Medicine and Health Sciences Commons^™

Shifting From Hypofractionated To "Conventionally" Fractionated Thoracic Radiotherapy: A Single Institution's 10-Year Experience In The Management Of Limited-Stage Small-Cell Lung Cancer Using Concurrent Chemoradiation, Gregory Videtic, Pauline Truong, A. Dar, Edward Yu, Larry Stitt

Edward Yu

PURPOSE: To perform a retrospective review of a single institution's 10-year experience in treating limited-stage small-cell lung cancer (LS-SCLC) with a concurrent chemoradiation regimen modeled after the experimental arm of a randomized National Cancer Institute of Canada trial in which hypofractionated radiotherapy started with cycle 2 of chemotherapy. We then looked at the impact on patient outcomes of changing the RT during the course of the decade to a "conventionally" (2 Gy) fractionated regimen, with a focus on toxicity and survival rates. METHODS AND MATERIALS: Between 1989 and 1999, 215 LS-SCLC patients received six cycles of chemotherapy consisting of cyclophosphamide, …

The Natural Course Of Bulimia Nervosa And Eating Disorder Not Otherwise Specified Is Not Influenced By Personality Disorders, Carlos M. Grilo, Charles A. Sanislow, M. Tracie Shea, Andrew E. Skodol, Robert L. Stout, Maria E. Pagano, Shirley Yen, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

Objective: To examine prospectively the natural course of bulimia nervosa (BN) and eating disorder not otherwise specified (EDNOS) and to test the effects of personality disorder (PD) comorbidity on the outcomes.

Method: Ninety-two female patients with current BN (N ¼ 23) or EDNOS (N ¼ 69) were evaluated at baseline enrollment in the Collaborative Longitudinal Personality Disorders Study (CLPS). Eating disorders (EDs) were assessed with the Structured Clinical Interview for DSM-IV Axis I Disorders. Personality disorders (PDs) were assessed with the Diagnostic Interview for DSM-IV PD (DIPD-IV). The course of BN and EDNOS was assessed with the Longitudinal Interval Follow-up …

Clinical Features And Impairment In Women With Borderline Personality Disorder (Bpd) With Post-Traumatic Stress Disorder (Ptsd), Bpd Without Ptsd, And Other Personality Disorders With Ptsd, Caron Zlotnick, Dawn M. Johnson, Shirley Yen, Cynthia Battle, Charles A. Sanislow, Andrew E. Skodol, Carlos M. Grilo, Thomas H. Mcglashan, John G. Gunderson, Donna S. Bender, Mary C. Zanarini, M. Tracie Shea

Charles A. Sanislow, Ph.D.

The aims of this study were to examine differences in clinical features, impairment, and types of childhood traumas among women with borderline personality disorder (BPD), women with BPD and posttraumatic stress disorder (PTSD), and those with other personality disorders and PTSD. Using baseline data from the Collaborative Longitudinal Study of Personality Disorders, 186 women were divided into 3 groups (BPD+PTSD, BPD, PTSD), based on structured diagnostic interviews for Axis I and Axis II disorders and compared on selected clinical variables. The additional diagnosis of PTSD in borderline women did not significantly increase the degree of borderline pathology and psychiatric morbidity …

The Representation Of Four Personality Disorders By The Schedule For Nonadaptive And Adaptive Personality Dimensional Model Of Personality, Leslie C. Morey, Megan B. Warner, M. Tracie Shea, John G. Gunderson, Charles A. Sanislow, Carlos M. Grilo, Andrew E. Skodol, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

This study examined the relationships of the Schedule for Nonadaptive and Adaptive Personality (SNAP) model of personality to 4 targeted personality disorders (PDs) in a large multisite sample of patients. Data were examined from 529 patients, who were assigned 1 of 5 primary diagnoses: borderline, schizotypal, avoidant, and obsessive–compulsive PDs and major depression without PD. Patients were administered the SNAP questionnaire and results were compared among diagnostic groups and between patient groups and nonclinical norms. Results indicated that the dimensions of the model appear to have considerable promise in differentiating normal from abnormal personality, particularly in the propensity of individuals …

Diagnosing Patients With Tiredness In General Practice, Jenny Doust

Jenny Doust

Trying to sort out which patients have a relatively simple problem that will resolve spontaneously from those that require medical treatment and those that require urgent attention is one of the aspects of general practice that makes it interesting and challenging. Patients who present with tiredness in general practice can have any of a long list of diagnoses ranging from the trivial to the life threatening, and knowing how to determine who has which is an essential skill for competent practice.

Axis I And Ii Disorders As Predictors Of Prospective Suicide Attempts: Findings From The Collaborative Longitudinal Personality Disorders Study, Shirley Yen, M. Tracie Shea, Maria Pagano, Charles A. Sanislow, Carlos M. Grilo, Thomas H. Mcglashan, Andrew E. Skodol, Donna S. Bender, Mary C. Zanarini, John G. Gunderson, Leslie C. Morey

Charles A. Sanislow, Ph.D.

This study examined diagnostic predictors of prospectively observed suicide attempts in a personality disorder (PD) sample. During 2 years of follow-up, 58 participants (9%) reported at least 1 definitive suicide attempt. Predictors that were examined include 4 PD diagnoses and selected Axis I diagnoses (baseline and course). Multivariate logistic regression analyses indicated that baseline borderline personality disorder (BPD) and drug use disorders significantly predicted prospective suicide attempts. Controlling for baseline BPD diagnosis, proportional hazards analyses showed that worsening in the course of major depressive disorder (MDD) and of substance use disorders in the month preceding the attempt were also significant …

Gender Differences In Borderline Personality Disorder: Findings From The Collaborative Longitudinal Personality Disorders Study, Dawn M. Johnson, M. Tracie Shea, Shirley Yen, Cynthia L. Battle, Caron Zlotnick, Charles A. Sanislow, Carlos M. Grilo, Andrew E. Skodol, Donna S. Bender, Thomas H. Mcglashan, John G. Gunderson, Mary C. Zanarini

Charles A. Sanislow, Ph.D.

A majority of the literature on borderline personality disorder (BPD) focuses on its occurrence in women or does not specifically assess for gender differences in clinical presentations. Some studies report that men with BPD may be more likely to be diagnosed with substance use disorders, as well as paranoid, passive-aggressive, narcissistic, sadistic, and antisocial personality disorders (PDs). Additionally, women with BPD appear to be more likely to report histories of adult physical and sexual abuse and to meet diagnostic criteria for post-traumatic stress disorder (PTSD) and eating disorders. The purpose of the present study was to further examine gender differences …

The Love And Belonging Healthcare Needs Of Hiv Infected African-American Men Upon Admission To An Aids Dedicated Nursing Home., Sheldon Fields

Sheldon D. Fields

The purpose of this study was to describe the love and belonging healthcare needs of HIV infected African-American men upon admission to an AIDS dedicated nursing home. Subjects were 73 (N=73) African-American men 26 to 60 years of age that were admitted to an AIDS dedicated nursing home in the Southern New England area between 1995 and 1999. Most of the men were single (n = 39) and estranged from their immediate families. Many of these men did not have a family member supportive of discharge (n = 60) and did not desire discharge back out into the community (n …

Continued Cigarette Smoking By Patients Receiving Concurrent Chemoradiotherapy For Limited-Stage Small-Cell Lung Cancer Is Associated With Decreased Survival, Gregory Videtic, Larry Stitt, A. Dar, Walter Kocha, Anna Tomiak, Pauline Truong, Mark Vincent, Edward Yu

Edward Yu

PURPOSE: To determine the impact of continued smoking by patients receiving chemotherapy (CHT) and radiotherapy (RT) for limited-stage small-cell lung cancer (LSCLC) on toxicity and survival. PATIENTS AND METHODS: A retrospective review was carried out on 215 patients with LSCLC treated between 1989 and 1999. Treatment consisted of six cycles of alternating cyclophosphamide, doxorubicin, vincristine and etoposide, cisplatin (EP). Thoracic RT was concurrent with EP (cycle 2 or 3) only. Patients were known smokers, with their smoking status recorded at the start of chemoradiotherapy (CHT/RT). RT interruption during concurrent CHT/RT was used as the marker for treatment toxicity. RESULTS: Of …

Fatal Injuries In The United States Involving Respirators, 1984-1995, Anthony Suruda, William Milliken, Dale Stephenson, Richard Sesek

Dale J. Stephenson

There is little published information concerning the epidemiology of fatal injuries involving respiratory protection. We compiled a case series from U.S. Occupational Safety and Health Administration investigation reports from 1984 through 1995. For the 12-year period there were 41 incidents resulting in 45 deaths due to asphyxiation or chemical poisoning while wearing a respirator. There were 23 deaths related to airline respirators, 17 deaths involving use of negative pressure (air purifying) respirators, and 5 deaths involving self-contained breathing apparatus. Among the 23 deaths involving airline respirators, 15 were associated with compatible connection couplings for breathable air and inert gases. Three …

Global Challenges Show, Nat Quansah

Nat Quansah

No abstract provided.

Do Eating Disorders Co-Occur With Personality Disorders? Comparison Groups Matter., Carlos M. Grilo, Charles A. Sanislow, Andrew E. Skodol, John G. Gunderson, Robert L. Stout, M. Tracie Shea, Mary C. Zanarini, Donna S. Bender, Leslie C. Morey, Ingrid R. Dyck, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

OBJECTIVE: To assess and compare lifetime rates of occurrence of eating disorders (ED) with four Axis II personality disorders (PD) and with major depressive disorder (MDD) without PD. The eating disorders met criteria outlined in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).

METHOD: Six hundred sixty-eight patients recruited for the Collaborative Longitudinal Personality Disorders Study (CLPS) were reliably assessed with the Structured Clinical Interview for DSM-IV Axis I Disorders and the Diagnostic Interview for DSM-IV Personality Disorders. The distribution of ED diagnoses was compared among four PD study groups (schizotypal, borderline, avoidant, obsessive-compulsive) and …

Correlates Of Suicide Risk In Juvenile Detainees And Adolescent Inpatients, Charles A. Sanislow, Carlos M. Grilo, Dwain C. Fehon, Seth R. Axelrod, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

OBJECTIVE: To compare correlates of risk for suicidal behavior in juvenile detainees with those in another high-risk group, adolescent psychiatric inpatients.

METHOD: Eighty-one adolescents in a short-term juvenile detention center were contrasted with a matched group of 81 adolescent psychiatric inpatients on a clinical assessment battery of established instruments including a measure for risk of suicidal behavior.

RESULTS: Juvenile detainees and adolescent psychiatric inpatients reported similar levels of distress on measures of suicide risk, depression, impulsivity, and drug abuse. After controlling for depression, impulsivity and drug abuse remained significantly associated with suicide risk scores in the juvenile detention group, but …

Environmental Health In Public Health, R. Konkel, Darryl Barnett, Joe Beck, Worley Johnson

Steve Konkel

A most intriguing question, and one that leads to many debates both inside and outside of the environmental health field, is a definition of environmental health. The answer given is often tempered by one's political slant (i.e., liberal, moderate, or conservative) and by one's professional training (e.g., public health sanitation, chemistry, nursing, ecology, planning, public administration, etc). Although agreement is needed to effectively address the challenges in the field, disagreement often centers on what constitutes environmental health and even on the name or nickname that should be applied to individuals whose primary focus is on one or many aspects of …

Diagnostic And Management Strategies For Anaemia In Adults, Jenny Doust

Jenny Doust

BACKGROUND Anaemia is often an incidental finding or is discovered when patients present with nonspecific symptoms such as tiredness. OBJECTIVE This article presents strategies to identify the cause of anaemia and uses four case studies to illustrate these principles. DISCUSSION Few diagnostic tests can completely rule in or rule out causes of anaemia. This makes the investigation of anaemia complex. An understanding of the limitations of tests in aiding diagnosis is required.

Through The Causality Web: Looking At Etiology And Resistance In Aboriginal Cancer Experiences, Treena Orchard

Dr. Treena Orchard

No abstract provided.

Emergency Operations Rural Household Food And Livelihood Security Baseline: Midland And Masvingo Provinces, Zimbabwe. Care., John Mazzeo

John Mazzeo, Ph.D.

No abstract provided.

Space Ship Earth – Clinic In Forest, Nat Quansah

Nat Quansah

No abstract provided.

Promoting Better Use Of The Psa Test In General Practice: Randomized Controlled Trial Of Educational Strategies Based On Outreach Visits And Mailout, D Weller, F May, D Rowett, A Esterman, C Pinnock, S Nicholson, Jenny Doust, C Silagy

Jenny Doust

Background. Prostate-specific antigen (PSA) testing for prostate cancer is controversial. Demand for PSA testing is likely to rise in the UK, Australia and other western countries. Primary care needs to develop appropriate strategies to respond to this demand. Objectives. Our aim was to compare the effectiveness of educational outreach visits (EOVs) and mailout strategies targeting PSA testing in Australian primary care. Methods. A randomized controlled trial was conducted in general practices in southern Adelaide. The main outcome measures at baseline, 6 months and 12 months post-intervention were PSA testing rates and GP knowledge in key areas relating to prostate cancer …

Lesotho Vulnerability Assessment. Care., John Mazzeo

John Mazzeo, Ph.D.

No abstract provided.

Factors Influencing Women’S Use Of Health Services For Sexually Transmitted Infections In Eastern Nepal, Kalpana Poudel-Tandukar, Krishna Poudel, Colin Macdougall

Kalpana Poudel-Tandukar

The Physiologic Health Care Needs Of Hiv-Infected Black Men On Admission To An Aids-Dedicated Nursing Home., Sheldon Fields

Sheldon D. Fields

The purpose of this study is to describe the physiologic health care needs of HIV-infected Black men on admission to an AIDS-dedicated nursing home. Participants were 68 Black men aged 26 to 60 years who were admitted to an AIDS-dedicated nursing home in the southern New England area between 1995 and 1999. The participants were very ill and weak on their admission to the nursing home, with most having diagnoses of AIDS (n = 65), an average Karnofsky Performance Scale score of 44 (SD = 14.90), and some degree of mental impairment. The late-stage of disease of the participants was …

Environmental Planning, R. Steven Konkel

Steve Konkel

Our understanding of the importance of healthy ecosystems and the impact of people on the natural and the built environment continues to grow. The need for stewardship to preserve, protect, and enhance the natural environment and promote healthy populations is increasingly seen as a universal responsibility of environmental health and safety (EHS) professionals.

Hiding In Plain Sight: A Practical Guide To Identifying Victims Of Trafficking In The United States, Donna M. Hughes Dr.

Donna M. Hughes

Underlying Causes Of Livelihood Insecurity Among The Poor In Malawi: The Testing Of Five Hypotheses. Care., John Mazzeo

John Mazzeo, Ph.D.

No abstract provided.

Livelihood Monitoring For Southeast Bangladesh. Care., John Mazzeo

John Mazzeo, Ph.D.

No abstract provided.

Dengue, Aedes Aegypti, And Hurricane Reconstruction In The Caribbean And Central America: Prevention And Control Following A Natural Disaster, Frank Cortez Flores

Frank Cortez Flores

Abstract: Dengue is currently the most important vector-borne viral disease affecting people, in terms of both morbidity and mortality. Repeated epidemics of dengue and dengue hemorrhagic fever afflicting millions of individuals occur annually in tropical and subtropical areas of the world, including The Caribbean and Central America, inhabited by the Aedes aegypti mosquito.

Accordingly, the main purpose of this study was to identify and address the dominating factors influencing the resurgence of dengue fever following a natural disaster such as a hurricane.

This study also depicted an arguable approach to dengue surveillance as well as described existing efforts to prevent, …

Black Men Who Have Sex With Men And The Hiv Epidemic: Next Steps For Public Health, David J. Malebranche

David J Malebranche

No abstract provided.

Crisis Intervention Services In Juvenile Detention Centers, Charles A. Sanislow, John Chapman, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

The prevalence of mental disorders among juvenile detainees is estimated to be as high as 60 percent, and reports suggest that adolescents who are detained have a three- to fourfold risk of suicide. The transfer of juveniles who commit serious offenses to the adult legal system and the problems of overwhelmed child care agencies appear to have precipitated a shift in the composition of populations in juvenile detention centers. Adolescents are often detained for minor legal charges that occur in the context of severe behavioral problems and family stress. We report on a collaborative venture between a state juvenile justice …

Plausibility And Possible Determinants Of Sudden 'Remissions' In Borderline Patients, John G. Gunderson, Donna S. Bender, Charles A. Sanislow, Shirley Yen, Jennifer Bame Rettew, Regina Dolan-Sewell, Ingrid R. Dyck, Leslie C. Morey, Thomas H. Mcglashan, M. Tracie Shea, Andrew E. Skodol

Charles A. Sanislow, Ph.D.

THIS STUDY documents dramatic improvements in patients with borderline personality disorder (BPD) and explores their possible determinants. From a sample of the 160 carefully diagnosed borderline patients on whom prospective follow-along data was collected, a subsample of 18 was identified whose DSM-IV criteria count fell to two or fewer during the course of the first 6 months of the study and retained that improvement for the next 6 months. Follow-along data including month-by-month ratings of BPD criteria; week-by-week ratings of Axis I disorders, medication changes, and life events were then used to establish concensus ratings on four hypothesized causes: Axis …