The extraordinary hope of antiretroviral therapy in South Africa (even for patients with tuberculosis or kaposi sarcoma!).
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Biomedical subjects
Publications and source records attributed to Thomas Campbell.
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Because of the pathogenic effects of chronic stress exposure, it is important to identify factors, such as effective coping strategies, that mitigate stress-induced pathology. Of interest in the present study was the consistency of behavioral responses across a diverse array of stressors. Sixteen male and 16 female Long-Evans rats were assigned to either a stress or control group. The stressed animals were subsequently exposed to a battery of ecologically relevant stressors (e.g., predator odor, novel stimuli, and immunological challenge) to determine trends in coping strategies. Blood was collected for corticosterone (CORT) assay and brains were harvested for assessment of fos immunoreactivity in the paraventricular hypothalamus (PVH) and central amygdala (CEA) following exposure to the final stressor of fox urine. A correlational analysis indicated that certain response strategies (e.g., latency to respond in different stress tests such as the open-field and novel item tests) persist across several behavioral tests, especially those tests involving exploratory components. A subsequent principal component factor analysis revealed the following four components: initiative to explore, low reactivity, variable reactivity, and high reactivity. Females exhibited higher recovery CORT levels than males; however, sex only affected one behavioral response measure (i.e., females demonstrated more attempts to climb the wall in the forced-swim test than their male counterparts). In conclusion, these results support the importance and prevalence of initiative to explore as a common factor in many stress tests; additionally, the principal component analysis indicated that physiological correlates of stress are more closely associated with more challenging environments and stimuli such as forced swimming, immunological challenges, and exposure to predator odors.
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Our objective was to compare two new objective measures of ease of breathing with the visual analog scale (VAS). Twenty-eight patients with CF, 7-34 years old (FEV(1) 25-114% of predicted), enrolled. Ease of breathing was evaluated by a standard 10-cm VAS, maximum phonation (time, in seconds, to sustain the syllable "Ahh") using a single breath, and counting in a single breath at one number per second (Count) at rest, following 3 min of stepping exercise at 15 steps per minute (STEP15), and 3 min at 30 steps per minute (STEP30). Heart rate (HR) and oxyhemoglobin saturation (SaO(2)) were measured.HR and VAS increased significantly, and SaO(2), phonation, and Count decreased significantly from rest to STEP15 and STEP30. Phonation time correlated significantly (and inversely) with HR after exercise. Phonation time was positively correlated with SaO(2) at rest and after STEP30. Counts at rest and after STEP30 were significantly related to SaO(2). VAS showed no relationship to heart rate at rest or after exercise, but was related to SaO(2) at the end of STEP30. Test-retest reliability for three trials of phonation was 0.92, and for the five trials of counting was 0.93. Correlation coefficients for maximum phonation at rest, STEP15, and STEP30 on 2 separate days were 0.61, 0.94, and 0.91, respectively. Correlation coefficients for Count at rest, STEP15, and STEP30 on 2 separate days were 0.96, 0.94, and 0.94, respectively. Correlation coefficients for VAS at rest, STEP15, and STEP30 on 2 separate days were 0.25, 0.89, and 0.97, respectively. Thus both the maximum phonation and Count have good test-retest reliability within one session, and across 2 separate days, for both rest and exercise conditions. In conclusion, maximum phonation and Count are valid and reliable measures of ease of breathing; they reflect increasing work loads and show stronger correlations with heart rate and SaO(2) than does VAS. These measures could be an important tool for clinical research and patient care.
BACKGROUND: We wanted to determine whether an intervention to enhance partner support helps as an adjunct to a smoking cessation program. METHODS: We undertook a meta-analysis of English-language, randomized controlled trials of smoking cessation interventions through July 2002 using the following data sources: Cochrane Tobacco Addiction Group specialized register, Cochrane controlled trials register, CDC Tobacco Information and Prevention Database, MEDLINE, Cancer Lit, EMBASE, CINAHL, PsycINFO, ERIC, PsycLIT, Dissertation Abstracts, SSCI and HealthSTAR, with reviews of bibliographies of included articles. Included were trials that assessed a partner support component with a minimum follow-up of 6 months. The outcomes measured were abstinence and biochemical assessment at 6 to 9 months and more than 12 months after treatment. Partner Interaction Questionnaire scores were primary and secondary outcomes. RESULTS: Nine studies (31 articles) met inclusion criteria. Partner definition varied among studies. All studies included self-reported smoking cessation rates, but there was limited biochemical validation of abstinence. For self-reported abstinence at 6 to 9 months after treatment, the Peto odds ratio (OR) = 1.08 (95% confidence interval [CI], 0.81-1.44) and at 12 months Peto OR = 1.0 (95% CI, 0.75-1.34). Sensitivity analysis of studies using live-in, married, and equivalent-to-married partners found a higher odds ratio at 6 to 9 months after treatment, Peto OR = 1.64 (95% CI, 0.5-4.64). Sensitivity analysis of studies reporting significant increases in partner support found at 6 to 9 months after treatment Peto OR = 1.83 (95% CI, 0.9-3.47); and at 12 months Peto OR = 1.22 (95% CI, 0.67-2.23). CONCLUSIONS: Interventions to enhance partner support showed the most promise for clinical practice when implemented with live-in, married, and equivalent-to-married partners. Such interventions should focus on enhancing supportive behaviors, while minimizing behaviors critical of smoking.