Integrated screening and testing for TB and COVID-19 in Peru

We describe the experience of integrating COVID-19 screening and testing into a mobile TB screening unit in Lima, Peru. All attendees received chest radiographs, which were analysed using CAD4TB and CAD4COVID; Xpert MTB/RIF Ultra was used to test for TB, and antibody and polymerase chain reaction (PCR) for SARS-CoV-2. One Xpert-positive TB case was diagnosed per 168 people screened, one person with SARS-CoV-2 antibodies per 3 people screened, and one PCR-confirmed SARS-CoV-2 infection per 8 people screened. Integrated screening can help to avoid delays in the diagnosis of both TB and COVID-19.

Divergent abiotic spectral pathways unravel pathogen stress signals across species

Plant pathogens pose increasing threats to global food security, causing yield losses that exceed 30% in food-deficit regions. Xylella fastidiosa (Xf) represents the major transboundary plant pest and one of the world's most damaging pathogens in terms of socioeconomic impact. Spectral screening methods are critical to detect non-visual symptoms of early infection and prevent spread. However, the subtle pathogen-induced physiological alterations that are spectrally detectable are entangled with the dynamics of abiotic stresses. Here, using airborne spectroscopy and thermal scanning of areas covering more than one million trees of different species, infections and water stress levels, we reveal the existence of divergent pathogen- and host-specific spectral pathways that can disentangle biotic-induced symptoms. We demonstrate that uncoupling this biotic-abiotic spectral dynamics diminishes the uncertainty in the Xf detection to below 6% across different hosts. Assessing these deviating pathways against another harmful vascular pathogen that produces analogous symptoms, Verticillium dahliae, the divergent routes remained pathogen- and host-specific, revealing detection accuracies exceeding 92% across pathosystems. These urgently needed hyperspectral methods advance early detection of devastating pathogens to reduce the billions in crop losses worldwide.

Sources and fates of perchlorate in soils in Chile: A case study of perchlorate dynamics in soil-crop systems using lettuce (Lactuca sativa) fields

Perchlorate occurs naturally in the environment in deposits of nitrate and can be formed in the atmosphere and precipitate into soil. However, little is known about the occurrence and levels of perchlorate in soils and fertilizers in Chile and its impacts on agricultural systems and food safety. In this study, concentrations of perchlorate were determined in 101 surface soils and 17 fertilizers [nitrogenous (n = 8), nitrogen-phosphorous-potassium (NPK; n = 3), phosphate (n = 2) and non-nitrogenous (n = 4)] collected across Chile from 2017 to 2018. Our results show that perchlorate was detected mainly in agricultural soils (mean: 0.32 ng g-1), grassland rotation sites (0.41 ngg-1) and urban locations (0.38 ng g-1). Interestingly, elevated concentrations of perchlorate (9.66 and 54.0 ng g-1) were found in agricultural soils. All fertilizers contained perchlorate: nitrogenous fertilizers (mean: 32.6 mg kg-1), NPK (mean: 12.6 mg kg-1), non-nitrogenous fertilizers (mean: 10.2 mg kg-1) and phosphates (mean: 11.5 mg kg-1). Only one type of nitrogenous fertilizer (KNO3: 95.3 mg kg-1) exceeded the international regulation limit (50 mg kg-1). For two agronomic practices, the content of perchlorate in lettuce increased as the fertilizer application rate increased, with fertigation promoting a more significant accumulation. However, the concentrations generally remained below regulatory values. Our results suggest that fertilizers constitute an important source of perchlorate in soils.

Previsual symptoms of Xylella fastidiosa infection revealed in spectral plant-trait alterations

Plant pathogens cause significant losses to agricultural yields and increasingly threaten food security¹, ecosystem integrity and societies in general^2-5. Xylella fastidiosa is one of the most dangerous plant bacteria worldwide, causing several diseases with profound impacts on agriculture and the environment⁶. Primarily occurring in the Americas, its recent discovery in Asia and Europe demonstrates that X. fastidiosa's geographic range has broadened considerably, positioning it as a reemerging global threat that has caused socioeconomic and cultural damage^7,8. X. fastidiosa can infect more than 350 plant species worldwide⁹, and early detection is critical for its eradication⁸. In this article, we show that changes in plant functional traits retrieved from airborne imaging spectroscopy and thermography can reveal X. fastidiosa infection in olive trees before symptoms are visible. We obtained accuracies of disease detection, confirmed by quantitative polymerase chain reaction, exceeding 80% when high-resolution fluorescence quantified by three-dimensional simulations and thermal stress indicators were coupled with photosynthetic traits sensitive to rapid pigment dynamics and degradation. Moreover, we found that the visually asymptomatic trees originally scored as affected by spectral plant-trait alterations, developed X. fastidiosa symptoms at almost double the rate of the asymptomatic trees classified as not affected by remote sensing. We demonstrate that spectral plant-trait alterations caused by X. fastidiosa infection are detectable previsually at the landscape scale, a critical requirement to help eradicate some of the most devastating plant diseases worldwide.

ACVIM small animal consensus statement on safe use of cytotoxic chemotherapeutics in veterinary practice

The purpose of this report is to offer a consensus opinion of ACVIM oncology diplomates and technicians on the safe use of cytotoxic chemotherapeutics in veterinary practice. The focus is on minimizing harm to the personnel exposed to the drugs: veterinary practitioners, veterinary technicians, veterinary staff, and pet owners. The safety of the patient receiving these drugs is also of paramount importance, but is not addressed in this statement. Much of the information presented is based on national recommendations by Occupational Safety and Health Administration, National Institute for Occupational Safety and Health, United States Pharmacopeia, and other published regulations. These directives reflect an abundance of caution to minimize exposure to medical personnel, but large-scale studies about the consequences of long-term occupational exposure are not available in veterinary medicine. Challenges in the delivery of optimal treatment safely and economically to veterinary patients in general practice without access to a veterinary oncologist or other specialist, because of costs or proximity, remain.

Gestational diabetes as a risk factor for pancreatic cancer: a prospective cohort study

BACKGROUND

Diabetes is known to be associated with cancer of the pancreas, though there is some debate as to whether it is a cause or a consequence of the disease. We investigated the incidence of pancreatic cancer in a cohort of 37926 Israeli women followed for 28-40 years for whom information on diabetes had been collected at the time they gave birth, in 1964-1976, in Jerusalem. There were 54 cases of pancreatic cancer ascertained from the Israel Cancer Registry during follow-up.

METHODS

We used Cox proportional hazards models to adjust for age at baseline and explore effects of other risk factors, including ethnic groups, preeclampsia, birth order and birth weight of offspring.

RESULTS

We observed no cases of pancreatic cancer in the women with insulin dependent diabetes; however, there were five cases in the women with gestational diabetes. The interval between the record of diabetes in pregnancy and the diagnosis of pancreatic cancer ranged from 14-35 years. Women with a history of gestational diabetes showed a relative risk of pancreatic cancer of 7.1 (95% confidence interval, 2.8-18.0).

CONCLUSION

We conclude that gestational diabetes is strongly related to the risk of cancer of the pancreas in women in this population, and that gestational diabetes can precede cancer diagnosis by many years.

Late fetal death in offspring and subsequent incidence of prostate cancer in fathers: the Jerusalem Perinatal Study cohort

BACKGROUND

Little is known of the causes of prostate cancer and few previous studies have investigated men's reproductive histories in relation to this disease. We sought to determine whether risk of prostate cancer was altered in men who had fathered stillborn offspring.

METHODS

We studied the incidence of prostate cancer (N = 252) in a cohort of 15,268 fathers followed for 28-41 years from the birth of a live offspring, whose wives participated in one of two separate surveys of outcomes of previous births. Proportional hazards models were used to estimate relative risks (RR) associated with previous stillbirths, controlling for changes in incidence over time, social and occupational factors.

RESULTS

The 543 men with one or more stillborn offspring experienced an increased risk of prostate cancer (adjusted RR = 1.87, 95% confidence interval = 1.17-3.00, P = 0.0095), compared to men without stillbirths. With one reported stillbirth, the RR was 1.68 (0.99-2.84); with two or more, the RR was 3.29 (1.22-8.88). Results were consistent in men whose wives were interviewed in 1965-1968 and 1974-1976. In 100 fathers with no male offspring and at least one stillbirth the RR was 4.04 (1.87-8.71, P = 0.0004).

CONCLUSIONS

These findings should be considered hypothesis-generating and require confirmation in other studies. They suggest that stillbirth and prostate cancer may have shared environmental causes; alternatively, genetic susceptibility to prostate cancer might increase the risk of a stillbirth in offspring.

The Language Proficiency Profile-2: Assessment of the Global Communication Skills of Deaf Children Across Languages and Modalities of Expression

Data are presented from two studies that investigate the developmental trends and concurrent validity of a measure of language and communication skills for deaf children, the Language Proficiency Profile-2 (LPP-2), developed by Bebko and McKinnon (1993). The LPP-2 was designed to evaluate the overall linguistic/communicative skills of deaf children, independent of any specific language or modality of expression. It focuses on the totality of the children's communication skills. Experiment 1 investigated developmental trends of the LPP-2 for both deaf and hearing children, studying a combined sample of deaf and hearing children from the United States and Canada. Experiment 2 investigated the relationship between the LPP-2 and two commonly used measures to assess deaf children on language development (Preschool Language Scale-3) and early reading skills (Test of Early Reading Ability-Deaf/Hard-of-Hearing). Results from the two studies indicate that the LPP-2 has good utility not only as a measure of overall language development but also as a predictor of achievement for English language and early reading skills.

Behavioral treatment of hypertensive heart disease in African Americans: rationale and design of a randomized controlled trial

African Americans experience higher morbidity and mortality than Whites do as a result of hypertension and associated cardiovascular disease. Chronic psychosocial stress has been considered an important contributing factor to these high rates. The authors describe the rationale and design for a planned randomized controlled trial comparing Transcendental Meditation, a stress-reduction technique, with lifestyle education in the treatment of hypertension and hypertensive heart disease in urban African Americans. They pretested 170 men and women aged 20 to 70 years over a 3-session baseline period, with posttests at 6 months. Outcomes included clinic and ambulatory blood pressure, quality of life, left ventricular mass measured by M-mode echocardiography, left ventricular diastolic function measured by Doppler, and carotid atherosclerosis measured by beta-mode ultrasound. This trial was designed to evaluate the hypothesis that a selected stress reduction technique is effective in reducing hypertension and hypertensive heart disease in African Americans.

Microsatellite DNA markers from HLA region (D6S105, D6S265 and TNFa) in autochthonous Basques from Northern Navarre (Spain)

BACKGROUND

The extent of the genetic polymorphism of the HLA complex is becoming well characterized in Basque population and their subpopulations. This level of knowledge mainly concerns HLA class I loci. However, Basque population surveys dealing with HLA class II genes and/or microsatellites in the HLA region are still very scarce.

AIM

The population genetics of three highly polymorphic short tandem repeat (STR) loci, D6S105, D6S265 and TNFa, from HLA region has been analysed in autochthonous (indigenous) Basques from Northern Navarre (Spain). The same blood samples have been typed for HLA class II genes from DQ/DR/DP regions and some findings from that information can be found therein.

SUBJECTS AND METHODS

Blood samples were taken from 107 unrelated autochthonous Basques from Northern Navarre. The criterion used to define Northern Navarrese identity was that of three generations of Basque surnames and birthplaces.

RESULTS

The main features observed in Navarrese Basques were the rather high frequencies of alleles D6S105*4 and D6S265*7. A novel allele has been detected at the D6S265 locus (13: 145 bp). The most frequent haplotype was D6S105*8-D6S265*4 with a highly significant linkage disequilibrium being presented. The high frequency of allele TNFa*1 in Basques is noteworthy and this characteristic is not shared by other European populations, where TNFa*1 is absent or shows negligible values. The multidimensional scaling analysis (MDS) for TNFa allele frequencies has shown a high variability among populations and that alleles TNFa*1 (F(ST) = 0.0615) and TNFa*12 (F(ST) = 0.0424) seem to have significant influence over the spatial population configuration. TNFa*2 showed the lowest FST value (0.0077) because of its conspicuous homogeneous distribution all over the European populations.

CONCLUSIONS

Findings shown here on HLA microsatellites and their relationships with other HLA class I and class II genes in Basques can be helpful for those studies mainly addressed at detecting associations between HLA genes and diseases in the Basque area as a whole, and particularly in its autochthonous population, settled there since remote times.

Emergence of tics in children with attention deficit hyperactivity disorder treated with stimulant medications

The emergence of tics in children treated with stimulant medication for attention deficit hyperactivity disorder (ADHD) was investigated. A retrospective chart review of the medical records of 555 subjects was performed to examine the emergence of tics in relation to treatment with a stimulant medication, dosage, duration of treatment, and age of subjects. A total of 7.8% of the subjects treated with stimulants developed tics: 8.3% of subjects treated with methylphenidate, 6.3% with dextroamphetamine, and 7.7% with pemoline. The subjects who developed tics were significantly younger than those who did not. Subjects treated with higher doses of stimulant medication were not more likely to develop tics. While the emergence of tics was common, these subjects may have developed tics irrespective of stimulant medication. Controversy remains as to the long-term risk of tics in relation to stimulant medication and to appropriate practice should tics emerge during the course of stimulant medication treatment.

Stress, stress reduction and hypercholesterolemia in African Americans: a review

Psychological stress may directly contribute to the disproportionately high rates of coronary heart disease morbidity and mortality and its etiologic risk factors in African Americans. Specifically, acute and chronic stress have been shown to raise serum lipids and are associated with clinical coronary events. The mechanisms by which stress contributes to alterations in lipid levels are not fully known, but various pathways (ie, hormonal, dietary, etc) have been implicated. Traditional methods for reducing blood serum lipids include diet, drugs or both. These methods have been criticized because of issues of compliance, side effects, and cost. Because of these limitations, nondrug behavioral methods are recommended by the National Cholesterol Education Program as the first line of prevention and treatment for hypercholesterolemia and other risk factors. Research shows that CHD morbidity and mortality and major risk factors may be modifiable by behavioral intervention. Specifically, the Transcendental Meditation technique, an effective antidote to stress, reduces levels of major CHD risk factors including hypercholesterolemia, as well as blood pressure and smoking. Using an effective stress reduction approach for prevention and treatment of CHD and its risk factors in African Americans may prove to be a valuable asset for this underserved population.

Parental Involvement in Deaf Children's Education Programs as a Predictor of Child's Language, Early Reading, and Social-Emotional Development

This study examined the impact of school-based, teacher-rated parental involvement on four child outcomes: language development, early reading skills, and positive and negative measures of social-emotional development. The 28 children were assessed for outcomes between 9 to 53 months post-graduation from a birth-to-3 early intervention (EI) program for children with hearing loss. Other factors included in the study were child's hearing loss, mother's education level, mother's current communication skills with her child, and maternal use of additional services beyond those offered by the early intervention program or the child's school program. Parental involvement in children's school-based education program is a significant positive predictor to early reading skills but shares considerable variance with maternal communication skill for this outcome. In this study, maternal communication skills and the child's hearing loss were the strongest predictors for language development. Maternal use of additional services was the strongest predictor to poorer social-emotional adjustment. The study's findings indicate that although parental involvement in their deaf child's school-based education program can positively contribute to academic performance, parental communication skill is a more significant predictor for positive language and academic development. Factors associated with parental involvement, maternal communication, and use of additional services are explored and suggestions are offered to enhance parental involvement and communication skills.

Stress and coping in hearing mothers of children with hearing loss: factors affecting mother and child adjustment

The present study examines maternal and child adjustment as a result of the application of a stress and coping model (Folkman, Schaefer, & Lazarus 1979) to factors associated with having a school-aged child with a hearing loss. Thirty-six hearing mothers of children with hearing loss participated in the study. Information was gathered through parent and teacher questionnaires and home interviews and observations. Results indicated that (a) social support emerged as an important predictor of maternal adjustment as well as a buffer between current life stress and maternal adjustment, and (b) maternal problem-solving skill emerged as a significant predictor of child adjustment and as a mediating factor between child's age and teacher rating of child adjustment. The discussion focuses on possible explanations for these findings, the utility of a competency-based rather than psychopathology-based perspective in understanding parent and child outcomes, and implications for intervention strategies.

Characteristics of hearing families and their young deaf and hard of hearing children. Early intervention follow-up

Children with hearing loss are at risk for outcomes below their potential despite institution of educational approaches at increasingly younger ages. Research suggests some benefits of early intervention (EI) for these children and their families. However, previous investigators have not delineated broader family, child, and program variables that warrant consideration in understanding the role, success, and limitations of EI. The present study involved 28 hearing families and their children with hearing impairments aged 42 to 87 months, 9 to 42 months postgraduation from an EI program. The information gathered included demographics, duration and intensity of the EI, parent involvement, and educational and communication choices. Results provide a descriptive profile of children with hearing loss and their hearing families from EI through the preschool years. The discussion reflects upon EI in the context of this population's significant heterogeneity. Complex and confounding factors are presented that may affect children's and families' short- or long-term progress and the goals of EI.

Early social-emotional, language, and academic development in children with hearing loss. Families with and without fathers

As a group, children with significant hearing loss are at greater risk than other children for outcomes far below their potential, despite the institution of various educational approaches at increasingly earlier ages. Research suggests some benefits of early intervention for deaf children and their families. However, there remains a paucity of research into how family variables may affect child outcomes. The present study investigated the effect of paternal presence or absence on the social-emotional, language, and academic outcomes of 22 deaf and hard of hearing children ages 43-83 months. The children had graduated anywhere from 9 to 47 months earlier from an early intervention program for deaf and hard of hearing children 3 years of age or younger. Results indicated that children whose father is present have significantly better academic and language outcomes than those without a father present. Possible explanations for the findings are discussed, as well as implications of these findings for services offered by early intervention programs.

Anthropology of the apoplipoprotein E (apo E) gene: low frequency of apo E4 allele in Basques and in tribal (Baiga) populations of India

The distribution of apolipoprotein E (apo E) polymorphism was examined in 11 population groups not previously studied for this system. There is a marked difference in phenotype and gene frequency between the populations of England and Spain. The south European populations of Basques and Spanish non-Basques showed greater similarity to the populations of South Asia. The study clearly indicates that the distribution of apo E alleles does match with regions showing a high mortality rate of coronary heart disease. The data presented also indicate that authochthon groups such as Basques in Europe and tribals in India may throw better light on the role of apolipoproteins in the regulation of lipid levels in disease.

Study of three hypervariable DNA loci (D1S7; D7S22 and D12S11) in three European populations

To investigate the population genetic characteristics and genetic affinity, DNA profiles of three highly polymorphic VNTR (variable number of tandem repeats) loci (D1S7; D7S22 and D12S11) were studied in 405 individuals from three major European populations (English, Spanish and Basques). Like other studies on VNTRs, a large significant heterozygote deficiency was observed in all three populations. This decrease was ascribed to the limitation, coalescence and non-detectibility of alleles associated with the RFLP (restriction fragment length polymorphism) technique, through which the VNTR loci are genotyped. When the non-detectable alleles were taken into consideration, analyses of fragment sizes at these loci within each sample, as well as their fixed binned analyses, reveal that the assumptions of independence of allelelic occurrences within and between loci are valid for this European data. By comparing genetic variation at three VNTR loci with 17 blood groups, proteins and HLA loci in three well defined European populations, it is shown that the pattern of differentiation at these sets of loci are in general parallel especially for the hypervariable loci HLA and VNTR. Fixed-bin allele frequencies, therefore, are the best descriptions of such a database both for population genetic and forensic calculation studies. The Basques, with regard to VNTR loci, do not show any reduced genetic variability compared to other two European populations (English and Spanish).

A survey of child and adolescent psychiatry residents : demographic characteristics, program selection factors, training satisfaction, and career choice

This study attempted to discover how child and adolescent psychiatry residents chose their training programs, what they intended to do with their careers, and how they perceived their educational experiences. The survey was distributed to all psychiatry residents in the United States through their training directors in 1990. The authors received 310 responses. Significant differences were noted between male and female residents. Most residents expressed an intention to go into private practice after training. There were significant differences in residents interested in private practice vs. academic careers. The residents had applied to comparatively few programs and made training decisions early. The study generated objective information that may yield more specific recruitment strategies for child and adolescent psychiatry.

Depression in young people: initial presentation and clinical course

OBJECTIVE

This project was designed to provide prospective data on the clinical presentation and longitudinal course of depression in children and adolescents.

METHOD

Children and their parent(s) completed a structured diagnostic interview (Schedule for Affective Disorders and Schizophrenia for School Age Children) at intake, and then yearly for 3 years. Collateral data were collected on school, social, and family functioning.

RESULTS

Mean length of initial depressive episode was 35.6 weeks, SD of 26 weeks. Of the 65 depressed youths who completed the 3-year follow-up, 35 (54%) disclosed another episode of depression. Demographic, family-environment, and diagnostic variables were explored as predictors of characteristics of initial episode, recurrence of depression, and psychosocial competence at follow-up. Female gender and presence of a coexisting anxiety disorder were significantly related to severity of initial depression. Family environment was the only predictor significantly related to overall psychosocial competence over 3 years.

CONCLUSIONS

The findings confirm depression in youth as a valid clinical phenomenon, with substantial risk of recurrence. Increased levels of stress in the family environment were associated with poorer overall outcomes.

HLA frequencies in Basques in Spain and in neighbouring populations

HLA antigen and gene frequencies at the A, B, and C loci are examined in a sample of 181 Basques and 102 non-Basques in Bilbao, Spain. The most common associations of genes at the A and B loci are as in western Europe generally. The results are compared with gene frequencies in other Basque and non-Basque samples in Spain and France. There is clear distinction in gene frequency between Basques and non-Basques, to which the greatest contribution is made by A1 and B35, followed by B7, B8 and B12; and a difference between Basques in France and in Spain, notably in A28, 29, 30 and 31 and B17 and 18.

The 3-year longitudinal course of suicidality and predictive factors for subsequent suicidality in youths with major depressive disorder

This study followed the course of suicidal thoughts and behaviors in youths 7 to 17 years of age who recently experienced an episode of major depression. Suicidal was expressed by 72% of the youths at some time during the study. These predominantly outpatient youths tended to be suicidal on multiple occasions, but their severity of suicidality did not increase over time. Three variables at presentation predicted later suicidality: severity of initial suicidality, anger, and age. These results suggest that milder forms of suicidality represent a feature of depression rather than characterizing a subgroup of high-risk depressed youths. The results also suggest that suicidality and anger may mark a predominantly irritable form of depression as youths mature.

The role of somatic complaints in the diagnosis of depression in children and adolescents

The question of whether somatic complaints are a significant feature of depression independent of anxiety was explored. Structured interview (Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children) and Child Behavior Checklist data from depressed and nondepressed psychiatric controls were analyzed to explore the interaction of somatic complaints, anxiety, and depression. Seventy percent of the children who met criteria for depression also had significant somatic complaints in contrast to 34% of the controls. Findings revealed that frequency of somatic complaints increased with severity of depression regardless of coexisting anxiety.

ABH antigen secretion in Basques and the spatial variation pattern of the secretor locus in Spain

Secretion of the ABH blood group antigen was analyzed in 305 saliva samples of students in the Basque Country University. The frequency of ABH non-secretor was 26.23%, a result very close to that obtained in autoctonous Basques (22-23%) and in other populations from the West (Galicia) and Centre (Castille) of Spain. With certain exceptions, the frequencies of non-secretor se allele present a fairly homogeneous variability pattern and no significant spatial orientation or tendencies of se gene distribution are observed in the Iberian Peninsula.

Risks for suicidality in major depressive disorder

This investigation developed a hierarchical multiple regression model to assess the potential risk factors for suicidality in youths 7 to 17 years old. Variables were assessed in three domains: self-perceptions, demography and diagnosis, and home/environment. The model controlled for major depressive disorder (MDD), which has confounded previous investigations, by evaluating potential risks in a diagnostically heterogenous sample, and then evaluating these risks in a subsample with MDD. Conduct problems and depressive thinking emerged as the most powerful predictors in both samples. Hopelessness, life stress, and maternal psychopathology predicted suicidality only in the total sample. Separation anxiety protected MDD youths. These results suggest that suicidal MDD youths may comprise a distinct subgroup of depressed youths.

Screening for anxiety and depression in an adolescent clinic

The Spielberger State-Trait Anxiety Inventory (STAI) and the Children's Depression Inventory (CDI) were administered to 228 consecutive adolescent clinic patients and provisional physician diagnoses were compared with test scores obtained in 205 valid replies. The age range was 10 to 17 with a mean +/- SD of 14.3 +/- 1.8 years. Racial distribution was 176 white, 21 black, 4 Asian, and 4 other. The provisional diagnoses were categorized as follows: medical diagnosis only, 140; psychiatric diagnosis only, 45; and combined medical/psychiatric diagnosis, 20. Mean scores +/- SD for the entire study population were STAI-State 41.1 +/- 10.9, STAI-Trait 41.3 +/- 11.8, and CDI 10.1 +/- 8.3. Odds ratios showed that patients with only a psychiatric diagnosis had higher STAI scores than those with only a medical diagnosis and those with a combined medical/psychiatric diagnosis; patients with only a psychiatric diagnosis and those with a combined medical/psychiatric diagnosis had higher CDI scores than those with only a medical diagnosis. The medical records of 30 patients in the medical diagnosis category with high STAI and CDI scores were reviewed; of 140 patients with medical diagnoses, screening detected 15 patients (10.7%) who warranted further intervention for psychiatric disorders.

Incidence of regional lymph node metastasis in operable osteogenic sarcoma

Records of 182 consecutive patients with the diagnosis of operable osteogenic sarcoma, treated between 1954 through 1980 by the Breast, Bone and Mixed Tumors Department of the Instituto Nacional de Enfermedades Neoplasicas (Lima, Peru), were reviewed to study the incidence of regional lymph node metastases in this disease. All the patients included in this study had radical surgery, which means the complete resection of the bone where the tumor is located, including the proximal joint, which permitted excision of the regional lymph nodes. Nineteen patients (10.4%) had evidence of sarcoma metastatic to draining lymph nodes. A comprehensive analysis of the literature shows that the incidence of metastasis to the lymph nodes in this study, is higher than those cited in a review of the literature, probably due to the policy in the management of osteogenic sarcoma in our institution, during the period of study.

Consanguinity in the Archbishopric of Toledo, Spain, 1900-79. I. Types of consanguineous mating in relation to premarital migration and its effects on inbreeding levels

This study, the first of a series on consanguinity in the Archbishopric of Toledo from 1900 to 1979, analyses in detail the types of consanguineous mating in a population of considerable size, some 650,000 persons, in Central Spain. During the period covered, very important transformations occurred in Spanish society. The data relate to 21,464 consanguineous marriages. They were divided into two groups, according to the premarital migration of the couple. Significant differences in the frequencies of the types of consanguineous matings, and their secular evolution, are found for the two groups. The expected trend in inbreeding in the total area shows two different tendencies: constancy till the end of the 1950s, followed by a fast decline during the last two decades.

Psychopathology in parents of depressed children and adolescents

One hundred and seventeen biological mothers and 63 biological fathers of depressed and nondepressed, psychiatrically disturbed children and adolescents were interviewed with the Schedule for Affective Disorders and Schizophrenia-Lifetime Version. Diagnostic information was also obtained on 54 biological fathers who were unavailable for interview. Histories of depressive disorders and other forms of psychopathology were reported at high rates in the parents. Major depression was the most commonly reported disorder in interviewed parents of both sexes, but it was reported more often in mothers. Substance abuse and antisocial pathology was more prevalent in fathers. Depression in parents did not distinguish depressed from nondepressed probands, but maternal history of anxiety disorders, alcoholism and/or drug abuse, and suicidality did. Depressed probands were more likely than their nondepressed peers to have two parents with histories of depression. Mothers of younger patients had more substance abuse and suicidality in their histories than mothers of adolescents. They also reported earlier age of onset of depression and earlier age of entry into treatment.

Scintigraphic demonstration of a diaphragmatic defect as the cause of massive hydrothorax in cirrhosis

A 64-year-old man presented with a massive right-sided hydrothorax associated with cirrhosis of the liver. There was no clinical evidence of ascites nor other underlying disease. The usual complementary tests failed to demonstrate any causative abnormality. Chest and abdominal scintigraphy after intraperitoneal injection of 99mTc-human serum albumin disclosed early filling of the pleural space by the radiopharmaceutical and suggested a diaphragmatic defect as the cause for this rare association.

Early intervention using simultaneous communication with deaf infants: the effect on communication development

This report presents findings on an independent evaluation of an early intervention program for severely and profoundly deaf children. Located in Vancouver, British Columbia, this comprehensive program served families with children under age 3. The evaluation included comparison with a matched sample of deaf children without intervention. Included were a developmental assessment and videotape of linguistic and social interactions. Results indicated more developmentally mature communication and higher-quality interaction in families who had received intervention.

Inbreeding, migration and age at marriage in rural Toledo, Spain

The natural region of the Jara, with an area of 2500 km2 occupies much of the south west of the province of Toledo, and extends into the provinces of Caceres and Ciudad Real. It is situated between the Tajo and Guadiana rivers, south of the town of Talavera de la Reina, the centre of the economic life in this region. Its highlands are covered with xerophytic vegetation, of which the most common plant is the jara (Cistus ladaniferus), from which this zone takes it name, (Fig. 1). It has been occupied from the neolithic period onwards by peoples of different origins, e.g. Romans, Muslims, Jews, Mozarabs (Jimenez de Gregorio, 1959) but the present population derives from settlement from the north of the Tajo river beginning in the 14th century following the upheavals of the Moslem–Christian wars.

A epidemiological assessment of water quality and "swimmer's ear"

In an effort to determine if bacterial water quality was related to the incidence of otitis externa (swimmer's ear), a retrospective study was conducted from July, 1980 to September, 1980. Data from 29 cases and 29 controls matched for age and sex were collected. Warm air, warm water, age of less than 18 yr, swimming, and length of time spent swimming were associated positively with cases of otitis externa. Water quality, as measured by fecal coliforms, enterococci, and Pseudomonas aeruginosa was not found to be associated with otitis externa.