Digital Commons Network^™

Ethnicity And Mental Health Treatment Utilization By Patients With Personality Disorders, Donna S. Bender, Andrew E. Skodol, Ingrid R. Dyck, John C. Markowitz, M. Tracie Shea, Shirley Yen, Charles A. Sanislow, Anthony Pinto, Mary C. Zanarini, Thomas H. Mcglashan, John G. Gunderson, Maria T. Daversa, Carlos M. Grilo

Charles A. Sanislow, Ph.D.

The authors examined the relationship between ethnicity and treatment utilization by individuals with personality disorders (PDs). Lifetime and prospectively determined rates and amounts of mental health treatments received were compared in over 500 White, African American, and Hispanic participants with PDs in a naturalistic longitudinal study. Minority, especially Hispanic, participants were significantly less likely than White participants to receive a range of outpatient and inpatient psychosocial treatments and psychotropic medications. This pattern was especially pronounced for minority participants with more severe PDs. A positive support alliance factor significantly predicted the amount of individual psychotherapy used by African American and Hispanic …

The Epidemiology And Economics Of Chronic Obstructive Pulmonary Disease, David M. Mannino, S. Braman

David M. Mannino

Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease responsible for a large human and economic burden around the world. Cigarette smoking is the main risk factor for COPD in the developed world, although other important risk factors include occupational exposures, air pollution, airway hyperresponsiveness, asthma, and genetic predisposition. In most of the world, COPD prevalence and mortality continue to rise in response to increases in smoking, particularly by women and adolescents. COPD is also an important cause of disability, and is linked to comorbid diseases, such as depression and cardiovascular disease, which adds to the large economic …

Smallpox, Richard N. Bradley

Richard N Bradley

Description Viral infection of the human respiratory tract. Causes Infection by variola virus. Risk Factors Exposure to a biological warfare or bioterror attack or contact with an infected person. Symptoms

Fever, cough and body aches, followed by a spotted, bumpy rash.

Diagnosis

Confirmed by testing blood or the fluid from the blisters.

Treatments

None currently approved but experts are testing some medications.

Pathogenesis

The virus enters and multiplies in the respiratory passages.

Prevention

Avoid those with the disease. During an outbreak a vaccine is available that will prevent the disease or lessen its severity.

Epidemiology

Completely eradicated from nature, but …

Role Of N-Epsilon-(Carboxymethyl)Lysine In The Development Of Ischemic Heart Disease In Type 2 Diabetes Mellitus, Ikram Shah Ismail

Ikram Shah Ismail

This study aims to determine the levels of N-epsilon-(carboxymethyl)lysine (CML) in patients with Type 2 diabetic patients with and without ischemic heart disease (IHD) and to find for a possible association between circulating CML and a number of clinical parameters including lipids, hemoglobin Ale (HbA1c) and malondialdehyde (NIDA) in Type 2 diabetic 1111) patients. Serum CML levels were measured by enzyme-linked immunosorbent assay using polyclonal anti-CML antibodies. Serum levels of CML and NIDA were assessed in 60 IHD patients with Type 2 diabetes, 43 HID patients without Type 2 diabetes, 64 Type 2 diabetics without IHD, and 80 sex- and …

Copd And Lung Cancer Have Come A Long Way...Baby, David M. Mannino

David M. Mannino

Comment on

The growing burden of chronic obstructive pulmonary disease and lung cancer in women: examining sex differences in cigarette smoke metabolism.

http://www.atsjournals.org/doi/pdf/10.1164/rccm.200704-590ED

Comparison Of Alternative Models For Personality Disorders, Leslie C. Morey, Christopher J. Hopwood, John G. Gunderson, Andrew E. Skodol, M. Tracie Shea, Shirley Yen, Robert L. Stout, Mary C. Zanarini, Carlos M. Grilo, Charles A. Sanislow, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

BACKGROUND: The categorical classification system for personality disorder (PD) has been frequently criticized and several alternative dimensional models have been proposed.

METHOD: Antecedent, concurrent and predictive markers of construct validity were examined for three models of PDs: the Five-Factor Model (FFM), the Schedule for Nonadaptive and Adaptive Personality (SNAP) model and the DSM-IV in the Collaborative Study of Personality Disorders (CLPS) sample.

RESULTS: All models showed substantial validity across a variety of marker variables over time. Dimensional models (including dimensionalized DSM-IV) consistently outperformed the conventional categorical diagnosis in predicting external variables, such as subsequent suicidal gestures and hospitalizations. FFM facets …

Positive Childhood Experiences: Resilience And Recovery From Personality Disorder In Early Adulthood, Andrew E. Skodol, Donna S. Bender, Maria E. Pagano, M. Tracie Shea, Shirley Yen, Charles A. Sanislow, Carlos M. Grilo, Maria T. Daversa, Robert L. Stout, Mary C. Zanarini, Thomas H. Mcglashan, John G. Gunderson

Charles A. Sanislow, Ph.D.

OBJECTIVE: Recent follow-along studies of personality disorders have shown significant improvement in psychopathology over time. The purpose of this study was to prospectively investigate the association between positive childhood experiences related to resiliency and remission from personality disorder.

METHOD: Five hundred twenty patients with DSM-IV-based semistructured interview diagnoses of schizotypal, borderline, avoidant, or obsessive-compulsive personality disorders were evaluated 6 times over 4 years between September 1996 and June 2002. Positive childhood experiences, including achievements, positive interpersonal relationships with others, and caretaker competencies, were measured using the Childhood Experiences Questionnaire-Revised. The effects of positive childhood experiences on clinically significant remission from …

Psychosocial Impairment And Treatment Utilization By Patients With Borderline Personality Disorder, Other Personality Disorders, Mood And Anxiety Disorders, And A Healthy Comparison Group, Emily B. Ansell, Charles A. Sanislow, Thomas H. Mcglashan, Carlos M. Grilo

Charles A. Sanislow, Ph.D.

This study compared psychosocial functioning and treatment utilization in 130 participants who were diagnosed with a borderline personality disorder (BPD), a non-BPD personality disorder (OPD), a mood and/or anxiety disorder (MAD), or had no current psychiatric diagnosis and served as a healthy comparison group. Diagnostic and Statistical Manual of Mental Disorders (4th Edition) diagnoses, psychosocial functioning, and treatment utilization were determined by using well-established semistructured research interviews conducted by trained doctoral-level clinicians. Analysis of variance revealed the most severe deficits in functioning characterized the BPD group across areas of global functioning with more moderate impairments in functioning occurring in OPD …

Longitudinal Diagnostic Efficiency Of Dsm-Iv Criteria For Borderline Personality Disorder: A 2-Year Prospective Study, Carlos M. Grilo, Charles A. Sanislow, Andrew E. Skodol, John G. Gunderson, Robert L. Stout, Donna S. Bender, Shirley Yen, M. Tracie Shea, Leslie C. Morey, Mary C. Zanarini, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

OBJECTIVE: To examine the longitudinal diagnostic efficiency of the DSM-IV criteria for borderline personality disorder (BPD). METHODS: At baseline, we used semistructured diagnostic interviews to determine criteria and diagnoses; blinded assessments were performed 24 months later with 550 participants. Diagnostic efficiency indices (specifically, conditional probabilities, total predictive power, and kappa) were calculated for each criterion determined at baseline, with the independent BPD diagnosis at follow-up used as the standard. RESULTS: Longitudinal diagnostic efficiencies for the BPD criteria varied, with the criteria of suicidality or self-injury and unstable relationships demonstrating the most predictive utility. CONCLUSIONS: BPD criteria differ in their predictive …

Natural Course Of Bulimia Nervosa And Of Eating Disorder Not Otherwise Specified: 5-Year Prospective Study Of Remissions, Relapses, And The Effects Of Personality Disorder Psychopathology, Carlos M. Grilo, Maria E. Pagano, Andrew E. Skodol, Charles A. Sanislow, Thomas H. Mcglashan, John G. Gunderson, Robert L. Stout

Charles A. Sanislow, Ph.D.

OBJECTIVE: To examine prospectively the natural course of bulimia nervosa and eating disorder not otherwise specified (EDNOS) and to test for the effects of personality disorder psychopathology on remission and relapse.

METHOD: Subjects were 92 female patients with current bulimia nervosa (N = 23) or EDNOS (N = 69) at baseline enrollment in the Collaborative Longitudinal Personality Disorders Study. Axis I psychiatric disorders (including eating disorders) were assessed with the Structured Clinical Interview for DSM-IV Axis I Disorders-Patient Version, and personality disorders were assessed with the Diagnostic Interview for DSM-IV Personality Disorders (DIPD-IV). The course of eating disorders was assessed …

High-Dose Pralidoxime For Organophosphorus Poisoning, Ashish Goel, Praveen Aggarwal, Sanjeev Bhoi, Vineet Gupta

Vineet Gupta, MD, FACP

No abstract provided.

Avoiding Bias In The Annualized Rate Of Changed Of Fev1, David M. Mannino, Matthew M. Reichert, Kourtney J. Davis

David M. Mannino

No abstract provided.

Adrb2 Arg16gly Polymorphism, Lung Function, And Mortality: Results From The Atherosclerosis Risk In Community Study, Jill M. Ferdinands, David M. Mannino, Marta L. Gwinn, Molly S. Bray

David M. Mannino

Background

Growing evidence suggests that the Arg16Arg genotype of the beta-2 adrenergic receptor gene may be associated with adverse effects of beta-agonist therapy. We sought to examine the association of beta-agonist use and the Arg16Gly polymorphism with lung function and mortality among participants in the Atherosclerosis Risk in Communities study.

Methodology and Principal Findings

We genotyped study participants and analyzed the association of the Arg16Gly polymorphism and beta-agonist use with lung function at baseline and clinical examination three years later and with all-cause mortality during 10 years of follow-up. Lung function was characterized by percent-predicted forced expiratory volume in 1 …

Personality Traits Predict Current And Future Functioning Comparably For Individuals With Major Depressive And Personality Disorders, Christopher J. Hopwood, Leslie C. Morey, M. Tracie Shea, Thomas H. Mcglashan, Charles A. Sanislow, Carlos M. Grilo, John G. Gunderson, Mary C. Zanarini, Andrew E. Skodol

Charles A. Sanislow, Ph.D.

Axes I and II were separated in DSM-III to encourage the consideration of the influence of both personality and psychopathology on patient behavior, on the assumption that an understanding of personality would increment syndromal diagnosis in treatment decisions. However, in practice the distinction between Axis I and Axis II is less clear. The current report investigates one aspect on which Axis I and Axis II might be expected to differ, that being the the significance of normative personality traits as an influence on functional status. In this study, the contribution of normative personality traits to functioning is presented for 2 …

Longitudinal Effects Of Personality Disorders On Psychosocial Functioning Of Patients With Major Depressive Disorder, John C. Markowitz, Andrew E. Skodol, Eva Petkova, Jianfeng Cheng, Charles A. Sanislow, Carlos M. Grilo, John G. Gunderson, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

OBJECTIVE: No previous research has focused on psychosocial functioning in understanding how personality disorders compound the impairment caused by major depressive disorder over time. This report describes the effects of persistent and remitting comorbid personality disorders on the depressive status and functioning of patients with major depressive disorder over the course of 2 years.

METHOD: Longitudinal data on functioning from the first 2 years of the Collaborative Longitudinal Personality Disorders Study were evaluated for 3 groups of subjects with major depressive disorder: subjects with major depressive disorder alone (N = 103), those with persistent comorbid personality disorders (N = 164), …

Race, Gender And Stroke Subtypes Mortality In Sao Paulo, Brazil., Paulo A. Lotufo

Paulo A Lotufo

Stroke mortality rates have a discrepant distribution according to socioeconomic variables as social exclusion in Brazil. Recently, data from race has been available from the official health statistics considering five categories: White, Mixed, Black, Asian and Native. We addressed in the city of São Paulo, Brazil, an analysis of cerebrovascular mortality according to race (excluding Asian and Native due to small number of events) and gender during 1999-2001 for people aged 30 to 79 years-old. For all cerebrovascular diseases, age-adjusted mortality rates (x 100,000) for men were higher for Black (150.2), intermediate for Mixed (124.2) and lower for White (104.5) …

Screening, Diagnosis, And Treatment Of Depression In Patients With End-Stage Renal Disease, Scott D. Cohen, Lorenzo Norris, Kimberly D. Acquaviva, Rolf A. Peterson, Paul L. Kimmel

Kimberly D. Acquaviva, PhD, MSW

Depression is common in patients with end-stage renal disease and has been linked to increased mortality. Screening for depression in the general medical population remains controversial; however, given the high prevalence of depression and its significant impact on morbidity and mortality, a strong case for depression screening in patients with end-stage renal disease can be made. Several studies have been performed to validate the more common depression screening measures in patients with chronic kidney disease. The Beck Depression Inventory, the Hamilton Rating Scale for Depression, the Nine-Question Patient Health Questionnaire, and the Center for Epidemiologic Studies Depression Scale are some …

Oaxacans Like To Work Bent Over: The Naturalization Of Social Suffering Among Berry Farm Workers, Seth M. Holmes Phd, Md

Seth M. Holmes PhD, MD

No abstract provided.

Let’S Not Talk About It: Suicide Inquiry In Primary Care, Mitchell D. Feldman, Peter Franks, Paul R. Duberstein, Steven D. Vannoy, Ronald Epstein, Richard L. Kravitz

Steven D Vannoy

ABSTRACT PURPOSE The purpose of this study was to ascertain physician characteristics associated with exploring suicidality in patients with depressive symptoms and the influence of patient antidepressant requests. METHODS Primary care physicians were randomly recruited from 4 sites in northern California and Rochester, NY; 152 physicians participated (53%-61% of those approached). Standardized patients portraying 2 conditions (major depres- sion and adjustment disorder) and 3 antidepressant request types (brand specific, general, or none) made unannounced visits to these physicians between May 2003 and May 2004. We examined factors associated with physician exploration of suicidality. RESULTS Suicide was explored in 36% of …

Aterosclerose: Comparando Brasil E Estados Unidos, Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.

Sunshine And Suicide At The Tropic Of Capricorn, São Paulo, Brazil, 1996–2004, Paulo A. Lotufo

Paulo A Lotufo

Several studies have confi rmed seasonal variation in suicide rates according to hours of sunshine. The suicide pattern was assessed in São Paulo, southeastern Brazil, at the tropic of Capricorn from 1996 to 2004. Poisson regression was employed to estimate parameters of seasonality, as well as to verify associations for each day between daylight duration and suicide. During the nine-year study period, there were 3,984 suicides (76.9% in men; median age=38.7 years old). Seasonal averages of suicides were similar, as were monthly averages. Poisson regression did not reveal any association between suicide rates and hours of sunshine (p=0.45) for both …

Partner Notification: A Promising Approach To Addressing The Hiv/Aids Racial Disparity In The United States, David J. Malebranche, Patricia Kissinger

David J Malebranche

No abstract provided.

Hiv/Aids Prevention Research Among Black Men Who Have Sex With Men: Current Progress And Future Directions, Gregorio A. Millett, David J. Malebranche, John L. Peterson

David J Malebranche

No abstract provided.

Weekends: A Dangerous Time For Having A Stroke?, Gustavo Saposnik

Gustavo Saposnik

No abstract provided.

Hospital Volume And Stroke Outcome: Does It Matter?, Gustavo Saposnik

Gustavo Saposnik

No abstract provided.

Definitive Radiation Therapy Management For Medically Non-Resectable Clinically Localised Non-Small Cell Lung Cancer: Results & Prognostic Factors, Edward Yu, Patricia Tai, Robert Ash, Michael Lee, Larry Stitt, George Rodrigues, Rashid Dar, Mark Vincent, Richard Inculet, Richard Malthaner

Edward Yu

The aim of this paper is to review the experience of radical radiation therapy and the prognostic factors of patient outcome for clinically localised, medically inoperable non-small cell lung cancer (NSCLC) patients. Clinically staged node-negative NSCLC patients who were not a surgical candidates due to co-morbid diseases but who were eligible for curative treatment, were reviewed in the London Regional Cancer Program (LRCP). This study population was treated between 1st Jan 1985 to 31st Jan 2004. Patients were excluded if they were previously treated with chest radiotherapy. Patients with localised disease, but who refused surgery, were also included in the …

Technological Iatrogenesis: New Risks Force Heightened Management Awareness, Patrick Albert Palmieri

Patrick Albert Palmieri

Iatrogenesis is a term typically reserved to express the state of ill health or the adverse outcome resulting from a medical intervention, or lack thereof. Three types of iatrogenesis are described in the literature: clinical, social and cultural. This paper introduces a fourth type, technological iatrogenesis, or emerging errors stimulated by the infusion of technological innovations into complex healthcare systems. While health information technologies (HIT) have helped to make healthcare safer, this has also produced contemporary varieties of iatrogenic errors and events. The potential pitfalls of technological innovations and risk management solutions to address these concerns are discussed. Specifically, failure …