No description available.

The purpose of the present study was to develop a measure of the Emotional Antecedents of Alcohol Use (EAAU) and investigate its psychometric properties. Focus groups and three pilot studies were conducted to develop and define the construct of alcohol consumption as a means of emotion regulation. Items were written based upon focus group results, existing published instruments, and a review of the literature. Independent raters evaluated the initial item pool for face validity and the initial EAAU was given to small pilot samples (N=64, N=39) to investigate initial internal consistency and content validity. Results of pilot studies suggested that the EAAU is a valid measure of alcohol consumption and positively associated with the Alcohol Use Disorders Identification Test (AUDIT; r = 0.445, p < .001; r = 0.607, p < .001). The EAAU was then administered to a larger sample (N=301) to investigate the structure of the instrument. Exploratory factor analysis results implied that a 14-factor model was the best fitting and most parsimonious and sufficient factor solution to represent the structure of the EAAU scores produced by the current sample. These 14 distinct emotional domains were interpreted as representing the following: (1) Relaxation, (2) Fear/Worry, (3) Reservation, (4) Negative High Arousal, (5) Shock, (6) Sedation, (7) Sadness, (8) Fatigue, (9) Anger, (10) Happiness, (11) Alertness, (12) Annoyance, (13) Serenity, and (14) Positive High Arousal. Results suggested the EAAU demonstrates convergent validity as small to moderate positive relationships were noted between the EAAU and measures of alcohol expectancies (r = 0.374, p < .001) and alcohol-related problems (r = 0.292, p < .001). Results supported marginal discriminant validity of the EAAU as negligible to small negative relationships were noted between the EAAU and a measure of self-esteem (r = -0.157, p = .007). Additionally, the EAAU demonstrated initial evidence of predictive validity as EAAU subscale scores were found to be predictive of difficulties in emotion regulation (R2 = .128, F(14, 286) = 2.991, p < .001) and alcohol consumption (R2 = .111, F(14, 286) = 2.539, p = .002). Lastly, gender and drinker status differences in EAAU scores were found. Males (M=267.74, SD=80.07) were found to obtain higher EAAU scores (t(290) = -2.59, p = .010) in comparison to women (M=244.47, SD=73.26), while problem drinkers (M=281.21, SD=69.81) were found to obtain higher EAAU scores (t(299) = 7.459, p < .001) in comparison to social drinkers (M=218.87, SD=74.61). Study limitations, implications, and future research directions are discussed.

Background. Clear cell sarcoma of the kidney (CCSK) is known for its propensity to metastasize to bone, but it also spreads to other sites including the brain. This study was undertaken to describe the treatment and outcomes of patients with recurrent CCSK involving the brain. Methods. A retrospective records review was conducted on eight patients with CCSK who developed brain metastases after complete responses to initial therapy. Results. The recurrences occurred at a median of 24.5 months after initial diagnosis (range, 12-53 months). At the time of recurrence, patients were treated with multimodal therapy including biopsy or resection, radiation therapy, and chemotherapy. All patients received a variable number of courses of ifosfamide, carboplatin, and etoposide (ICE), with or without other agents. Four patients received high-dose chemotherapy with autologous stem cell rescue. One patient died from complications of bacteremia 8 weeks after starting chemotherapy. The other seven patients achieved a complete response after either surgery or ICE chemotherapy. Of these, six patients were alive without disease with a median follow-up of 30 months from the time of recurrence (range, 24 to 71 months). All six survivors received radiation therapy and four had gross total resections. Three survivors received high-dose chemotherapy with stem cell rescue. Conclusion. Patients with recurrent CCSK involving the brain can have durable survival after recurrence. ICE chemotherapy, together with radiation therapy and surgery, provides a reasonable salvage regimen for recurrent CCSK. It is unclear whether high-dose chemotherapy confers a benefit compared to conventional-dose chemotherapy.

No description available.

Colorectal cancer (CRC) is common in Ontario. This study described the processes of care following CRC resection, and identified CRC relapse from administrative data. Methods: CRC patients aged 18-80 from 1996-2001 with a colorectal resection were identified from the Ontario Cancer Registry. Linked discharge abstracts and physician billings were examined for physician visits, body imaging and endoscopy over the 5 year follow-up period. Administrative codes suggesting disease relapse were compared with patient charts. Results: Overall, 12,804 patients were identified and 8,804 had no evidence of relapse. Most (96.2%) patients had general practitioner follow-up, while 49.3% had medical oncology and 80.4% had general surgery follow-up. Greater than 90% of patients received endoscopy, while only 68.7% of patients received body imaging. Detecting disease relapse was 87.5% sensitive and 93.0% specific. Conclusions: There is potential for improving post-resectional follow-up in CRC patients. It is possible to detect relapse through administrative databases.

Background: Sputum culture conversion at two months is an important indicator for the effectiveness of treatment and the infectivity of a patient with pulmonary TB. This study aimed at investigating factors that are associated with tuberculosis culture conversion at two months as well as investigating whether sputum culture conversion at two months is a reliable predictor of relapse. Methods: The study makes use of data obtained from 347 newly diagnosed tuberculosis patients who participated in a randomized placebo controlled immunotherapy trial at King George V hospital in Durban. Above objectives were met by carrying out statistical analysis of the secondary data. Chi-square tests for categorical explanatory variables such as HIV status and smoking status and (b) t-tests for continuous variables such as age were used for investigating factors associated with 2-month culture conversion. Multivariate models were used to find the most important variables for predicting 2-month culture conversion. Kaplan Meier curves were used for investigating whether culture conversion at two months is a reliable predictor of relapse. Findings: Of the 347 tuberculosis patients, 34 % were HIV sero-positive. Age, body mass index (BMI), smoking status and gender were found to be important variables that affect sputum culture conversion at two months. At 5 % significance level there was no evidence that those who culture convert at two months were less likely to relapse than those who had not culture converted at two months (p=0.1165). However the trend shown is striking to report as it may be of clinical significance. Among those who had not culture converted at two months, more people (40) than expected (34) relapsed an among those who had culture converted at to months, less people (19) than expected (24) relapsed. Interpretation and recommendations: Some behavioral and biological factors affect two month tuberculosis culture conversion therefore successful tuberculosis management need to take into account the effect of these factors. This study did not show that the sterilizing potential of an anti-tuberculosis regimen can be obtained by evaluation of the culture conversion rates at two months and this may be due to small sample size.

Proposição: O objetivo deste estudo foi avaliar a estabilidade das relações oclusais e da correção do apinhamento anteroinferior em curto e longo prazo, 5 e 35 anos póstratamento. Material e métodos: A amostra constituiu-se de 28 pacientes, sendo 15 Classe I e 13 Classe II, tratados com extrações de 4 pré-molares, com idade inicial média de 12,72 anos (d.p.= 0,99), idade final de 14,74 anos (d.p.=1,26), e um tempo de tratamento médio de 2,02 anos (d.p.=0,66). A idade média em curto prazo póstratamento foi de 20,15 anos (d.p.=1,34), e em longo prazo foi de 49,40 anos (d.p.=4,54). A média do tempo de avaliação em curto prazo pós-tratamento foi de 5,40 anos (d.p.=0,43) e em longo prazo foi de 34,65 anos (d.p.=4,25). Foram avaliados, nos modelos de estudo das fases inicial, final e em curto e longo prazo pós-tratamento, os índices PAR e de irregularidade de Little. Após a realização da estatística descritiva da amostra total, os índices avaliados foram comparados na amostra total entre os 4 tempos avaliados pelo teste ANOVA dependente e de Tukey. Resultados: Houve diferença significante do índice PAR entre as fases inicial, final e em curto e longo prazo pós-tratamento, sem diferença entre as fases em curto e longo prazo pós-tratamento. Houve diferença significante do índice de irregularidade de Little entre todas as fases estudadas, inicial, final, em curto prazo e em longo prazo pós-tratamento. Conclusões: As relações oclusais, avaliadas pelo índice PAR, foram significantemente corrigidas com o tratamento ortodôntico, apresentaram uma recidiva significante em curto prazo e demonstraram permanecer estáveis em longo prazo pós-tratamento. O apinhamento anteroinferior, medido pelo índice de irregularidade de Little, foi significantemente corrigido com o tratamento, apresentou uma recidiva significante em curto prazo, e continuou a sofrer recidiva significante em longo prazo pós-tratamento. / Proposition: The aim of this study was to evaluate the stability of occlusal relationships and correction of mandibular anterior crowding in short and long-term, 5 and 35 years posttreatment. Material and methods: The sample comprised 28 patients, 15 Class I and 13 Class II, treated with 4 premolars extraction, with mean initial age of 12.72 years (s.d.=0.99), final age of 14.74 years (s.d.=1.26) and mean treatment time of 2.02 years (s.d.=0.66). The mean short-term posttreatment age was 20.15 years (s.d.=1.34), and long-term was 49.40 years (s.d.=4.54). The mean time of short-term posttreatment evaluation was 5.40 years (s.d.=0.43) and long-term was 34.65 years (s.d.=4.25). It was assessed, in the dental casts of initial, final and short-term and long-term posttreatment stages, the PAR index and the Little irregularity index. Upon completion of the descriptive statistics of the total sample, these indices were compared for the whole sample among the 4 stages by dependent ANOVA and Tukey tests. Results: There was significant difference among the PAR index in initial, final and short and long-term posttreatment stages, with no difference between the short and long-term posttreatment stages. There was a significant difference in the Little irregularity index among all the stages studied: initial, final, short-term and long-term posttreatment. Conclusions: The occlusal relationships, assessed by PAR index were significantly corrected with orthodontic treatment, showed a significant relapse in the short-term and demonstrated to remain stable in the long-term posttreatment. The mandibular anterior crowding, measured by the Little irregularity index, was significantly corrected with treatment, showed a significant relapse in the short-term, and continued to suffer significant relapse in the long-term posttreatment.

Proposição: O objetivo deste estudo foi avaliar a estabilidade das relações oclusais e da correção do apinhamento anteroinferior em curto e longo prazo, 5 e 35 anos póstratamento. Material e métodos: A amostra constituiu-se de 28 pacientes, sendo 15 Classe I e 13 Classe II, tratados com extrações de 4 pré-molares, com idade inicial média de 12,72 anos (d.p.= 0,99), idade final de 14,74 anos (d.p.=1,26), e um tempo de tratamento médio de 2,02 anos (d.p.=0,66). A idade média em curto prazo póstratamento foi de 20,15 anos (d.p.=1,34), e em longo prazo foi de 49,40 anos (d.p.=4,54). A média do tempo de avaliação em curto prazo pós-tratamento foi de 5,40 anos (d.p.=0,43) e em longo prazo foi de 34,65 anos (d.p.=4,25). Foram avaliados, nos modelos de estudo das fases inicial, final e em curto e longo prazo pós-tratamento, os índices PAR e de irregularidade de Little. Após a realização da estatística descritiva da amostra total, os índices avaliados foram comparados na amostra total entre os 4 tempos avaliados pelo teste ANOVA dependente e de Tukey. Resultados: Houve diferença significante do índice PAR entre as fases inicial, final e em curto e longo prazo pós-tratamento, sem diferença entre as fases em curto e longo prazo pós-tratamento. Houve diferença significante do índice de irregularidade de Little entre todas as fases estudadas, inicial, final, em curto prazo e em longo prazo pós-tratamento. Conclusões: As relações oclusais, avaliadas pelo índice PAR, foram significantemente corrigidas com o tratamento ortodôntico, apresentaram uma recidiva significante em curto prazo e demonstraram permanecer estáveis em longo prazo pós-tratamento. O apinhamento anteroinferior, medido pelo índice de irregularidade de Little, foi significantemente corrigido com o tratamento, apresentou uma recidiva significante em curto prazo, e continuou a sofrer recidiva significante em longo prazo pós-tratamento. / Proposition: The aim of this study was to evaluate the stability of occlusal relationships and correction of mandibular anterior crowding in short and long-term, 5 and 35 years posttreatment. Material and methods: The sample comprised 28 patients, 15 Class I and 13 Class II, treated with 4 premolars extraction, with mean initial age of 12.72 years (s.d.=0.99), final age of 14.74 years (s.d.=1.26) and mean treatment time of 2.02 years (s.d.=0.66). The mean short-term posttreatment age was 20.15 years (s.d.=1.34), and long-term was 49.40 years (s.d.=4.54). The mean time of short-term posttreatment evaluation was 5.40 years (s.d.=0.43) and long-term was 34.65 years (s.d.=4.25). It was assessed, in the dental casts of initial, final and short-term and long-term posttreatment stages, the PAR index and the Little irregularity index. Upon completion of the descriptive statistics of the total sample, these indices were compared for the whole sample among the 4 stages by dependent ANOVA and Tukey tests. Results: There was significant difference among the PAR index in initial, final and short and long-term posttreatment stages, with no difference between the short and long-term posttreatment stages. There was a significant difference in the Little irregularity index among all the stages studied: initial, final, short-term and long-term posttreatment. Conclusions: The occlusal relationships, assessed by PAR index were significantly corrected with orthodontic treatment, showed a significant relapse in the short-term and demonstrated to remain stable in the long-term posttreatment. The mandibular anterior crowding, measured by the Little irregularity index, was significantly corrected with treatment, showed a significant relapse in the short-term, and continued to suffer significant relapse in the long-term posttreatment.

Prescription pain medication abuse is a developing social problem in the United States. This quantitative study, grounded in attachment theory, examined relationships between attachment, perceived social support, and relapse. It was hypothesized that significant relationships existed between (a) attachment dimensions and relapse and (b) perceived social support and relapse. A further hypothesis was that perceived social support was a mediator in the relationship between attachment and relapse. Participants were 69 adult females, each of whom completed a demographic questionnaire; the Advanced Warning of Relapse (AWARE) Questionnaire; the Experiences in Close Relationships, Revised (ECR-R); and the Personal Resource Questionnaire (PRQ). A multiple linear regression was conducted to determine relationships between attachment and perceived social support on relapse. A mediation analysis was conducted to determine whether perceived social support was a mediator between attachment and relapse. Results identified that women with anxious styles of attachment have higher relapse potential and that women with higher levels of perceived social support appeared to have decreased attachment anxiety. Results indicated that women with increased attachment anxiety who also reported higher levels of perceived social support showed a reduced potential to relapse. This research contributes to positive social change by confirming the importance for health professionals to incorporate both attachment theory and the role of social support into treatment modalities to prevent relapse and to increase public awareness about these psychological factors of prescription pain medication addiction.

There has been concern about the impact of cannabis use on the onset, course and relapse of psychosis. Evidence from retrospective and a small number of prospective studies has suggested that cannabis use may precipitate a latent psychosis, exacerbate psychotic symptoms and increase the likelihood of psychotic relapse. The purpose of the current study was to examine the influence of cannabis use on psychotic symptom exacerbation and relapse within the stress vulnerability-coping model of psychosis. Two studies were conducted. The influence of cannabis use on the onset and course of psychosis was retrospectively examined in the first study. The second study prospectively examined the influence of cannabis use on psychotic symptom exacerbation and relapse over a 6-month period. The influence of the severity of psychotic symptoms on a relapse in cannabis use was also explored. Eighty-four participants were assessed at admission, 81 of whom were followed up for a 6-month period. Measures consisted of structured diagnostic interviews and self-report measures of stress, medication compliance, family functioning, premorbid adjustment, quality of life, substance use and psychotic symptoms. The onset of cannabis use clearly preceded the onset of psychosis. Cannabis use was predictive of the severity of psychotic and general psychopathology symptoms at admission. Both the frequency and quantity of cannabis use was predictive of time to psychotic relapse over the 6-month follow up period. Psychotic symptom severity was predictive of a substantial increase in the quantity but not the frequency of cannabis use. Cannabis use was related to the onset, course and relapse of psychosis.