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Biomedical subjects

Denis M McCarthy

Publications and source records attributed to Denis M McCarthy.

At least 19 recordsLinked to original sources
PubMed2006

Escalation and initiation of younger adolescents' substance use: the impact of perceived peer use.

PURPOSE: The middle school years are peak years for substance use initiation. The current study assessed the impact of peer influence on both initiation and escalation of cigarette, alcohol, and marijuana use among sixth, seventh, and eighth graders. METHODS: Youth (n = 974; 45% male) were surveyed twice over an academic year and reported on their personal substance use and their perception of peer substance use. The sample ranged in age from 10 to 15 years at Time 1 (M age = 11.95) and was 44% White, 26% Latino, 7% Asian American/Pacific Islander, 4% African American, and 14% mixed ethnic origin. RESULTS: Hierarchical regressions examined whether personal and perceived peer substance use predicted later substance involvement, and logistic regressions assessed whether Time 1 perceived peer and personal use of other substances discriminated between initiates and noninitiates. After controlling for personal substance use, perceived peer alcohol use predicted both increased alcohol and marijuana use, and perceived peer marijuana use predicted increased alcohol use. Only perceived peer alcohol use was associated with initiation of alcohol, and both perceived peer alcohol and marijuana use predicted onset of marijuana use. CONCLUSIONS: Results highlight the importance of perceived peer use in predicting both onset and escalation of use and suggest utilizing a multifaceted prevention approach that targets multiple substances.

Adolescent↗
PubMed2006

Implicit and explicit measures of alcohol and smoking cognitions.

The present study tested convergent, discriminant, and incremental validity of implicit and explicit measures of alcohol and smoking cognitions. College-aged participants (n = 264) completed questionnaire measures of alcohol and smoking expectancies and behavior. Participants also completed the Implicit Association Test (IAT; Greenwald, McGhee, & Schwartz, 1998) for alcohol and smoking on two occasions, approximately 1 month apart. Psychometric qualities of these IATs were evaluated. Modest associations were found between implicit and explicit measures for the same substance. Both implicit and explicit measures had unique associations with use. Discriminant validity was stronger for alcohol measures than for smoking measures. These results support the utility of the IAT as a technique for assessing implicit associations about alcohol and smoking. They also provide some evidence that smoking motivations may make unique contributions to alcohol use.

Adolescent↗
PubMed2006

Development of a measure of drinking and driving expectancies for youth.

The present study constructs and provides initial validation for a measure of positive expectancies for drinking and driving for use with adolescents and young adults (PEDD-Y). In Study 1, items were generated through open-ended responses from high school- and college-age youth. Data collected from a 2nd sample of college students (n = 404) identified a 29 item, 4 factor questionnaire. Two of the PEDD-Y factors (Convenience, Avoiding Consequences) explained additional variance in drinking and driving behavior above and beyond other cognitions about drinking and driving. Study 2 extended these results to a high school sample (n = 185). Study 3 demonstrated test-retest reliability of the PEDD-Y in college-age youth (n = 165). These results provide initial evidence for the utility of the PEDD-Y in assessing drinking and driving risk in adolescents and college students.

Adolescent↗
PubMed2006

Malignant solitary fibrous tumor of the kidney: report of a case and comprehensive review of the literature.

Renal solitary fibrous tumors (SFTs) have been reported infrequently. We report a 76-year-old man with a left renal mass that had previously been shown radiographically to be stable, but was now growing. Grossly, the mass measured 12 cm, was poorly circumscribed, and invaded beyond the renal capsule. Approximately 10% of the neoplasm consisted of haphazardly arranged spindle cells admixed with dense collagenous bands, which is typical of benign SFT. However, the remainder of the mass was composed of pleomorphic, spindled sarcoma cells with frequent mitoses and foci of necrosis. Immunohistochemically, we observed CD34 labeling in the benign SFT component with loss of expression in the sarcomatous component, focal labeling for Bcl-2 protein in both areas, and absence of labeling for cytokeratin, renal cell carcinoma marker, S100 protein, CD117, and muscle markers in both areas. To our knowledge, this is the first reported case of malignant renal SFT, likely representing transformation from a histologically documented benign SFT component.

Aged↗
PubMed2005

An examination of self-medication and rebound effects: Psychiatric symptomatology before and after alcohol or drug relapse.

This study evaluated psychiatric symptoms preceding and following initial posttreatment substance use episodes. 125 veterans meeting DSM-IV criteria for alcohol, cannabis, and/or stimulant dependence at treatment entry were followed with quarterly interviews for one year. Approximately half of the sample met criteria for substance use disorders only (n = 65; SUD-only) and half additionally met criteria for an independent non-substance related Axis I disorder (n = 60; SUD-PSY). SUD-PSY adults reported more psychiatric symptoms preceding and following substance use compared to SUD-only adults. Depression and anxiety symptoms were commonly reported by both groups. Symptoms typically did not change or worsened after substance use, with depression worsening more than anxiety or psychotic symptoms. Findings are discussed in relation to the Self-Medication Hypothesis and the Rebound Hypothesis.

Adult↗
PubMed2005

Elementary school drinking: the role of temperament and learning.

Drinking in elementary school, despite its low base rate, has been shown to predict alcohol use in middle school (Wilson, Battistich, Syme, & Boyce, 2002), which in turn predicts alcohol abuse or dependence in young adults (Guo, Collins, Hill, & Hawkins, 2000). The authors report 1 of the 1st examinations of the relationship between personality and psychosocial learning risk factors and drinking behavior among elementary school students. Fifth-grade students completed measures of disinhibition, positive and negative alcohol expectancies, and drinking. MIMIC modeling, tests of mediation, and tests of moderation were completed to test these relations. It was found that disinhibition and positive alcohol expectancies were each related to drinking in 5th graders. Disinhibition moderated the relation between positive alcohol expectancies and drinking in some cases. Mediation was not supported.

Alcohol Drinking↗
PubMed2005

Relapse in alcohol- and drug-disordered adolescents with comorbid psychopathology: changes in psychiatric symptoms.

This study examined reciprocal relationships between posttreatment substance use and psychiatric symptoms in adolescents with both a substance use disorder and an Axis I mental health disorder. Participants (13-18 years old) were recruited from inpatient treatment centers and interviewed during treatment and monthly for 6 months. Participants who relapsed (N=103; 48% female) reported the incidence and severity of psychiatric symptoms experienced before and after their 1st posttreatment substance use. The number of symptoms and depression symptoms experienced were related to use of stimulants and other drugs during relapse. There was evidence for both self-medication (symptom reduction) and rebound (symptom exacerbation) effects of substance use on symptom severity. These results demonstrate that, for adolescents with both substance use and mental health disorders, psychiatric symptoms are 1 factor influencing posttreatment substance use.

Adolescent↗
PubMed2005

Automatic effects of alcohol cues on sexual attraction.

AIMS: The present study tested whether suboptimal priming (which may be defined as 'under viewing conditions rendering conscious identification highly improbable') with alcohol-related stimuli would activate existing expectancies about alcohol's effects on sexual desire. It was predicted that alcohol cues, relative to non-alcohol cues, would activate expectancies of alcohol's aphrodisiac properties. We hypothesized that for men, stronger expectancies in this regard would predict an increased tendency to judge women as sexually attractive following the alcohol primes. DESIGN: Two experimental studies manipulated cue (alcohol versus control) and rating dimension (attractiveness versus intelligence). Self-reported alcohol expectancies of sexual desire were assessed approximately 1 month prior to the study. Study 2 assessed additional expectancy content domains. SETTING AND PARTICIPANTS: Study 1 comprised 82 undergraduate males and study 2 78 undergraduate males. Studies were conducted at the University of Missouri-Columbia, Columbia, Missouri, USA. INTERVENTIONS: In both experiments, male participants were suboptimally primed with either alcohol-related or control words. Following this priming, they were presented with a series of photographs of young women and asked to either rate their attractiveness or their intelligence. FINDINGS AND CONCLUSIONS: In both studies, a three-way interaction between cue, rating dimension and alcohol expectancies was found. Within the attractiveness rating condition a two-way interaction was found, indicating that in this condition, stronger expectancies that alcohol increases sexual desire predicted higher attractiveness ratings after suboptimal exposure to alcohol primes. No effects emerged in the intelligence rating condition. Discussion centers on implications for sexual risk-taking as well as a range of other non-consumptive behaviors.

Adolescent↗
PubMed2005

Negative consequences and cognitions about drinking and driving.

OBJECTIVE: Drinking and driving has been found to be a highly persistent behavior, even after experiencing negative consequences, such as arrest. This study tested the association between consequences of drinking and driving and cognitions related to drinking and driving (e.g., attitudes, normative beliefs). We tested whether exposure to negative consequences was associated with perceptions of risk associated with drinking and driving. METHOD: Participants were 938 college students. The sample was 57% female and primarily white (86%). Questionnaire measures were used to assess alcohol use, drinking and driving behaviors, drinking and driving cognitions, and lifetime drinking and driving consequences. RESULTS: Results indicated that participants who had experienced consequences of drinking and driving (either as a driver or rider) reported more current drinking and driving and greater alcohol consumption. Analyses indicated that most cognition measures differentiated those reporting lifetime consequences from the rest of the sample, with the consequence groups reporting more risky cognitions. However, experiencing a personal consequence of drinking and driving was associated with perceiving negative consequences of drinking and driving to be more likely. CONCLUSIONS: These results provide evidence that most cognitive risk factors for drinking and driving remain high even after experiencing a negative consequence. This may contribute to the persistence of drinking and driving in prior offenders. The finding that the perception of negative consequences may be influenced by experiencing consequences may have implications for intervention and treatment efforts.

Adult↗
PubMed2004

Merkel cell carcinoma in a malignant pleural effusion: case report.

BACKGROUND: Merkel cell (neuroendocrine) carcinoma is a small round blue cell malignant neoplasm that primarily presents in the skin. The diagnosis of Merkel cell carcinoma in a pleural fluid is challenging because of the morphological similarity to many other malignant neoplasms. Immunohistochemical stains can be essential to establish the diagnosis of Merkel cell carcinoma. CASE PRESENTATION: A 77 year-old woman presented with a mass in her right buttock thought clinically to be a boil or sebaceous cyst. Upon histopathologic review including immunohistochemical analysis, a diagnosis of Merkel cell carcinoma was rendered. Wide-excision and sentinel lymph node biopsy revealed negative margins and no evidence of metastasis. Ten months later she complained of bone pain and a bone scan revealed multiple lesions. An abdominal CT scan revealed a T4 vertebral mass and local radiotherapy was administered. Two months later the patient presented with shortness of breath. A chest radiograph showed an effusion and thoracentesis was performed. The fluid was confirmed to contain metastatic Merkel cell carcinoma by cytology and immunohistochemical analysis. CONCLUSIONS: Merkel cell carcinoma is an aggressive neoplasm that can, despite careful surgical management, occasionally present as a malignant pleural effusion in a relatively short time period. Immunohistochemical analysis can aid in confirming this rare outcome.

Journal Article↗
PubMed2004

Management of bleeding peptic ulcer: current status of intravenous proton pump inhibitors.

Over 80% of ulcer bleeding stops spontaneously, but associated mortality and morbidity remain high. Occurrence of re-bleeding increases mortality 10-fold. Endoscopic findings in those that have bled predict the risk of recurrent bleeding. Patients whose ulcers show a 'flat dot' or clean base (Forrest Class 3) rarely rebleed or need hospitalization. However, actively bleeding ulcers or those with evidence of recent hemorrhage (Forrest Classes 1 and 2) are likely to re-bleed and may need intensive care. Meta-analyses indicate that endoscopic hemostasis has reduced re-bleeding and surgical intervention by over 60% and mortality by 45%. Beyond these reductions, data indicate that (unlike H2-receptor antagonists use, largely devoid of benefits in this area) continuous intravenous infusions of high doses of proton pump inhibitors reduce rebleeding, re-endoscopy, blood transfusion and surgical intervention, but have little effect (beyond endoscopic therapy) on associated mortality, much of it due to conditions other than rebleeding.

Anti-Ulcer Agents↗
PubMed2004

Impact of consent procedures on reported levels of adolescent alcohol use.

This study examined sample bias related to parental consent procedures in school-based survey research on alcohol-related behavior. Alcohol prevalence and severity of use estimates from a high school student survey using traditional-active parental consent (N = 1,429) were compared with estimates from 2 student surveys using alternative parental consent procedures (passive consent; N = 2,210 and N = 3,231). Traditional-active parental consent procedures resulted in underrepresentation of lifetime drinkers. Furthermore, traditional-active parental consent procedures resulted in lower levels of high-risk drinking, and this bias was most evident for Caucasians and both boys and girls. Findings accentuate the need for administrators, policymakers, and researchers to consider the impact consent procedure related bias may have on results and interpretation of findings from school-based substance use research.

Adolescent↗
PubMed2004

Adolescent alcohol reduction and cessation expectancies.

OBJECTIVE: Although many youths reduce or stop drinking without formal treatment, little is known of cognitive mechanisms influencing such alcohol change efforts during adolescence. The present research examines alcohol cessation expectancies of adolescents in the context of a cognitive-behavioral de-escalation model of alcohol use. Grounded in Developmental Social Information Processing theory (Coie and Dodge, 1998) and empirical findings on adolescent self-change process, alcohol cessation expectancies are defined as anticipated consequences of ceasing or decreasing drinking. The present study is the first to develop a measure of adolescent alcohol cessation expectancies. METHOD: A 23-item measure was administered to 5,446 high school students (51% female) as part of a survey on alcohol and drug use. RESULTS: Using data for adolescents who reported any history of alcohol use (N = 3,098), exploratory and confirmatory factor analyses identified expectations of global changes and social effects. Expectancy factor structure was examined within drinking groups (light, moderate, heavy drinkers) and as a function of age and change goal (reduction and cessation). Predictive validity of the expectancy measure was examined for youth who reported efforts to decrease or stop drinking during the prior year. Our results suggest greater differentiation in cessation expectancies with increased alcohol experience. The findings also provide evidence that youth cessation expectancies uniquely predict alcohol change efforts over and above alcohol use and problems. CONCLUSIONS: Youths maintain several types of alcohol reduction/cessation expectancies predictive of behavioral change efforts. Articulation of this construct for youth contributes to an understanding of mechanisms involved in adolescent efforts to reduce or stop drinking.

Adolescent↗
PubMed2004

Changes in alcohol involvement, cognitions and drinking and driving behavior for youth after they obtain a driver's license.

OBJECTIVE: This study tested whether obtaining a driver's license was associated with increases in alcohol and other drug involvement and changes in alcohol-related cognitions for youth, and whether drinking and driving behavior increased with driving experience. METHOD: Confidential, anonymous surveys were conducted at two time points (fall, spring) with students at four high schools in San Diego county (N = 2,865, 51% female). Data were collected on alcohol, cigarette and marijuana use, license status, alcohol use by peers, attitudes towards drinking and driving and drinking and driving behaviors. RESULTS: Nondrivers (60%), new drivers (obtained a license between Time 1 and Time 2) and experienced drivers (26%) were compared on study variables at both time points and over time. Initially obtaining a driver's license was associated with increased frequency of substance use. Results were not significant for quantity of alcohol use, frequency of heavy drinking or perceived alcohol use norms. Attitudes towards drinking and driving reflected an increase in the perceived dangerousness of this behavior for new drivers. Drinking and driving behavior during the last 30 days increased with increased driving experience. CONCLUSIONS: The results indicate a number of changes in substance involvement after obtaining a driver's license. However, initially this transition may also indicate a period of protection against drinking and driving. These results may have implications for the target and content of drinking and driving interventions.

Adolescent↗
PubMed2003

Constructing a short form of the Smoking Consequences Questionnaire with adolescents and young adults.

The goal of the present studies was to construct and validate a short form of the 50-item Smoking Consequences Questionnaire (SCQ; T.H. Brandon & T. B. Baker, 1991), a measure of smoking outcome expectancies. In Study 1, a 21-item short form (S-SCQ) was derived from a sample of 107 young adults previously treated for substance abuse. In Study 2, the measure was cross-validated on 125 adolescents in treatment for substance abuse. Confirmatory factor analyses revealed good model fit and factorial invariance for the 4 S-SCQ subscales across both samples. Validation analyses on each sample found that subscale scores generally correlated significantly with smoking-related variables. The present studies provide initial evidence for the utility of the S-SCQ when used with young adults and adolescents.

Adolescent↗
PubMed2003

Novel markers of pancreatic adenocarcinoma in fine-needle aspiration: mesothelin and prostate stem cell antigen labeling increases accuracy in cytologically borderline cases.

The interpretation of pancreas fine-needle aspiration (FNA) is extremely difficult given the cytologic overlap of neoplastic and reactive processes. Using serial analysis of gene expression, we have discovered 2 new markers of pancreatic adenocarcinoma, mesothelin and prostate stem cell antigen (PSCA), and confirmed their specificity by immunohistochemical labeling. Here we evaluate the potential contribution of immunohistochemical labeling of mesothelin and PSCA to the interpretation of pancreas FNAs. Thirty pancreas FNAs with follow-up data were reviewed. Unstained cell block sections from these aspirates labeled for mesothelin and PSCA using immunohistochemistry were compared with initial cytologic diagnoses and with follow-up diagnoses. On follow-up, 19 patients proved to have cancer, and 11 did not. Initial cytologic diagnosis of malignancy correlated with carcinoma on follow-up in 12 of 12 cases, and initial benign cytologic diagnosis correlated with benign follow-up in 8 of 9 cases (sensitivity, 92%; specificity, 100%). Six of the 9 patients with suspicious cytology were found to have a carcinoma on follow-up. PSCA labeling was present in 16 of the 19 patients who ultimately were proven to have carcinoma; PSCA labeling was absent in 10 of the 11 lesions proven to be benign (sensitivity, 84%; specificity, 91%). Mesothelin labeling was present in 13 of the 19 patients who ultimately were proven to have carcinoma; mesothelin labeling was absent in 10 of the 11 lesions proven to be benign (sensitivity, 68%; specificity, 91%). Five of the 6 cytologically suspicious cases with malignant follow-up labeled for either PSCA or mesothelin (83%), and 2 of the 6 cases labeled for both markers. None of the 3 suspicious cases with benign follow-up labeled for either PSCA or mesothelin. Increasingly, molecular techniques are identifying potential cancer markers that may have diagnostic utility. In this study, immunohistochemical labeling for 2 of these markers, PSCA and mesothelin, appears highly specific for pancreatic adenocarcinoma in FNA specimens and useful in categorizing cytologically suspicious lesions.

Adenocarcinoma↗