyre A-M.
Published: September 2007

Obesity can no longer be viewed as merely a cosmetic or social problem, but must be acknowledged as a serious disease, responsible for the premature death and morbidity of millions and for significant expenditure of limited healthcare resources. In addition, there are significant costs to the individual with regard to social status and quality of life. It has been argued that obesity is one of the most important preventable causes of ill health in the UK today. This is especially important when one considers that the incidence of obesity is actually rising, with 13% of men and 16% of women in the UK in 1997 being obese. To begin treating such a disease it is essential to raise awareness of this problem, not only from the associated morbidity and mortality risks that have been well documented, but the socio-economic and psychological costs. This paper reviews the literature available globally, giving some measure of the magnitude of the associated burden of illness.
Food consumption patterns of adults in the United Arab Emirates
Authors: Musaiger Abdulrahman O. , Abuirmeileh Neji M.
Published: September 2007

The objectives of this study were to determine the food consumption patterns of Emirati men and women over 20 years of age and to explore the association of age and sex with food intake. A proportional random sample of 1,122 men and 1,090 women was obtained from all the seven Emirates of the United Arab Emirates (UAE). The findings showed a significant difference in food frequency intake between men and women, and also between young (20-49 years) and old (50 years and above) subjects. In general the consumption of fresh fruit and vegetables and of milk was low. This is a source of concern as these foods are useful sources of vitamins and minerals. Elderly people were more likely to consume traditional foods such as fish and laban (diluted yoghurt) than young peo ple. Modification of dietary habits should be considered in any nutrition education pro gramme for the public in the UAE.
The effects of war . on mental health
Authors: Dunlop Joyce L.
Published: September 2007

A hundred claimants, almost entirely ex-service personnel who claimed sequelae following their war service, were assessed for their war pension rights. The difficulties they experienced are discussed, especially as regards physical symptoms, pre-morbid personality, length of time since event, effects of different locations, memory difficulties, concomitant old age etc. In spite of these difficulties it is still important to attempt to be unbiased and try to give the DHSS guidance in their difficult job.
Lessons to be learned
Authors: Chopdar Amresh
Published: September 2007

A 71-year-old male presented with a history of sudden partial visual loss in the right eye with an inferior visual field defect over the past 3-4 days. He had no history of headache or of facial pain. Clinical examination confirmed that vision on the right side was reduced to 6/18 and on the left to 6/12. The right eye showed a relative afferent pupillary defect. There was no other abnormality of the anterior segment of either eye. The right retina showed a pale swollen optic disc and a provisional diagnosis of anterior ischaemic optic neuropathy (AION) was made. An urgent erythrocyte sedimentation rate (ESR) was ordered and the patient was asked to return to the eye clinic in one month. However, 16 days later — when it was first recognised that his ESR was elevated to 75 mm in the first hour - the patient was recalled immediately in order to commence systemic steroid treatment; but regrettably, by this time, his right eye had become totally blind. In this case, although the attending doctor made a correct clinical diagnosis on presentation, he failed to act upon the result of the blood test.
Follow-up of sporadic cases of food-borne infection
Authors: Devine M.J. , Lighton L. , Johnson Mrs V.
Published: September 2007

The aim of the study was to evaluate the follow-up of sporadic cases of suspected food-borne illness by either a postal questionnaire or a personal visit by environmental health staff. This was achieved by comparing the practice in two authority areas within the West Pennine Health Authority in the north west of England. We included all identified cases of suspected food poisoning, campylobacteriosis, cryptosporidiosis, salmonellosis and dysentery occurring in the district between 1 July and 30 September 1996. The main outcome measures were: (1) the proportion of all cases which were successfully followed-up by each method; (2) the timeliness of follow-ups; (3) qualitative estimation by environmental health staff of the data obtained. Visiting by environmental health staff was successful in obtaining information from 76.3% (106/139) of cases, while the postal questionnaires elicited a 52% (50/96) response rate. We found that 70.5% of visits occurred within one week of notification. Although 69.8% (67/96) of questionnaires were issued within one week of notification, only 16% of replies to the questionnaire were received within this period. The information provided on the returned questionnaires was found by environmental health staff to be generally as useful as that obtained by visiting.
Smoking and urological disease
Authors: Mikhailidis D.P. , Ganotakis E.S. , Papadakis J.A. , Jeremy J.Y.
Published: September 2007

It is important to realise that virtually every part of the body, including the urological sys tem, is adversely affected by smoking. Smoking is the most important known preventable cause of urinary bladder cancer and is also associated with a risk of prostatic and renal can cer. The exact mechanism by which smoking increases the incidence of urological malig nancy is not known. One possibility is that chemicals in cigarette smoke inhibit the syn thesis of cytoprotective eicosanoids. Deficient local protection, against the hostile environ ment caused by the presence of urine, could then encourage the process of carcinogenesis. Smoking is a powerful predictor of erectile dysfunction; cessation may restore normal func tion. Cigarette smoke also exerts adverse effects on sperm motility and count. Although there is no convincing evidence of reduced fertility in male smokers, it is advisable for men to quit smoking should they have marginal semen quality and wish to start a family. Smoking causes substantial urological pathology; these facts can be used to convince patients with urological problems to quit smoking.
Intracranial pressure monitoring by time domain analysis
Authors: Penson R.P. , Allen R.
Published: September 2007

This paper discusses the developments in the assessment of intracranial hypertension in humans and recent research carried out by the authors on the techniques for the non-inva sive measurement of intracranial pressure. A brief historical review sets the scene with regard to clinical and invasive methods for the observation of intracranial pressure and goes on to look at non-invasive techniques for measuring blood flow and pressure from which it is pro posed that intracranial pressure can be predicted. Although a simulation and a frequency domain analysis of the dynamics of the human brain has been carried out, this paper con centrates only on the time domain experiments and analysis. The time domain analysis uses the cross-correlation of the non-invasive blood flow of the middle cerebral artery with blood pressure measurements and their varying phase shift with trauma characteristics to make predictions of intracranial pressure trends that lead to pathologically dangerous conditions. The paper concludes with a section concerning the development of software and associated graphical displays that could inform staff of trends in intracranial pressure and life threat ening conditions so that immediate action can be taken.
Improving infection control in general practice
Authors: Farrow S.C. , Zeuner D. , Hall C.
Published: September 2007

Infection control measures in the health care setting should protect patients and staff from cross- infection. The prevention of harm is an essential part of good medical practice and failure might result in professional misconduct proceedings by the General Medical Council (GMC) and prosecution under the Health and Safety at Work legislation, as well as civil liability. For a health authority, overall responsibility for public health includes arrangements for the control of communicable diseases and infection in hospital and the community (NHS Management Executive, 1993), a function usually led by the Consultant in Communicable Disease Control (CCDC). This paper describes one district's collaborative approach between public health and GPs to assess and improve local infection control standards.
Nigerian university students' knowledge, perceptions, and behaviours about HIV/AIDS: are these students at risk?
Authors: Harding A.K. , Anadu E.C. , Gray L.A. , Champeau D.A.
Published: September 2007

The purpose of the study was to determine the knowledge level of undergraduate students of a Nigerian university about HIV/AIDS, their perception of risk of contracting HIV/AIDS based on their sexual behaviour, and to assess how students acquire information about HIV/AIDS.

The sample consisted of 380 students from five faculties of the university who volunteered to participate in the study. Participants completed a survey asking about their knowledge about transmission, symptomatology and prevention of HIV/AIDS. The survey included questions about their sexual orientation, past and present sexual practices as well as sources of information about HN/AIDS.

The results indicated that the students were knowledgeable about transmission and symptomatology but there were some misconceptions about the mode of transmission of HIV Few students identified themselves to be at high risk even though majority of them (92%) were sexually experienced. The study also showed that even though these students are knowledgeable and concerned about contracting HIV/AIDS from their partners, this did not prevent them from engaging in unprotected sexual intercourse. It appears, however, that students are exercising caution when negotiating new sexual relationships, as they are likely to discuss (and insist on) using condoms, and ask to have a monogamous relationship.

Students obtained information about HIV/AIDS primarily from the media rather than from school classrooms and homes, which suggests a need to increase educational efforts at the university. Many students of this university may be at risk of becoming HIV infected due to their age bracket, level of sexual activity and past/present sexual behaviors. University faculty can be actively involved in developing and implementing HIV/AIDS education and prevention strategies on their campuses. Health educators must go beyond providing accurate and gender-specific information about HIV/AIDS; they must also help students realistically assess their own risk of infection, and develop communication processes which enable them to negotiate safer sexual practices.
A case-control study of the health status of male farmers registered at Ash Tree House Surgery, Kirkham Lancashire
Authors: McCrone J.C.
Published: September 2007

The relative health status of 74 male working farmers registered at Ash Tree House Surgery, Kirkham, Lancashire, was compared with a control group taken from the same surgery. Medical records over a five-year period were analysed to reveal differences in the health status of the two groups. Overall more farmers visited the surgery for acute consultations with the General Practitioner (GP) and significantly (using the chi-squared test for significance) less for health promotion (P<0.05) than the control group. When visits were classified by disease type, more farmers were found to have visited the surgery with infections (P<0.05); disorders of the nervous system (P<0.01); disorders of the skin (P<0.05) and external causes of injury (P<0.01). The finding that farmers visit the surgery more often for acute consultations and less for health promotion, coupled with the finding that there are significant differences in the pattern of ill health between the two groups suggest that there is a need for health promotion among the farming community of Kirkham, Lancashire.
Self-reported smoking habits, biochemical markers, and nicotine dependence in a sample of the Danish population
Authors: Seersholm Niels , Nielsen Niels Henrik , Tønnesen Philip
Published: September 2007

This study reports the smoking habits in a Danish population, evaluates plasma cotinine and thiocyanate levels in the detection of 'slips' (subjects participating in smoking cessation trials who begin to smoke a few cigarettes per week) and provides distribution scores on questionnaire measures of nicotine dependence.

A total of 599 subjects with a mean age of 41 years participated in the study. Of these 46% were current smokers with no difference in the proportion of males(46%) and females(45%) and with a mean cigarette consumption of 12.7 daily. Plasma samples were analyzed for cotinine and thiocyanate, and the smokers completed two questionnaires to measure nicotine dependence: the Fagerström Tolerance Questionnaire and the modified Horn-Russell scale. The mean plasma cotinine was 207 micrograms/l for smokers, 14.4 micrograms/l for occasional smokers and 8.0 micrograms/l for non-smokers (ex-smokers and never-smokers). For plasma thiocyanate the levels were 130 mg/l, 54.8 mg/l, and 54.3 mg/l, respectively.

The mean Horn-Russell score was 7.4 and the mean Fagerström score was 5.9. The two tests correlated with a r- value of 0.61 (p<0.001) and the scores in both tests increased with increasing cigarette consumption.

In conclusion, 75% of the smokers consumed 10 or more cigarettes per day and males smoked more cigarettes than females. It was impossible to distinguish occasional smokers (slips) from non-smokers using plasma cotinine or thiocyanate levels. We suggest that studies are needed to evaluate if light smokers benefit from nicotine replacement therapy because they achieve plasma cotinine levels which are similar to those seen when using patches for nicotine replacement therapy.
Hypohidrosis in children
Authors: Leung Alexander K. C. , Cho Helen Y. H. , Choi Matthew C. K. , Chan Paul Y. H.
Published: September 2007

Hypohidrosis has many causes. The condition may be generalised or segmental, acute or progressive, and central or peripheral in origin. Most of the causes can be diagnosed from the history and physical examination. Laboratory investigations are usually not necessary. Treatment should be directed at the underlying cause whenever possible.
Work-related stress among nurses: a challenge for health care institutions
Authors: Pikó B.
Published: September 2007

The issue of occupation stress amongst care professionals is currently a major concern in health policy. The main goal of the present study has been to investigate the relationship between levels of stress among nurses, and some of the psychosocial and organisational characteristics of their job. The participants of the cross-sectional survey were female nurses (n=218) chosen at random from public hospitals in Csongrad County, Hungary. A self- administered questionnaire was the method used for data collection: this questionnaire contained various items on psychosomatic symptoms, self-perceived health, sociodemographic data, job satisfaction, health risk behaviours, drug consumption, emotional load and social support from peers.

The findings suggest that the frequency of common psychosomatic symptoms (e.g. sleeping problems, tension headache, chronic fatigue or palpitations), regular alcohol drinking, heavy smoking, and frequent use of tranquilisers and sleeping pills can be read as an indicator of nurses' work-related stress level. Nurses with only primary education had the highest such levels, while those with baccalaureate-level education had the lowest. Furthermore, nurses aged 51-60 years and those on rotating night shift proved to be vulnerable to stress the most frequently. However, no significant differences were found between nurses working in- theatre and those non-theatre; nor was job satisfaction found to have a significant impact on the levels of stress experienced.

The results suggest that supportive relationships with peers may reduce the occurrence of high stress levels among nurses, leading the author to conclude that social support and the psychosocial work climate should be improved in health care institutions.
Possible health and safety problems in the use of novel plant essential oils and extracts in aromatherapy
Authors: Lis-Balchin M.
Published: September 2007

Aromatherapy is a branch of complementary or alternative therapy which is increasing in popularity, yet has scant scientific credibility. Aromatherapy should be defined as treatment using odours and practised as such. However, essential oils are usually used in conjunction with massage and often combined with counselling of some kind. The use of most commonly-used essential oils in massage is seldom dangerous, as they have low systemic toxicity, especially when used at 2% dilution (provided they are not adulterated); however, their safety during pregnancy, childbirth and babies has not been clearly demonstrated. Sensitisation, however, is a growing concern. Some aromatherapists are now introducing novel plant essential oils, extracts and phytols into their massage routine, many of which have no odour and are potentially toxic. The possible dangers of these plant products are therefore discussed using specific examples.
Cognitive behaviour therapy: its evolution and basic principles
Authors: Shawe-Taylor M. , Rigby J.
Published: September 2007

The historical and theoretical background to Cognitive Behaviour Therapy (CBT) is outlined. The main therapeutic approaches of Behaviour Therapy (BT) and Cognitive Therapy (CT) are described - and an overview is provided of the applications of these approaches to clinical problems. The relationships between BT, CT and CBT are clarified.
Occupant injury protection in automobile collisions
Authors: Peters G.A. , Peters B.J.
Published: September 2007

Modern technology has produced automotive vehicles that have become both a luxury and a necessity in modem civilisation. They have become highly useful, ever more varied in form and function, and capable of high speeds on crowded roadways. One unfortunate consequence is the high frequency of accidents and the greater severity of injuries when collisions do occur. In response, modem technology has produced a variety of safety and health features, devices, and designs intended for better occupant protection in high speed vehicles. Injury reduction has become a prime design objective, but there are residual risks, which, as technology evolves, require effective communication to those at risk There can be little risk avoidance behavior without awareness of the hazards and effective communication to the vehicle occupant, as to what could and should be done for self protection. For example, one out of three drivers apparently fails to understand the function of head restraints, few understand the 'safe zone' posture required for air bags, and many believe safety features should be adjusted only for comfort. Some of the current residual injury producing problems in occupant systems are specifically described here in order to illustrate what is needed in terms of both design remedies and health promotion activities.
The 1998 APHA Annual Lectu re What the UK can teach the US out health care
Authors: Light D.
Published: September 2007

This paper was originally presented at the Annual Lecture of the American Public Health Association, 16th November 1998.
Effects of Robot-Assisted Therapy on Upper Limb Recovery After Stroke: A Systematic Review
Authors: Kwakkel Gert , Kollen Boudewijn J. , Krebs Hermano I.
Published: September 2007

Objective. The aim of the study was to present a systematic review of studies that investigate the effects of robot-assisted therapy on motor and functional recovery in patients with stroke. Methods. A database of articles published up to October 2006 was compiled using the following Medline key words: cerebral vascular accident, cerebral vascular disorders, stroke, paresis, hemiplegia, upper extremity, arm, and robot. References listed in relevant publications were also screened. Studies that satisfied the following selection criteria were included: (1) patients were diagnosed with cerebral vascular accident; (2) effects of robot-assisted therapy for the upper limb were investigated; (3) the outcome was measured in terms of motor and/or functional recovery of the upper paretic limb; and (4) the study was a randomized clinical trial (RCT). For each outcome measure, the estimated effect size (ES) and the summary effect size (SES) expressed in standard deviation units (SDU) were calculated for motor recovery and functional ability (activities of daily living [ADLs]) using fixed and random effect models. Ten studies, involving 218 patients, were included in the synthesis. Their methodological quality ranged from 4 to 8 on a (maximum) 10-point scale. Results. Meta-analysis showed a nonsignificant heterogeneous SES in terms of upper limb motor recovery. Sensitivity analysis of studies involving only shoulder-elbow robotics subsequently demonstrated a significant homogeneous SES for motor recovery of the upper paretic limb. No significant SES was observed for functional ability (ADL). Conclusion. As a result of marked heterogeneity in studies between distal and proximal arm robotics, no overall significant effect in favor of robot-assisted therapy was found in the present meta-analysis. However, subsequent sensitivity analysis showed a significant improvement in upper limb motor function after stroke for upper arm robotics. No significant improvement was found in ADL function. However, the administered ADL scales in the reviewed studies fail to adequately reflect recovery of the paretic upper limb, whereas valid instruments that measure outcome of dexterity of the paretic arm and hand are mostly absent in selected studies. Future research into the effects of robot-assisted therapy should therefore distinguish between upper and lower robotics arm training and concentrate on kinematical analysis to differentiate between genuine upper limb motor recovery and functional recovery due to compensation strategies by proximal control of the trunk and upper limb.
Safety of 6-Hz Primed Low-Frequency rTMS in Stroke
Authors: Carey James R. , Evans Chad D. , Anderson David C. , Bhatt Ela , Nagpal Ashima , Kimberley Teresa J. , Pascual-Leone Alvaro
Published: September 2007

Background. Suppression of activity in the contralesional motor cortex may promote recovery of function after stroke. Furthermore, the known depressant effects of low-frequency repetitive transcranial magnetic stimulation (rTMS) can be increased and prolonged by preceding it with 6-Hz priming stimulation. Objective. The authors explored the safety of 6-Hz primed low-frequency rTMS in 10 patients with ischemic stroke. Methods. Priming consisted of 10 minutes of 6-Hz rTMS applied to the contralesional hemisphere at 90% of resting motor threshold delivered in 2 trains/min with 5 s/train and 25-second intervals between trains. Low-frequency rTMS consisted of an additional 10 minutes of 1-Hz rTMS at 90% of resting motor threshold without interruption. Possible adverse effects were assessed with the National Institutes of Health Stroke Scale (NIHSS), the Wechsler Adult Intelligence Scale—Third Edition (WAIS-III), the Hopkins Verbal Learning Test—Revised (HVLT-R), the Beck Depression Inventory—Second Edition (BDI-II), a finger movement tracking test, and individual self-assessments. Pretest, treatment, and posttest occurred on the first day with follow-up tests on the next 5 weekdays. Results. There were no seizures and no impairment of NIHSS, WAIS-III, or BDI-II scores. Transient impairment occurred on the HVLT-R. Transient tiredness was common. Occasional reports of headache, neck pain, increased sleep, reduced sleep, nausea, and anxiety occurred. Conclusion. Because there were no major adverse effects, the authors concluded that the treatment was safe for the individuals in this study and that further investigation is now warranted to examine efficacy and safety of serial treatments of 6-Hz primed low-frequency rTMS.
Review: Renin-angiotensin-aldosterone system intervention in the cardiometabolic syndrome and cardio-renal protection
Authors: Whaley-Connell Adam , Pavey Brian S. , Chaudhary Kunal , Saab Georges , Sowers James R.
Published: September 2007

The metabolic syndrome, also known as the cardiometabolic syndrome (CMS), is a state of metabolic and vascular dysregulation that is associated with activation of the renin-angiotensin-aldosterone system (RAAS). Clinical components of the CMS include central or visceral obesity, hypertension (HTN), dyslipidemia, insulin resistance/hyperinsulinemia, and microalbuminuria that collectively convey increases in oxidative stress, inflammation, and subsequent endothelial dysfunction. The cardio-renal inflammation and oxidative stress enhanced in the CMS increases the risk for cardiovascular disease (CVD) and renal disease end-points such as stroke, congestive heart failure, and chronic kidney disease (CKD). The development of proteinuria is known to herald progressive kidney disease (e.g. CKD) and both are now well accepted as CVD risk factors. Evidence suggests a role for visceral obesity, insulin resistance/hyperinsulinemia, HTN, and other components of the CMS lead to an increased risk for proteinuria and progressive loss of renal function. Intervention with agents that block the RAAS (e.g. ACE inhibitors and Angiotensin type 1 receptor blockers) have been shown to reduce proteinuria, CKD progression, and CVD events. Herein, we will examine the relationship between RAAS intervention and reductions in CKD and CVD events.
Predicting state transitions in the transcriptome and metabolome using a linear dynamical system model
Authors: Morioka Ryoko , Kanaya Shigehiko , Hirai Masami Y , Yano Mitsuru , Ogasawara Naotake , Saito Kazuki
Published: September 2007

Background

Modelling of time series data should not be an approximation of input data profiles, but rather be able to detect and evaluate dynamical changes in the time series data. Objective criteria that can be used to evaluate dynamical changes in data are therefore important to filter experimental noise and to enable extraction of unexpected, biologically important information.

Results

Here we demonstrate the effectiveness of a Markov model, named the Linear Dynamical System, to simulate the dynamics of a transcript or metabolite time series, and propose a probabilistic index that enables detection of time-sensitive changes. This method was applied to time series datasets fromBacillus subtilisandArabidopsis thalianagrown under stress conditions; in the former, only gene expression was studied, whereas in the latter, both gene expression and metabolite accumulation. Our method not only identified well-known changes in gene expression and metabolite accumulation, but also detected novel changes that are likely to be responsible for each stress response condition.

Conclusion

This general approach can be applied to any time-series data profile from which one wishes to identify elements responsible for state transitions, such as rapid environmental adaptation by an organism.
Identification of novel stem cell markers using gap analysis of gene expression data
Authors: Krzyzanowski Paul M , Andrade-Navarro Miguel A
Published: September 2007

We describe a method for detecting marker genes in large heterogeneous collections of gene expression data. Markers are identified and characterized by the existence of demarcations in their expression values across the whole dataset, which suggest the presence of groupings of samples. We apply this method to DNA microarray data generated from 83 mouse stem cell related samples and describe 426 selected markers associated with differentiation to establish principles of stem cell evolution.
NLR proteins: integral members of innate immunity and mediators of inflammatory diseases
Authors: Wilmanski Jeanette M , Petnicki-Ocwieja Tanja , Kobayashi Koichi S
Published: September 2007

The innate immune system is the first line of defense against microorganisms and is conserved in plants and animals. The nucleotide-binding domain, leucine rich containing (NLR) protein family is a recent addition to the members of innate immunity effector molecules. These proteins are characterized by a central oligomerization domain, termed nucleotide-binding domain (NBD) and a protein interaction domain, leucine-rich repeats (LRRs) at the C terminus. It has been shown that NLR proteins are localized to the cytoplasm and recognize microbial products. To date, it is known that Nod1 and Nod2 detect bacterial cell wall components, whereas Ipaf and Naip detect bacterial flagellin, and NACHT/LRR/Pyrin 1 has been shown to detect anthrax lethal toxin. NLR proteins comprise a diverse protein family (over 20 in humans), indicating that NLRs have evolved to acquire specificity to various pathogenic microorganisms, thereby controlling host-pathogen interactions. Activation of NLR proteins results in inflammatory responses mediated by NF-κB, MAPK, or Caspase-1 activation, accompanied by subsequent secretion of proinflammatory cytokines. Mutations in several members of the NLR protein family have been linked to inflammatory diseases, suggesting these molecules play important roles in maintaining host-pathogen interactions and inflammatory responses. Therefore, understanding NLR signaling is important for the therapeutic intervention of various infectious and inflammatory diseases.
Mechanisms of eosinophil secretion: large vesiculotubular carriers mediate transport and release of granule-derived cytokines and other proteins
Authors: Melo Rossana C N , Spencer Lisa A , Dvorak Ann M , Weller Peter F
Published: September 2007

Eosinophils generate and store a battery of proteins, including classical cationic proteins, cytokines, chemokines, and growth factors. Rapid secretion of these active mediators by eosinophils is central to a range of inflammatory and immunoregulatory responses. Eosinophil products are packaged within a dominant population of cytoplasmic specific granules and generally secreted by piecemeal degranulation, a process mediated by transport vesicles. Large, pleiomorphic vesiculotubular carriers were identified recently as key players for moving eosinophil proteins from granules to the plasma membrane for extracellular release. During secretion, these specialized, morphologically distinct carriers, termed eosinophil sombrero vesicles, are actively formed and direct differential and rapid release of eosinophil proteins. This review highlights recent discoveries concerning the organization of the human eosinophil secretory pathway. These discoveries are defining a broader role for large vesiculotubular carriers in the intracellular trafficking and secretion of proteins, including selective receptor-mediated mobilization and transport of cytokines.
Assessment of deliberate self-harm in adults
Authors: Owens David , House Allan
Published: September 2007

Deliberate self-harm remains a common problem in the United Kingdom, with rates in the order of 250–300 per 100 000 per year (Hawton & Fagg, 1992). Since the suicide rate in the 12 months after hospital attendance for deliberate self-harm is around 1% (Hawton & Fagg, 1988), each year approximately 2–3 per 100 000 of the population die by suicide within a year of attending hospital with a non-fatal episode of deliberate self-harm. This is about a quarter of the overall suicide rate of 11 per 100 000. There is therefore an easily definable group at risk of suicide who should be the focus of a suicide prevention strategy.
Somatoform and dissociative disorders: assessment and treatment
Authors: Gill David , Bass Christopher
Published: September 2007

The category ‘somatoform disorders' was introduced comparatively recently in DSM–III and thereafter in ICD–10: it is the umbrella term currently favoured to cover a heterogeneous group of interrelated and overlapping syndromes, which have been given many names over the years. All these syndromes have in common the process of somatisation: that is, the presence of physical symptoms unexplained by physical disease, with variable degrees of distress and loss of function, about which the patient consults doctors.
Management of medical students' health problems
Authors: Myers Michael F.
Published: September 2007

Studies of utilisation of psychiatric services have shown that between 4 and 18% of medical students annually identify themselves as ‘impaired’ (Dicksteinet al, 1990). An unknown number of students may be ill but do not seek help – they soldier on through classes and clinics not realising that their sleep disturbance, worry, vague pains, flagging spirits, failing grades or increasing use of alcohol represent symptoms of strain and possible psychiatric disorder. Some suspect or know that they are ill but the stigma of accepting mental illness or seeking professional help is so profound that they suffer silently.
Stepfamilies
Authors: Barnes Gill Gorell
Published: September 2007

Family life in Britain is changing daily to include more stepfamilies, which have widely differing structures with varying histories, losses, transitions and economic circumstances. Of the one in five children who currently experience separation before they are 16, over half will live in a stepfamily at some point in their lives. Of the 150 000 couples with children who divorced each year at the end of the 1980s, a further 35 000 had a subsequent divorce. For some children we need to think of step-parenting within wider processes of transition, which include relationship changes of many kinds. The National Stepfamily Association have calculated that if current trends of divorce, cohabitation, remarriage and birth continue, there will be around 2.5 million children and young adults growing up in a stepfamily by the year 2000. The true pattern of re-ordering of partnership and family life is hard to chart, since many couples second or third time around prefer to cohabit rather than to marry.
Children and adolescents: victims who become perpetrators
Authors: Bentovim Arnon , Williams Bryn
Published: September 2007

Irrespective of whether one considers official statistics, the proliferation of clinical referrals, research initiatives, review articles or even media attention, the problem of children and adolescents who sexually abuse other children has become a subject of increased attention. Given the proportion of young abusers who are themselves victims of sexual abuse, understanding the continuities between sexual victimisation and sexually abusive behaviour has been important. Despite the paucity of reliable evidence, it is clear that the majority of children who are sexually abused do not become abusers. Moreover, we know that around half of all young abusers have not themselves been victims of abuse. This paper sets out to consider these issues and highlight potentially important factors in understanding the origins and development of sexually abusive behaviour at an early age.
Individual psychoanalytical psychotherapy with perpetrators of sexual abuse
Authors: Zachary Anne
Published: September 2007

Victims of child and other forms of sexual abuse receive increasing attention and resources but it is often difficult to extend the same kind of understanding and possibilities of treatment to their perpetrators. Many of the perpetrators have been victims themselves, which is often a major reason for their having developed in such a way; sometimes the offenders are virtually children themselves (Royal College of Psychiatrists, 1994b).
Psychiatric aspects of diabetes mellitus
Authors: Trigwell Peter , Peveler Robert
Published: September 2007

In 1899, Maudsley wrote:

“Diabetes is a disease which often shows itself in families in which insanity prevails: whether one disease predisposes in any way to the other or not, or whether they are independent outcomes of a common neurosis, they are certainly found to run side by side, or alternately with one another more often than can be accounted for by accidental coincidence or sequence”.

Recent research confirms that a range of psychological problems and psychiatric disorders are common in people with diabetes. Such problems are important not only because of the suffering caused, but also because of their impact upon the management and outcome of the diabetes itself. This article reviews the psychosocial impact of diabetes and its treatment, describes the range of psychological problems and psychiatric disorders which commonly occur in people with diabetes, and outlines the role of the psychiatrist in the recognition and management of these clinical problems.
Second World War veterans with chronic post-traumatic stress disorder
Authors: ⊘rner Roderick J. , de Loos Wolter S.
Published: September 2007

The present case study describes a typically complex clinical presentation of chronic post-traumatic stress disorder (PTSD) suffered by a Second World War veteran and advises on multi-disciplinary out-patient management extending to acute hospital care. Limited symptomatic impact of psychological and psychopharmacological therapies is discussed, and related to patient reports of satisfaction with therapeutic outcome.
Commentary
Authors: Fisher Jenny
Published: September 2007

I have enjoyed reading Buchanan's paper very much. It is clear, thoughtful and contains much valuable information. As I read it, I began to think it would make a good foundation for a short factual leaflet for carers. However, they are unlikely to read it in its present form, since many would find the scientific style and wording hard going. Words such as compliance, drugs and intrusive have connotations and need to be used with care by professionals. The National Schizophrenia Fellowship uses the term adherence instead of compliance.
Treatment of sleep disorders in adults
Authors: Wilson Sue , Nutt David
Published: September 2007

One-third of our lives is spent asleep, but the reasons why we sleep are not yet fully understood. Sleep is a state of inactivity accompanied by a loss of awareness and a markedly reduced responsiveness to environmental stimuli. When a recording is made of an electroencephalogram (EEG) and other physiological variables such as muscle activity and eye movements during sleep (a technique called polysomnography) a pattern of sleep consisting of five different stages emerges. This pattern varies from person to person, but usually consists of four or five cycles of quiet sleep alternating with paradoxical (active) sleep, with longer periods of paradoxical sleep in the latter half of the night. A representation of these various stages over time is known as a hypnogram, and one of these derived from a normal control subject is shown in Figure 1. The quiet sleep is divided further into four stages, each with a characteristic EEG appearance, with progressive relaxation of the muscles and slower, more regular breathing as the deeper stages are reached. Most sleep in these deeper stages occurs in the first half of the night.
Treatment of imagined ugliness
Authors: Castle David , Harrison Tracey
Published: September 2007

The term ‘dymorphophobia’ – derived from the Greekdysmorphia, meaning ugliness (expressly of the face) – was first coined by Morselli in the late-19th century. He described a subjective feeling of a physical defect which the patient feels is noticeable to others, although his appearance is within normal limits. Dysmorphophobia first appeared in the US psychiatric nosology (as an atypical somatoform disorder) in 1980, with the publication of DSM–III (American Psychiatric Association, 1980). However, the term was subsequently criticised both because the condition does not represent a phobia as such, and also because the use of the term had become so broad and imprecise (see Munro & Stewart, 1991).
Presentation and management of depression in people with learning disability
Authors: Prasher Vee P.
Published: September 2007

The occurrence of depression in people with learning disability is not a late-20th century phenomenon. Reports were first published in the 1800s describing the existence of depression in individuals with intellectual impairment (Clouston, 1883). However, as we enter a new millennium, the appropriate diagnosis, assessment and treatment of depression, and indeed all forms of mental illness in people with learning disability, will become the focus of considerable concern for all professionals working in this field. With recent national trends towards de-institutionalisation, referral of individuals with learning disability to psychiatrists to ‘rule out a possible depressive illness' and to ‘advise about further treatment’ will increase. It remains essential for all psychiatrists in learning disability to continue to improve their diagnostic skills to better manage depressive episodes and, where possible, to learn how to prevent a future relapse. This review highlights the important presentation and management issues relating to depression in the field of learning disability. Depression in this review implies a single major depressive episode, irrespective of whether or not it conforms to any given classification system.
Randomized, Placebo-Controlled Phase II Study of Vandetanib Plus Docetaxel in Previously Treated Non–Small-Cell Lung Cancer
Authors: Heymach John V. , Johnson Bruce E. , Prager Diane , Csada Edit , Roubec Jaromír , Pešek Miloš , Špásová Irena , Belani Chandra P. , Bodrogi István , Gadgeel Shirish , Kennedy Sarah J. , Hou Jeannie , Herbst Roy S.
Published: September 2007

Purpose

Vandetanib is a once-daily oral inhibitor of vascular endothelial growth factor receptor-2 and epidermal growth factor receptor kinase activity. The activity of vandetanib plus docetaxel was assessed in patients with previously treated non–small-cell lung cancer (NSCLC).

Patients and Methods

This two-part study comprised an open-label run-in phase and a double-blind randomized phase. Eligible patients had locally advanced or metastatic (stage IIIB/IV) NSCLC after failure of first-line platinum-based chemotherapy. The primary objective of the randomized phase was to prolong progression-free survival (PFS) in patients receiving vandetanib (100 or 300 mg/d) plus docetaxel (75 mg/m2 intravenous infusion every 21 days) versus placebo plus docetaxel. The study was designed to have more than 75% power to detect 50% prolongation at a one-sided significance level of P < .20. Secondary objectives included objective response rate, overall survival, safety and tolerability.

Results

In the randomized phase (n = 127), median PFS was 18.7 weeks for vandetanib 100 mg plus docetaxel (n = 42; hazard ratio v docetaxel = 0.64; one-sided P = .037); 17.0 weeks for vandetanib 300 mg plus docetaxel (n = 44; hazard ratio v docetaxel = 0.83; one-sided P = .231); and 12 weeks for docetaxel (n = 41). There was no statistically significant difference in overall survival among the three treatment arms. Common adverse events included diarrhea, rash, and asymptomatic prolongation of corrected QT (QTC) interval.

Conclusion

The primary objective was achieved, with vandetanib 100 mg plus docetaxel demonstrating a significant prolongation of PFS compared with docetaxel in relation to the prespecified significance level. On the basis of these encouraging data, phase III evaluation of vandetanib 100 mg plus docetaxel in second-line NSCLC has been initiated.
Aristotle My Beloved: Poetry, Diagnosis, and the Dreams of Julius Caesar Scaliger*
Authors: Haugen Kristine Louise
Published: September 2007

Notoriously Aristotelian in his poetic theory, linguistics, and natural philosophy, Julius Caesar Scaliger (1484–1558) also reimagined the lost love poetry that Aristotle himself was said to have written. Scaliger'sNew Epigramsof 1533 combine a distinctively humanist view of Aristotle as an elegant polymath with a sustained experiment in refashioning the Petrarchan love lyric. Most visibly in poems about dreams and dreaming, Scaliger educes his speaker's erotic despair from philosophical problems in contemporary Aristotelian accounts of the soul, knowledge, and personal identity. The strange but compelling texts that result form a crossroads for Scaliger's own identities as physician, philosopher, and poet.
Why Does Constructed Action Seem Obligatory? An Analysis of Classifiers and the Lack of Articulator-Referent Correspondence
Authors: Quinto-Pozos David
Published: September 2007

This article explores constructed action (a signer's use of various parts of their body—such as the head, torso, and eyegaze—to depict the actions of a character) and why it appears to be an obligatory accompaniment to some so-called "classifier" (or polycomponential) signs. It is posited that constructed action is used to depict aspects of animate entities because polycomponential signs cannot capture such information, in a simultaneous fashion, on their own. In particular, the conventionalization of entity polycomponential signs, the number and shape of articulators in polycomponential signs, and motoric constraints for polycomponential sign production appear to be factors that could influence the use of constructed action. As such, constructed action appears to be a complementary strategy to the use of polycomponential signs (and perhaps other types of signs and signed language grammar) for communication. Possible reasons for the robustness of constructed action are offered.