Long-term reductions in tinnitus severity

BACKGROUND: This study was undertaken to assess long-term changes in tinnitus severity exhibited by patients who completed a comprehensive tinnitus management program; to identify factors that contributed to changes in tinnitus severity within this population; to contribute to the development and refinement of effective assessment and management procedures for tinnitus. METHODS: Detailed questionnaires were mailed to 300 consecutive patients prior to their initial appointment at the Oregon Health & Science University Tinnitus Clinic. All patients were then evaluated and treated within a comprehensive tinnitus management program. Follow-up questionnaires were mailed to the same 300 patients 6 to 36 months after their initial tinnitus clinic appointment. RESULTS: One hundred ninety patients (133 males, 57 females; mean age 57 years) returned follow-up questionnaires 6 to 36 months (mean = 22 months) after their initial tinnitus clinic appointment. This group of patients exhibited significant long-term reductions in self-rated tinnitus loudness, Tinnitus Severity Index scores, tinnitus-related anxiety and prevalence of current depression. Patients who improved their sleep patterns or Beck Depression Inventory scores exhibited greater reductions of tinnitus severity scores than patients who continued to experience insomnia and depression at follow-up. CONCLUSIONS: Individualized tinnitus management programs that were designed for each patient contributed to overall reductions in tinnitus severity exhibited on follow-up questionnaires. Identification and treatment of patients experiencing anxiety, insomnia or depression are vital components of an effective tinnitus management program. Utilization of acoustic therapy also contributed to improvements exhibited by these patients

Dietary intake and breast density in high-risk women: a cross-sectional study

Background Women with a family history of breast cancer may be at higher risk for breast cancer, but few previous studies evaluating diet and breast cancer have focused on such women. The objective of the present study was to determine whether diet, a modifiable risk factor, is related to breast density among women at high genetic risk for breast cancer. Methods Women with at least one first-degree or second-degree relative with breast cancer or ovarian cancer participating in the Fox Chase Cancer Center Family Risk Assessment Program completed health history and food frequency questionnaires and received standard screening mammograms. Cranial–caudal mammographic images were classified into the four Breast Imaging Reporting and Data System categories ranging from \u27entirely fatty\u27 to \u27extremely dense\u27. Logistic regression analysis using proportional odds models for polychotomous outcomes provided estimates of odds ratios for having a higher category versus a lower category of breast density. Results Among 157 high-risk women, breast density was inversely associated with vitamin D intake (odds ratio for third tertile versus first tertile, 0.5; 95% confidence interval, 0.2–1.0). In contrast, intakes above the median level for protein (odds ratio, 3.0; 95% confidence interval, 1.3–6.9) and above the median level for animal protein (odds ratio, 4.3; 95% confidence interval, 1.8–10.3) were associated with higher breast density, but only among women whose family history did not reflect a known familial cancer syndrome or a breast cancer predisposition gene. Conclusion For women with a strong family history that was not associated with known cancer syndromes, dietary factors may be associated with breast density, a strong predictor of breast cancer risk. Since women with strong family history are often very motivated to change their lifestyle habits, further studies are needed to confirm whether changes in diet will change the breast density and the subsequent onset of breast cancer in these women

Outcome measures associated with perceived stress

We tend to think of situations in life as stressful when they are unpredictable, uncontrollable or overloading. Stress is a very personal experience. Perceived stress is a reflection of how such external stressful events and everyday hassles are ‘filtered’ according to our individual personality traits and coping strategies. People with tinnitus describe various stress-related complaints, but these symptoms are not just restricted to tinnitus. Poor concentration, sense of loss of control, sleep disturbance and irritability are also shared with people who are experiencing a state of generalised anxiety or depression. Whatever their origin, the goal of any clinical intervention for people with tinnitus should be to reduce these negative symptoms. This chapter takes a look at the way in which perceived stress associated with tinnitus has been measured. My focus is on clinical trials, but I start from the perspective of questionnaire construction by describing and comparing tinnitus-specific and general stress measures. I then evaluate how these instruments have been applied in a range of contemporary tinnitus trials. The chapter includes tutorials that introduce the reader to fundamental concepts in clinical trial design, understanding the purpose of questionnaires and appreciating the relevance of sample size calculations

Hemoparasites of the genus Trypanosoma (Kinetoplastida: Trypanosomatidae) and hemogregarines in Anurans of the São Paulo and Mato Grosso do Sul States - Brazil

Wild animals are exposed to numerous pathogens, including hemoparasites. The Trypanosoma and hemogregarinegroup are frequently reported as parasites in anurans (frogs, tree frogs and toads). The identification of these hemoparasites is usually made through stage observation of their morphology in the peripheral blood of the host. There areno studies, however, based on the biological cycle of these hemoparasites. The objective of the present study was toevaluate the presence of hemogregarines and Trypanosoma spp. in anurans captured in the States of São Paulo andMato Grosso do Sul- Brazil and to perform the morphological and morphometric characterization of these hemoparasites. The species of anurans examined were: Dendropsophus nanus, D. minutus, Leptodactylus chaquensis L. podicipinus, L. labyrinthicus, L. fuscus, Bufo granulosus, B. schneideri, Phyllomedusa hypocondrialis, Trachicephalus venulosus, Scinax fuscovarius and Hypsiboas albopunctatus. Of the total of 40 animals studied, four (10%)were positive for hemogregarines and eight (20%) were positive for Trypanosoma spp. Hemogregarine gamontsshowed variable morphology and, in addition to intraerythrocytic forms, extraerythrocytic forms were also observed.Extremely different forms of Trypanosoma were observed, as described in the literature, with the broad and oval forms being the most common.<br>Os animais silvestres estão expostos a inúmeros patógenos,dentre eles estão os hemoparasitas. Podem-se destacar espécies do gênero Trypanosoma e do grupo das hemogregarinas,que ocorrem com freqüência parasitando anuros (rãs, pererecas e sapos). Normalmente, a descrição destes hemoparasitas é feita através da morfologia dos estágios observados nosangue periférico do hospedeiro e as pesquisas sobre o ciclobiológico desses hemoparasitas são escassas. Os objetivos dopresente estudo foram avaliar a presença de hemogregarinas eTrypanosoma spp. em anuros capturados nos Estados de São Paulo e Mato Grosso do Sul e fazer a caracterização morfológica e morfométrica dos seus hemoparasitas. As espécies deanuros examinadas foram: Dendropsophus nanus, D. minutus, Leptodactylus chaquensis, L. podicipinus, L. labyrinthicus, L. fuscus, Bufo granulosus, B. schneideri, Phyllomedusahypocondrialis, Trachicephalus venulosus, Scinax fuscovarius e Hypsiboas albopunctatus. Dos 40 animais estudados, foramencontrados quatro (10%) positivos para hemogregarinas e oito(20%) positivos para Trypanosoma spp. Foram observadosgamontes de hemogregarinas com morfologia variável e, alémdas formas intraeritrocíticas, também foram observados gamontes fora das hemácias. As formas de Trypanosoma encontradas eram muito polimórficas, conforme é descrito na literatura, sendo na sua maioria, larga e oval

Structural Principles of Tau and the Paired Helical Filaments of Alzheimer's Disease

Tau, a major microtubule-associated protein in brain, forms abnormal fibers in Alzheimer's disease and several other neurodegenerative diseases. Tau is highly soluble and adopts a natively unfolded structure in solution. In the paired helical filaments of Alzheimer's disease, small segments of tau adopt a beta-conformation and interact with other tau molecules. In the filament core, the microtubule-binding repeat region of tau has a cross-beta structure, while the rest of the protein retains its largely unfolded structure and gives rise to the fuzzy coat of the filaments