Latent class analysis of attention and white matter correlation in children with attention-deficit/hyperactivity disorder.

This study aimed to explore attentional patterns among children with inattentive attention-deficit/hyperactivity disorder (ADHD-I) and children with typical development (TD), using a latent class analysis (LCA). Patterns of brain connectivity were also explored. The sample comprised 29 ADHD-I and 29 TD matched children. An LCA was conducted to reclassify subjects according to their attentional performance, considering cognitive measures of attention and behavioral symptoms, regardless of group of origin. The new clusters were then compared in respect to brain white matter measurements (extracted from diffusion tensor imaging). Participants were rearranged in 2 new latent classes, according to their performance in an attention task and the results of behavioral scales, resulting in groups with more homogeneous attentional profiles. A comparison of the 2 new classes using the white matter measurements revealed increased fractional anisotropy in the left inferior fronto-occipital fasciculus and left inferior longitudinal fasciculus for the class composed by participants with a higher risk of attentional problems. The findings indicated that it was possible to observe variability regarding neuropsychological profile, accompanied by underpinning neurobiological differences, even among individuals with the same disorder subtype - inattentive ADHD. This specific data-driven clustering analysis may help to enhance understanding of the pathophysiology of the disorder's phenotypes.

Latent class analysis of attention and white matter correlation in children with attention-deficit/hyperactivity disorder

This study aimed to explore attentional patterns among children with inattentive attention-deficit/hyperactivity disorder (ADHD-I) and children with typical development (TD), using a latent class analysis (LCA). Patterns of brain connectivity were also explored. The sample comprised 29 ADHD-I and 29 TD matched children. An LCA was conducted to reclassify subjects according to their attentional performance, considering cognitive measures of attention and behavioral symptoms, regardless of group of origin. The new clusters were then compared in respect to brain white matter measurements (extracted from diffusion tensor imaging). Participants were rearranged in 2 new latent classes, according to their performance in an attention task and the results of behavioral scales, resulting in groups with more homogeneous attentional profiles. A comparison of the 2 new classes using the white matter measurements revealed increased fractional anisotropy in the left inferior fronto-occipital fasciculus and left inferior longitudinal fasciculus for the class composed by participants with a higher risk of attentional problems. The findings indicated that it was possible to observe variability regarding neuropsychological profile, accompanied by underpinning neurobiological differences, even among individuals with the same disorder subtype - inattentive ADHD. This specific data-driven clustering analysis may help to enhance understanding of the pathophysiology of the disorder's phenotypes.

Use of hormone replacement therapy by postmenopausal women in the United States.

BACKGROUND: The benefits and risks of hormone replacement therapy (HRT) in postmenopausal women are not fully defined, and individual characteristics and preferences may influence decisions to use this therapy. Previous studies of postmenopausal women who use HRT have been conducted in local or highly selected cohorts or have not focused on current use. OBJECTIVE: To examine sociodemographic, clinical, and psychological factors associated with current use of HRT in a national population-based cohort. DESIGN: Random-digit telephone survey. SETTING: Probability sample of U.S. households with a telephone. PARTICIPANTS: 495 postmenopausal women 50 to 74 years of age in 1995. MEASUREMENTS: Current use of HRT. RESULTS: Current use of HRT was reported by 37.6% of women (58.7% of those who underwent hysterectomy and 19.6% of those who did not undergo hysterectomy; P = 0.001). In multivariable analyses, use of HRT was more common among women in the South (adjusted odds ratio, 2.67 [95% CI, 1.08 to 6.59]) and West (odds ratio, 2.76 [CI, 1.01 to 7.53]) than the Northeast. Use was more common among college graduates (odds ratio, 3.72 [CI, 1.29 to 10.71]) and less common among women with diabetes mellitus (odds ratio, 0.17 [CI, 0.05 to 0.51]). Other cardiac risk factors and most psychological characteristics were not associated with HRT use. CONCLUSIONS: Sociodemographic factors, such as region and education, may be more strongly associated with use of HRT than clinical factors, such as risk for cardiovascular disease. Future efforts should focus on understanding sociodemographic variations, defining which women are most likely to benefit, and targeting therapy to them.

Early occlusion of coronary by-pass associated with the presence of factor V Leiden and the prothrombin 20210A allele: case report.

The presence of factor V Leiden mutation and the variation of the prothrombin gene 20210GA have been described as additional risk factors for arterial thrombosis when other acquired or metabolic risk factors are present. We report here a 56-year-old man who developed coronary artery disease since 1980 without any known risk factor and underwent a cardiopulmonary by-pass in 1997. In the first month after surgery, he became symptomatic, and an angiography showed complete occlusion of the grafts and some native coronary arteries. Three months after the second cardiopulmonary by-pass, a thrombophilic state was searched, and plasma levels of lipoprotein (a) (LPa) were measured. The patient is heterozygous for factor V Leiden mutation and has the variation 20210GA of the prothrombin gene and high levels of LPa. These findings induced us to add oral anticoagulation to the aspirin treatment, and the patient is in a good condition 11 months later.

The impact of family structure and social change on adolescent sexual behavior.

PIP: This article presents a biophysical perspective on adolescent sexual feelings and behavior. The study particularly analyzes sexual attraction, desire, and mate selection as evolutionary adaptations just as important to species survival. Sex differences in mating strategies are described as part of this evolutionary adaptation. Recent research findings demonstrate how these strategies explain contemporary sexual and reproductive behavior in Western societies today, as they do sexual behavior in the past or across diverse cultures. The implications of this analysis are significant to intervention efforts to postpone sexual initiation and avert nonmarital births. Discussion on demographic and normative changes that affect adolescent sexual behavior included trends in sexual maturation and changing marriage norms. The author urges greater emphasis on the early pubertal years; increased attention to teaching adolescents more about their own sexual development; a less absolutist focus on sexual abstinence, which may be appropriate and more feasible for 12 year olds but not for 16 year olds; better and more widespread sex education at earlier ages and throughout the school curriculum; frank discussion of all the options available for those who experience an unwanted pregnancy; and same level of attention towards adolescent boys and girls.^ieng

The future in the making: recent trends in the work-family interface.

Following a review of recent demographic trends in family life and gender roles, and of new developments in the American economy, their interactive effects are discussed. Directions for socioeconomic change are then suggested with a view to easing the burden on married adults that results from the combination of family and work obligations.

Abortion in context: historical trends and future changes.

Reform of abortion laws in the United States stemmed from concern over the health consequences of illegal abortion. Feminists were relative latecomers to the movement, and abortion did not become a major political issue until after the Roe v. Wade decision by the Supreme Court. Most social scientists began to study public attitudes toward abortion, which have been relatively stable since that 1973 decision, only after the Supreme Court ruling, and they thus probably missed documenting the period in which the major attitudinal changes occurred. Polls showed that the American public is most likely to approve of abortion when there is a fetal defect and when the pregnancy endangers maternal health or is the result of rape. These single reasons do not seem to jibe with the complexities of real life, however: The majority of women who have abortions indicate more than one reason for doing so, and the major reasons given concern the conflicting responsibilities of school, work and family and an inability to afford another child. A view of the abortion controversy that puts it into a larger context than do most polls and most American research suggests that legal abortion in the United States is unlikely to be jeopardized in the long run. The trend in most Western industrial nations is toward a more secularized society that features more individual discretion and less control by religious and political institutions over private aspects of life. In the immediate future, a number of factors will perpetuate the need for access to abortion. Among them are early sexual activity that often results in pregnancies among very young women; dim prospects for innovative technological advances in the contraceptive field; and the AIDS epidemic, which may result in the use of contraceptives that are more effective against that deadly virus but less effective at preventing pregnancy. Nor will abortion decisions become any easier for the families and individuals involved, as technology continues to advance in its ability to identify fetal defects and to keep alive babies born at earlier and earlier stages of gestation.