"I'm 100% for it! I'm a convert!": women's experiences of a yoga programme during treatment for gynaecological cancer; an interpretative phenomenological analysis.

OBJECTIVES: To explore patients' experiences of taking part in a yoga intervention while undergoing treatment for gynaecological cancer. DESIGN: Sixteen women (age range 31-79 years; mean age 60) participated in focus groups based on a semi-structured question schedule. Resulting discussions were audio-recorded, transcribed verbatim and analysed using interpretative phenomenological analysis (IPA). SETTING: Royal Derby Hospital, UK. INTERVENTIONS: Patients took part in a 10-week course of Hatha yoga, where they participated in a one hour long class per week. RESULTS: Three themes emerged from the data: applying breathing techniques, engaging in the physicality of yoga and finding a community. The first theme was particularly important to the patients as they noted the breadth and applicability of the techniques in their day-to-day lives. The latter two themes reflect physical and social perspectives, which are established topics in the cancer and yoga literature and are contextualised here within the women's experiences of cancer treatment. CONCLUSIONS: The women's perceptions of the programme were generally positive, providing a previously unseen view of the patient experience of participating in a yoga intervention. The difference between the women's prior expectations and lived experiences is discussed.

An exploration of the experience of mental health service users when they decide they would like to change or withdraw from prescribed medications.

This paper reports on a collaborative research project initiated by service user representatives and led by clinicians from the mental health service in Derbyshire. The study explored the experiences of mental health service users when they either changed or terminated their use of mental health-related medications. Three focus groups were conducted with mental health service users from across the county. An inductive thematic analysis identified six key themes, three of which are reported here: the 'two faces' of service provision, describing the positive and negative experiences of services; the general practice/mental health divide, relating to the lack of continuity between the two services; and becoming an informed service user, where participants discussed the importance of seeking information. It is important that mental health professionals always consider presenting their 'best face' to service users, and facilitate the prescribing process with general practitioners. The findings also highlight the potential for supporting service users in using different sources of information to become more informed about medication.

Re-establishment of clinal variation in flowering time among introduced populations of purple loosestrife (Lythrum salicaria, Lythraceae).

Range expansion during biological invasion requires that invaders adapt to geographical variation in climate, which should yield latitudinal clines in reproductive phenology. We investigated geographic variation in life history among 25 introduced populations of Lythrum salicaria, a widespread European invader of North American wetlands. We detected a strong latitudinal cline in initiation of flowering and size at flowering, which paralleled that reported among native populations. Plants from higher latitudes flowered earlier and at a smaller size than those from lower latitudes, even when raised in a uniform glasshouse. Early flowering was associated with greatly reduced reproductive output, but this was not associated with latitudinal variation in abundance, and probably did not result from a genetic correlation between time to and size at flowering. As introduction to North America c. 200 years ago, L. salicaria has re-established latitudinal clines in life history, probably as an evolutionary response to climatic selection.

Nizatidine enhances the gastrocolonic response and the colonic peristaltic reflex in humans.

Animal studies demonstrate that nizatidine, an H2-receptor inhibitor, may enhance colonic activity independent of its effect on acid secretion. The effect of nizatidine on human colonic motility is unknown. We evaluated the potential prokinetic property of nizatidine in 12 healthy subjects (10 men and 2 women, age 21-46 years). Each subject received either nizatidine (600 mg), famotidine (80 mg, a H2-receptor inhibitor used as a control), or a placebo, on separate days in randomized order at least 3 days apart. Following an overnight fast, a three-lumen catheter fitted with a stimulus balloon and two barostat bags was placed in the descending colon. The gastrocolonic response was tested by antral balloon inflation and the colonic peristaltic reflex was evaluated by colonic distension. Changes in colonic motility were assessed by volume changes in the barostat bags. Antral distension evoked volume-dependent increases in colonic motility, maximal at a 300-ml inflation, as demonstrated by a reduced bag volume. Nizatidine enhanced colonic motility in response to antral distension at 200 and 300 ml, compared with famotidine and placebo. Colonic distension evoked volume-dependent increases in colonic motility proximal to the stimulus balloon. Compared with famotidine and placebo, nizatidine enhanced the ascending and descending contractile limbs of the peristaltic reflex but did not affect relaxation distal to the balloon. In conclusion, nizatidine enhanced the gastrocolonic response and the colonic peristaltic reflex in healthy subjects. Further research on the prokinetic action of nizatidine in the colon may lead to novel treatments for idiopathic constipation.

Intragastric acidification reduces the occurrence of false-negative urea breath test results in patients taking a proton pump inhibitor.

OBJECTIVE: The aim of this study was to investigate whether reducing intragastric pH, at the time of urea ingestion, decreases the likelihood of false-negative (FN) urea breath test (UBT) results in patients taking a proton pump inhibitor (PPI). METHODS: Patients with active Helicobacter pylori infection underwent a baseline 14C-UBT (UBT-1) followed by treatment with lansoprazole 30 mg/day for 14 to 16 days. On day 13, patients returned for a repeat standard UBT (UBT-2). Between days 14 to 16, patients underwent a modified UBT (UBT-3), which included consuming 200 ml of 0.1 N citrate solution 30 min before and at the time of 14C-urea administration. Breath samples were collected 10 and 15 min after 14C-urea ingestion. Mean 14CO2 excretion and the number of FN and equivocal UBT results were compared for the three UBTs. RESULTS: A total of 20 patients completed the study. Lansoprazole caused a significant decrease in mean breath 14CO2 excretion (disintegrations per minute) between UBT-1 (2.96 +/- 0.23) and UBT-2 (2.08 +/- 0.52, p < 0.05). Lansoprazole caused six (30%) FN and eight (40%) equivocal UBT-2 results. Mean breath 14CO2 excretion for UBT-3 (677 +/- 514) was greater than for UBT-2 (234 +/- 327, p = 0.001). UBT-3 caused only two (10%) FN and three (15%) equivocal results. The 15-min breath sample caused fewer FN and equivocal results than the 10-min sample for both UBT-2 and UBT-3. CONCLUSIONS: Giving citrate before and at the time of 14C-urea administration increases mean breath 14CO2 excretion and decreases FN and equivocal UBT results in patients taking a PPI. These observations suggest that it may be possible to design a UBT protocol that will remain accurate in the face of PPI therapy.

The effect of task on determination of habitual pitch.

The purpose of this study was to investigate if there was an effect of task on determination of habitual pitch, or speaking fundamental frequency (SFF). Seven tasks commonly used to elicit habitual pitch in clinical voice evaluations were compared. Three groups of normal subjects (N = 36) were examined (adult males, adult females, and male and female prepubescent children). For the adult male (n = 12) and pediatric (n = 12) subjects, no significant effect of task was found. For the adult female (n = 12) subjects, a statistically significant (P < .001) effect of task was found. All tasks were found to have high (>0.90) test-retest reliability for all subjects. Implications of the use of one task for determination of habitual pitch are discussed, as is the possibility of a task effect on determination of other voice parameters.

The effect of task on determination of maximum phonational frequency range.

The purpose of this study was to investigate if there was an effect of task on determination of maximum phonational frequency range (MPFR). Two tasks commonly used to elicit MPFR in clinical voice evaluations were compared. Normal adult females (N = 30) were examined. No statistically significant effect of task was found. Both tasks (glissando and discrete-step) were found to have a high positive correlation (0.84). Implications of the use of one task for determination of maximum phonational frequency range are discussed, as is the possibility of a task effect on determination of other voice parameters.

Appropriate timing of the 14C-urea breath test to establish eradication of Helicobacter pylori infection.

OBJECTIVE: The aim of this study was to determine the performance characteristics of the 14C-urea breath test (UBT) performed 2 wk after the completion of therapy for Helicobacter pylori using a 4 to 6 wk study as the gold standard. METHODS: Patients with active Helicobacter pylori infection at four medical centers received proton pump inhibitor-based triple or quadruple therapy for 10-14 days. Patients underwent the 14C-UBT 2 and 4-6 wk after the completion of therapy. A positive test was defined as 14CO2 excretion of >200 dpm, a negative test as <50 dpm, and an equivocal test as >50 but <200 dpm. Performance characteristics of the 2-wk UBT were calculated using the 4 to 6-wk result as a gold standard. RESULTS: Eighty-five patients were enrolled and 82 patients (mean +/- SD age, 62 +/- 15 yr; 15 women) completed the protocol. Four patients had equivocal UBT results and were excluded from the analysis. Of the 78 patients, 68 (87%) had a negative 4 to 6-wk UBT. The 2-week UBT yielded a sensitivity of 90% (95% confidence interval 72-100%), specificity of 99% (97-100%), and accuracy of 97% (93-100%). In patients with a persistently positive UBT, 14CO2 excretion at 2 wk was significantly lower than at 4-6 wk after therapy (p = 0.03). CONCLUSIONS: A UBT performed 2 wk after therapy yielded results comparable to 4 to 6 wk testing. Further studies to evaluate the optimal time of confirmatory testing in the age of more effective proton pump inhibitor-based triple therapies are warranted.

Growth factor effects on survival and development of calbindin immunopositive cultured septal neurons.

Alzheimer's disease (AD) is a neurodegenerative disease characterized by dementia, senile plaques, fibrillary tangles, and a reduction of cholinergic neurons in areas of the brain, including the septal nucleus. Certain growth factors may promote the long-term survival of this subpopulation of neurons at risk. This study was undertaken to characterize growth factors' long-term effects on survival and development of neurons expressing the calcium-binding protein calbindin. In order to accomplish this, embryonic day 16 rat septal neurons were grown in bilaminar culture with astrocytes and in the absence of serum. These cultures were chronically treated with estrogen (Es), insulin-like growth factors I/II (IGF-I, IGF-II), basic fibroblast growth factor (bFGF), and nerve growth factor (NGF). Insulin-like growth factor II significantly increased the number of neurons immunoreactive for calbindin by 155%, suggesting either an increase in the survival of this subpopulation or an increase in the percentage of cells expressing calbindin. Chronic treatment with NGF, IGF-II, and Es significantly increased the number of primary neuritic processes on calbindin-positive neurons, whereas NGF and Es caused significant increases in the number of secondary processes and in the total lengths of the neuritic processes. Thus, effects of IGF-II, estrogen, and NGF on survival and maintenance of this neuronal subpopulation may be dependent on alterations in neurons which are immunopositive for calbindin.

Ammonium lactate 12% lotion versus a liposome-based moisturizing lotion for plantar xerosis. A double-blind comparison study.

Two emollients, ammonium lactate 12% lotion and a liposome-based moisturizing lotion, were compared in a double-blind test for efficacy in the treatment of plantar xerosis. A total of 43 out of 57 participants (75%) with bilateral plantar xerosis followed instructions completely and applied the lotions (one to each foot) twice daily for 4 weeks. Each participant was evaluated once a week for 6 weeks (the final 2 weeks for evaluation of post-treatment regression) to determine xerotic grade (degree of dryness) and treatment effectiveness. With both lotions, significant improvement began during the second week of treatment and continued into the fourth week. There were no significant differences between the two lotions in the 6-week patterns of either xerotic grade or treatment effectiveness.

A necessary role for reduced intracellular potassium during the DNA degradation phase of apoptosis.

Apoptosis is a highly organized mechanism that allows specific cells to die in a controlled manner. Apoptosis can be induced by a variety of agents in a great number of cell types, but cell shrinkage and discrete chromatin cleavage remain common components of apoptosis that is manifested by constitutive enzymes. Despite intensive investigation, the actual event or events that signal this cell death process have not been completely identified. Because of their ability to effect a great number of cellular enzymes simultaneously, we have hypothesized that ions in high concentration (150 mM) in living cells may act as a repressor of apoptotic effectors. In this manuscript we review data that shows that DNA degradation only occurs in the shrunken population of lymphocytes treated with glucocorticoid, shrunken cells loose K+ and become hypotonic, and physiological concentrations on K+ inhibit nuclease activity irrespective of proteins. Together, these data suggest that the reduction in potassium levels appears necessary for the DNA degradation that occurs during apoptosis.

A comparison of three fingerstick, whole blood antibody tests for Helicobacter pylori infection: a United States, multicenter trial.

OBJECTIVE: We compared three whole blood antibody tests for Helicobacter pylori (H. pylori) in a United States, multicenter trial. METHODS: Patients referred for EGD at three medical centers were recruited. During EGD, biopsies were taken for histology and rapid urease testing (RUT). Immediately after endoscopy, patients underwent the antibody tests (FlexPack HP, Abbott Diagnostics; QuikVue, Quidel Corporation; AccuMeter, ChemTrak) using whole blood obtained by two to three fingersticks. Performance characteristics were calculated for each antibody test using the biopsy-based methods as a gold standard. RESULTS: A total of 131 patients participated; 50 (38%) patients had histological evidence of H. pylori infection. Using histology as a gold standard, the sensitivities of FlexPack HP, QuikVue, and Accumeter were 76%, 78%, and 84%, respectively. Specificity was 79% with FlexPack HP and 90% with QuikVue and Accumeter. There were no significant differences in the performance of the three antibody tests though there was a trend toward superior performance for AccuMeter compared to FlexPack HP (p = 0.019). However, RUT proved superior to FlexPack HP using histology as a gold standard (p = 0.008). Using either concordant histology and RUT results or a positive histology or RUT to define active H. pylori infection, there was no statistically significant difference between the antibody tests. CONCLUSIONS: There were no statistically significant differences in the performance of the three antibody tests. These tests proved only marginally sensitive in detecting patients infected with H. pylori. Clinicians should be aware of the limitations of these tests, particularly when using them as a sole means of testing for H. pylori.

Preliminary information on stuttering characteristics contrasted between African American and white children.

There is a lack of studies looking at variation of behavioral stuttering among various cultures. This study compared verbal disfluency and accessory characteristics of 15 African American and 15 White male stutterers between the ages of 8 and 12. In addition to a speaking attitude scale for each of the subjects, conversational and reading samples were gathered. Good intra- and inter-judge reliability was found in assessing the various tasks. Overall results revealed no statistically significant differences in verbal or visual disfluency behaviors on either the reading or conversation tasks between the African American and White groups of children. In addition, no differences in attitudes toward speaking situations was found between the two groups of children. Implications for the diagnosis and treatment of disfluent African American elementary school aged children are discussed. Specific suggestions are made for additional disfluency research with African American children.

Comparison of attitudes about communication in children and adolescents with sickle cell disease.

Survey responses of 24 African-American children and adolescents with sickle cell disease suggest similar, generally positive communication attitudes.

The demography of limb dominance, body-mass index, and metatarsus adductus deformity.

To test the null hypothesis that limb dominance (laterality) and side of complaint are not associated in a diverse population, nearly 400 patients (40% male, 60% female) of varying age and body size from three South Florida podiatric medical teaching facilities were surveyed in 1995-1996. Radiographs of feet were available for 15% of the patients, and the metatarsus adductus angle was measured on each x-ray. The typical patient was a women (median age, 49 years) of average body weight and average body-mass index. No statistical association was found between laterality and side of complaint in the broader sample, although a significant association did appear in the subsample of patients with bilateral x-rays. The prevalence of metatarsus adductus deformity (metatarsus adductus angle > 15 degrees) among patients with x-rays was 62%. No sex-specific, age-specific, or body size-specific associations were found between handedness and metatarsus adductus deformity.