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Summary: Background: Serum pepsinogen 1 (SPG1) and anti‐Helicobacter pylori serology have been used for gastric risk stratification in Asia. Aim: To assess utility of these markers in a Western population. Methods: SPG1 measurements were available for 21 895 Finnish male smokers in the Alpha‐Tocopherol, Beta‐Carotene Cancer Prevention Study. We used Cox proportional hazards models adjusted for potential confounders to estimate gastric cancer hazard ratios (HR) and 95% confidence intervals (95% CI) for low SPG1 (<25 μg/L). In a subset (n = 3555) with anti‐H. pylori serology, these markers jointly defined the following: Group A (H. pylori[−], SPG1[normal]; reference group), Group B (H. pylori[+], SPG1[normal]), Group C (H. pylori[+], SPG1[low]) and Group D (H. pylori[−], SPG1[low]). Odds ratios (ORs) and 95% CI were calculated using multivariate logistic regression. Results: There were 329 gastric cancers diagnosed an average of 13.9 years after baseline. Pre‐diagnostic low SPG1 was significantly associated with increased gastric cancer risk (HR 2.68, 95% CI 1.99‐3.61). Among subjects with both SPG1 and H. pylori serology, groups B, C and D had increased gastric cancer ORs (95% CI) of 1.79 (1.21‐2.64), 3.85 (2.36‐6.28) and 6.35 (2.20‐18.34), respectively. CagA seropositives had significantly higher ORs than CagA seronegatives within group B (Pheterogeneity = 0.01). For groups B and C, repeat SPG1 level at 3 years did not further stratify gastric cancer risk. Conclusions: Low SPG1 was associated with increased gastric cancer risk in our large Finnish cohort. A single measurement of SPG1 along with H. pylori whole cell and CagA serology provides potentially useful prediction of gastric cancer risk. [ABSTRACT FROM AUTHOR]

The article reports on the study of bipolar disorder (BP) in children. It states that children with BD have poor academic performance with neurocognitive deficits and violent school behavior. Also mentioned are the treatments for the BP such as family focused treatment (FFT), multifamily psycho-education group psychotherapy (MFPEP), and the child and family-focused cognitive behavioral therapy.

Presents a study which examined the magnitude of the flux of biogenic particulate organic carbon exported from the surface waters of the world ocean and remineralized at depth. Export flux of atmospheric carbon dioxide to oceans; Methodology of the study; Discussion on the results of the study.

An intravenous (i.v.) formulation of mycophenolate mofetil (MMF; CellCept®, Roche Pharmaceuticals, Inc., Palo Alto, CA) that will enable its administration to patients unable to tolerate oral medication is available. Two separate studies, an open-labeled pharmacokinetic (PK) study and a double-blind safety study, were performed. Within 24 h after transplant, 153 (safety study) and 45 (PK study) first or second renal transplant recipients were started on i.v. MMF 1 g Q12h or placebo (used in the safety study only, 2:1 MMF:placebo), given over 2 h via a dedicated peripheral venous catheter. In the safety study, per os (p.o.) MMF (1g Q12h) or placebo was administered, starting within 72 h after transplant, whereas in the PK study, p.o. MMF was started on the evening of day 5. Sequential blood samples obtained on study days 5 (i.v. MMF) and 6 (p.o. MMF) before and up to 12 h after the AM dose were analyzed for mycophenolic acid (MPA) and MPA glucuronide (MPAG) concentrations by high-performance liquid chromatography. The area under the concentration curve (AUC) was calculated using the linear trapezoidal rule. The MPA AUC0–12 was higher for i.v. MMF than p.o. MMF (40.8±11.4 μg·h/mL vs. 32.9±15, p<0.001). There were no other significant PK differences for plasma MPA or MPAG. In the safety study (n=98 i.v. MMF vs. n=55 placebo), 11 patients (11%, i.v. MMF) and 4 patients (7%, placebo) discontinued their use of the drug because of an adverse event (AE). Overall, AEs were similar between i.v. MMF and placebo. Injection site phlebitis (4%) and thrombosis (4%) were observed only with i.v. MMF. MMF i.v. 1 g twice daily (b.i.d.) should provide efficacy at least equivalent to p.o. MMF without increased toxicity, and it provides an acceptable alternative dose form in the immediate period after transplant. [ABSTRACT FROM AUTHOR]

SummaryAim: To determine the efficacy and tolerability of sibutramine hydrochloride in obese patients whose type 2 diabetes was poorly controlled on diet alone or with an oral antidiabetic agent Methods: This study was a 24-week, double-blind, multicentre trial following a 5-week placebo run-in period. One hundred and seventy-five obese (body mass index (b.m.i.) ≥27 kg/m2) patients with poorly controlled type 2 diabetes mellitus were randomized either to sibutramine (n = 89; mean age 53.5 years; mean weight 99.3 kg) or placebo (n = 86; mean age 55 years; mean weight 98.2 kg) at 16 participating centres. To achieve moderate calorie restriction (deficit ≥ 250–500 kcal/day), individual dietary counselling was accompanied by either placebo or sibutramine (initial dosage of 5 mg/day titrated up by 5 mg biweekly through week 6, and maintained at 20 mg through week 24). The main outcome measures included changes in weight, b.m.i., waist and hip circumference, glycaemic control, lipid profile, and quality of life, and evaluation of reported adverse events. Results: Sixty-seven per cent of sibutramine patients and 71% of placebo patients completed the study. At week 24 when comparing those who completed the course, sibutramine compared with placebo patients showed significantly greater (p < 0.001) absolute (-4.3 vs. -0.4 kg) and percentage (-4.5% vs. -0.5%) weight loss. Weight loss ≥5% or 10% was achieved by 33% and 8% of sibutramine patients, respectively, but no placebo patients (p < 0.03 or better). Improvement in glycaemic control was correlated with weight loss (p < 0.001). In 5% and 10% weight-loss responders, mean treatment differences were -0.53% and -1.65% (p ≤ 0.05), respectively, for HbA1c, and -1.4 mmol/l (p ≤0.05) and -3.8 (p ≤0.05) mmol/l for fasting plasma glucose. Sibutramine patients also showed improvements in fasting insulin, triglycerides, HDL cholesterol, and quality-of-life... [ABSTRACT FROM AUTHOR]

While methadone maintenance treatment (MMT) has been demonstrated to be an effective treatment for opiate dependence, its impact on the treatment outcome of other illicit drug abuse is not as clear. Using the initial urine drug screen (UDS) and follow-up UDS at 1, 6, 12, and 24 months, 167 patients consecutively admitted to MMT were evaluated for opiate, sedative (predominantly benzodiazepine), and stimulant (predominantly cocaine) use. Retention for the opiate only group was 97.32 days longer on average than for patients using opiates along with stimulants, sedatives, or both stimulants and sedatives. Patients abusing opiates only had the greatest decrease in drug use; however, MMT was also associated with decreases in cocaine and sedative use over the 24 month follow-up period. There was no evidence that patients "switched" their drugs of abuse with time in treatment. The negative impact of non-opiate drug use on outcome in MMT and its implications for treatment planning are discussed. [ABSTRACT FROM AUTHOR]

Changes in lip morphology and area, measured in two dimensions from standardized lateral head films, were assessed in a series of twenty adults at three times: pre-surgically, 8-14 months post-surgically, and a long-term follow-up at 5-7 years. All individuals received the same, single surgical procedure (Obwegeser sagittal split for correcting mandibular prognathism. Upper and lower lip changes were quantified as millimetres displacement of the lip centroid vertically and horizontally, plus changes in cross- sectional area. Direction and amount of change, its dependency on the amount and kind of surgically induced symphyseal changes, and the intercorrelations among lips and among lip and symphysis variables were statistically evaluated, both univariately and multivariately. Three measures are made of symphysis change: horizontal and vertical repositioning and amount and direction of rotation, Horizontal repositioning primarily affected the lengthening and areal increase of the upper lip. Vertical repositioning had its major influence in the height and cross-sectional area of the lower lip: a superior shift of the mandible made the lower lip shorter, more protrusive and smaller in area; an inferior shift produced an increase in lower lip height with increased area. The third variable, symphyseal rotation, had its greatest influence on the labial-lingual shift of the upper lip's centroid. The long-term follow-up showed little change from the 1 year post-operative conditions; equilibrium of the soft tissue components was then achieved fairly soon after surgery. [ABSTRACT FROM AUTHOR]

Crystals, diffracting best to around 3 Å have been grown from intact large and small ribosomal subunits. The bright synchroton radiation necessary for the collection of the higher-resolution X-ray diffraction data introduces significant decay even at cryo temperatures. Nevertheless, owing to the reasonable isomorphism of the recently improved crystals of the small ribosomal subunits, reliable phases have been extracted at medium resolution (5-6 Å) and an interpretable five-derivative MIR map has been constructed. For the crytals of the large subnnits, however, the situation is more complicated because at higher resolmion (2.7-7 Å) they suffer from substantial radiation sensitivity, a low level of isomorphism instability of the longest unit-cell axis and nonisotropic mosaicity. The 8 Å MIR map, constructed to gain insight into this unusual system, may provide feasible reasoning for the odd combination of the properties of these crystals as well as hints for future improvement. Parallel efforts, in which electron-microscopy-reconstructed images are being exploited for molecular-replacemem studies, are also discussed. [ABSTRACT FROM AUTHOR]

- A study of urinary cytology and selected mucosal biopsies in conjunction with cystoscopy provided additional information of value in the management of 318 patients with bladder cancer. These procedures were especially helpful in patients with no visible lesion on follow-up cystoscopies in assessing the bladder epithelium, the behaviour of which may be unpredictable in that no further tumours may occur, or they may arise at irregular intervals. [ABSTRACT FROM AUTHOR]

Comparison of the mass spectral behaviour of the dimethyl esters of the epimeric ( cis- and trans-) cyclobut-3-ene-1,2-dicarboxylic acids and the isomeric muconates ( cis, cis-, cis, trans- and trans, trans-) and some substituted analogues shows that no correlation exists between the electron-impact-induced fragmentation and the predicted photochemical or thermal transformations in these systems. The comparison involved fragmentation patterns (supported by deuterium labelling), metastable transitions, and also kinetic energy release in the field free region. [ABSTRACT FROM AUTHOR]

Elimination of CH3OH from the molecular ions of the methyl esters of cyclobut-3-ene-1, 2-dicarboxylic acids under electron-impact occurs to a much greater extent in stereoisomers having a trans configuration than in the cis analogues. Deuterium labelling shows that this process takes place via different mechanisms in the stereoisomeric esters. The abundance ratio [M  CH3OH]˙+/[M  CH3O]+ is suggested as the most sensitive criterion for the deduction of configuration in this system. Determination of the geometry of the cyclobutene esters by n.m.r. spectroscopy as well as by pyrolysis to corresponding isomeric muconates is also discussed. [ABSTRACT FROM AUTHOR]

The isomeric 3,4-diethylmuconic acid dimethyl esters behave differently under electronimpact. Methanol elimination from the molecular ion is one of the most important processes in the trans, trans diester. In the cis, cis and cis, trans isomers, however, the loss of a methoxyl radical from the molecular ion occurs to a much greater extent than elimination of methanol. This distinctive behaviour is interpreted in terms of different distances between the methoxy groups and the allylic hydrogen atoms in the geometrical isomers. Other differences in the mass spectra of the isomers are reported and discussed. [ABSTRACT FROM AUTHOR]

Presents a reply to a commentary, referred to as BNC2004, on the manner in which a group of researchers have chosen to assess the variability in the particulate organic carbon export flux estimated using the thorium-234 method. Primary objection of the BNC2004 comment; Effect of the BNC2004 comment on the objectives of the study; Concern about natural variability versus uncertainty.

A seroepidemiological survey was made of the prevalence of antibodies reactive with in stray and pet dogs from five geographical regions of Israel. Serum samples from 410 dogs were assayed by an indirect fluorescent antibody test and serum reactive at a 1:20 dilution or greater was considered positive. The overall seroprevalence was 30 per cent with 23.9 per cent in pet dogs and 37.5 per cent in stray dogs. The seroprevalence in apparently healthy pets (17.6 per cent) was lower but did not differ significantly from the seroprevalence in sick animals (26.6 per cent). The seroprevalence was highest in the north of Israel and lowest in the central hilly area, and followed the same trend in both the populations sampled. Young dogs (under one year old) had a lower seroprevalence (14.9 per cent) than adult (one to eight years) (36.4 per cent) or older dogs (over eight years) (34.2 per cent). The results demonstrate that dogs in Israel are extensively exposed to and indicate that ehrlichiosis is endemic in this area of the Middle East. [ABSTRACT FROM PUBLISHER]

A correction to the article "Montelukast for treating seasonal allergic rhinitis: a randomized, double-blind, placebo-controlled trial performed in the spring" is presented.

Summary Background Cysteinyl leukotrienes are important proinflammatory mediators believed to have a role in allergic rhinitis. Objective This multicentre, randomized, double-blind, placebo- and active-controlled trial evaluated the effectiveness and tolerability of montelukast, a cysteinyl leukotriene receptor antagonist, for treating patients with seasonal allergic rhinitis. Methods After a 3- to 5-day, single-blind placebo run-in period, 1302 male and female patients (aged 15–81 years) with active allergic rhinitis symptoms were randomly assigned to receive montelukast 10 mg (n = 348), loratadine 10 mg ( n = 602), or placebo ( n = 352) administered once daily at bedtime for 2 weeks during the spring allergy season. Results Mean patient characteristics and symptom scores at baseline were similar for the three treatment groups. The primary end-point, daytime nasal symptoms score (mean of nasal congestion, rhinorrhea, nasal pruritus, and sneezing scores; 0–3 scale), improved from baseline during treatment by (least squares mean, 95% confidence interval) - 0.37 (- 0.43, - 0.31), - 0.47 (- 0.52, - 0.43), and - 0.24 (- 0.29, - 0.18) in the montelukast, loratadine, and placebo groups, respectively (P ≤ 0.001 comparing each active treatment with placebo). Mean changes from baseline in all other diary-based scores, including night-time and eye symptom scores, were significantly greater for each active treatment than for placebo. The rhinoconjunctivitis quality of life overall score improved significantly with montelukast and with loratadine as compared with placebo. Montelukast and loratadine showed a safety profile comparable to that of placebo. Conclusion Montelukast is well tolerated and provides improvements in daytime and night-time symptoms, as well as quality of life parameters, for patients with seasonal allergic rhinitis. [ABSTRACT FROM AUTHOR]

Aim: This study examined whether speech abnormalities typical of formal thought disorder in schizophrenia vary with the degree of positive schizotypy in the healthy population. We hypothesized that participants with high levels of positive schizotypy would show greater abnormality in speech relative to those with low levels of positive schizotypy., Methods: Participants (n=107) were prescreened with a positive schizotypy scale. Those meeting criteria for either high (n=23) or low (n=27) schizotypy provided speech samples which were assessed with a clinical though disorder rating scale (Thought and Language Index) for the presence of abnormality., Results: No significant differences were found in positive (P=0.25) or negative (P=0.21) speech abnormality between the high and low schizotypy groups., Conclusion: Although schizotypy is normally distributed in the general population, speech abnormality is not. Thus, the presence of aberrations in speech may predict risk of psychosis. Potential implications for risk assessment are discussed., (© 2008 The Authors. Journal compilation © 2008 Blackwell Publishing Asia Pty Ltd.)

In the context of an NIAAA/Fetzer Institute-funded study designed to look at the impact of spirituality in an inpatient alcohol treatment, this retrospective case control study investigated whether spiritual growth occurred during an inpatient phase of treatment for alcohol dependence, the degree to which spiritual gains (if noted) would be maintained at follow-up, and whether spiritual growth would be associated with follow-up sobriety. To accomplish this goal, thirty-six individuals who reported relapsing to alcohol at three-month follow-up were compared with thirty-six matched controls who reported abstinence at follow-up. Spiritual development and change was assessed via a set of six measures. Paired t-tests revealed that spiritual growth occurred across all measures during the treatment phase. Repeated measures analysis of variance (ANOVA) indicated that this growth was maintained at three-month follow-up. Two-way repeated measures ANOVA revealed that while non-relapsers maintained spiritual growth over the course of four weeks of treatment and in the three-month period following treatment, renewed alcohol use was associated with decreased spirituality.

We argue that computation via quantum mechanical processes is irrelevant to explaining how brains produce thought, contrary to the ongoing speculations of many theorists. First, quantum effects do not have the temporal properties required for neural information processing. Second, there are substantial physical obstacles to any organic instantiation of quantum computation. Third, there is no psychological evidence that such mental phenomena as consciousness and mathematical thinking require explanation via quantum theory. We conclude that understanding brain function is unlikely to require quantum computation or similar mechanisms., (2006 Lawrence Erlbaum Associates, Inc.)

Cravings for alcohol are identified as a trigger for relapse, though laboratory studies of cravings produce mixed results in predicting relapse. The objective of this analysis is to assess the usefulness of craving as a predictor of relapse by assessing 218 adult, alcohol-dependent patients admitted to two separate residential addiction treatment programs. Days craving reported in the week prior to discharge predicted alcohol use at three-month follow-up. Admission spirituality, alcohol-refusal self-efficacy, and depression levels differentiated cravers from non-cravers. Patients who crave alcohol in residential treatment may be at higher relapse risk and identified by intake assessments of self-efficacy, depression, and spirituality.

We compared outcomes during and after treatment for mixed substance dependent patients (N=143) randomly assigned to a high-structure, behaviorally-oriented (HSB) or a low-structure, facilitative (LSF) individual counseling style. We hypothesized that patients with different coping characteristics would respond differently to the two styles of counseling. Patients were treated in once-weekly individual HSB or LSF counseling for up to 12 weeks. Outcome measures included patient and counselor ratings of benefit, retention, symptom reduction, and negative urines; follow-up assessments included control of substance use and psychosocial adjustment. While no differences in outcomes during or after treatment were found for the HSB and LSF patients, both groups did improve equally. Contrary to our hypothesis, our coping measures did not predict different outcomes for patients treated in the LSF and HSB styles. Post-hoc analyses, however, revealed that outcomes could be predicted in each style from patterns of pretreatment characteristics, which included measures of coping strategies, psychological characteristics, and treatment readiness. Moreover, the patterns associated with positive outcomes were different for the HSB and LSF patients: high treatment readiness was most important for success in HSB counseling, while low psychiatric severity and positive coping styles were important for the LSF clients. The finding of no HSB-LSF outcome differences calls into question the exclusive emphasis on behavioral treatment approaches by the present-day managed care industry. Also, the traditional approach to matching studies, ie, employing one patient characteristic at a time to predict differential outcomes for particular treatments, may be simplistic. An alternative approach employing multivariate statistical procedures to predict outcomes from several patient characteristics may hold more promise.

Outcomes during treatment were compared for inner-city drug-dependent individuals randomly assigned to high-structure, behaviorally-oriented (HSB) or to low-structure, facilitative (LSF) individual counseling. No group differences were found for symptom reduction, patient and counselor ratings of benefit, retention, or drug free urines. However, the more depressed and "helpless" clients showed significantly better control of substance use in HSB counseling, while the less depressed and helpless patients realized better control in LSF treatment. These results suggest that outcomes might be improved by matching patients to high- and low-structure counseling based on their pretreatment levels of depression and learned helplessness.

Aims: Equivocal findings of the effect that therapist and patient similarity plays in treatment outcome led us to examine the impact of race- and sex-matching on treatment retention and outcome for a sample of people seeking outpatient substance abuse treatment., Design: Patient and therapist characteristics were crossed in a 2 x 2 factorial design. Matching effects were then tested using retrospective data., Participants: Participants were 116 African-American cocaine-dependent people., Setting: The study site was a university-sponsored outpatient treatment facility located in an economically depressed area of a large Northeastern US city., Measurements: Follow-up data were drawn from the Addiction Severity Index, the Risk for AIDS Behavior Inventory and a questionnaire measuring post-discharge need for treatment, employment and education. Retention was defined as the number of days inclusive between the last date of service and the date admitted., Findings: No meaningful effects in favor of matching were observed on outcome measures., Conclusion: While matching therapists and drug-dependent people does not appear to be essential in promoting positive retention and outcome, limitations of this study that include sample size and the homogeneous demographic nature of those seeking therapeutic services at our facility lead us to conclude that replication with a larger number of therapists and patients is needed. In a different therapeutic setting, with a different population presenting for treatment, the mismatching of patients and therapists with respect to factors such as those explored here might well yield differing results.

Aims: The current study was conducted to (a) replicate previous findings regarding the effect of patient/therapist race and sex-matching as this relates to the early dropout rate of substance abusers, and (b) to extend previous work by examining the impact of such matching on treatment retention and 9-month outcome., Design: Patient and therapist characteristics were crossed in a 2 x 2 factorial design. Matching effects were then tested using retrospective data., Participants: Participants were 967 African-American cocaine-dependent people., Setting: The study site was a university sponsored outpatient treatment facility located in an economically depressed section of a large Northeastern US city., Measurements: Follow-up data were drawn from the Addiction Severity Index, the Risk for AIDS Behavior Inventory, and a questionnaire measuring post-discharge need for treatment, employment and education. Retention was defined as the number of days inclusive between the last date of service and the date of admission., Findings: No significant differences in early dropout rates were found after initial contact with 10 different therapists. Matching therapist and patients with respect to gender and race did not decrease the premature dropout rate, but partial support for gender matching was noted., Conclusion: Matching therapist and substance abusing patients on gender and race may not be essential to improving retention and outcome.