Anxiety and Depression: A Comparison between Living and Cadaveric Renal Transplant Recipients.

BACKGROUND: Anxiety and depression are the most common psychological disorders in kidney transplant recipients that may affect disease process and graft survival. OBJECTIVE: Based on the types of kidney donation in our country, living vs. cadaveric donation, we conducted this study to compare psychological problems in renal recipients. METHODS: This cross-sectional study was conducted on kidney transplant recipients who were categorized according to their donors to "living" and "cadaveric" groups. Patients with stable condition were followed monthly in outpatient clinics. The psychological status of each patient was assessed by clinical interview and Spielberg State Trait Anxiety Inventory and the Beck Depression Inventory (BDI). The calculated Cronbach alpha for the reliability of the total scale was 0.95. RESULTS: We recruited 120 recipients (60 patients in each group of living and cadaveric donor transplantation) for the study. There was no significant difference in demographic data between two studied groups (p>0.05). The mean±SD anxiety score was significantly lower among living transplant recipients compared to cadaveric transplant recipients (80.2±15.2 vs. 86.9±18.8 p=0.03). We also found significant relation between depression score and kind of graft donation (11.6±5.7 in living vs. 16.4±9.4 in cadaveric groups; p<0.005). CONCLUSION: Psychological problems such as depression and anxiety are significantly higher in cadaveric than living renal recipients. Periodic psychological evaluations should be recommended for kidney transplant recipients, especially for the cadaveric group.

Evolution of repellent tolerances in representative arthropods.

Eight commercial insect repellents were tested against Ornithodoros parkeri (Acari: Argasidae), Dermacentor variabilis (Acari: Ixodidae), Aedes aegypti (Diptera: Culicidae), and Xenopsylla cheopis (Siphonaptera: Pulicidae). Patterns of tolerance to the test materials were distinctive for each test species. Levels of tolerance were coded as character state 0 (sensitive), 1 (intermediate), or 2 (tolerant) and mapped on a cladogram reflecting the accepted classification of the test species. Character state 0 was regarded as primitive, as indicated by the ontology of repellent tolerances in ticks. Aedes aegypti was least evolved and X. cheopis was most evolved in tolerance to repellents. Multiple parallelism of the arachnid and X. cheopis lines occurred in the evolution of the observed tolerances.

U.S. Army soldiers' perceptions of arthropod pests and their effects on military missions.

A survey was conducted to determine the effects of biting and stinging arthropods on military personnel, operations, and training. Nearly 70% of respondents reported experiencing problems attributable to arthropods. Arthropods obstructed movement and field position, prevented concealment and cover, disrupted maneuvers, and caused panic. Twenty percent of respondents reported attendance at sick call for treatment of bites or stings, and 4% were hospitalized or assigned to quarters. Median lost time was 2 days. Bee, wasp, and ant stings and spider and chigger bites were the most frequent causes of lost time. Additional training on biting and stinging arthropods, use of repellents and other personal protective measures, first aid for bites and stings, and conditions requiring medical attention is needed in field units to enhance mission performance and reduce time lost because of arthropods. Materials for treatment of bites and stings should be included in first-aid kits issued for field use.

Evaluation of controlled-release mosquito repellent formulations.

Eight polymer and 9 microcapsule formulations of deet were tested on laboratory rabbits against Aedes aegypti and Anopheles albimanus. Several formulations were significantly more effective than simple (unformulated) deet at the same strength for periods up to 24 h. Best results were obtained with a polymer formulation containing a high molecular weight fatty acid and 3 microcapsule formulations containing lanolin, gum arabic, gelatin, tannic acid, stearic acid, polypropylene glycol, water, and a commercial lotion in the microcapsule and carrier fractions.

Evaluation of the laboratory rabbit model for screening topical mosquito repellents.

The laboratory rabbit was evaluated as a model for screening topical mosquito repellents, using data obtained in tests of deet (N,N-diethyl-3-methylbenzamide) against Aedes aegypti on humans and rabbits. Host-specific differences in the action of the test material were quantified by multiple regression analysis. The test material was less effective but more persistent in tests on rabbits, and responses of the mosquito test population were more variable.

Myiasis in a wounded soldier returning from Panama.

An imported case of traumatic myiasis occurred in a soldier wounded during military action in Panama in December 1989 and evacuated to Brooke Army Medical Center, Fort Sam Houston, Texas. At the medical center, five larvae were removed from the scalp wound, reared to the adult stage, and identified as Cochliomyia hominivorax (Coquerel). Though this was the only reported case of wound myiasis of the 254 servicemen evacuated for medical treatment, this incident indicates a potential mechanism for the reintroduction of C. hominivorax into the United States.

Attraction of mosquitoes to diethyl methylbenzamide and ethyl hexanediol.

Studies by prior workers have shown that insect repellents can act as attractants when present as low concentrations, deposits or residues. In the present study deet and ethyl hexanediol were tested in 2-fold serial doses from 1.9 X 10(-9) to 1.6 X 10(-2) mg/cm2 on the forearms of volunteers against colonized Anopheles albimanus, Aedes aegypti and Ae. taeniorhynchus. Both compounds were significantly repellent at the high end of the dose range, as expected. Neither was significantly attractant to An. albimanus in low doses. However, deet was significantly attractant to Ae. aegypti in the dose range 7.6 X 10(-9) to 1.2 X 10(-4) mg/cm2 and to Ae. taeniorhynchus in the dose ranges 1.9 X 10(-9) to 3.1 X 10(-8) mg/cm2 and 2.0 X 10(-6) to 2.5 X 10(-4) mg/cm2. Ethyl hexanediol was significantly attractant to Ae. taeniorhynchus in the dose range 1.9 X 10(-9) to 6.2 X 10(-5) mg/cm2. Based on these results and prior work of V.G. Dethier and C.N.E. Ruscoe, a model sequence of the effects of chemicals on insects with increasing dose was developed. It was concluded that the labels of commercial repellents should be amended to include instructions to wash off or reapply the repellent when it is no longer effective.

Mutagenic potential of permethrin in the Drosophila melanogaster (Diptera: Drosophilidae) sex-linked recessive lethal test.

When permethrin was tested for mutagenicity in Drosophila melanogaster Meigen with the sex-linked recessive lethal test, it was nonmutagenic under conditions of this study. The frequencies of spontaneous mutation for permethrin and the negative control were 0.135% and 0.133%, respectively; the spontaneous mutation frequency for positive control was 12.6%. The difference between the mutation frequency of permethrin and the negative control was not significant.

Laboratory evaluation of controlled-release insect repellent formulations.

Seven microcapsule formulations and two polymer formulations of deet were tested on white rabbits for their repellency against the mosquito, Aedes aegypti. Two microcapsule formulations and one polymer formulation provided more than 80% protection for 12 hours. Results demonstrated that the protection period of deet can be extended through controlled-release techniques.

Mathematical models of the effectiveness and persistence of mosquito repellents.

Two models of the effectiveness and persistence of mosquito repellents on the skin were developed from published functions and data. The probit plane model, Y = a + b1X1 + b2X2, relates the response (Y, in probits) of the mosquito test population to the log dose (X1) of repellent applied and the test period, or elapsed time from the time of application (X2). The exponential decay model, Z = X1 + (b2/b1)X2, estimates the repellent residue (log-1 Z) from X1 and X2. The models were validated with original data from tests of deet (N,N-diethyl-3-methylbenzamide) and ethyl hexanediol (2-ethyl-1,3-hexanediol) on the forearm against the yellow fever mosquito, Aedes aegypti. The probit plane model was evaluated as Y = 8.83 + 1.56 X1-0.69X2 for deet and Y = 8.67 + 1.68X1 - 0.92X2 for ethyl hexanediol when X1 is in log mg/cm2 and X2 is in hours. The exponential decay model was evaluated as Z = X1 - 0.45X2 for deet and Z = X1 - 0.55X2 for ethyl hexanediol. The decay constant (lambda) and half-life (t1/2) were estimated as 1.03 hr-1 and 0.67 hr for deet and 1.26 hr-1 and 0.55 hr for ethyl hexanediol from the slope parameter (b2/b1) of the decay model. Applicable correlation coefficients, standard errors and confidence limits are given. The introduction of these models of the pharmacodynamics of mosquito repellents is a step toward establishing a rational basis for the research, development, testing and evaluation of repellents and for their regulation by the government.(ABSTRACT TRUNCATED AT 250 WORDS)