Ingroup perception and responses to stigma among persons with mental illness.

OBJECTIVE: Mental illness stigma is common, but it is unclear why it affects some individuals more than others. We tested the hypothesis that the way persons with mental illness perceive their ingroup (people with mental illness) in terms of group value, group identification and entitativity (perception of the ingroup as a coherent unit) shapes their reaction to stigma. METHOD: Ingroup perceptions, perceived legitimacy of discrimination and reactions to stigma (educating or helping others, social performance, secrecy, social distance, hopelessness) were assessed among 85 people with mental illness using questionnaires and a standardized role-play test. RESULTS: Controlling for depression and perceived discrimination, high group value and low perceived legitimacy of discrimination predicted positive reactions to stigma. High group identification and entitativity predicted positive reactions only in the context of high group value or low perceived legitimacy of discrimination. CONCLUSION: Group value and perceived legitimacy of discrimination may be useful targets to help people with mental illness to better cope with stigma.

Electrochemical adsorptive behavior of some fluoroquinolones at carbon paste electrode.

Cyclic voltammetry and differential pulse voltammetry were used to explore the adsorption behavior of three antibacterial agents at a carbon paste electrode. The drugs were accumulated on a carbon paste electrode, and a well-defined oxidation peak was obtained in acetate buffer (pH 5.0). The adsorptive stripping response was evaluated as a function of some variables such as the scan rate, pH and accumulation time. A simple, precise, inexpensive and sensitive voltammetric method has been developed for the determination of the cited drugs (Lomefloxacin (LFX), Sparfloxacin hydrochloride (SFX), and Gatifloxacin (GFX)). A linear calibration was obtained from 2 x 10(-7) M to 4 x 10(-5) M for LFX, 2 x 10(-7) M to 6 x 10(-5) M for SFX, and GFX. The limits of detection (LOD) were 4.2 x 10(-7), 7 x 10(-7) and 6.6 x 10(-7) M, while the limits of quantification (LOQ) were 1.4 x 10(-6), 2.3 x 10(-6) and 2.2 x 10(-6) M for LFX, SFX, and GFX, respectively. The R. S. D. of five measurements at the 1 x 10(-6) M level were 0.4, 0.5 and 0.3 for LFX, SFX and GFX, respectively. The method was applied to the determination of LFX, SFX and GFX in dilute urine samples and dosage forms, and compared with the HPLC method.

Clinical value of increased serum creatinine concentration as predictor of short-term outcome in decompensated cirrhosis.

BACKGROUND: The purpose of this study was to assess whether serum creatinine concentration alone or associated with other biological parameters was an independent predictor of short-term mortality in patients with decompensated cirrhosis. METHODS: A total of 212 consecutive episodes of decompensated cirrhosis in patients admitted to the hospital between January 1999 and December 2001 were reviewed retrospectively. Depending on a serum creatinine concentration equal to or greater than 1.5 mg/dL at the time of admission, patients were divided into decompensated cirrhosis with renal failure (101 episodes in 59 patients, aged 69.8 +/- 10 years) and without renal failure (111 episodes in 61 patients, aged 64.5 +/- 13 years). Outcome (alive, death) during the episode of decompensation of liver disease and outcome at 90 days after admission were assessed. RESULTS: Differences in the frequency of variables according to outcome in the overall episodes of decompensated cirrhosis with and without renal failure showed significant differences between patients who died and those who were alive both at hospital discharge and at 90 days in serum bilirubin, Child-Pugh score, MELD (model for end-stage liver disease) score, and serum creatinine levels. In the multivariate analysis, serum creatinine was not an independent predictor of outcome. The prediction accuracy according to the area under the ROC (receiver operating characteristic) curve was greater for the MELD scale than for serum creatinine. CONCLUSIONS: Serum creatinine concentration is a parameter that should be included in the prognostic assessment of patients with decompensated cirrhosis, but should be combined with other specific parameters of liver function, such as bilirubin, albumin, and the international normalized ratio (INR) for prothrombin time.

RETRACTED: Coated graphite-epoxy ion-selective electrode for the determination of chromium(III) in oxalic medium.

This article has been retracted at the request of the Talanta Editors-in-Chief. Reason: After publication this article was discovered to have been plagiarized from an earlier work by Orlando Fatibello-Filho, Marcos Fernando de Souza Teixeira, Alexandre Zambon Pinto, presented in their paper 'Coated graphite-epoxy ion-selective electrode for the determination of iron(III) in oxalic medium', published in Analytical Letters 30 (1997) 417-427. We very much regret this error, and offer our apologies to Professor Fatibello-Filho and his co-workers. J-M. Kauffmann G.D. Christian Editors-in-Chief.

Polymeric matrix membrane sensors for sensitive potentiometric determination of some beta-blockers in pharmaceutical preparations.

Five poly(vinyl chloride) matrix membrane sensors responsive to some beta-blockers (atenolol, bisoprolol, metoprolol, propranolol and timolol) are described and characterized. The sensors are based on the use of the ion-association complexes of the beta-blocker cations with tungstophosphate anion as electroactive materials. The performance characteristics of these sensors, evaluated according to IUPAC recommendations, reveal fast, stable and near-Nernstian response for 10(-2)-2 x 10(-7) mol l(-1) of different beta-blockers over the pH range 2-9. Many inorganic and organic cations as well as drug excipients and diluents normally used in drug formulations do not interfere. The sensors are used for direct potentiometry of beta-blockers in some pharmaceutical preparations. Validation of the method according to the quality assurance standards shows suitability of the proposed sensors for use in the quality control assessment of these drugs. Results with an average recovery of 99.1% and a mean standard deviation of +/- 1.3% of the nominal are obtained which compare fairly well with data obtained using the British Pharmacopoeia method.

Polarographic determination of propranolol in pharmaceutical formulation.

Propranolol was reacted with nitric acid to give nitropropranolol and was then measured in Britton-Robinson solutions in the pH range 2.0-12.0 by differential-pulse polarography. Nitropropranolol gave rise to a well-resolved differential-pulse polarographic peak at pH 2.0. A linear calibration graph in the range 5.0 x 10(-7)-5.0 x 10(-5) M and a detection limit of 5 nM was obtained. The relative standard deviation was 1.95% (n = 10) at 5 x 10(-6) M. The effect of common exceipient on the peak height was evaluated. The method was applied for the determination of the drug in the tablet dosage form.

Predictors of morbidity and mortality after the first episode of upper gastrointestinal bleeding in liver cirrhosis.

BACKGROUND/AIMS: Upper gastrointestinal (GI) bleeding is one of the most frequent causes of morbidity and mortality in the course of liver cirrhosis. The aim of this study was to determine the independent predictors of morbidity, mortality, and survival after the first episode of GI bleeding in patients with liver cirrhosis. METHODS: In a retrospective study of 403 cirrhotic patients who were admitted in the period January 1982 to December 1994 because of a first episode of GI hemorrhage, epidemiological factors, bleeding-related variables and cirrhosis-related variables that may be associated with hepatic and extrahepatic complications, mortality at 48 h and 6 weeks, and survival up to 30 June 1996 were assessed. RESULTS: Forty-five percent of patients developed hepatic and/or extrahepatic complications, with a mortality rate of 7.4% at 48 h and 24% at 6 weeks. Renal failure, rebleeding, hepatocellular carcinoma, and hepatic encephalopathy were independent predictors of mortality. The Kaplan-Meier method showed a median survival of 30.9+/-4.5 months (95% confidence interval 22 to 39.7 months). The cumulative percentage of survivors was 60.2% at 1 year, 33.6% at 5 years, and 14% at 10 years. In a Cox's multiple regression analysis, age, hepatic encephalopathy, hepatocellular carcinoma, Child-Pugh grade, and renal failure were independently associated with long-term survival. CONCLUSIONS: The first episode of GI bleeding in patients with liver cirrhosis is associated with high morbidity and mortality. Renal failure, rebleeding, hepatocellular carcinoma, and hepatic encephalopathy were independent risk factors for early death.

Maximal biliary transport of sulfobromophthalein in patients with a T-tube placed in the common bile duct.

In 19 adult patients with choledocholithiasis who were operated on, excretion of free and conjugated sulfobromophthalein (BSP) in the bile collected through a T-tube inserted in the common bile duct was determined. The transport maximum (Tm) for BSP was calculated by the constant-infusion technique after an intravenous infusion of the dye at a rate of 0.3 and 0.09 mg/kg/min for the first and second hour, respectively. Free and conjugated BSP were measured in blood samples obtained at 30, 40, and 50 min of each hourly-infusion period, and in bile collected during the first 30 min (sample A) and between 30-50 min (sample B) after starting the first BSP infusion, and during the first 30 min (sample C) and between 30-50 min (sample D) after starting the second infusion. No correlations between Tm of BSP and glutathione transferase activity and between Tm and bilirubin and alkaline phosphatase in serum were found. Although there was an overall correlation between Tm of BSP and biliary excretion of BSP after 30 min of starting the BSP infusion (samples B, C and D) (r = 0.4716; P = 0.41), Tm values were always lower than recoveries of free BSP in bile. It seems that Tm of BSP (measured with the Wheeler's method) overestimates the actual values of biliary excretion of free BSP, and that the percentage of conjugated BSP in serum is related to the degree of impairment of biliary transport of BSP.

Plasma sulfobromophthalein disappearance in Gilbert's syndrome.

BACKGROUND/AIMS: We studied the metabolism of sulfobromophthalein and its relationship with serum bilirubin levels in 40 patients with Gilbert's syndrome (type I 30; type II 6; type III 4). MATERIAL AND METHODS: Plasma sulfobromophthalein disappearance studies were carried out and 72 hours later, serum bilirubin concentrations (total and unconjugated fraction) were determined at baseline and after 24 and 48 hours of dietary restriction to 400 calories/day. RESULTS: The fractional transfer rate of sulfobromophthalein from plasma to liver was significantly higher in types I (14.7 +/- 3.4 ml/min) and II (14.9 +/- 2.7 ml/min) than in type III (8.7 +/- 1.5 ml/min). The fraction of the plasma sulfobromophthalein pool irreversibly cleared per min was significantly higher in type I (12.2 +/- 2.6 ml/min) than in types II (9.5 +/- 1.5 ml/min) and III (9.3 +/- 3.8). In all patients, serum bilirubin concentrations were significantly higher after fasting as compared with baseline. There was a significant correlation between the increments of serum unconjugated bilirubin levels after the fasting test and the transfer rate of sulfobromophthalein from plasma to liver (F = 9.8411, r = -0.4535, p = 0.003). CONCLUSION: These findings indicate the presence of an active uptake system shared by bilirubin and sulfobromophthalein.

[Comparative study of the prevalence of hepatitis B virus infection and human immunodeficiency virus type 1 infection in the prison population between 1985 and 1992]. / Estudio comparativo de la prevalencia de infección por virus de la hepatitis B y virus de la inmunodeficiencia humana tipo 1 en la población penitenciaria entre 1985 y 1992.

The prisoner population of the penitentiaries presents an elevated prevalence of hepatitis B virus (HBV) and human immunodeficiency type 1 (HIV-1) infection markers. In the last few years different measures have been developed to prevent infection. This study evaluates whether there have been changes in the prevalence of infection by these virus over the last few years within a penitentiary. A group of prisoners (n = 163) studied in 1985 were therefore compared with another group (n = 750) studied in 1992. Demographic, social, risk and penitentiary factors were included. In each of the subjects studied alanine aminotransferase (ALT), hepatitis B virus (HBsAG, antiHBs and antiHBc) and anti-HIV-1 markers were determined. It was globally observed that following the 7 years between the two studies there was a decrease in the prevalence of HBV (X = 14.63, p = 0.0001, OR = 2; CI 95%: 1.38-2.9), which was mainly observed in the group of prisoners with no drug addiction habits. No differences were observed with regard to the prevalence of anti-HIV-1 which remained similar among the IV drug consumers and not consumers (64% and 66.6% in 1985 and 1992, respectively). In conclusion, from 1985 to 1992 a decrease has been observed in the prevalence of hepatitis B virus infection in the penitentiary population while the prevalence of anti-HIV-1 has remained unchanged.

Immune response to hepatitis B vaccine in parenteral drug abusers.

Responsiveness was assessed to a programme of vaccination of hepatitis B vaccine in a cohort of 197 intravenous drug addicts (mean age, 23.7 years) and their antibody response was compared with that of 271 healthy controls (mean age, 24.2 years). All participants were seronegative for hepatitis B surface antigen (HBsAg) and antibody to HBsAg (anti-HBs). The vaccination schedule consisted of three intramuscular injections (deltoid area) at months 0, 1 and 2. Although 70% of parenteral drug abusers received the three doses of vaccination, only 43.6% were evaluable for immune response. Fifty-eight per cent of heroin addicts and 80% of controls had evidence of anti-HBs seroconversion at 1 month after vaccination (chi 2 = 15.52, p less than 0.001). Geometric mean antibody titres were also significantly higher in controls (69.1 IU l-1; confidence interval 95%, 56.83 and 84.04) than in parenteral drug abusers (18.2 IU l-1; confidence interval 95%, 12.85 and 25.73) (F = 20.951, p less than 0.0001). The anti-HBs response was not influenced by coexistent anti-HBc, HCV antibody or HIV antibody seropositivity.

[Extrinsic compression of the right atrium due to a mediastinal germ-cell tumor]. / Compresión extrínseca de la aurícula derecha por un tumor germinal mediastínico.

A patient with a mediastinal mass detected by plain chest roentgenogram is presented. The echocardiographic-Doppler examination and the computed tomography precise the gross nature and extent of the tumour and its anatomical location producing obstruction of the right atrium and modifying the blood flow pattern in this chamber. The serum tumour markers and the transthoracic biopsy confirm the diagnosis of primary mediastinal germ cell tumour.

[Recurrent benign intrahepatic cholestasis. A case report]. / Colestasis intrahepática recurrente benigna. A propósito de un caso.

A case of benign and recurrent intrahepatic cholestasis in a 46 year old female is presented. This patient, who correctly coincided with the diagnosis criteria, had 2 episodes of jaundice and pruritus over a period of 4 years. The diagnosis criteria, clinical features, blood tests, etiopathogenesis and treatment are reviewed.

[Hepatic activity of glutathione transferase and bromsulphalein metabolism]. / Actividad hepática de la glutatión transferasa y metabolismo de la bromosulfotaleína.

The gluthatione transferase activity has been studied in liver biopsies from patients suffering with different hepatic lesion and related to the bromsulphalein (BSP) maximal transport (MT) and the conjugated dye present in serum. Results prove that the MT of BSP is independent of the enzyme activity, but is correlated to the conjugated BSP present in serum during the first perfusion. The enzyme activity, the MT of BSP and BSP conjugated rare in serum are not related to the liver lesion stage. From the analysis of our results we conclude that in the beginning the BSP conjugated proportion is determined by the enzyme activity which is not a restrictive factor of the BSP maximal transport.

[A comparative study of the oral and rectal ammonium overload test in liver cirrhosis]. / Estudio comparativo del test de sobrecarga amónica por vía oral y rectal en la cirrosis hepática.

The ammonium loading test has been realized in 66 patients, 8 of them without clinical or laboratory data of hepatic disease and 58 diagnosed of hepatic cirrhosis (HC). In 40 patients with HC and 8 patients without liver disease the ammonium was administered by rectum and in the remaining 18 patients with HC it was administrated orally. In each case, non stagnant venous blood was drawn at 0, 30, 45, 60 and 75 minutes after the administration of ammonium and plasmatic levels were measured. The results show that in patients with HC there are no significant differences between rectal and oral administration although the rectal way presented less secondary effects and is better tolerated. The test is discriminatory when comparing patients with HC and patients without liver disease as well as between patients with HC and portal hypertension and those without clinical signs of portal hypertension.

Prevalence of liver disease and infection by hepatitis B, delta virus, and human immunodeficiency virus in two Spanish penitentiaries.

We studied the prevalence of liver disease and the carrier state for hepatitis B (HBV), delta virus (HDV) and HIV-1 infection in two Valencian penitentiaries, one for males and the other for females. Serological results were correlated with history of intravenous drug addiction, alcohol abuse, homosexuality or prostitution (high-risk groups), and duration and number of internments. A high prevalence of increased transaminase levels (52.2%) and serological markers for HBV infection (66.5%) was observed amongst the inmates, figures being higher amongst high-risk individuals and inmates confined for more than 6 months. No signs of HDV or HIV-1 infection were found amongst the prison staff. Anti-HIV-1 positivity was observed most frequently amongst individuals combining both drug abuse and homosexuality/and prostitution.

Effect of L-carnitine upon ammonia tolerance test in cirrhotic patients.

In a group of liver cirrhosis (LC) patients subjected to a rectal ammonium overload test, the effect of L-carnitine on ammoniemia and on the type A numerical connection and star clock psychomotor tests has been evaluated. On comparing 40 LC patients given L-carnitine with 40 control cirrhotics given a placebo, no significant differences were observed in ammonium levels after performing the overload test in both groups. However, on studying the patients with the greatest liver involvement, those given L-carnitine showed smaller elevations in ammoniemia and better responses to the psychometric tests than those receiving the placebo. The results obtained emphasize the need to continue testing the effect of L-carnitine using either similar tests or carrying out long-term evaluations to determine its protective effect in the appearance of hepatic encephalopathy, perhaps even including its evaluation in the treatment of established encephalopathy.

[Acute hepatitis in heroin addicts: etiologic and follow-up study of 110 cases]. / Hepatitis aguda en heroinómanos: estudio etiológico y evolutivo de 110 casos.

In order to know the etiology and natural history of acute viral hepatitis in intravenous drugs abusers, a panel of 110 heroin addicts, suffering acute hepatitis, is studied. The B virus, by itself or in conjunction with the delta virus was responsible for 63 cases. 35 patients suffered of NANB hepatitis and only two patients were diagnosed of hepatitis A. Delta infection was detected in 38 of the 77 cases of HBsAg-positive acute hepatitis. All the hepatitis B patients had serum conversion within the first 6 months of the acute episode. All the patients suffering acute delta hepatitis and 75% of those suffering non-A, non-B hepatitis, developed chronic hepatic disease. We conclude that in our environment, the B virus is the main responsible for acute hepatitis in heroin addicts. Delta infection is detected in almost half of the heroin addicts with HBsAg-positive acute hepatitis. The acute hepatitis caused by B virus, or by B and delta viruses simultaneously, have a satisfactory evolution, thus, almost all the cases are cured within 6 months. On the contrary, hepatitis caused by NANB or delta viruses usually progresses to chronic hepatic disease.