Frequencies of obesity susceptibility alleles among ethnically and racially diverse bariatric patient populations.

Background: Genetic factors likely play a role in obesity and the outcomes after bariatric surgery. Single nucleotide polymorphisms in or near the insulin-induced gene 2 (INSIG-2), fat mass and obesity-associated gene (FTO), melanocortin 4 receptor gene (MC4R), and proprotein convertase subtilisn/kexin type 1 gene (PCSK-1) have been associated with class III obesity in whites. Minimal data are available regarding the genetic susceptibility to obesity in class III obese nonwhites, especially Hispanics.

Origin, frequency and clinical significance of glandular cells in liquid-based pap tests from patients posthysterectomy.

Objective: To quantify the frequency and significance of glandular cells in posthysterectomy liquid-based (SurePath, TriPath Imaging, Burlington, North Carolina, U.S.A.

Recovery and spiritual transformation among peer leaders of a modified methadone anonymous group.

This analysis of five recovery narratives from leaders of a peer-led, 12-Step-based self- help group in a methadone treatment program highlights the importance of spiritually-mediated role transformation in the recovery process. For these men and women in their forties and fifties, their progression to a leadership role helping others with their recovery validated the spiritual transformation they regarded as underlying their own recovery process. Assumption of this new leadership/helper role marked a tangible sign that their deepened spirituality allowed them to assume a new, higher function in a struggle with the addiction that had plagued their lives.

Orientation toward spirituality and self-help approaches in the therapeutic community.

Although Alcoholics Anonymous and other Twelve-Step interventions are among the most widely utilized self-help options by persons with chemical dependency, little is known concerning whether this approach should be integrated with non-spirituality based self-help approaches. The purpose of this study was to assess the extent to which clients receiving inpatient treatment in a residential therapeutic community (TC) felt that spirituality based interventions should be featured in TC treatment. Three hundred twenty-two members of the Daytop TC completed a survey assessing personal orientation to spirituality and attitudes towards spirituality based treatments.

Methadone Anonymous: A 12-Step Program for Methadone Maintained Heroin Addicts.

Methadone Anonymous (MA) is a new 12-step fellowship developed for methadone maintained heroin addicts. A total of 53 MA members completed a survey assessing factors related to methadone maintenance treatment program (MMTP) entry, drug use, MA participation, beliefs concerning effectiveness of MMTP and MA, and level of social cohesiveness. Length of time in MA was associated with a decreased use of alcohol, cocaine, and marijuana.

Effects of leuprolide acetate on low-grade endometrial stromal sarcoma.

We describe a low-grade endometrial stromal sarcoma coexistent with leiomyoma and adenomyosis treated with leuprolide acetate. We describe its histologic characteristics and clinical significance.

Peritoneal cytology in uterine papillary serous carcinoma.

Objective: To highlight the significance of positive peritoneal cytology in uterine papillary serous carcinoma (UPSC).

Study Design: Seventeen consecutive UPSC cases with peritoneal cytology from 1993 to 1997 were reviewed and compared with the original cytologic diagnosis and extent of tumor involvement in tissues.

Results: Of the 17 post-menopausal women with UPSC, 11 had early-stage tumors (clinical stage I and II); three cases (27%) with positive peritoneal cytology were upgraded from at least International Federation of Gynecologists and Obstetricians stage IA to IIIA.

Correlates of protracted homelessness in a sample of dually diagnosed psychiatric inpatients.

The authors assessed sociodemographic, drug use, and diagnostic correlates of protracted homelessness in a sample of 147 dually diagnosed patients who required admission to the hospital. When 58 patients with protracted homelessness, defined as continuous undomiciled status for over a year, were compared with 74 patients without protracted homelessness, significant differences were found with regard to diagnosis, employment status, criminality, Brief Psychiatric Rating Scale score on admission, and history of injection drug use. The results of a multiple logistic regression analysis confirmed that a history of injection drug use, current unemployment, and a diagnosis of schizophrenia were positively associated with a history of protracted homelessness.

Increased transmission of vertical hepatitis C virus (HCV) infection to human immunodeficiency virus (HIV)-infected infants of HIV- and HCV-coinfected women.

The transmission of perinatal hepatitis C virus (HCV) infection was studied retrospectively in 62 infants born to 54 HCV- and human immunodeficiency virus (HIV)-coinfected women enrolled in a prospective natural history study of HIV transmission. Infant HCV infection was assessed by nested RNA polymerase chain reaction. The overall rate of vertical HCV transmission was 16.

Crack cocaine and schizophrenia as risk factors for PPD reactivity in the dually diagnosed.

We studied factors contributing to an increased risk of PPD positive status among 147 inpatients dually diagnosed for mental illness and substance abuse in a large urban hospital. Ninety-three percent (N = 137) were tested for PPD on admission. The rate of positive PPDs was 30.

Intrathecal injection: unusual complication of trigger-point injection therapy.

Trigger-point injection therapy is a common procedure in primary care medicine and emergency medicine and is generally considered safe. A 28-year-old woman experienced respiratory depression and hemiplegia after the injection of a superficial trapezius trigger point. The patient required emergency tracheal intubation for ventilatory support.

HIV-1 infection in a population-based twin sample.

Objective: To examine factors associated with perinatal HIV-1 transmission among twins.

Methods: We identified twins delivered by a population-based cohort of HIV-infected mothers on New York State Medicaid. Tested algorithms were applied to Medicaid files to identify HIV infection in mothers and twins.

Cholestatic hepatitis in children infected with the human immunodeficiency virus.

A distinct clinical syndrome of cholestasis and hepatitis occurred during early infancy in seven infants with perinatally acquired human immunodeficiency virus 1 infection. In five infants hepatitis was the first manifestation of human immunodeficiency virus 1 infection. The median age of onset of hepatitis was 7 months (range, 5 to 10 months).

Delayed recognition of human immunodeficiency virus infection in preadolescent children.

Thirty-two (18%) of 181 children cared for at our institution who were infected with the human immunodeficiency virus type 1 (HIV-1) were first seen, and HIV was diagnosed, when they were 4 years of age and older. Initial complaints or diagnoses for these children included the following: hematologic disorders (5) (3 idiopathic thrombocytopenic purpura, 1 neutropenia, 1 anemia); recurrent bacterial infections (10); Pneumocystis carinii pneumonia (3); developmental delay (1); skin disorders (2) (1 genital wart, 1 chronic zoster); weight loss (3); malignancy (1); and nephropathy (1). Eight children were referred for evaluation because of maternal HIV-1 infection.

Bretylium tosylate and electrically induced cardiac arrhythmias during hypothermia in dogs.

The effect of bretylium tosylate on plasma catecholamines and on electrically induced arrhythmias was evaluated in anesthetized hypothermic dogs. Bretylium at a dose of 7.5 mg/kg was administered prior to cooling from 37 degrees C to 27 degrees C.

Perinatal human immunodeficiency virus infection: ruminations on mechanisms of transmission and methods of intervention.

Perinatal human immunodeficiency virus (HIV) infection is undoubtedly a multifactorial process. Neither the quantity of viremia nor the level of neutralizing antibody in the infected mother is alone predictive of HIV transmission to her offspring. Additional cofactors may include the ability of maternal immunity to control the host cell range and rate of viral replication.

Radionuclide quantitation of renal function.

Quantitation of renal function may be performed with a variety of radiopharmaceuticals which reflect slightly different renal functions. Plasma sampling techniques and imaging techniques have been used to derive absolute measurements of renal function. The addition of imaging permits the determination of relative or "split" function.

Disseminated fungal infections in children infected with human immunodeficiency virus.

A retrospective review of charts of 156 human immunodeficiency virus-infected children cared for during a 7.5-year period revealed 11 episodes of disseminateed candidiasis (DC) occurring in 11 patients (7%). All 11 patients developed the fungal infection in the context of advanced human immunodeficiency virus infection.

Radiographic evaluation of focal lung disease.

Optimal clinical management of patients with focal lung pathology necessitates thorough familiarity with basic concepts in imaging. Over the past decade, radiologic evaluation has undergone rapid change, reflecting considerable growth in imaging technology. As this article discusses and illustrates at length, improvements in computed tomography technology in particular have resulted in a significant alteration in our approach to both the diagnosis and treatment of patients with focal lung disease.

Radiation therapy for intracranial germinoma: the case for limited volume treatment.

Although radiation therapy has been universally accepted as the treatment of choice for primary intracranial germinomas, the optimal treatment technique continues to be a matter of controversy. Some authors advocate routine prophylactic craniospinal irradiation for all patients with localized intracranial germinomas whereas others have recommended partial brain fields. A retrospective analysis was performed on all 30 patients with tumors of the pineal and suprasellar regions irradiated at our institution between 1967 and 1987.

Screening for respiratory syncytial virus and assignment to a cohort at admission to reduce nosocomial transmission.

To limit nosocomial spread of respiratory syncytial virus (RSV) infection, a longitudinal intervention trial was instituted. Nasal secretions or washes were screened for RSV antigen by enzyme-linked immunosorbent assay, and patients were assigned to an RSV-infected or an RSV-uninfected cohort. The baseline (preintervention) rate of 7.

Analysis of multiple prognostic factors in patients with stage IB cervical cancer: age as a major determinant.

To evaluate the prognostic importance of age in patients with Stage IB cervical cancer we reviewed the results of 131 patients treated between 1974 and 1985. Patients ranged in age from 25 to 87 (mean 48) and were followed for a median of 65 months. One hundred twenty-five patients had complete follow-up information for survival analysis.