Risk for alcohol use problems in severe mental illness: Interactions with sex and racial/ethnic minority status

BACKGROUND

Alcohol use disorder (AUD) is exceedingly common among individuals with bipolar disorder and schizophrenia. However, studies on alcohol use in psychiatric illness rely largely on population surveys with limited representation of severe mental illness (SMI); schizophrenia and bipolar disorder.

METHODS

Using data from the Genomic Psychiatry Cohort (GPC) (Pato MT, 2013), associations of bipolar disorder and schizophrenia with alcohol use problems were examined in a diverse US based sample, considering the influence of self-described race (African Ancestry (AA), European Ancestry (EA), or Latinx Ancestry (LA)), sex, and tobacco use. Participants answered alcohol use problem items derived from the CAGE instrument, yielding a summed "probable" alcohol use disorder (pAUD) risk score.

RESULTS

This study included 1952 individuals with bipolar disorder with psychosis (BDwP), 409 with bipolar disorder without psychosis (BD), 9218 with schizophrenia (SCZ), and 10,416 unaffected individuals. We found that SMI (BDwP, BD, SCZ) was associated with elevated AUD risk scores (B = 0.223, p < 0.001), an association which was strongest in females, particularly those of AA and LA, and in tobacco users. Schizophrenia was associated with the greatest increase in pAUD score (B = 0.141, p < 0.001). pAUD risk scores were increased among participants with bipolar disorder, with greater increases in BDwP (B = 0.125, p < 0.001) than in BD without psychosis (B = 0.027, p < 0.001).

LIMITATIONS

Limitations include reliance on self-report data, screening items for AUD, voluntary recruitment bias, and differences in race/sex distribution between groups, which were statistically adjusted for in analytic models.

CONCLUSIONS

SMI is associated with risk for AUD, particularly among females from racial minority groups, smokers, and those with psychotic disorders.

Contributions of common genetic variants to risk of schizophrenia among individuals of African and Latino ancestry

Schizophrenia is a common, chronic and debilitating neuropsychiatric syndrome affecting tens of millions of individuals worldwide. While rare genetic variants play a role in the etiology of schizophrenia, most of the currently explained liability is within common variation, suggesting that variation predating the human diaspora out of Africa harbors a large fraction of the common variant attributable heritability. However, common variant association studies in schizophrenia have concentrated mainly on cohorts of European descent. We describe genome-wide association studies of 6152 cases and 3918 controls of admixed African ancestry, and of 1234 cases and 3090 controls of Latino ancestry, representing the largest such study in these populations to date. Combining results from the samples with African ancestry with summary statistics from the Psychiatric Genomics Consortium (PGC) study of schizophrenia yielded seven newly genome-wide significant loci, and we identified an additional eight loci by incorporating the results from samples with Latino ancestry. Leveraging population differences in patterns of linkage disequilibrium, we achieve improved fine-mapping resolution at 22 previously reported and 4 newly significant loci. Polygenic risk score profiling revealed improved prediction based on trans-ancestry meta-analysis results for admixed African (Nagelkerke's R2 = 0.032; liability R2 = 0.017; P < 10-52), Latino (Nagelkerke's R2 = 0.089; liability R2 = 0.021; P < 10-58), and European individuals (Nagelkerke's R2 = 0.089; liability R2 = 0.037; P < 10-113), further highlighting the advantages of incorporating data from diverse human populations.

Challenges and Opportunities to Meet the Mental Health Needs of Underserved and Disenfranchised Populations in the United States

This article investigates the gap in access to and quality of mental health care in the United States. This work first discusses how minority populations are most affected by the treatment gap. It summarizes recent literature on the topic for better understanding the needs of psychiatrically underserved and disenfranchised populations and the causes of mental health disparities. It reviews some of the barriers to behavioral health care, including lack of insurance coverage, lack of community-based interventions, unequal access to evidence-based practices, stigma, mental health workforce shortages, and geographical maldistribution of providers. Second, it reviews opportunities to address these disparities. The article provides examples of effective interventions that researchers worldwide have already implemented to address the gap of mental health services within the collaborative care model and global mental health initiatives. Telepsychiatry and improvements in training of the mental health workforce are also listed as useful implementations to overcome the treatment gap for patients seeking mental health care.

Anti-calculus efficacy of Periogen® oral rinse in gingivitis patients

Dental biofilm is a complex, organized microbial community that is the primary etiologic factor for plaque, the most frequently occurring oral contamination for gingivitis, dental caries and periodontal diseases. In dentistry, calculus is a form of hardened dental plaque, caused by precipitation of calcium (Ca) and phosphorous (P) ions deposited from saliva and gingival crevicular fluid. Although the dental biofilm cannot be eliminated, it can be controlled with comprehensive mechanical and chemotherapeutic oral hygiene practices. Chemotherapeutic agents have difficulty penetrating the polysaccharide matrix to reach and affect the microorganisms. The purpose of the present study was to evaluate the anti-calculus efficiency of a mouthwash containing an association of sodium tripolyphosphate, tetrapotassium pyrophosphate, sodium bicarbonate and citric acid in patients affected with gingivitis.

Prognostic significance of miR-215 in colon cancer

BACKGROUND

We have previously shown that miR-215 suppressed the expression of key targets such as thymidylate synthase (TS), dihydrofolate reductase, and denticleless protein homolog (DTL) in colon cancer. miR-215 is a tumor suppressor candidate due to the upregulation of p53 and p21 by targeting DTL. However, high levels of miR-215 conferred chemoresistance due to cell cycle arrest and reduced cell proliferation by suppressing DTL. In this study, the clinical significance of miR-215 was further investigated as a potential prognostic biomarker in colon cancer patients.

METHODS

Total RNAs were extracted from 34 paired normal and colon (stage II and III) tumor specimens using the Trizol-based approach. The levels of miR-215 and a closely related miR-192 were quantified using quantitative real-time polymerase chain reaction (qRT-PCR) expression analysis. The expression of DTL mRNA and protein were quantified by real time qRT-PCR and immunohistochemistry.

RESULTS

The expression levels of miR-192 (P = .0008) and miR-215 (P < .0001) were significantly decreased in colon tumors compared with normal tissues. DTL was significantly over-expressed and was inversely correlated with miR-215, further suggesting an in vivo physiologic relevance of miR-215 mediated DTL suppression. Kaplan-Meier survival analysis by Cox regression revealed that high levels of miR-215 expression (hazard ratio, 3.516; 95% confidence interval, 1.007-12.28, P = .025) are closely associated with poor patient's overall survival. Furthermore, an elevated expression of a miR-215 target protein DTL was detected in colon cancer tissues whereas no expression was present in normal tissues.

CONCLUSION

miR-215 has a unique potential as a prognostic biomarker in stage II and III colon cancer.

Abstract 2263: Prognostic significance of miR-215 in colon cancer

Background: We have previously shown that miR-215 suppressed the expression of key targets such as thymidylate synthase (TS), dihydrofolate reductase (DHFR), and denticleless protein homolog (DTL) in colon cancer. miR-215 is a tumor suppressor candidate due to the up-regulation of p53 and p21 by targeting DTL. However, high levels of miR-215 conferred chemoresistance due to cell cycle arrest and reduced cell proliferation by suppressing DTL. In this study, the clinical significance of miR-215 was further investigated as a potential prognostic biomarker in colon cancer patients.

Methods: Total RNAs were extracted from 34 paired normal and colon (stage II and III) tumor specimens using Trizol based approach. The levels of miR-215 and a closely related miR-192 were quantified using real time qRT-PCR expression analysis. The expression of DTL mRNA and protein were quantified by real time qRT-PCR and immunohistochemistry.

Results: The expression levels of miR-192 (p=0.0008) and miR-215 (p&lt;0.0001) were significantly decreased in colon tumors compared to normal tissues. DTL was significantly over-expressed and was inversely correlated with miR-215, further suggesting an in vivo physiological relevance of miR-215 mediated DTL suppression. Kaplan-Meier survival analysis revealed that high levels of miR-215 expression (hazard ratio, 0.36; log rank test, p=0.04) are closely associated with poor patient's overall survival. Furthermore, an elevated expression of a miR-215 target protein DTL was detected in colon cancer tissues while no expression was present in normal tissues.

Conclusion: miR-215 has a unique potential as a prognostic and diagnostic biomarker in stage II and III colon cancer.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 2263. doi:10.1158/1538-7445.AM2011-2263

Abstract 158: Expression of miR-205 is significantly associated with prognosis of endometrial cancer

Background: microRNAs (miRNAs) have emerged as key regulators of gene expression, and their altered expression has been associated with tumorigenesis and tumor progression. As a result, miRNAs represent important diagnostic biomarkers for the advancement of cancer and potential therapeutic approaches. They may be up-regulated or down-regulated in various tumor types, thus act as oncogenes or tumor suppressors. Although accumulating evidence suggests the role of aberrant miRNA expression in endometrial carcinogenesis, there is still limited data available about the endrometrial miRNAs. Endometrial cancer is characterized by frequently infiltrating tumors, and one of the most important molecular alterations in this process is through epithelial-mesencymal transition (EMT). Several studies implicated the role of miRNAs targeting the critical players during EMT. The goal of this study is to investigate the clinical utility of selected key miRNAs in archival FFPE tissue samples of patients with endometrial cancer. In this study, the expression of miR-26a, miR-205, miR-200c, miR-192, miR-215, let-7g, miR-21, miR-181b were quantified from 20 stage I, 2 stage II, 5 stage III, 8 stage IV endometrial cancer patients (endometrioid-type endometrial cancer (EEC), endometrial serous carcinoma(ESC), clear cell carcinoma(CCC) undifferentiated carcinoma (UDC), malignant mullerian mixed tumor (MMMT)) with up to 15 years clinical follow up information.

Methods: Using archival FFPE tissues, areas of tumor and normal tissues were identified according to the corresponding hematoxylin and eosin stained sections, and cores of 1.5 mm in diameter were extracted. Total RNAs were isolated from 35 paired endometrial tumor and adjacent normal tissue specimens by using Trizol based approach. The expression levels of miRNAs were quantified by using real-time qRT-PCR analysis.

Results: The expression of miR-205 (p=0.0002) and miR-200c (p&lt;0.0001) were significantly elevated in endometrial cancer tissue specimens when compared to adjacent normal tissues. Kaplan-Meier survival analysis indicated that low levels of miR-205 expression (hazard ratio, 0.309; log rank test, p=0.018) is closely associated with better patient's overall survival.

Conclusions: miR-205 holds a great potential as a prognostic biomarker in endometrial cancer.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 158. doi:10.1158/1538-7445.AM2011-158

Recoveries of four representative organophosphorus pesticides from 18 plant products belonging to different botanical categories: Implications for matrix effects

A study of the matrix effect was performed in order to evaluate the influence of some matrices on the gas chromatographic responses of representative organophosphorus insecticides. In particular, three fortification levels and the maximum residual level of four organophosphorus pesticide standard solutions were added into 18 matrices (15 belonging to five specific botanical categories and three botanically unclassified). The recoveries of the examined pesticides were determined using a simple official multiresidue method of detection, without any additional clean-up step. Recoveries were estimated based on standards prepared in solvent. The recovery percentages of the most polar pesticides, especially methamidophos (20.2-288.4%), were much higher than those of non-polar ones (chlorpyrifos and methidathion 25.7-136.4 and 37.6-292.6%, respectively), except for quince. Pronounced matrix effects (>120%) were observed to the lowest fortification levels (maximum residual levels established by the European Union), of dimethoate and methamidophos (i.e. the most polar analytes) in the majority of product extracts. Furthermore, it was proved that there is no correlation between the classification of plant products, according to their botanical characteristics, and the recoveries of pesticides in the equivalent extracts. Indeed, there were significant differences in the recoveries of pesticides in extracts, derived from matrices belonging to the same botanical group (especially in the categories of pome fruits and citrus). Consequently, it was shown that, under the examined conditions, obtaining recovery data, derived from only one representative matrix, with the purpose to validate an official method in its botanical category is, possibly, an erroneous practice.

Immunity to tetanus of a rural population in a Greek county

Tetanus is still a common problem in countries with poor health conditions. On the contrary, where there is a systematic program of vaccination in children it is very rare. The aim of this study was to check the immunity level of a representative sample of rural people from villages of Achaia County in Southern Greece. Samples were taken from 140 locals during a six-month period (January till July 2002). In each sample, we estimated IgG antibodies against Clostridium tetani toxin. A protection level of 0.1 IU/ml was set. 15.7% of the people had sufficient immunization cover while a statistically significant superiority of immunized men was found. The results of this study revealed low immunity percentage of the examined inhabitants and a vaccination program against the disease has been proposed to the local health authorities.

The role of the flight surgeon in Greece

From 1915 [corrected], the first time a flight surgeon participated in an aeromedical evacuation, to the present, the role has become more fundamental by working in wars and operations, experiencing search and rescue aeromedical evacuations from mass accidents or motor accidents, treating seriously ill individuals, and caring for wounded victims of attacks either at the scene or at the hospital. The improvements in cognitive and technological standards of medical science and in the education available have contributed in upgrading the role of flight surgeons; however, their presence in flight is considered essential in 20-60% of aeromedical evacuations, with the remainder of the flights being covered by paramedical personnel. In the Greek territory, the development of Air Force medicine began with the U.S. education of Panagiotis Korombilis, founder of the Center for Flight Crew Health Examination in 1936. In 1976, the Air Force Medical Center was established in the General Air Force Hospital while the educational and medical work of Air Force physicians led to the development of Air Force Medicine and supported Olympic Airways and Military Air Force development, which provides aircraft and personnel for patient aeromedical evacuations. An organized aeromedical evacuation system based on the National Health System, however, began operating in 1982 and was upgraded in 1994. Currently, the flight surgeon's work remains important in supporting the Military Air Force by offering regular examinations at the Air Force Medical Center for all personnel flying on civil and military aircrafts, and by educating all the Greek territory and Cypriot Air Force surgeons (of the National Emergency Assistance Center and the Military Services) at the Air Force Medical Center. Their presence at Air Force bases is important, as is their support of the overall well-being of flight personnel, their assistance in upholding the territory's future by improving aircraft and equipment and by purchasing search-rescue aeromedical evacuation helicopters and hospital aeromedical transportation aircraft capable of transporting seriously ill patients, their promotion of collaboration with other countries in educating Air Force surgeons, and in support of valuable human life according to the Hippocratic Oath.

Ceftriaxone distribution between maternal blood and fetal blood and tissues at parturition and between blood and milk postpartum

The penetration of ceftriaxone into the fetus at parturition was studied in 17 subjects. Despite its high protein binding, ceftriaxone quickly reached the umbilical cord blood, amniotic fluid, and placenta, achieving substantial concentrations, which then disappeared, with elimination half-lives of approximately 6 h, identical to that of the mother. The elimination half-life of ceftriaxone of 5 to 6 h in these mothers was somewhat shorter than that reported for normal subjects. The concentrations of ceftriaxone achieved in fetal tissues were sufficient for therapeutic effects. The penetration of ceftriaxone into milk was studied 3 days postpartum in 20 other patients. This antimicrobial agent entered breast milk rapidly and disappeared with a half-life of 12 to 17 h. The concentrations achieved were only 3 to 4% of those in maternal serum and were most likely of little clinical relevance.