Distribution by Scientific Domains
Distribution within Medical Sciences

Terms modified by Borderline

  • borderline association
  • borderline case
  • borderline change
  • borderline lesion
  • borderline malignancy
  • borderline ovarian tumor
  • borderline ovarian tumour
  • borderline patient
  • borderline personality
  • borderline personality disorder
  • borderline result
  • borderline significance
  • borderline significant
  • borderline statistical significance
  • borderline tumor
  • borderline tumour

  • Selected Abstracts

    Personality pathology, depression and HPA axis functioning

    I. Schweitzer
    Abstract Hypothalamic pituitary adrenal (HPA) axis functioning, as measured by the dexamethasone suppression test (DST), has been extensively investigated in major depressive disorder (MDD). Evaluating DST response in MDD patients while simultaneously considering clinically relevant personality disorders may further clarify the contribution of both personality pathology and HPA axis function to depressive symptoms. The present study measured personality pathology by administering the revised version of the Millon Clinical Multiaxial Inventory (MCMI-II) in a sample of 25 patients diagnosed with MDD. Analyses revealed that suppressors (n,=,19) scored significantly higher than non-suppressors (n,=,6) on six of the 13 MCMI-II personality disorder scales: Avoidant, Schizoid, Self-Defeating, Passive-Aggressive, Schizotypal and Borderline. Increased personality pathology was associated with normal suppression of cortisol following the DST. This suggests that suppression of the DST may be associated with depressive states linked with personality pathology while the more biologically based depression is associated with abnormal HPA pathophysiology. Copyright © 2001 John Wiley & Sons, Ltd. [source]

    Personality disorder traits evident by early adulthood and risk for eating and weight problems during middle adulthood

    Jeffrey G. Johnson PhD
    Abstract Objective: The current article investigates the association of personality disorder (PD) with the subsequent development of eating and weight problems. Method: Psychiatric interviews were administered to a community-based sample of 658 individuals at mean ages 14, 16, 22, and 33 years. Results: Individuals with PD by age 22 were at an elevated risk for eating disorders at mean age 33 years. PDs were associated with risk for onset of binge eating, purging, daily dietary restriction, and obesity among individuals without a history of these problems. Borderline and histrionic PD symptoms were associated with recurrent binging and purging at mean age 33 years. Antisocial and schizotypal symptoms were associated with recurrent binging and obesity at mean age 33 years. Depressive PD symptoms were associated with recurrent binging and dietary restriction at mean age 33 years. Conclusion: PD symptoms, evident by early adulthood, may be associated with the risk for the development of eating and weight problems by middle adulthood. © 2006 Wiley Periodicals, Inc., Int J Eat Disord, 2006 [source]

    The Roles of Risk Perception and Borderline and Antisocial Personality Characteristics in College Alcohol Use and Abuse,

    Emily Crawford
    This study examined the relationships among risk perceptions, alcohol use and abuse, and borderline and antisocial personality characteristics in college students. College students who perceived themselves less able to avoid negative consequences reported drinking more and having more substance abuse symptoms than those who perceived themselves as more able to avoid negative consequences. College students who scored higher on borderline or antisocial personality tended to rate personal avoidability of negative consequences lower than those who scored lower on these personality characteristics. A multiple regression model accounted for 50% of the variance in self-reported substance abuse symptoms. Low perceived personal avoidability of negative drinking consequences and high borderline or antisocial personality characteristics are risk factors for substance abuse problems. [source]

    The associations among personality disorder symptoms, suicide proneness and current distress in adult male prisoners,

    Dorian A. Lamis
    Suicide is the 11th leading cause of death in the United States, and the third leading cause of death in US jails and penitentiaries. Research has shown that the presence of an Axis II personality disorder (PD) increases the risk for suicidal behaviour. While many correctional institutions screen inmates for suicidal ideation upon intake, they can neglect to assess for the presence of PD symptoms other than those associated with criminality such as Antisocial PD. The current study examined whether symptoms of various PDs were associated with self-reports of current suicide proneness and distress in a small sample of adult male inmates residing in a medium or a maximum security facility. As hypothesized, elevated scores on numerous PD Millon Clinical Multiaxial Inventory-III scales (e.g. Schizoid, Depressive, Sadistic, Schizotypal, Borderline) were significantly associated with both self-reports of current suicide proneness and psychological distress. Once the nature of these associations in inmates is better understood, more effective suicide prevention programs can be designed and implemented in correctional facilities. Copyright © 2008 John Wiley & Sons, Ltd. [source]

    Report from borderland: an addendum to ,What works?'


    Abstract:, Based on personal experience the following paper briefly argues that forming a supportive relationship prior to analysis is important for certain ,borderline' patients. Should such a relationship not be established analysis may prove destructive, despite the best of intentions. Direct expression of feeling is important here but, it is suggested, has been undervalued in the history of analysis because of fear of spontaneity. This also affects current day writing about analysis. Translations of Abstract A partir de mon expérience personnelle, j'avance l'idée que tisser une relation de soutien préalable à l'analyse est importante avec certains patients "borderline". Si une telle relation n'est pas établie, l'analyse est susceptible de s'avérer destructrice, aussi louable en soient les intentions. L'expression directe du sentiment ou du ressenti de l'analyste est importante dans ces cas, bien que, ainsi que je le suggère, elle ait été sous-estimée dans l'histoire de l'analyse, par crainte de la spontanéité. Ce travers affecte également de nos jours l'écriture clinique. Basierend auf persönlicher Erfahrung wird im Folgenden dargelegt, dass es für gewisse ,Borderline'-Patienten und-Patientinnen wichtig ist, eine unterstützende Beziehung herzustellen, bevor mit der eigentlichen analytischen Arbeit begonnen wird. Wenn eine solche Beziehung nicht besteht, kann sich die Analyse, ungeachtet der besten Absichten, als destruktiv herausstellen. In der Arbeit wird darauf hingewiesen, dass ein unmittelbarer Ausdruck von Gefühlen hier wichtig ist, aber in der Geschichte der Analyse aufgrund der Furcht vor Spontaneität unterbewertet wurde. Dies wirkt sich bis heute in schriftlichen Abhandlungen über Analyse aus. Basato su esperienze personali il lavoro seguente sostiene che lo stabilire una relazione di supporto prima dell'analisi è importante per certi pazienti ,borderline'. Se tale relazione non si stabilisce l'analisi può risultare distruttiva, nonostante le migliori intenzioni. L'espressione diretta del sentimento è in questi casi importante, ma penso che sia stata sottovalutata nella storia dell'analisi a causa della paura della spontaneità. Ciò influenza ancora ai giorni nostri gli scritti che riguardano l'analisi. Basándose en una experiencia personal el presente trabajo argumenta que establecer una relación de apoyo previa al análisis es importante para algunos pacientes borderline. Si esta relación no se establece el análisis puede resultar destructivo, aún cuando se tengan las mejores intenciones. La expresión abierta de los sentimientos es importante en estos casos sin embargo, tal como se sugiere, ella ha sido devaluada en la historia del análisis debido a el miedo a la espontaneidad. Esto afecta también los actuales escritos sobre el análsis. [source]

    Identification and classification of skin sensitizers: identifying false positives and false negatives

    CONTACT DERMATITIS, Issue 5 2006
    David A. Basketter
    The first step in regulatory evaluation of substances involves the identification of their intrinsic hazards, including the potential for skin sensitization. This is, quite properly, entirely different from assessment of the risks to human health, which might arise from incorporation of substances in products. EU guidance on regulations concerning the classification of skin sensitizers suggests a range of sources of information be deployed in the hazard identification process. These include chemical structure, predictive animal tests, and various types of human data. Where the information is clear-cut, then uncertainties rarely arise. However, for some materials, discordant information arises, perhaps because the substance is on the borderline of test sensitivity and classification (sensitizing materials of insufficient potency do not classified according to the EU scheme), due to conflicting results in predictive tests or for other reasons. In this study, we review data on a number of substances where a classification decision is complicated by such discordances and seek to use these examples to demonstrate how best to make a weight of evidence decision on whether a substance should, or should not, be classified as a skin sensitizer. [source]

    Trials update in wales

    CYTOPATHOLOGY, Issue 2007
    A. Fiander
    Three ongoing studies will be presented and discussed. Prevalence of Human Papillomavirus Infection in a South Wales Screening population Methods: A total of 10 000 consecutive, anonymous liquid based cytology screening samples were collected over a five month period in 2004. Age, cytology result and social deprivation score was provided for each specimen. The methodology was chosen to ensure inclusion of all women attending routine cervical screening, avoiding potential constraints associated with obtaining individual informed consent. The liquid based cytology samples were processed and reported by the receiving cytology laboratory and the residual specimens sent to the HPV Research Laboratory, Wales College of Medicine, where they were processed and stored at -80°C until analysis. High risk and low risk HPV Typing was undertaken using PCR , EIA (Jacobs et al 1997). Full high risk typing was performed on HPV positive specimens. Results: The study population had a mean age of 38 years with 92% negative, 5% borderline and 3% dyskaryotic cytology. The average social deprivation score was 17.4 (based upon the Welsh Index of multiple deprivation). The following results will be presented: HPV prevalence by age. HPV prevalence by cytology result. Type specific HPV prevalence in single and multiple infection. Conclusion: This study represents the largest type specific HPV Prevalence Study in the UK to date. As such it will form a useful base line against which to access performance of marketed HPV tests and evaluating the impact following implementation of HPV vaccination. [Funded by Welsh Office for Research and Development] CRISP , 1 Study (Cervical Randomized Intervention Study Protocol -1) Background: Indole-3-carbinol (I3C) and Diindolylmethane (DIM) are found in cruciferous vegetables and have been identified as compounds that could potentially prevent or halt carcinogenesis. I3C spontaneously forms DIM in vivo during acid digestion. I3C has been shown to prevent the development of cervical cancer in HPV 16 transgenic mice and both I3C and DIM have been shown to promote cell death in cervical cancer cell models. DIM is the major active bi-product of I3C and preliminary data indicate that DIM is active in cervical dysplasia and may be better tolerated than I3C. Aim: To investigate chemoprevention of high grade cervical neoplasia using Diindolylmethane (DIM) supplementation in women with low grade cytological abnormalities on cervical cytology. Objectives: To observe any reduction in the prevalence of histological proven high-grade cervical intraepithelial neoplasia (CIN) after 6 months of supplementation. ,,To observe any reduction in the prevalence of cytological abnormalities. ,,To observe any changes in the clinical appearance of the cervix. To assess acceptability and monitor any side effects of DIM supplementation. ,,To assess whether any benefit is seen in relation to Human Papillomavirus (HPV) status including HPV Type, Viral load and integration. Methods: This is a double blind randomized placebo-controlled trial involving 600,700 women with low grade cytological abnormalities on a cervical smear. Randomization is in the ratio of 2 : 1 in favour of active medication. Women with first mildly dyskaryotic smear or second borderline smear are eligible. They are asked to take two capsules daily for 6 months. At the end of 6 months they undergo repeat cervical cytology, HPV testing and colposcopy. Results: A progress report will be given for this ongoing study. [Funded: - Cancer Research UK] Type Specific HPV Infection in Welsh Cervical Cancers Background: Whilst there have been numerous studies of HPV infection associated with cervical cancer and on prevalence of Human Papillomavirus in diverse populations there have been no studies of these variables in the same population. Against a background of prophylactic HPV vaccination it is important to assess potential protection against cervical cancer within a given population. The most comprehensive analysis of HPV type specific cervical cancer is a meta-analysis published by the IARC in 2003. This however included only three UK based studies, totalling 118 cases, 75 of which were only investigated by HPV type PCR for four high risk types. None of this data was presented with associated population based prevalence data. Therefore, the research objectives for this study in combination with the first study above, are as follows: To determine the frequency of specific HPV types in cervical cancers in Wales. To compare the distribution of specific HPV types amongst cervical cancers with their prevalence in the general population. This will allow accurate delineation of the relationship between prevalence of specific HPV types in the general population and their association with clinically relevant disease. This information is a pre-requisite to assess the potential impact of prophylactic vaccination against HPV infection in Wales. Methods: Welsh Cervical Cancer specimens from 2000,2005 will be identified from pathology departments within Wales. The pathology of each tumour will be reviewed by a single Gynaecological Pathologist. The age of the patient and pathological features of the tumour will be noted. DNA will be extracted from the paraffin sections and HPV typed by PCR-EIA. Results: A progress report will be given for this ongoing study. [Funded by Welsh Office for Research and Development] [source]


    CYTOPATHOLOGY, Issue 2006
    L. Gregory
    With the exception of information from the liquid based cytology (LBC) pilot site there has been limited data to date on the impact of the introduction of SurePathÔ LBC in the NHSCSP. We will present data to show the impact on a medium sized laboratory (42 000 requests per annum) over the first phases of rollout. Data from before, during and post conversion, a period of 28 months, shows the following trends: (1) A significant fall in the inadequate rate (2) A slight decrease in the borderline / mild dyskaryosis rate (3) A small increase in the high-grade squamous dyskaryosis reporting rate (4) An increase in both the number and specificity of glandular lesions reported (5) A largely unchanged positive predictive value for high-grade abnormalities (6) A significant increase in laboratory productivity, unrelated to inadequate rate but through increased speed of screening. Although our experience is not directly comparable to the experience of the LBC pilot, our observations may well reflect that we were fortunate to be trained by staff from one of the LBC sites and thereby benefited directly from their experience. [source]

    Ataxia, autism, and the cerebellum: a clinical study of 32 individuals with congenital ataxia

    Ingegerd Åhsgren MD
    The suggested link between autism and cerebellar dysfunction formed the background for a Swedish clinical study in 2001. Thirty-two children (17 females, 15 males; mean age 12y, SD 3y 10mo; range 6 to 21y) with a clinical suspicion of non-progressive congenital ataxia were examined, and parents were interviewed about the presence of neuropsychiatric problems in the child. Twelve children had simple ataxia, eight had ataxic diplegia, and 12 had,borderline'ataxia. All but one of the 32 children had a mild to moderate gross motor disability according to Gross Motor Function Classification System (15 were categorized as level I,16 as level II, and one child as level IV). Neuroimaging and neuropsychological testing were achieved in most cases. There was a strong association between learning disability* and autism spectrum disorder (often combined with hyperactivity disorder) on the one hand, and both simple and borderline,ataxia'on the other, but a weaker link between ataxic diplegia and neuropsychiatric disorders. A correlation between cerebellar macropathology on neuroimaging and neuropsychiatric disorders was not supported. Congenital ataxia might not be a clear-cut syndrome of cerebellar disease, but one of many signs of prenatal events or syndromes, leading to a complex neurodevelopmental disorder including autism and learning disability. [source]

    Context-Oriented Model Development in Psychotherapy Planning (,COMEPP'): a useful adjunct to diagnosis and therapy of severe personality disorders

    M. Fischer-Kern
    Objective:, Pathogenous interpersonal (e.g. interfamilial) relationships and reference styles can compromise treatment efforts in severely disturbed (i.e. psychotic or borderline) patients. The integration of family- and individual-centred starting points may be useful in establishing interdisciplinary treatment concepts in these patients. Context-Oriented Model Development in Psychotherapy Planning (COMEPP) represents a diagnostic and therapy planning process, integrating both systemic and psychoanalytic conceptualizations. Method:, COMEPP is exemplified by the case of a young man with psychotic personality disorder who had previously been unresponsive to pharmacological and psychological treatment. Results:, After psycho-dynamical conflicts (i.e. primitive projective processes from the patient's mother to her son) had been elucidated during the COMEPP process, a sufficient treatment setting could be established. Conclusion:, COMEPP provides a psychotherapeutical approach to treatment planning on case-specific premises and may serve as an adjunct to concomitant pharmacological and psychological treatment strategies in so-called ,therapy refractory' patients. [source]

    Atypical papillary proliferation in gynecologic patients: A study of 32 pelvic washes,

    Karyna C. Ventura M.D.
    Abstract Papillary clusters in gynecologic pelvic washes frequently cause diagnostic challenges because they can be associated with borderline or malignant ovarian tumors, as well as benign pelvic diseases. The objective of our study was to review all pelvic washes with atypical papillary proliferation (APP) and investigate whether cytomorphology and/or immunohistochemistry on cell block could determine their origin. Thirty-two pelvic washes from 31 patients containing APP were reviewed and correlated with their corresponding gynecologic or pelvic disease. Previously obtained cell blocks with immunohistochemical (IHC) stains were reviewed also. Nine of 32 washes (28%) were overcalled as malignant and were from patients with 5 borderline serous ovarian tumors (BSTO), 1 ovarian follicular cyst, 1 serous cystadenofibroma, and 1 endometrial carcinoma with ovarian seromucinous cystadenoma. BSTO and endometriosis were the most common sources of APP. Cell blocks could not discriminate further the etiology of APP. Immunohistochemistry was performed rarely and not fully contributory. Caution in interpreting papillary groups and cytohistological correlation is recommended to prevent a high false positive rate. Diagn. Cytopathol. 2005;32:76,81. © 2005 Wiley-Liss, Inc. [source]

    Prevalence of personality disorders in patients with eating disorders: a pilot study using the IPDE

    Izaskun Marañon
    Abstract Objective The present study aims to determine the comorbidity of personality disorders (PD) with anorexia and bulimia nervosa, and to establish the major personality characteristics of eating disorders subtypes. Method Using the International Personality Disorders Examination (IPDE), the study investigated the personality profiles of 66 outpatients with eating disorders. Statistical analyses were carried out using non-parametric methods such as the Kruskal-Wallis H test and Mann-Whitney U. Results 51.5% of the overall sample met criteria for at least one personality disorder. Purging anorexia nervosa patients were the most affected. The most common personality disorders were obsessive-compulsive, avoidant, dependent, borderline and not otherwise specified. Discussion More than half of the subjects with AN and BN met the criteria for at least one PD. This finding is a challenge for clinical practice. Implications for further research in this area are commented on. Copyright © 2004 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

    Changes in contractile properties of motor units of the rat medial gastrocnemius muscle after spinal cord transection

    Jan Celichowski
    The effects of complete transection of the spinal cord at the level of Th9/10 on contractile properties of the motor units (MUs) in the rat medial gastrocnemius (MG) muscle were investigated. Our results indicate that 1 month after injury the contraction time (time-to-peak) and half-relaxation time were prolonged and the maximal tetanic force in most of the MUs in the MG muscle of spinal rats was reduced. The resistance to fatigue also decreased in most of the MUs in the MG of spinal animals. Moreover, the post-tetanic potentiation of twitches in MUs diminished after spinal cord transection. Criteria for the division of MUs into three types, namely slow (S), fast fatigue resistant (FR) and fast fatigable (FF), applied in intact animals, could not be directly used in spinal animals owing to changes in contractile properties of MUs. The ,sag' phenomenon observed in unfused tetani of fast units in intact animals essentially disappeared in spinal rats and it was only detected in few units, at low frequencies of stimulation only. Therefore, the MUs in spinal rats were classified as fast or slow on the basis of an adjusted borderline of 20 ms, instead of 18 ms as in intact animals, owing to a slightly longer contraction time of those fast motor units with the ,sag'. We conclude that all basic contractile properties of rat motor units in the medial gastrocnemius muscle are significantly changed 1 month after complete spinal cord transection, with the majority of motor units being more fatigable and slower than those of intact rats. [source]

    Effects of nucleoside reverse transcriptase inhibitor backbone on the efficacy of first-line boosted highly active antiretroviral therapy based on protease inhibitors: meta-regression analysis of 12 clinical trials in 5168 patients

    HIV MEDICINE, Issue 9 2009
    A Hill
    Objectives Tenofovir/emtricitabine (TDF/FTC) and abacavir/lamivudine (ABC/3TC) are widely used with ritonavir (RTV)-boosted protease inhibitors (PIs) as first-line highly active antiretroviral therapy (HAART), but there is conflicting evidence on their relative efficacy. The ACTG 5202 and BICOMBO trials suggested higher efficacy for TDF/FTC, whereas the HEAT trial showed no efficacy difference between the nucleoside reverse transcriptase inhibitor (NRTI) backbones. Methods A systematic MEDLINE search identified 21 treatment arms in 12 clinical trials of 5168 antiretroviral-naïve patients, where TDF/FTC (n=3399) or ABC/3TC (n=1769) was used with RTV-boosted PI. For each NRTI backbone and RTV-boosted PI, the percentage of patients with viral load <50 HIV-1 RNA copies/mL at week 48 by standardized Intent to Treat, Time to Loss of Virological Failure (ITT TLOVR) analysis were combined using inverse-variance weighting. The effect of baseline HIV RNA, CD4 cell count and choice of NRTI backbone were examined using a weighted analysis of covariance. Results Across all the trials, HIV RNA suppression rates were significantly higher for those with baseline viral load below 100 000 copies/mL (77.2%) vs. above 100 000 copies/mL (70.9%) (P=0.0005). For the trials of lopinavir/ritonavir (LPV/r), atazanavir/ritonavir (ATV/r) and fosamprenavir/ritonavir (FAPV/r) using either TDF/FTC or ABC/3TC, the HIV RNA responses were significantly lower when ABC/3TC was used, relative to TDF/FTC, for all patients (P=0.0015) and for patients with baseline viral load <100 000 copies/mL (70.1%vs. 80.6%, P=0.0161), and was borderline for those with viral load >100 000 copies/mL (67.5%vs. 71.5%, P=0.0523). Conclusions This systematic meta-regression analysis suggests higher efficacy for first-line use of a TDF/FTC NRTI backbone with boosted PIs, relative to use of ABC/3TC. However, this effect may be confounded by differences between the trials in terms of baseline characteristics, patient management or adherence. [source]

    Contributions of the mother,infant relationship to dissociative, borderline, and conduct symptoms in young adulthood

    Karlen Lyons-Ruth
    Recent high-risk longitudinal studies have documented a unique contribution of the quality of the early mother,child relationship to diverse forms of psychopathology in young adulthood, even with family economic status, later traumatic experiences, and some genetic factors controlled. In addition, measures of attachment-related deviations in caregiver,infant interaction predict more than measures of infant attachment behavior alone. This article reviews those findings in the context of cross-disciplinary thinking on the importance of shared subjectivities in human evolution and development and in the context of recent studies beginning to map the intersection between processes of interaction and the development of the child's propensities to share mental states with others. [source]

    Segmental testicular ischaemia: presentation, management and follow-up

    D. Gianfrilli
    Summary Segmental infarction of the testis is a rare event. Less than 40 cases have been reported in the literature and its aetiology remains largely unknown. The diagnosis is challenging and its identification crucial as partial ischaemia is frequently confused with testicular tumours and unnecessarily treated with orchiectomy. The objectives of this study are to: (i) raise awareness of this rare condition, (ii) provide the distinctive clinical and radiological features enabling pre-operative diagnosis, (iii) promote appropriate screening of causative factors and (iv) propose an alternative management approach to avoid surgery and preserve fertility. We describe three cases of partial testicular ischaemia in men presenting with reduced sperm quality. The cases demonstrate the ultrasound and magnetic resonance imaging appearance of testicular ischaemia. The surveillance strategy adopted for these lesions indicates that over 2 years of follow-up, marginal changes in the lesions can occur. Histology revealed that infiltration by stromal cells, leucocytes and macrophages is responsible for the remodelling of these lesions. Screening of risk factors for thromboembolism revealed that all patients carried a methylenetetrahydrofolate reductase 677C,T (MTHFR) mutation in a gene involved in folate metabolism, and either borderline or elevated homocysteine levels. Distinctive features permit the pre-operative diagnosis of segmental testicular ischaemia. There are sufficient data to assert that a surveillance strategy is safe and feasible. We speculate that the defects in folate metabolism may pre-dispose individuals to the development of testicular infarction and infertility. [source]

    Type-specific roles of histone deacetylase (HDAC) overexpression in ovarian carcinoma: HDAC1 enhances cell proliferation and HDAC3 stimulates cell migration with downregulation of E-cadherin

    Akiko Hayashi
    Abstract Histone acetylation/deacetylation controls chromatin activity and subsequent gene transcription. Recent studies demonstrated the activation of histone deacetylases (HDACs) in various human malignancies; however, the expression and function of HDACs in ovarian tumors are not fully understood. In this study, we examined the immunohistochemical expression of HDAC1, HDAC2 and HDAC3 using tissues obtained from 115 cases of ovarian tumors and compared it with that of Ki-67 (a growth marker), p21, and E-cadherin and clinicopathological parameters. In addition, we analyzed the effect of specific siRNA for HDAC1, HDAC2 and HDAC3 on the expression of cell cycle-related molecules and E-cadherin to clarify the functional difference among the 3 HDACs. The results indicated that the immunohistochemical expression of nuclear HDAC1, HDAC2 and HDAC3 proteins increased stepwise in benign, borderline and malignant tumors. The expression of HDAC1 and HDAC2 was correlated with Ki-67 expression and that of HDAC3 was inversely correlated with E-cadherin expression. Among the HDACs examined, only HDAC1 was associated with a poor outcome, when overexpressed. Treatment with HDAC inhibitors suppressed the proliferation of ovarian cancer cells in association with apoptosis. A specific siRNA for HDAC1 significantly reduced the proliferation of ovarian carcinoma cells via downregulation of cyclin A expression, but siRNA for HDAC3 reduced the cell migration with elevated E-cadherin expression. Our results suggested that HDAC1 plays an important role in the proliferation of ovarian cancer cells, whereas HDAC3 functions in cell adhesion and migration. Therefore, specific therapeutic approaches should be considered according to the HDAC subtypes. [source]

    Carotenoids/vitamin C and smoking-related bladder cancer

    J. Esteban Castelao
    Abstract Previous epidemiological studies of fruit and vegetable intake and bladder cancer risk have yielded inconsistent results, especially with respect to the role of cigarette smoking as a possible modifier of the diet-bladder cancer association. A population-based case-control study was conducted in nonAsians of Los Angeles, California, which included 1,592 bladder cancer patients and an equal number of neighborhood controls matched to the index cases by sex, date of birth (within 5 years) and race between January 1, 1987 and April 30, 1996. Information on smoking, medical and medication history, and intake frequencies of food groups rich in preformed nitrosamines, vitamins A and C and various carotenoids, were collected through in-person, structured interviews. Beginning in January 1992, all case patients and their matched control subjects were asked for a blood sample donation at the end of the in-person interviews for measurements of 3- and 4-aminobiphenyl (ABP) hemoglobin adducts, and glutathione S -transferases M1/T1/P1 (GSTM1/T1/P1) and N -acetyltransferase-1 (NAT1) genotypes. Seven hundred seventy-one (74%) case patients and 775 (79%) control subjects consented to the blood donation requests. In addition, all case patients and matched control subjects were asked to donate an overnight urine specimen following caffeine consumption for measurements of cytochrome P4501A2 (CYP1A2) and N -acetyltransferase-2 (NAT2) phenotypes. Urine specimens were collected from 724 (69%) case patients and 689 (70%) control subjects. After adjustment for nondietary risk factors including cigarette smoking, there were strong inverse associations between bladder cancer risk and intake of dark-green vegetables [p value for linear trend (p) = 0.01], yellow-orange vegetables (p = 0.01), citrus fruits/juices (p = 0.002) and tomato products (p = 0.03). In terms of nutrients, bladder cancer risk was inversely associated with intake of both total carotenoids (p = 0.004) and vitamin C (p = 0.02). There was a close correlation (r = 0.58, p = 0.0001) between intakes of total carotenoids and vitamin C in study subjects. When both nutrients were included in a multivariate logistic regression model, only total carotenoids exhibited a residual effect that was of borderline statistical significance (p = 0.07 and p = 0.40 for total carotenoids and vitamin C, respectively). Cigarette smoking was a strong modifier of the observed dietary effects; these protective effects were confined largely to ever smokers and were stronger in current than ex-smokers. Smokers showed a statistically significant or borderline statistically significant decrease in 3- and 4-aminobiphenyl (ABP)-hemoglobin adduct level with increasing intake of carotenoids (p = 0.04 and 0.05, respectively). The protective effect of carotenoids on bladder cancer seemed to be influenced by NAT1 genotype, NAT2 phenotype and CYP1A2 phenotype; the association was mainly confined to subjects possessing the putative NAT1 -rapid, NAT2-rapid and CYP1A2-rapid genotype/phenotype. The carotenoid-bladder cancer association was not affected by the GSTM1, GSTT1 and GSTP1 genotypes. © 2004 Wiley-Liss, Inc. [source]

    High tumor tissue concentration of urokinase plasminogen activator receptor is associated with good prognosis in patients with ovarian cancer

    Christer Borgfeldt
    Abstract The urokinase plasminogen activator (uPA) system is involved in tumor growth and metastasis. We assayed the components of the uPA system in homogenates of 64 primary epithelial ovarian tumors and 5 metastases and evaluated the association of these parameters to prognosis in the 51 malignant cases. The levels of uPA, PAI-2 and the uPA:PAI-1 complex increased with progressive loss of histological differentiation (ptrend <0.001, <0.05 and <0.001). The level of PAI-1 was higher in poorly than in well/moderately differentiated tumors (p = 0.03). The content of uPAR was lower in benign tumors as compared to borderline malignancies (p = 0.002), invasive primary tumors (p < 0.001), and metastases (p = 0.002). Surprisingly, the level of uPAR was lower in poorly differentiated as compared to both borderline (p = 0.01) and well differentiated malignant tumors (p = 0.005). Also, the level of uPAR was lower in advanced as compared to early stages of the disease (ptrend = 0.002). The median follow-up time for patients was 5.8 years. High tumor tissue levels of uPAR were associated with longer postoperative survival (HR = 0.4, 95% CI = 0.2,0.8, p = 0.01). In contrast, shorter survival was evident in patients with high tumor levels of uPA from 2 years on after operation (HR = 4.6, 95% CI = 1.2,17, p = 0.02). High tPA levels tended to be associated with shorter overall survival after 2 years (HR = 2.9, 95% 95% CI = 0.9,9.8, p = 0.08). Although high tumor tissue content of uPAR was associated with a less aggressive phenotype characterized by well differentiated histology and longer survival, low content of uPAR in the poorly differentiated tumors and metastases presumably results from increased elimination of uPAR. © 2003 Wiley-Liss, Inc. [source]

    Self-rated health and classical risk factors for coronary heart disease predict development of erectile dysfunction 25 years later

    R. Borgquist
    Summary Aim:, To investigate the impact of classical coronary heart disease (CHD) risk factors on the development of future erectile dysfunction (ED). Methods and results:, A total of 830 randomly selected subjects were included. Baseline CHD risk factors were evaluated in relation to ED (evaluated by the International Index of Erectile Function-5 questionnaire) 25 years later. At follow-up, 499 men (60%) had some degree of ED. In age-adjusted logistic regression analysis, self-rated health [odds ratio (OR) 1.59, 95% confidence interval (CI): 1.09,2.31], family history of CHD (OR 1.75, CI: 1.17,2.61), fasting blood glucose (OR 1.52, CI: 1.14,2.02), triglycerides (OR 1.25, CI: 1.01,1.54), systolic blood pressure (SBP) (OR 1.19, CI: 1.04,1.35), body mass index (OR 1.08, CI: 1.03,1.13) and serum glutamyl transferase (GT) (OR 1.81, CI: 1.23,2.68), predicted ED. Independent predictors were higher age, low self-rated health, higher blood glucose, higher GT and a family history of CHD. Higher SBP was borderline significantly independent (p = 0.05). Furthermore, baseline age-adjusted Framingham risk score for CHD, also predicted future ED (OR 1.20, CI: 1.03,1.38). Conclusions:, Our study supports and expands previous findings that ED and CHD share many risk factors, further underscoring the close link between ED and CHD. Men presenting with ED should be evaluated for the presence of other CHD risk factors. [source]

    The Roles of Risk Perception and Borderline and Antisocial Personality Characteristics in College Alcohol Use and Abuse,

    Emily Crawford
    This study examined the relationships among risk perceptions, alcohol use and abuse, and borderline and antisocial personality characteristics in college students. College students who perceived themselves less able to avoid negative consequences reported drinking more and having more substance abuse symptoms than those who perceived themselves as more able to avoid negative consequences. College students who scored higher on borderline or antisocial personality tended to rate personal avoidability of negative consequences lower than those who scored lower on these personality characteristics. A multiple regression model accounted for 50% of the variance in self-reported substance abuse symptoms. Low perceived personal avoidability of negative drinking consequences and high borderline or antisocial personality characteristics are risk factors for substance abuse problems. [source]

    Sometimes Higher Heart Rate Variability Is Not Better Heart Rate Variability: Results of Graphical and Nonlinear Analyses

    Objective: To determine the prevalence and effect on traditional heart rate variability (HRV) indices of abnormal HRV patterns in the elderly. Methods: Hourly Poincaré plots and plots of spectral HRV from normal-to-normal interbeat intervals and hourly nonlinear HRV values were examined in a subset of 290 consecutive participants in the Cardiovascular Health Study. Only subjects in normal sinus rhythm with ,18 hours of usable data were included. Eligible subjects were 71 ± 5 years. During 7 years of follow-up, 21.7% had died. Hours were scored as normal (0), borderline (0.5), or abnormal (1) from a combination of plot appearance and HRV. Summed scores were normalized to 100% to create an abnormality score (ABN). Short-term HRV versus each 5th percentile of ABN was plotted and a cutpoint for markedly increased HRV identified. The t -tests compared HRV for subjects above and below this cutpoint. Cox regression evaluated the association of ABN and mortality. Results: Of 5,815 eligible hourly plots, 64.4% were normal, 14.5% borderline, and 21.1% abnormal. HR, SDNN, SDNNIDX, ln VLF and LF power, and power law slope did not differ by the cutpoint for increased short-term HRV, while SDANN and ln ULF power were significantly lower for those above the cutpoint. However, many HRV indices including LF/HF ratio and normalized LF and HF power were significantly different between groups (P < 0.001). Increased ABN was significantly associated with mortality (P = 0.019). Despite similar values for many HRV indices, being in the group above the cutpoint was significantly associated with mortality (P = 0.04). Conclusions: Abnormal HR patterns that elevate many HRV indices are prevalent among the elderly and associated with higher risk of mortality. Consideration of abnormal HRV may improve HRV-based risk stratification. [source]

    A new model for predicting the timing of leukapheresis on the basis of CD34+ cell and hematopoietic progenitor cell levels

    Hao-Wei Teng
    Abstract We developed a model (depending on peripheral CD34+ cell count and hematopoietic progenitor cell count) to determine the optimal timing of 3-day leukapheresis in patients pretreated with chemotherapy and G-CSF. Marrow potentials were identified on the basis of three patterns of leukapheretic yield. Pattern 1 predicted good marrow potential. The positive predictive value of a first-day leukapheretic yield of >1 × 106 CD34+ cells/kg (mean 3-day yield = 8.18 × 106 CD34+ cells/kg, n = 11) was 100%. Pattern 2 predicted poor marrow potential. The negative predictive value of a 3-day leukapheretic yield of >1 × 106 CD34+ cells/kg (3-day yield = 0.26 × 106 CD34+ cells/kg, n = 1) was 100%. Pattern 3 met neither of the above criteria (mean 3-day yield = 1.37 × 106 CD34+ cells/kg, n = 19). The marrow potential was borderline and patients could be further divided into two subgroups according to peripheral CD34+ cell counts when WBC reached >10,000/,l. The mean yield differed significantly between pattern 1 and 3 (P < 0.001). For patients with good marrow potential, leukapheresis should begin as soon as the WBC count is >5,000/,l. Patients with borderline marrow potential may benefit from delaying leukapheresis until the WBC level is >10,000/,l and leukapheresis extended more than 3 days. J. Clin. Apheresis 2007. © 2007 Wiley-Liss, Inc. [source]

    The Beavers Systems Model of Family Functioning

    Robert Beavers
    Family competence and family style are the two main dimensions of the Beavers Systems Model of Family Functioning. The competence dimension ranges from optimal through adequate, midrange and borderline to severely dysfunctional. The style dimension ranges from centripetal to centrifugal. When the two dimensions are combined, they diagramatically define nine distinct family groupings, three of which are relatively functional and six of which are thought to be sufficiently problematic to require clinical intervention. A family's status on the competence and style dimensions may be established with the Beavers interactional scales. The self-report family inventory may be used to evaluate family members' perceptions of their status on the competence dimension. The reliability and validity of the self-report instrument and observational rating scales have been documented in over thirty papers and books published by the Beavers research team since 1970. The model has proved useful in training, research and clinical work. [source]

    Preschool children with and without developmental delay: behaviour problems, parents' optimism and well-being

    B. L. Baker
    Abstract Background Children with intellectual disability are at heightened risk for behaviour problems, and these are known to increase parenting stress. This study explored the relation of behaviour problems to less child-related domains of parent well-being (depression and marital adjustment), as well as the moderating effect of a personality trait, dispositional optimism. Method Participating children (N = 214) were classified as developmentally delayed, borderline, or nondelayed. Mothers' and fathers' well-being and child behaviour problems were assessed at child ages 3 and 4 years. Results Parents of delayed and nondelayed preschoolers generally did not differ on depression or marital adjustment, but child behaviour problems were strongly related to scores on both measures. Optimism moderated this relationship, primarily for mothers. When child behaviour problems were high, mothers who were less optimistic reported lower scores on measures of well-being than did mothers who were more optimistic. Conclusions Interventions for parents that aim to enhance both parenting skills and psycholog- ical well-being should be available in preschool. It may be beneficial for such programmes to focus not only on behaviour management strategies aimed at child behaviour change, but also on parents' belief systems, with the aim of increasing dispositional optimism. [source]

    Accuracy of frozen section in the diagnosis of malignant ovarian tumor

    Dittakarn Boriboonhirunsarn
    Abstract Aim:, To evaluate the diagnostic accuracy of frozen section for histopathologic diagnosis of ovarian tumors. Methods:, A total of 147 surgically removed ovarian tumors were studied. Each ovarian tumor sample was evaluated for histopathologic diagnosis using both frozen and paraffin sections. Interpretation was separate and blinded between each technique. Accuracy, diagnostic values and their 95% confidence intervals (CI) were estimated by comparing the results from both techniques, using paraffin section as a gold standard. Results:, Overall accuracy of frozen section was 89.8% (95% CI 83.4,94.0). Sensitivity was 90.4% (95% CI 78.2,96.4) for malignant, 33.3% (95% CI 6.0,75.9) for borderline, and 93.3% (95% CI 85.4,97.2) for benign tumors. The predictive value was 100% (95% CI 90.6,100) for malignant, 20% (95% CI 3.5,55.8) for borderline, and 92.2% (95% CI 84.1,96.5) for benign tumors. Most false negatives occurred in mucinous and borderline tumors. No benign tumor was misdiagnosed as malignant by frozen section. Accuracy and negative predictive value were significantly lower in epithelial rather than germ and other cell types. Excellent agreement with regard to histologic cell type was observed (Kappa 0.81). Conclusion:, Frozen section appears to be an accurate technique for the histopathologic diagnosis of ovarian tumors. Some limitations were observed among borderline and mucinous tumors; this emphasizes the great value of frozen section in the diagnosis of ovarian tumors. [source]

    Solvolyses of naphthoyl chlorides.

    Grunwald, Solvent effect, Winstein correlation analyses with YxBnCl scales
    Abstract The solvolyses of 1-naphthoyl (2), 2-naphthoyl (3), 4-methyl-1-naphthoyl (4) and 6-methoxy-2-naphthoyl (5) chlorides in a variety of solvents were studied, and correlation analyses by using the single- and dual-parameter Grunwald,Winstein equations were examined. An excellent linear relationship (R,=,0.995) for 4, log (k/k0),=,0.733YxBnCl,+,0.269NOTs, was observed. An SN1-like mechanism with decreasing extent of nucleophilic solvent participation was found in the solvolysis of 2 and 4. 2-Naphthoyl chloride is likely to have a mechanism at the borderline of SN1-like dissociation and an addition,elimination process. 6-Methoxy-2-naphthoyl chloride shows more SN1-like character than 3 and is associated with nucleophilic solvent intervention more pronounced than that for 2 and 4. The applicability and the advantages of using the YxBnCl scale for different types of substrates are discussed. Copyright © 2002 John Wiley & Sons, Ltd. [source]

    Objective, Subjective, and Self-Assessment of Preadolescent Orthodontic Treatment Need , A Function of Age, Gender, and Ethnic/Racial Background?

    Elizabeth A. Christopherson
    Abstract Children from socioeconomically disadvantaged and/or underrepresented minority backgrounds in the United States have limited or no access to orthodontic treatment. Objectives: To determine whether preadolescents' (a) objectively assessed orthodontic treatment need; (b) subjectively assessed orthodontic treatment need; and (c) self-perceptions of the psychologic aspects of their oral health-related quality of life and desire to have braces vary as a function of age, gender, ethnicity/race, and socioeconomic status (SES). Methods: Data were collected from 1,566 preadolescents (age range: 8 to 11 years; 47.3 percent male/52.7 percent female; 55.7 percent African-American/39.7 percent White/2.9 percent Hispanic) in oral exams and in face to face interviews. Malocclusion was determined with the Index of Orthodontic Treatment Need. Results: Children (17.2 percent) had definite treatment need, 33.7 percent were borderline, and 49.1 percent had little or no need. Objectively and subjectively assessed treatment need was not affected by the children's age or gender. However, girls were more critical of their smiles and wanted braces more than boys. The older the children were, the more critical they were and the more they wanted braces. African-American children and children in schools with higher percentages of children on free school lunches had less treatment need than White children and children in schools with lower percentages of students with free school lunches. While the provider-assessed treatment need was higher for White children than for Black children, Black children were less happy with their smiles than White children, and wanted braces more than White children. SES did not affect the children's self-perceptions. Conclusions: Findings showed that substantial percentages of the preadolescents have an orthodontic treatment need. Orthodontic need and child self-perceptions varied as a function of the children's age, gender, ethnicity/race, and SES. [source]

    SCA2 may present as levodopa-responsive parkinsonism

    MOVEMENT DISORDERS, Issue 4 2003
    Haydeh Payami PhD
    Abstract Some kindreds with familial parkinsonism exhibit genetic anticipation, suggesting possible involvement of trinucleotide repeat expansion. Recent reports have shown trinucleotide repeat expansions in the spinocerebellar ataxia 2 (SCA2) gene in patients with levodopa-responsive parkinsonism. We tested 136 unrelated patients with familial parkinsonism for SCA2 mutations. Two probands had borderline mutations; the rest were normal. (,31 repeats is normal, 32,35 is borderline, ,36 is pathogenic). The expanded allele segregated with neurological signs in one kindred. The absence of borderline mutations in the normal population, and the co-segregation of the expanded allele with neurological signs in one kindred suggest that SCA2 mutations may be responsible for a subset of familial parkinsonism. © 2002 Movement Disorder Society [source]

    Desmopressin treatment in nocturia; an analysis of risk factors for hyponatremia

    A. Rembratt
    Abstract Aims To explore the incidence, severity, time course, and risk factors of clinically significant hyponatremia in desmopressin treatment for nocturia. Methods Data from three multi-center phase III trials were pooled. Hyponatremia was categorised as borderline (134,130 mmol/L) or significant (<130 mmol/L). Risk factors were explored with logistic regression and subgroup analysis performed to explore threshold values for contra-indication. Results In total 632 patients (344 men, 288 women) were analyzed. During dose-titration, serum sodium concentration below normal range was recorded in 95 patients (15%) and 31 patients (4.9%) experienced significant hyponatremia. The risk increased with age, lower serum sodium concentration at baseline, higher basal 24-hr urine volume per bodyweight and weight gain at time of minimum serum sodium concentration. Age was the best single predictor. Elderly patients (,65 years of age) with a baseline serum sodium concentration below normal range were at high risk (75%). Limiting treatment in elderly with normal basal serum sodium concentration to those below 79 years and with a 24-hr urine output below 28 ml/kg would reduce the risk from 8.1% to 3.0% at the cost of 34% fulfilling the contra-indication. Conclusions The majority of nocturia patients tolerate desmopressin treatment without clinically significant hyponatremia. However, the risk increases with increasing age and decreasing baseline serum sodium concentration. Treatment of nocturia in elderly patients with desmopressin should only be undertaken together with careful monitoring of the serum sodium concentration. Patients with a baseline serum sodium concentration below normal range should not be treated. © 2005 Wiley-Liss, Inc. [source]