The spectrum of clinical manifestations, outcome and treatment of pericardial tamponade in patients with systemic lupus erythematosus: a retrospective study and literature review.

Pericardial effusions causing pericardial tamponade are rare in patients with systemic lupus erythematosus (SLE). The goal of this study is to describe in detail the clinical and laboratory characteristics of a group of patients with pericardial effusions and pericardial tamponade secondary to SLE. We retrospectively reviewed the records of 71 patients with SLE, admitted to our Hospital between 1985 and 2006 with a diagnosis of pericarditis, pericardial effusion and tamponade.

Development and initial validation of the PEG, a three-item scale assessing pain intensity and interference.

Background: Inadequate pain assessment is a barrier to appropriate pain management, but single-item "pain screening" provides limited information about chronic pain. Multidimensional pain measures such as the Brief Pain Inventory (BPI) are widely used in pain specialty and research settings, but are impractical for primary care. A brief and straightforward multidimensional pain measure could potentially improve initial assessment and follow-up of chronic pain in primary care.

Pharmacotherapy of chronic pain: a synthesis of recommendations from systematic reviews.

Objectives: Chronic pain is one of the most prevalent, costly and disabling conditions in both clinical practice and the workplace, yet often remains inadequately treated. Moreover, chronic pain commonly co-occurs with depression, anxiety and somatoform disorders, and adversely affects response of these conditions to psychiatric treatments. This article provides an evidence-based approach to the pharmacotherapy of chronic pain.

Topological Analysis of the Interactions between Organic Molecules and Co(Ni)MoS Catalytic Active Phases.

The adsorption modes of toluene, 2,3-dimethylbut-1-ene, and 2-methylthiophene on the edges of Co(Ni)MoS nanocrystallites has been investigated with the ELF topological approach of chemical bonding. The chemisorbed modes are characterized by the formation of bonding basins linking the substrate to the catalytic sites. The electronic rearrangements within the substrate are discussed.

Psychosocial stress and anxiety in musculoskeletal pain patients with and without depression.

Objective: The objective of this study was to determine if psychosocial stress and anxiety were associated with depression severity in primary care patients with chronic musculoskeletal pain.

Methods: A cross-sectional sample of 500 primary care patients with musculoskeletal pain (250 with depression and 250 without depression) was assessed for anxiety, psychosocial stress, depression severity and demographics. The depressed and nondepressed participants were compared using t test and chi(2) analyses.

Comparative benefits and harms of second-generation antidepressants: background paper for the American College of Physicians.

Background: Second-generation antidepressants dominate the management of major depressive disorder, dysthymia, and subsyndromal depression. Evidence on the comparative benefits and harms is still accruing.

Purpose: To compare the benefits and harms of second-generation antidepressants (bupropion, citalopram, duloxetine, escitalopram, fluoxetine, fluvoxamine, mirtazapine, nefazodone, paroxetine, sertraline, trazodone, and venlafaxine) for the treatment of depressive disorders in adults.

Meta-analysis of major depressive disorder relapse and recurrence with second-generation antidepressants.

Objective: This meta-analysis reviewed data on the efficacy and effectiveness of second-generation antidepressants for preventing major depression relapse and recurrence during continuation and maintenance phases of treatment, respectively.

Methods: MEDLINE, EMBASE, and PsycINFO, the Cochrane Library, and International Pharmaceutical Abstracts were searched for the period of January 1980 through April 2007 for reviews, randomized controlled trials, meta-analyses, and observational studies on the topic. Two persons independently reviewed abstracts and full-text articles using a structured data abstraction form to ensure consistency in appraisal and data extraction.

Comparative risk for harms of second-generation antidepressants : a systematic review and meta-analysis.

Background: Evidence indicates that only minor differences in efficacy exist among second-generation antidepressants for the treatment of major depressive disorder (MDD). However, a comprehensive assessment of both benefits and harms is crucial to evaluate the net benefit.

Objective: To review systematically the comparative harms of second-generation antidepressants for the treatment of MDD in adults by including both experimental and observational evidence.

Treating the physical symptoms of depression with second-generation antidepressants: a systematic review and metaanalysis.

Background: Approximately two-thirds of patients with depression experience physical pain symptoms. Coexisting pain complicates the treatment of depression and is associated with worse depression outcomes.

Objective: The authors reviewed the effect of newer antidepressants on pain in patients with depression.

Accuracy of the pain numeric rating scale as a screening test in primary care.

Background: Universal pain screening with a 0-10 pain intensity numeric rating scale (NRS) has been widely implemented in primary care.

Objective: To evaluate the accuracy of the NRS as a screening test to identify primary care patients with clinically important pain.

Design: Prospective diagnostic accuracy study

Participants: 275 adult clinic patients were enrolled from September 2005 to March 2006.

The difficult doctor? Characteristics of physicians who report frustration with patients: an analysis of survey data.

Background: Literature on difficult doctor-patient relationships has focused on the "difficult patient." Our objective was to determine physician and practice characteristics associated with greater physician-reported frustration with patients.

Methods: We conducted a secondary analysis of the Physicians Worklife Survey, which surveyed a random national sample of physicians.

An innovative approach to teaching resuscitation skills.

We report the impact of a monthly educational exercise for residents that emphasized practical skills and equipment usage rather than knowledge of advanced cardiac life support (ACLS) protocols. Residents were divided into groups of approximately four that rotated through three stations. Each station included several objectives, most of which related to specific types of equipment.

Measures of adiposity and risk of breast cancer in older postmenopausal women.

Objectives: To determine whether higher adiposity is associated with greater breast cancer risk in older postmenopausal women.

Design: Prospective cohort study with mean follow-up of 11.3 years.

Caspase-3 dependent cleavage and activation of skeletal muscle phosphorylase b kinase.

Phosphorylase b kinase (PhK) is a key enzyme involved in the conversion of glycogen to glucose in skeletal muscle and ultimately an increase in intracellular ATP. Since apoptosis is an ATP-dependent event, we investigated the regulation of skeletal muscle PhK during apoptosis. Incubation of PhK with purified caspase-3 in vitro resulted in the highly selective cleavage of the regulatory alpha subunit and resulted in a 2-fold increase in PhK activity.

Early sexual maturity in male hamadryas baboons (Papio hamadryas hamadryas) and its reproductive implications.

We present data on sexual maturity in young hamadryas baboon males (Papio hamadryas hamadryas) and its reproductive consequences in a large captive baboon colony. Hamadryas baboons live in a multilevel social system, with one-male units (OMUs) as the smallest social entity. Male leaders of OMUs are believed to monopolize matings within their OMUs; hence mating is believed to be polygynous and monandrous.

CK2 phosphorylation of eukaryotic translation initiation factor 5 potentiates cell cycle progression.

Casein kinase 2 (CK2) is a ubiquitous eukaryotic Ser/Thr protein kinase that plays an important role in cell cycle progression. Although its function in this process remains unclear, it is known to be required for the G(1) and G(2)/M phase transitions in yeast. Here, we show that CK2 activity changes notably during cell cycle progression and is increased within 3 h of serum stimulation of quiescent cells.

Phytoestrogens for treatment of menopausal symptoms: a systematic review.

Objective: To assess the efficacy and tolerability of phytoestrogens for treatment of menopausal symptoms.

Data Sources: We searched the Cochrane Library and MEDLINE from 1966 to March 2004, using a detailed list of terms related to phytoestrogens and menopausal symptoms and also hand-searched abstracts from relevant meetings.

Methods Of Study Selection: Randomized trials were eligible if they involved symptomatic perimenopausal or postmenopausal women, compared phytoestrogen with placebo or control, reported hot flush frequency or menopausal symptom scores, and were at least 4 weeks in duration.

Association and regulation of casein kinase 2 activity by adenomatous polyposis coli protein.

Mutations in the adenomatous polyposis coli (APC) gene are responsible for familial adenomatous polyposis coli and also sporadic colorectal cancer development. By using antibodies raised against the N-terminal region of APC protein, we have detected the variable masses of endogenous APC proteins in individual cell lines established from human colorectal carcinomas caused by nonsense mutations of the gene. Phosphorylation of immunoprecipitates of full-length and truncated APC were observed in in vitro kinase reaction, indicating association of APC with protein kinase activity.

The hidden curriculum in multicultural medical education: the role of case examples.

Explicit cross-cultural learning experiences in medical education are provided within the context of implicit experiences provided by a greater "hidden curriculum." The authors conducted a content analysis of 983 cases presented in the 1996-1998 year one and year two curriculum at the University of Minnesota Medical School to determine in what ways they might embody elements of the hidden curriculum, i.e.

Both phosphorylation and caspase-mediated cleavage contribute to regulation of the Ste20-like protein kinase Mst1 during CD95/Fas-induced apoptosis.

The serine/threonine kinase Mst1, a mammalian homolog of the budding yeast Ste20 kinase, is cleaved by caspase-mediated proteolysis in response to apoptotic stimuli such as ligation of CD95/Fas or treatment with staurosporine. Furthermore, overexpression of Mst1 induces morphological changes characteristic of apoptosis in human B lymphoma cells. Mst1 may therefore represent an important target for caspases during cell death which serves to amplify the apoptotic response.

Leptin induces insulin-like signaling that antagonizes cAMP elevation by glucagon in hepatocytes.

Although many effects of leptin are mediated through the central nervous system, leptin can regulate metabolism through a direct action on peripheral tissues, such as fat and liver. We show here that leptin, at physiological concentrations, acts through an intracellular signaling pathway similar to that activated by insulin in isolated primary rat hepatocytes. This pathway involves stimulation of phosphatidylinositol 3-kinase (PI3K) binding to insulin receptor substrate-1 and insulin receptor substrate-2, activation of PI3K and protein kinase B (AKT), and PI3K-dependent activation of cyclic nucleotide phosphodiesterase 3B, a cAMP-degrading enzyme.