Benzo-pyrones for reducing and controlling lymphoedema of the limbs.

Background Lymphoedema is the accumulation of excess fluid in the body caused by obstruction of the lymphatic drainage mechanisms. Treatment with Benzo-pyrones is thought to reduce fluid forming in the subcutaneous tissues and reduce pain and discomfort of the affected area. Objectives To assess the effectiveness of benzo-pyrones compared to placebo in the management of lymphoedema. Search strategy We searched the Cochrane Breast Cancer Group register (September 2003), the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 4,2003), MEDLINE, EMBASE, CINAHL, UnCover, PASCAL, SIGLE, reference lists produced by The British Lymphology Society, the National Research Register (NRR) and The International Society of Lymphology congress proceedings. Selection criteria Randomised controlled trials comparing Benzo-pyrones with placebo. Data collection and analysis Trials were selected for eligibility and tested for quality by two blinded reviewers who independently extracted data. Meta-analysis was not performed due to the poor quality of the trials. Main results Fifteen trials were included. Three oxerutin trials tested the same dose over 6 months against placebo and included a total of 127 participants (data were available for 81). There were insufficient data from these to calculate the per cent reduction or increase in baseline excess limb volume. One trial testing Cyclo 3 Fort (approved name) was found (57 participants) but insufficient data was provided to allow a proper analysis of its findings. A single trial of Daflon (approved name) was found (104 participants) but this also provided insufficient information to reach a conclusion about the effectiveness of the drug. Three trials of coumarin combined with troxerutin were found which tested two different doses of the drug against each other with no placebo, however participant numbers and baseline data were not provided. Eight trials of coumarin were identified. Two of these reported the same trial and the other potentially also referred to the same trial but this could not be confirmed. A further two papers also appeared to refer to the same trial but again this was unconfirmed. Five studies added anti-filarial drugs to the interventions tested. Participant data could not be extracted and the reporting of outcome measures in most was unclear. Loprinzi's 1999 trial was reported in more detail but its conclusions were very much at odds with other findings. Authors' conclusions It is not possible to draw conclusions about the effectiveness of Benzopyrones in the management of lymphoedema from the current available trials

Molecular techniques reveal cryptic life history and demographic processes of a critically endangered marine turtle

The concept of ‘effective population size’ (Ne), which quantifies how quickly a population will lose genetic variability, is one of the most important contributions of theoretical evolutionary biology to practical conservation management. Ne is often much lower than actual population size: how much so depends on key life history and demographic parameters, such as mating systems and population connectivity, that often remain unknown for species of conservation concern. Molecular techniques allow the indirect study of these parameters, as well as the estimation of current and historical Ne. Here, we use genotyping to assess the genetic health of an important population of the critically endangered hawksbill turtle (Eretmochelys imbricata), a slow-to-mature, difficult-to-observe species with a long history of severe overhunting. Our results were surprisingly positive: we found that the study population, located in the Republic of Seychelles, Indian Ocean, has a relatively large Ne, estimated to exceed 1000, and showed no evidence of a recent reduction in Ne (i.e. no genetic bottleneck). Furthermore, molecular inferences suggest the species' mating system is conducive to maintaining a large Ne, with a relatively large and widely distributed male population promoting considerable gene flow amongst nesting sites across the Seychelles area. This may also be reinforced by the movement of females between nesting sites. Our study underlines how molecular techniques can help to inform conservation biology. In this case our results suggest that this important hawksbill population is starting from a relatively strong position as it faces new challenges, such as global climate change

The effect of ocean acidification on organic and inorganic speciation of trace metals

Rising concentrations of atmospheric carbon dioxide are causing acidification of the oceans. 20 This results in changes to the concentrations of key chemical species such as hydroxide, 21 carbonate and bicarbonate ions. These changes will affect the distribution of different forms 22 of trace metals. Using IPCC data for pCO2 and pH under four future emissions scenarios (to 23 the year 2100) we use a chemical speciation model to predict changes in the distribution of 24 organic and inorganic forms of trace metals. Under a scenario where emissions peak after 25 the year 2100, predicted free ion Al, Fe, Cu and Pb concentrations increase by factors of up 26 to approximately 21, 2.4, 1.5 and 2.0 respectively. Concentrations of organically complexed 27 metal typically have a lower sensitivity to ocean acidification induced changes. 28 Concentrations of organically-complexed Mn, Cu, Zn and Cd fall by up to 10%, while those 29 of organically-complexed Fe, Co and Ni rise by up to 14%. Although modest, these changes 30 may have significance for the biological availability of metals given the close adaptation of 31 marine microorganisms to their environment

Rapid identification of mutations in GJC2 in primary lymphoedema using whole exome sequencing combined with linkage analysis with delineation of the phenotype.

Background: Primary lymphoedema describes a chronic, frequently progressive, failure of lymphatic drainage. This disorder is frequently genetic in origin, and a multigenerational family in which eight individuals developed postnatal lymphoedema of all four limbs was ascertained from the joint Lymphoedema/Genetic clinic at St George's Hospital. Methods: Linkage analysis was used to determine a locus, and exome sequencing was employed to look for causative variants. Results: Linkage analysis revealed cosegregation of a 16.1 Mb haplotype on chromosome 1q42 that contained 173 known or predicted genes. Whole exome sequencing in a single affected individual was undertaken, and the search for the causative variant was focused to within the linkage interval. This approach revealed two novel non-synonymous single nucleotide substitutions within the chromosome 1 locus, in NVL and GJC2. NVL and GJC2 were sequenced in an additional cohort of individuals with a similar phenotype and non-synonymous variants were found in GJC2 in four additional families. Conclusion: This report demonstrates the power of exome sequencing efficiently applied to a traditional positional cloning pipeline in disease gene discovery, and suggests that the phenotype produced by GJC2 mutations is predominantly one of 4 limb lymphoedema

Delinquency Theories, Group Composition, Treatment Locus, and a Service-Research Model for \u27Traditional\u27 Social Work Agencies

Summary Rehabilitative endeavors within correctional institutions have failed because of overpopulation, high costs, labelling and stigmatization of inmates, low transferability of treatment changes to the outside community, and deviant peer group composition. Community treatment programs have fared little better because they also entail client stigmatization and typically are conducted within the context of deviant peer groups. Consequently, in order to enhance the rehabilitative potential of community treatment, subsequent efforts should be conducted within traditional agencies and within pro-social peer groups. The emphasis upon pro-social rehabilitation environments does not posit any particular assets and/or liabilities of a given socio-economic stratum, thus avoiding a major deficiency of many sociological theories of juvenile delinquency, viz., the tendency to derive particularized etiological and interventive principles from a generalized variable, that is, social class. Instead, our basic assumption is that both anti-social and pro-social environments are to be found within any social stratum, and that the latter ought to constitute the preferred loci for rehabilitative endeavors. A brief overview of major formulations concerning juvenile delinquency reveals at least minimum consonance between their basic assumptions and the proposals set forth here. Moreover, although the proposals envision a broad scale augmentation of rehabilitation resources the operational consequences for individual agencies and their members appear to be minimal. Forthcoming empirical data will permit specific detailed examination of the foregoing proposals. However, as additional agencies choose to adopt or reject them prior to accumulation of all the requisite data one might easily conduct a separate study of considerable merit, the subject of which would be innovation within social work institutions

Can a stress management programme reduce stress and improve quality of life in people diagnosed with multiple sclerosis?

Background Despite evidence of perceived stress as a risk factor for multiple sclerosis activity, the evidence for managing stress is limited. Objective To evaluate a stress management programme on perceived stress and quality of life, over 6 months. Methods One hundred people with multiple sclerosis were randomly assigned to either a stress management programme of mindfulness, meditation and progressive muscle relaxation, or wait list. Perceived stress and quality of life were assessed at three intervals across 6 months. Salivary cortisol levels were assessed at two intervals: baseline and first follow-up. Results The stress management programme did not significantly reduce perceived stress, when comparing mean scores. Secondary analysis using median scores found a significant improvement for quality of life, favouring the intervention group. Conclusion Stress management had no significant effect on the primary outcome of perceived stress but did improve quality of life in a secondary analysis of median scores

Client Costs and Early Discontinuance from a Community-Based Treatment Program

In social work circles client withdrawal from a treatment program commonly has been labeled as discontinuance . Discontinuance rates have been inordinately high for both casework and group work endeavors, ranging in some instances to 59Z of all clients following the first interview (Aronson and Overall, 1966; Empey and Erickson, 1972; Goldstein, Heller, and Sechrest, 1966; Levinger, 1960; Overall and Aronson, 1963). Discontinuance represents an obvious and essential concern for social work for one overarching reason, to wit, treatment interventions cannot be implemented should the client(s) withdraw from the therapeutic relationship. Additionally, as some investigators have shown, discontinuance represents a focal concern for evaluative research since valid estimates of treatment success cannot be obtained unless early discontinuers are regarded as instances of treatment failure (cf. Lerman, 1968; Empey and Erickson, 1972). A variety of reasons have been posited for the high rates of discontinuance in social work and allied treatment professions. Among the foremost are inaccurate or incongruent role expectations held by the two people most central to the therapeutic relationship, namely, the therapist and the client (Frank, 1961; Freeman and Simmons, 1958, 1959; Garvin, 1969; Goldstein, 1966; Heine and Trosman, 1960; Kadushin and Wieringa, 1960; Lefton, et al., 1962; Mayer and Timms, 1970; Mechanic, 1961; Olsen and Olsen, 1967; Oxley, 1966; Shapiro, 1971). These and other factors have been posited to result in counter-therapeutic client uncertainties (Erikson, 1957), anxieties (Dibner, 1967), and misperceptions (Sapolsky, 1965; Thomas, et al., 1955) and, consequently, in discontinuance. Interestingly, the great majority of studies concerning discontinuance in social work have focused solely upon endogenous features of the therapeutic relationship per se, that is, upon social variables that emanate from the interaction between client(s) and therapist(s) and that determine their ongoing interaction. For the most part, however, exogenous determinants of that relationship have been ignored in the literature. This is especially unfortunate in the case of group work since the course of treatment may depend upon a variety of socio-cultural attributes and behaviors that the various members bring to the treatment group

Whole lifespan microscopic observation of budding yeast aging through a microfluidic dissection platform

Important insights into aging have been generated with the genetically tractable and short-lived budding yeast. However, it is still impossible today to continuously track cells by high-resolution microscopic imaging (e.g., fluorescent imaging) throughout their entire lifespan. Instead, the field still needs to rely on a 50-y-old laborious and time-consuming method to assess the lifespan of yeast cells and to isolate differentially aged cells for microscopic snapshots via manual dissection of daughter cells from the larger mother cell. Here, we are unique in achieving continuous and high-resolution microscopic imaging of the entire replicative lifespan of single yeast cells. Our microfluidic dissection platform features an optically prealigned single focal plane and an integrated array of soft elastomer-based micropads, used together to allow for trapping of mother cells, removal of daughter cells, monitoring gradual changes in aging, and unprecedented microscopic imaging of the whole aging process. Using the platform, we found remarkable age-associated changes in phenotypes (e.g., that cells can show strikingly differential cell and vacuole morphologies at the moment of their deaths), indicating substantial heterogeneity in cell aging and death. We envision the microfluidic dissection platform to become a major tool in aging research.

The UK register of HIV seroconverters: Methods and analytical issues

A Register of HIV-infected persons who have had a negative antibody test within 3 years of their first antibody positive test (seroconverters) is being set up in the UK to monitor the distribution of times from HIV seroconversion to AIDS (the incubation period) and to death. It will also provide a national resource for use by those designing studies in this group of individuals. Clinicians caring for HIV-positive persons in Genito-Urinary Medicine, Infectious Disease and other departments throughout the UK were asked to participate by providing information on eligible subjects. Most laboratories undertaking HIV antibody testing were also contacted and asked to provide the name of the attending clinician for all seroconverters identified through the HIV laboratory reporting systems of the PHLS Communicable Disease Surveillance Centre (CDSC) and the Scottish Centre for Infection and Environmental Health (SCIEH) and for any other seroconverters known to them but not identified by CDSC or SCIEH. Data items sought for the Register include: sex, ethnic group, probable route of HIV transmission, annual CD4 counts, details of therapy and prophylaxis prescribed, AIDS-defining events and vital status. Follow up information is collected annually. Wherever possible, all seroconverters known to a clinic have been identified, whether currently alive or dead, either from clinic records or laboratory reporting or both. The objective is to establish and update a complete register of seroconverters on a long-term basis to provide reliable estimates of the incubation period on which future projections of AIDS cases in the UK can be made