Clinical correlates of quality of life in systemic sclerosis measured with the World Health Organization Disability Assessment Schedule II.

Objective: To identify the clinical characteristics of systemic sclerosis (SSc) that best correlate with the health-related quality of life (HRQOL) of patients with SSc, using the World Health Organization Disability Assessment Schedule II (WHODAS II) as the measure of HRQOL.

Methods: A cross-sectional, multicenter study of 337 patients from the Canadian Scleroderma Research Group Registry was conducted. Patients were assessed through detailed clinical histories, medical examination, and the WHODAS II.

Quality of life in systemic sclerosis: psychometric properties of the World Health Organization Disability Assessment Schedule II.

Objective: To determine the validity of the World Health Organization Disability Assessment Schedule II (WHODAS II) in systemic sclerosis (SSc).

Methods: Patients enrolled in the Canadian Scleroderma Research Group registry participated in a standardized evaluation and completed the WHODAS II. Criterion validity was assessed by comparing the WHODAS II with the Medical Outcomes Study Short Form 36 (SF-36), construct validity was assessed by examining how it relates to common measures of outcome in SSc, and discriminative validity was assessed by examining how it distinguishes patients with more severe disease from those with less severe disease.

Usefulness of persistent symptoms of depression to predict physical health status 12 months after an acute coronary syndrome.

Previous research has focused on the relation between depression after an acute coronary syndrome (ACS) and subsequent cardiac morbidity and mortality. However, the relation between depression and quality of life during recovery remains unclear. We investigated whether symptoms of depression during hospitalization for ACS or the course of depressive symptoms after ACS predict physical health status 12 months after ACS, controlling for physical health status at the time of the ACS.

Mortality risk and length of stay associated with self-inflicted burn injury: evidence from a national sample of 30,382 adult patients.

Objective: Existing studies report contradictory findings regarding characteristics and outcomes of patients admitted with self-inflicted burn injuries. The objective of this study was to report demographic and medical characteristics of patients admitted to burn centers with self-inflicted burn injuries and to assess mortality risk and length of stay compared with patients whose injuries were not self-inflicted.

Design: Retrospective, cohort study.

Contextualizing specificity: specific and non-specific effects of treatment.

Modern medicine thrives on the ideal of specific diseases, and specificity has revolutionized thinking in clinical practice (e.g., psychiatry) as well as biomedical research (e.

Depression in patients with systemic sclerosis: a systematic review of the evidence.

Objective: To assess the prevalence, course, and predictors of depression in patients with systemic sclerosis (SSc).

Methods: We conducted a comprehensive search in November 2006 of MEDLINE, PsycINFO, and CINAHL databases to identify original research studies published in any language that used a structured interview or validated questionnaire to assess major depressive disorder or clinically significant symptoms of depression in patients with SSc. The search was augmented by hand searching 26 selected journals through December 2006 and references from identified articles and reviews.

Anxiety affects the relationship between parents and their very low birth weight infants.

The goal of this study was to examine the medical and sociodemographic factors associated with parental anxiety following the birth of a very low birth weight infant (VLBW, below 1500 g), and to determine the impact of anxiety on the behavior of parents with their VLBW infants in the Neonatal Intensive Care Unit (NICU). The parents of 88 VLBW infants were recruited through the NICU of a tertiary-care hospital, approximately 2 weeks following delivery. Parents completed self-report questionnaires measuring anxiety, marital quality, and social support.

A brief two-item screener for detecting a history of physical or sexual abuse in childhood.

Background: A number of medical practice guidelines and recommendations call for screening adult patients for a history of physical or sexual abuse in childhood, but no brief screening tools exist. The objective of this study was to assess the accuracy of a two-item screener for physical or sexual abuse in childhood.

Methods: This is a cross-sectional study of randomly selected women (aged 18-65 years) from a large health maintenance organization.

Documentation on the anesthetic record: correlation with clinically important variables : [Documentation sur le dossier anesthésique : corrélation avec les variables cliniques importantes].

Purpose: A survey was undertaken at a single Academic Health Sciences Centre to document the opinions of anesthesiologists regarding what variables are important to document on the anesthetic record. A subsequent chart review of anesthetic records was undertaken to determine the extent to which these anesthesiologists record the variables they consider important.

Methods: A survey form was mailed to all practicing staff anesthesiologists at the four adult McGill University affiliated hospitals.

Impact of chronic lisinopril therapy on left atrial volume versus dimension in chronic organic mitral regurgitation.

Background: Chronic mitral regurgitation imparts a volume load on the left atrium (LA). Because this chamber may dilate asymmetrically, changes in left atrial size may be underestimated using standard two-dimensional or M-mode techniques.

Methods: The effect of lisinopril therapy in the setting of chronic organic mitral regurgitation on LA dimension was studied using standard M-mode techniques and LA volumes using the biplane Simpson's method.

Overexpression of estrogen receptors in columnar cell change and in unfolding breast lobules.

Columnar cell change (CCC) is common and has often been considered of little clinical interest. However, some investigators have suggested that it may be a marker for increased risk of breast cancer. To see whether CCC is subject to hormonal influences, the distribution of estrogen receptors (ER) was determined in a series of breast specimens showing this change.

Retinoic acid mediates degradation of IRS-1 by the ubiquitin-proteasome pathway, via a PKC-dependant mechanism.

Insulin receptor substrate-1 (IRS-1) mediates signaling from the insulin-like growth factor type-I receptor. We found that all-trans retinoic acid (RA) decreases IRS-1 protein levels in MCF-7, T47-D, and ZR75.1 breast cancer cells, which are growth arrested by RA, but not in the RA-resistant MDA-MB-231 and MDA-MB-468 cells.

Long-term changes in defense styles with psychodynamic psychotherapy for depressive, anxiety, and personality disorders.

Objective: This study examined 1) whether patients with chronic and recurrent anxiety and depressive disorders and/or personality disorders demonstrate improvement in their defense styles with long-term dynamic psychotherapy and 2) what the relationship is between defense style change and symptomatic change.

Method: Measures of defense (Defense Style Questionnaire) and symptoms and functioning were administered at regular intervals over the course of 3-5 years to adults who entered a naturalistic study of long-term psychodynamic psychotherapy. With hierarchical linear regression, the relative contributions of change in variables on the Defense Style Questionnaire to change in other outcome variables were calculated.

Double-blind randomized, placebo-controlled study of pilocarpine to salvage salivary gland function during radiotherapy of patients with head and neck cancer.

Objective: The efficacy of pilocarpine given during radiotherapy for head-neck cancer to reduce xerostomia was assessed.

Study Design: 58 patients receiving 5000 cGy radiotherapy (RT) involving salivary glands bilaterally were selected at the Jewish General Hospital, Montreal, Canada. Patients were randomly assigned to pilocarpine (5 mg, PILO, n=29) or placebo group (PLA, n=29).

Solitary fibrous tumor of the ischioanal fossa: report of a case and review of the literature.

Solitary fibrous tumor of the ischioanal fossa is a rare neoplasm. To our knowledge, this is the first report of a solitary fibrous tumor in the ischioanal fossa. The presentation and symptomatology are presented.

Retinoic acid-induced growth arrest of MCF-7 cells involves the selective regulation of the IRS-1/PI 3-kinase/AKT pathway.

In the MCF-7 breast cancer cell line, insulin-like growth factors (IGFs) are known to elicit antiproliferative actions via the insulin receptor substrate-1 (IRS-1)/PI 3-kinase/AKT pathway. All-trans retinoic acid (RA) is a potent inhibitor of MCF-7 cell proliferation, but the mechanism by which growth regulation is achieved remains unclear. We investigated the effects of RA on the regulation of the IGF-IR and its key signaling elements: IRS-1, IRS-2, and SHC.

Response to histone deacetylase inhibition of novel PML/RARalpha mutants detected in retinoic acid-resistant APL cells.

Resistance to all-trans retinoic acid (ATRA) remains a clinical problem in the treatment of acute promyelocytic leukemia (APL) and provides a model for the development of novel therapies. Molecular alterations in the ligand-binding domain (LBD) of the PML/RARalpha fusion gene that characterizes APL constitute one mechanism of acquired resistance to ATRA. We identified missense mutations in PML/RARalpha from an additional ATRA-resistant patient at relapse and in a novel ATRA-resistant cell line, NB4-MRA1.

Readmission for small-bowel obstruction in the early postoperative period: etiology and outcome.

Objectives: To determine the frequency of readmission for early postoperative small-bowel obstruction (SBO), to highlight factors that may predispose to this condition, to define the risks of strangulation and to compare the immediate and long-term risks and benefits of operative versus nonoperative treatment.

Design: A chart review.

Setting: The Sir Mortimer B.

Molecular targets of arsenic trioxide in malignant cells.

Arsenic trioxide (As2O3; ATO) has considerable efficacy in the treatment of relapsed acute promyelocytic leukemia (APL), inducing partial differentiation and promoting apoptosis of malignant promyelocytes. Although initial studies focused on the role of the characteristic APL fusion protein, PML-RARalpha, in mediating response to ATO, subsequent investigations have revealed that ATO acts on numerous intracellular targets. ATO broadly affects signal transduction pathways and causes a wide range of alterations leading to apoptosis.

The course of postpartum psychiatric disorders in women and their partners.

This study examined the course of postpartum psychiatric disorders in a community sample of mothers and their partners to determine whether sociodemographic variables, life stress, and psychiatric history were related to persistence of mental health problems. At 6 months postpartum, 48 index couples where the wife had a psychiatric disorder at 2 months postpartum and 50 control couples with no such diagnosis underwent diagnostic interviews and completed questionnaires on psychological symptoms, life stress, and treatment history. The results indicate that at follow-up, 54% of the index mothers still had a psychiatric diagnosis, as did 60% of their partners who had had a psychiatric diagnosis at 2 months postpartum.

Novel operative management of primary mesenteric volvulus.

Mesenteric volvulus is a potentially life-threatening condition. Little information is available for the recommended treatment of viable bowel and virtually no information is available for the suggested elective treatment of a mesenteric volvulus. This communication details a series of enteropexies that were successful in the management of this disorder.

The dramatic presentation of colonic lipomata: report of two cases and review of the literature.

Colonic lipoma with a dramatic presentation requiring urgent operation is a rare occurrence. We report two such cases in conjunction with a review of the literature on colonic lipomata. Clinicopathologic features of two patients who required urgent resection were studied.

Role of molecular diagnostic testing in familial adenomatous polyposis and hereditary nonpolyposis colorectal cancer families.

Purpose: Genetic tests are available for familial adenomatous polyposis and hereditary nonpolyposis colorectal cancer. The goal of this review was to develop an algorithm for application of molecular diagnostic techniques to the management of hereditary colorectal carcinoma and to familiarize the clinician with the vocabulary of molecular genetic testing for hereditary colorectal carcinoma.

Methods: Studies examining the clinical use of genetic testing for hereditary colorectal carcinoma syndromes are evaluated.