Clinical disease activity is associated with anxiety and depressive symptoms in adolescents and young adults with inflammatory bowel disease.

BACKGROUND: Youths with inflammatory bowel disease (IBD) are at risk for developing anxiety and depressive symptoms with a reported 20%-50% prevalence rate. AIMS: This prospective study aimed to: (1) describe the prevalence and severity of anxiety and depressive symptoms in a large Dutch cohort of young IBD patients, and (2) identify demographic and clinical risk factors for anxiety and depression. METHODS: IBD patients (n = 374; 10-25 years) were screened for anxiety, depression and quality of life using validated age-specific questionnaires. Patients with elevated scores for anxiety and/or depressive symptoms received a diagnostic interview assessing psychiatric disorders. Demographic and clinical characteristics were retrieved from medical charts. Multiple logistic regression analysis was performed to identify risk factors for anxiety and/or depression. RESULTS: Patients (mean age 18.9 years, 44.1% male, Crohn's disease 60.4%) had disease in remission (75.4%), or mild, moderate and severe clinical disease activity in, respectively, 19.8%, 2.7% and 2.1%. Mild anxiety/depressive symptoms were present in 35.2% and severe symptoms in 12.4% of patients. Elevated symptoms of either anxiety (28.3%), depression (2.9%) or both (15.8%) were found and did not differ between adolescents (10-17 years) and young adults (18-25 years). Active disease significantly predicted depressive symptoms (odds ratio (OR): 4.6 [95% confidence interval [CI]: 2.4-8.8], P < 0.001). Female gender (OR: 1.7 [95% CI: 1.1-2.7]), active disease (OR: 1.9 [95% CI: 1.1-3.2]) and a shorter disease duration (OR: 1.3 [95% CI: 0.6-1.0) (all P < 0.025) significantly predicted anxiety and/or depressive symptoms. CONCLUSIONS: Considering the high prevalence of anxiety and depressive symptoms, psychological screening is recommended in young IBD patients. Screening facilitates early recognition and psychological treatment. Female patients and patients with active disease are the most vulnerable.

Population structure of the primary malaria vector in South America, Anopheles darlingi, using isozyme, random amplified polymorphic DNA, internal transcribed spacer 2, and morphologic markers.

A genetic and morphologic survey of Anopheles darlingi populations collected from seven countries in Central and South America was performed to clarify the taxonomic status of this major malaria vector species in the Americas. Population genetics was based on three techniques including isozyme, random amplified polymorphic DNA-polymerase chain reaction (RAPD-PCR), and internal transcribed spacer 2 (ITS2) markers. The results of the isozyme analysis indicated moderate differences in the allele frequencies of three putative loci (glutamate oxalaoacetate transaminase-1, isocitrate dehydrogenase-1, and phosphoglucomutase) of the 31 analyzed. No fixed electromorphic differences separated the populations of An. darlingi, which showed little genetic divergence (Nei distances = 0.976-0.995). Fragments produced by RAPD-PCR demonstrated evidence of geographic partitioning and showed that all populations were separated by small genetic distances as measured with the 1 - S distance matrix. The ITS2 sequences for all samples were identical except for four individuals from Belize that differed by a three-base deletion (CCC). The morphologic study demonstrated that the Euclidean distances ranged from 0.02 to 0.14, with the highest value observed between populations from Belize and Bolivia. Based on these analyses, all the An. darlingi populations examined demonstrated a genetic similarity that is consistent with the existence of a single species and suggest that gene flow is occurring throughout the species' geographic range.

Morphological, molecular, and chromosomal discrimination of cryptic Anopheles (Nyssorhynchus) (Diptera: Culicidae) from South America.

Based on similarity of male genitalia, the malaria vector Anopheles trinkae Faran from the eastern Andean piedmont of Colombia, Ecuador, Peru, and Bolivia was determined by Peyton (1993) to be a junior synonym of An. dunhami Causey, then known from a single locality in Amazonian Brazil. Following an appraisal of molecular, chromosomal, and morphological characters, we conclude herein that the 2 taxa are specifically distinct and remove An. trinkae from synonymy with An. dunhami. Eggs of the 2 species are distinguished easily by the anterior crown, long floats, and closed deck that occur only in An. trinkae. The X chromosome of larval polytenes is divisible into R and L arms in An. dunhami, but not in An. trinkae. A phenogram based on banding pattern scores from 18 random amplified polymorphic DNA primers separated with 100% resolution An. dunhami, An. trinkae, Anopheles nuneztovari Gabaldón and Anopheles darlingi Root. In the ITS2 region of rDNA, 25% of base sites distinguished An. trinkae from An. dunhami and 21% from the related An. nuneztovari; males of these 3 species had accessory glands of significantly different sizes. Preliminary isoenzyme screening indicated that 3 of 11 loci were diagnostic for separating An. trinkae from An. dunhami. The results indicate that An. dunhami is related more closely to An. nuneztovari than to An. trinkae and illustrate the merits of a multidisciplinary approach to mosquito systematics.

The potential for bias due to attrition in the National Exposure Registry: an examination of reasons for nonresponse, nonrespondent characteristics, and the response rate.

This study examined attrition in the Trichloroethylene (TCE) Subregistry of the National Exposure Registry (NER). The analyses focused on 3915 persons exposed to the chemical TCE through the drinking water in their home. Baseline data were compared for subgroups of the TCE Subregistry members who were eligible to participate in the first TCE Subregistry follow-up. Study members were grouped according to their participation status in the first follow-up: remainers (n = 3494) and losses (n = 421), and three subgroups of losses: refusals, unable to locate, and unable to contact. The comparison of demographic variables of remainers and losses revealed that remainers had a higher percent of females, currently smoked less, were older, and fewer had no education and more had education beyond high school. These differences occurred for the losses subgroups unable to locate and unable to contact, however, not for refusals. The comparison of reporting rates of remainers and losses for 2.3 health outcomes revealed statistically significant decreases by losses for five health conditions but the pattern of statistically significant differences for the losses subgroups was not clear-cut. Altogether, the analyses indicated that the potential for bias due to attrition was minimal.