Changes in C-reactive protein during weight loss and the association with changes in anthropometric variables in men and women: LIFE Study.

OBJECTIVE: To investigate whether sex differences exist in the pattern of change in C-reactive protein (CRP) levels during weight loss, and whether the associations between weight change and CRP change differ by the types of anthropometric variables. DESIGN: Longitudinal, prospective analysis of subjects participating in an intentional weight loss trial (the Lose It For Ever: LIFE Study) followed-up for 30 months. SUBJECTS: A total of 212 healthy, obese men and women (age: 23-77 years, body mass index (BMI): 30-39 kg m(-2)) took part in this study. MEASUREMENTS: BMI, waist and hip circumferences, and waist-to-hip ratio, CRP and lifestyle variables repeatedly measured at baseline, 6, 12, 18 and 30-month follow-up. RESULTS: Weight change was J shaped with a nadir at 12 months in both men and women (P for month(2) <0.0001). CRP level was consistently higher in women than in men, but the differences were less prominent and were not statistically significant at 12- and 18-month follow-up. CRP changes between any two consecutive visits were significantly associated with changes in BMI during the same period in women. However, the associations between CRP changes and changes in waist or hip circumference were not as consistent, especially between 18- and 30-month follow-up when CRP significantly increased. The associations in men were generally similar among the different anthropometric measures. The association between changes in BMI and CRP was stronger in men than in women. CONCLUSION: BMI change generally correlated well with CRP changes in both men and women in the course of follow-up. Significant sex difference in CRP level at baseline diminished at 12- and 18-month follow-up, when both sexes had maintained the lost weight.

Diagnótico indirecto del abuso/dependencia al alcohol en población adulta peruana: validación de un encuesta / Indirect diagnose of alcohol of abuse/dependency in an adult peruvian population: validation of a survey

Objetivo: Realizar la validación de la encuesta para diagnóstico indirecto de abuso/dependencia al alcohol en la sierra peruana. Material y método: Se usó la base de datos del Estudio Epidemiológico de Salud Mental 2003 realizado en la sierra peruana que contenía módulos que evaluaban la situación de salud mental. Se utilizó el módulo de diagnóstico directo de abuso/dependencia al alcohol, aplicado al adulto y la encuesta diagnóstico indirecto de abuso/dependencia al alcohol, aplicado a la mujer unida. La muestra fue de 1 302 parejas mujer unida û adulto. Para hallar la confiabilidad se utilizó el coeficiente alfa de Cronbach. Se realizó la validez de criterio comparándola con el cuestionario directo y la de constructo utilizando el análisis factorial. Resultados: Se obtuvo una coherencia interna de 93,1 por ciento. La probabilidad estimada de que el criterio externo y el cuestionario coincidan en el diagnóstico es 77 por ciento. Siendo el punto de mejor sensibilidad (70,4 por ciento) y especificidad (74,9 por ciento) en 2 ítems. El análisis factorial indica que la mayoría de ítems satura a un factor predominante. Conclusiones: El cuestionario indirecto para diagnóstico de abuso/ dependencia de alcohol es parcialmente válido para poblaciones con características similares a las de la sierra peruana.

Objective: Validation of a survey for making an indirect diagnosis of abuse/dependence of alcohol survey in the Peruvian Andes. Material and method: We used the database of The Mental Health Epidemiological Study conducted in the Peruvian Andes in 2003, which includes surveys assessing mental health. We used the direct diagnosis of alcohol abuse/dependence module in adult males, and indirect diagnosis of alcohol abuse/dependence survey in their spouses. The sample size was 1,302 adult couples. CronbachÆs Alpha coefficient was used in order to verify reliability of the tests. Validity of criteria was obtained by comparing them with the direct questionnaire and the validity of the construct was determined by using a factorial analysis. Results: The internal consistency of the questionnaire was 93.1 percent. The estimated probability of matching between the indirect survey and the external criteria is 77 percent. Best sensitivity (70.4 percent) and specificity (74.9 percent) values were located in 2 positive items. The factorial analysis indicated that most of the items saturate one predominant factor. Conclusions: The questionnaire for indirect diagnosis of alcohol abuse/ dependence is partially valid in populations with similar characteristics to those from the Peruvian Andes.

Effects of bacterial infestation caused by human wastes on the skin structures of Mugil platanus Günther, 1880 (Mugilidae).

Manifestation of infectious pathologies in fishes usually increases in environments where organic wastes are disposed. Specimens of Mugil platanus Günther, 1880 and water samples collected at three points of the Tramandaí river were analyzed during a one year period. The macroscopic observation revealed ulcerations in the caudal peduncle area covered with a mass of amorphous and whitened tissues. Histopathologic analysis showed the presence of negative gram bacteria, probably responsible for alterations of the normal structure of the epidermic tissues. Non-parametric statistical analysis for ammonia concentration showed a significant variation among the three collected spots as well as in the multiple comparison between two spots. In this study, we describe cutaneous lesions observed in Mugil platanus specimens and tested their correlation with environmental ammonia concentration.

Effects of bacterial infestation caused by human wastes on the skin structures of Mugil platanus Günther, 1880 (Mugilidae) / Efeitos da infestação de bactérias provocada por resíduos humanos na pele de Mugil platanus Günther, 1880 (Mugilidae)

Manifestation of infectious pathologies in fishes usually increases in environments where organic wastes are disposed. Specimens of Mugil platanus Günther, 1880 and water samples collected at three points of the Tramandaí river were analyzed during a one year period. The macroscopic observation revealed ulcerations in the caudal peduncle area covered with a mass of amorphous and whitened tissues. Histopathologic analysis showed the presence of negative gram bacteria, probably responsible for alterations of the normal structure of the epidermic tissues. Non-parametric statistical analysis for ammonia concentration showed a significant variation among the three collected spots as well as in the multiple comparison between two spots. In this study, we describe cutaneous lesions observed in Mugil platanus specimens and tested their correlation with environmental ammonia concentration.

A manifestação de patologias infecciosas em populações de peixes costuma ser incrementada em ambientes onde são lançados despejos orgânicos. Exemplares da espécie Mugil platanus Günther, 1880 coletados em três pontos do rio Tramandaí foram utilizados para análise das alterações, e amostras de água foram tomadas durante o período de um ano para verificação da presença de bactérias. A observação macroscópica revelou ulcerações na região do pedúnculo caudal revestidas por uma massa de tecido amorfo e esbranquiçado. A análise histopatológica mostrou a presença de bactérias gram negativas, que provavelmente foram as responsáveis pela alteração da estrutura normal dos tecidos de revestimento do corpo. O resultado da análise estatística não paramétrica para a concentração de amônia mostrou variação significativa entre os três pontos amostrados bem como nas comparações múltiplas entre os pontos dois a dois. Este trabalho descreve as lesões cutâneas observadas em Mugil platanus e testa sua correlação com a concentração de amônia.

Channel-consistency following unilateral stroke: an examination of patient communications across verbal and nonverbal domains.

One way in which the dyadic communicative process can go awry is for one or both parties to send channel-inconsistent communications - communications in which the verbal and nonverbal elements are not matched in emotional valence (e.g., uttering positive words with a frown). We hypothesized that unilateral stroke patients would be likely to send such messages. Given the verbal impairments typically associated with left hemisphere damage (LHD), e.g., agrammatism, and the nonverbal impairments typically associated with right hemisphere damage (RHD), we expected LHD and RHD patients to send messages in which the impaired channel was perceived as inconsistent with the unimpaired channel. Ten LHD, 11 RHD and six normal control patients were videotaped while engaging in social interaction. Observers made judgments about the valence of the patients' (1) words (based on transcripts of the interactions), and (2) facial expressions (based on soundless videos of the interactions). Analysis of word-face difference scores revealed a significant linear trend, with messages of LHD patients judged more positive in facial expression than in verbal content, messages of RHD patients judged more positive in verbal content than in facial expression, and messages of control patients judged channel-consistent (similar in valence across facial and verbal channels).

Observer liking of unilateral stroke patients.

OBJECTIVE: To examine observers' initial affective impressions of unilateral stroke patients, based on exposure to the patients' verbal and nonverbal behavior. Given the linguistic deficits associated with left hemisphere damage (LHD), the authors expected affective judgments based on exposure to patients' utterances to be reduced for patients with LHD. Given the nonverbal deficits associated with right hemisphere damage (RHD), the authors expected affective judgments based on exposure to patients' facial expressions to be reduced for patients with RHD. METHOD: Ten patients with LHD, 11 patients with RHD, and seven normal control (NC) patients were videotaped while engaging in social interaction. Observers read transcripts of the interactions and made judgments about how much they liked the patients. They then watched soundless videotapes and made similar liking judgments. This reflected a 3 (patient group) x 2 (coding modality) mixed factorial design. RESULTS: A 2 x 3 analysis of variance yielded a significant interaction. When liking judgments were based on utterances, patients with LHD were liked less than patients with RHD and NC patients. When liking judgments were based on facial expressions, patients with RHD were liked less than patients with LHD and NC patients. CONCLUSIONS: The verbal behavior of patients with LHD and the nonverbal behavior of patients with RHD may affect others' impressions of them, and consequently put these patients at interpersonal risk.

Personality and social competency following unilateral stroke.

Neuropsychological research indicates that the left hemisphere plays a dominant role in verbal production and processing, while the right hemisphere plays a dominant role in nonverbal production and processing. This study sought to examine the effects of such differential hemispheric specialization on personality and social competency. Ten left hemisphere damaged (LHD) stroke patients, 11 right hemisphere damaged (RHD) stroke patients, and 7 neurologically normal (NHD) patients were videotaped while engaging in social interaction with their spouse and an interviewer. Segments of the interactions were independently coded by two observers. Patients and spouses were rated with respect to their level of social competency and the extent to which they were characterized by 10 personality adjectives (e.g., outgoing, warm). Ratings for the personality items were summed to create an aggregate score. Analysis of these scores revealed both LHD and RHD patients to have lower (i.e., more negative) mean scores than NHD patients, suggesting that stroke patients as a whole were seen as socially impaired. Analysis of the socially competent item revealed particular LHD deficits; LHD patients were seen as less socially competent than both RHD and NHD patients. Spouses of LHD, RHD, and NHD patients, in contrast, did not differ in observer-rated social behavior.

Symptomatic therapy of multiple sclerosis.

Despite decades of aggressive research into the cause and cure of multiple sclerosis (MS), a direct management strategy remains lacking. As research continues, patients who strive for an improved quality of life may attain it through the improved management of symptoms. Symptoms occur in MS as a consequence of loss of myelin (primary symptoms), as the result of primary symptoms (secondary symptoms), and because of psychological dysfunction associated with MS (tertiary symptoms). This paper emphasizes the recent developments in the management of primary symptoms including visual loss, weakness, spasticity, urinary and sexual dysfunction, and fatigue. The adjective multiple emphasizes the numerous potential symptoms of MS. It is through their management that people with MS may lead happier, more productive lives until a cause and cure are found.

Sneddon's syndrome: an antiphospholipid antibody syndrome?

A 44-year-old woman with livedo reticularis, multiple ischemic strokes, and transient ischemic attacks (Sneddon's syndrome) had antiphospholipid antibodies--the lupus anticoagulant and anticardiolipin antibodies. This patient provides support for the hypothesis that these antibodies are involved in the pathogenesis of this rare but now potentially treatable disorder.