January 2006

Some Selected Abstracts:


Chochinov HM, Hack T, Hassard T, Kristjanson LJ, McClement S, Harlos M. Dignity therapy: a novel psychotherapeutic intervention for patients near the end of life. J Clin Oncol. 2005 Aug 20;23(24):5520-5.

Department of Psychiatry, Family Medicine, Community Health Sciences, and Faculty of Nursing, University of Manitoba, Canada.

PURPOSE: This study examined a novel intervention, dignity therapy, designed to address psychosocial and existential distress among terminally ill patients. Dignity therapy invites patients to discuss issues that matter most or that they would most want remembered. Sessions are transcribed and edited, with a returned final version that they can bequeath to a friend or family member. The objective of this study was to establish the feasibility of dignity therapy and determine its impact on various measures of psychosocial and existential distress. PATIENTS AND METHODS: Terminally ill inpatients and those receiving home-based palliative care services in Winnipeg, Canada, and Perth, Australia, were asked to complete pre- and post-intervention measures of sense of dignity, depression, suffering, and hopelessness; sense of purpose, sense of meaning, desire for death, will to live, and suicidality; and a post-intervention satisfaction survey. RESULTS: Ninety-one percent of participants reported being satisfied with dignity therapy; 76% reported a heightened sense of dignity; 68% reported an increased sense of purpose; 67% reported a heightened sense of meaning; 47% reported an increased will to live; and 81% reported that it had been or would be of help to their family. Post-intervention measures of suffering showed significant improvement (P = .023) and reduced depressive symptoms (P = .05). Finding dignity therapy helpful to their family correlated with life feeling more meaningful (r = 0.480; P = .000) and having a sense of purpose (r = 0.562; P = .000), accompanied by a lessened sense of suffering (r = 0.327; P = .001) and increased will to live (r = 0.387; P = .000). CONCLUSION: Dignity therapy shows promise as a novel therapeutic intervention for suffering and distress at the end of life.


Merckaert I, Libert Y, Delvaux N, Marchal S, Boniver J, Etienne AM, Klastersky J, Reynaert C, Scalliet P, Slachmuylder JL, Razavi D. Factors that influence physicians' detection of distress in patients with cancer: can a communication skills training program improve physicians' detection? Cancer. 2005 Jul 15;104(2):411-21.

Faculte des Sciences Psychologiques et de l'Education, Universite Libre de Bruxelles, Brussels, Belgium.

BACKGROUND: No study to date has assessed the impact of skills acquisition after a communication skills training program on physicians' ability to detect distress in patients with cancer. METHODS: First, the authors used a randomized design to assess the impact, on physicians' ability to detect patients' distress, of a 1-hour theoretical information course followed by 2 communication skills training programs: a 2.5-day basic training program and the same training program consolidated by 6 3-hour consolidation workshops. Then, contextual, patient, and communication variables or factors associated with physicians' detection of patients' distress were investigated. After they attended the basic communication skills training program, physicians were assigned randomly to consolidation workshops or to a waiting list. Interviews with a cancer patient were recorded before training, after consolidation workshops for the group that attended consolidation workshops, and approximately 5 months after basic training for the group that attended basic training without the consolidation workshops. Patient distress was recorded with the Hospital Anxiety and Depression Scale before the interviews. Physicians rated their patients' distress on a visual analog scale after the interviews. Physicians' ability to detect patients' distress was measured through computing differences between physicians' ratings of patients' distress and patients' self-reported distress. Communication skills were analyzed according to the Cancer Research Campaign Workshop Evaluation Manual. RESULTS: Fifty-eight physicians were evaluable. Repeated-measures analysis of variance showed no statistically significant changes over time and between groups in physicians' ability to assess patient distress. Mixed-effects modeling showed that physicians' detection of patients' distress was associated negatively with patients' educational level (P = 0.042) and with patients' self-reported distress (P < 0.000). Mixed-effects modeling also showed that physicians' detection of patient distress was associated positively with physicians breaking bad news (P = 0.022) and using assessment skills (P = 0.015) and supportive skills (P = 0.045). CONCLUSIONS: Contrary to what was expected, no change was observed in physicians' ability to detect distress in patients with cancer after a communication skills training programs, regardless of whether physicians attended the basic training program or the basic training program followed by the consolidation workshops. The results indicated a need for further improvements in physicians' detection skills through specific training modules, including theoretical information about factors that interfere with physicians' detection and through role-playing exercises that focus on assessment and supportive skills that facilitate detection.


Widmer IE, Puder JJ, Konig C, Pargger H, Zerkowski HR, Girard J, Muller B. Cortisol response in relation to the severity of stress and illness. J Clin Endocrinol Metab. 2005 Aug;90(8):4579-86.

Division of Endocrinology, Diabetes, and Clinical Nutrition, University Hospital, Basel, Switzerland.

BACKGROUND: The aim of the study was to compare the adrenal response, the course of the ACTH/cortisol ratio, as well as the variance and the diagnostic performance of different cutoffs after 1 and 250 microg ACTH stimulation in different stress situations. METHODS: We investigated three groups with increasing stress levels: ambulatory controls (group A; n = 20), hospitalized medical patients (group B; n = 25), and patients undergoing coronary artery bypass grafting (group C; n = 29). All subjects underwent four consecutive ACTH stimulation tests and were randomized to either a 1- or 250-microg dose. RESULTS: Stimulated cortisol levels in group A were similar to basal cortisol levels under maximal stress (C3; P = 0.8). Peak cortisol concentrations were higher after 250 microg compared with 1 microg ACTH in group B (P = 0.006) and under maximal stress after extubation (group C3; P = 0.027), whereas there were no differences in group A. The ACTH/cortisol ratio was lower in surgical patients after extubation compared with unstressed conditions (P < or = 0.03) The within-subject variance was similar in ambulatory controls and medical patients and after both ACTH doses (all 17-36% of total variance). Cutoff dependent, the diagnosis of relative adrenal insufficiency would have been made in 0-58.3%, respectively. CONCLUSION: In moderate and major stress situations, cortisol concentrations in patients without hypothalamic-pituitary-adrenal disease were higher after stimulation with 250 microg compared with 1 mug ACTH. Data from our study give insight into the physiological adaptations of the hypothalamic-pituitary-adrenal axis to stress.


Kwah YC, Leow YH. Not all pustules are infective in nature: acute generalised exanthematous pustulosis causing pustular eruptions in an elderly woman. Singapore Med J. 2005 Jul;46(7):349-51.

National Skin Centre, 1 Mandalay Road, Singapore 308205.

Acute generalised exanthematous pustulosis (AGEP) is an adverse drug reaction that can occur in any age group. It is commonly mistaken as pustular psoriasis or cutaneous infection, resulting in unnecessary commencement of medications such as methotrexate and antibiotics that can cause harm to the patient or interact and adversely affect the efficacy of other medications. Early diagnosis of AGEP avoids unnecessary investigations and treatment, which not only can harm the patient but also escalate health care, as the condition is self-limiting. This case report illustrates AGEP secondary to Cefaclor occurring in a 72-year-old Chinese woman. Although the literature has documented the occurrence of AGEP with Cefaclor, the unique feature of this case is the occurrence of AGEP following repeated uneventful courses of Cefaclor. This case highlights that AGEP must never be forgotten in the work-up for pustular eruptions in an elderly patient.


13519.  Ceylan E, Aksoy N, Gencer M, Vural H, Keles H, Selek S. Evaluation of oxidative-antioxidative status and the L-arginine-nitric oxide pathway in asthmatic patients. Respir Med. 2005 Jul;99(7):871-6.

13520.  Comhair SA, Ricci KS, Arroliga M, Lara AR, Dweik RA, Song W, Hazen SL, Bleecker ER, Busse WW, Chung KF, Gaston B, Hastie A, Hew M, Jarjour N, Moore W, Peters S, Teague WG, Wenzel SE, Erzurum SC. Correlation of systemic superoxide dismutase deficiency to airflow obstruction in asthma. Am J Respir Crit Care Med. 2005 Aug 1;172(3):306-13.

13521.  Fujisawa T. Role of oxygen radicals on bronchial asthma. Curr Drug Targets Inflamm Allergy. 2005 Aug;4(4):505-9. Review.


13522.  Alsaadi TM, Marquez AV. Psychogenic nonepileptic seizures. Am Fam Physician. 2005 Sep 1;72(5):849-56. Review.

13523.  Ashok PW, Hamoda H, Flett GM, Kidd A, Fitzmaurice A, Templeton A. Psychological sequelae of medical and surgical abortion at 10-13 weeks gestation. Acta Obstet Gynecol Scand. 2005 Aug;84(8):761-6.

13524.  Basoglu M, Livanou M, Crnobaric C, Franciskovic T, Suljic E, Duric D, Vranesic M.  Psychiatric and cognitive effects of war in former yugoslavia: association of lack of redress for trauma and posttraumatic stress reactions. JAMA. 2005 Aug 3;294(5):580-90.

13525.  Bigi R, Gregori D, Cortigiani L, Colombo P, Fiorentini C. Stress recovery index for risk stratification of asymptomatic patients following coronary bypass surgery. Chest. 2005 Jul;128(1):42-7.

13526.  Chochinov HM, Hack T, Hassard T, Kristjanson LJ, McClement S, Harlos M. Dignity therapy: a novel psychotherapeutic intervention for patients near the end of life. J Clin Oncol. 2005 Aug 20;23(24):5520-5.

13527.  Hartl TL, Rosen C, Drescher K, Lee TT, Gusman F.  Predicting high-risk behaviors in veterans with posttraumatic stress disorder. J Nerv Ment Dis. 2005 Jul;193(7):464-72.

13528.  Hill TD, Angel RJ. Neighborhood disorder, psychological distress, and heavy drinking. Soc Sci Med. 2005 Sep;61(5):965-75.

13529.  Hou WL, Wang HH, Chung HH. Domestic violence against women in Taiwan: their life-threatening situations, post-traumatic responses, and psycho-physiological symptoms: an interview study. Int J Nurs Stud. 2005 Aug;42(6):629-36.

13530.  Merckaert I, Libert Y, Delvaux N, Marchal S, Boniver J, Etienne AM, Klastersky J, Reynaert C, Scalliet P, Slachmuylder JL, Razavi D. Factors that influence physicians' detection of distress in patients with cancer: can a communication skills training program improve physicians' detection? Cancer. 2005 Jul 15;104(2):411-21.

13531.  Olley BO, Zeier MD, Seedat S, Stein DJ. Post-traumatic stress disorder among recently diagnosed patients with HIV/AIDS in South Africa. AIDS Care. 2005 Jul;17(5):550-7.

13532.  Ruuska J, Kaltiala-Heino R, Rantanen P, Koivisto AM. Psychopathological distress predicts suicidal ideation and self-harm in adolescent eating disorder outpatients. Eur Child Adolesc Psychiatry. 2005 Aug;14(5):276-81.

13533.  Takahashi M, Tanaka K, Miyaoka H. Depression and associated factors of informal caregivers versus professional caregivers of demented patients. Psychiatry Clin Neurosci. 2005 Aug;59(4):473-80.

13534.  Tsai PF. Predictors of distress and depression in elders with arthritic pain. J Adv Nurs. 2005 Jul;51(2):158-65.

13535.  van Dooren S, Seynaeve C, Rijnsburger AJ, Duivenvoorden HJ, Essink-Bot ML, Tilanus-Linthorst MM, Klijn JG, de Koning HJ, Tibben A. Exploring the course of psychological distress around two successive control visits in women at hereditary risk of breast cancer. Eur J Cancer. 2005 Jul;41(10):1416-25.

  Heart Disease:

13536.  Benarroch EE. Paraventricular nucleus, stress response, and cardiovascular disease. Clin Auton Res. 2005 Aug;15(4):254-63. Review.

13537.  Bernardi L, Porta C, Spicuzza L, Sleight P. Cardiorespiratory interactions to external stimuli. Arch Ital Biol. 2005 Sep;143(3-4):215-21. Review.

13538.  Broadley AJ, Korszun A, Abdelaal E, Moskvina V, Jones CJ, Nash GB, Ray C, Deanfield J, Frenneaux MP.  Inhibition of cortisol production with metyrapone prevents mental stress-induced endothelial dysfunction and baroreflex impairment. J Am Coll Cardiol. 2005 Jul 19;46(2):344-50.

13539.   Cighetti G, Paroni R, Marzorati S, Borotto E, Giudici R, Magnanini G, Iapichino G. Evaluation of oxidative stress in serum of critically ill patients by a commercial assay and gas chromatography-mass spectrometry. Clin Chem. 2005 Aug;51(8):1515-7.

13540.  Gulati M, Black HR, Shaw LJ, Arnsdorf MF, Merz CN, Lauer MS, Marwick TH, Pandey DK, Wicklund RH, Thisted RA. The prognostic value of a nomogram for exercise capacity in women. N Engl J Med. 2005 Aug 4;353(5):468-75.

13541.  Kiji T, Dohi Y, Takasawa S, Okamoto H, Nonomura A, Taniguchi S. Activation of regenerating gene Reg in rat and human hearts in response to acute stress. Am J Physiol Heart Circ Physiol. 2005 Jul;289(1):H277-84.

13542.  Lee TH. Ask the doctor. I haven't had such good luck with my heart--a heart attack ten years ago and angioplasty with two stents inserted last year. Would it make sense for me to have a yearly stress test? If I had been doing that after my heart attack, maybe my doctor would have seen the blockage and we could have done something about it earlier. Harv Heart Lett. 2005 Aug;15(12):8.

13543  Miller TD, Roger VL, Hodge DO, Gibbons RJ. A simple clinical score accurately predicts outcome in a community-based population undergoing stress testing. Am J Med. 2005 Aug;118(8):866-72.

13544.  Sinzinger H. Does the risk factor profile have predictive value for the site of atherosclerosis? J Neurol Neurosurg Psychiatry. 2005 Aug;76(8):1045.

13545.  Szabo G, Bahrle S. Role of nitrosative stress and poly(ADP-ribose) polymerase activation in myocardial reperfusion injury. Curr Vasc Pharmacol. 2005 Jul;3(3):215-20. Review.

13546.  Vukovic DS, Krotin ME, Babic MM, Zivanovic BM. Anxiety level and responses to stress caused by air raids among patients with ischemic heart disease. Prehospital Disaster Med. 2005 Jul-Aug;20(4):249-52.

13547.  Widmer IE, Puder JJ, Konig C, Pargger H, Zerkowski HR, Girard J, Muller B. Cortisol response in relation to the severity of stress and illness. J Clin Endocrinol Metab. 2005 Aug;90(8):4579-86.

13548. Zern TL, Wood RJ, Greene C, West KL, Liu Y, Aggarwal D, Shachter NS, Fernandez ML.  Grape polyphenols exert a cardioprotective effect in pre- and postmenopausal women by lowering plasma lipids and reducing oxidative stress. J Nutr. 2005 Aug;135(8):1911-7.


13549.  Escobales N, Crespo MJ. Oxidative-nitrosative stress in hypertension. Curr Vasc Pharmacol. 2005 Jul;3(3):231-46. Review.

13550.  Fortuno A, Jose GS, Moreno MU, Diez J, Zalba G. Oxidative stress and vascular remodelling. Exp Physiol. 2005 Jul;90(4):457-62. Epub 2005 May 12. Review.

13551.  McCaffrey R, Ruknui P, Hatthakit U, Kasetsomboon P.  The effects of yoga on hypertensive persons in Thailand. Holist Nurs Pract. 2005 Jul-Aug;19(4):173-80.

13552.  Rodrigo R, Parra M, Bosco C, Fernandez V, Barja P, Guajardo J, Messina R. Pathophysiological basis for the prophylaxis of preeclampsia through early supplementation with antioxidant vitamins. Pharmacol Ther. 2005 Aug;107(2):177-97. Review.


April 2006

Some Selected Abstracts:


 Radi S, Lang T, Lauwers-Cances V, Diene E, Chatellier G, Larabi L, De Gaudemaris R; IHPAF group. Job constraints and arterial hypertension: different effects in men and women: the IHPAF II case control study. Occup Environ Med. 2005 Oct;62(10):711-7.

Departement d'Epidemiologie et de Sante Publique, Unite INSERM 558, Faculte de Medecine, Toulouse, France.

AIMS: To examine, in a working population of men and women, the relation between organisational job constraints (job strain, passive and active jobs) and incident hypertension and the buffering effect of social support at work on this relation. METHODS: A nested case control study was designed within the IHPAF (Incidence of Hypertension in a French Working Population) cohort study. The 20 worksite physicians participating in the study enrolled 203 cases and matched each case for age (SD 10 years) and sex with two normotensive subjects attending the follow up screening immediately after him or her. As a result, 426 men and 183 women were included in the study. RESULTS: Mean age was 41.8 (SD 7.8) years in men and 43.5 (SD 7.5) years in women. Relations between job constraints and hypertension were stronger in women than in men. Odds ratios (OR) were 3.20 (95% CI 0.92 to 11.12) in women and 2.60 (95% CI 1.15 to 5.85) in men for job strain, 4.73 (95% CI 1.36 to 16.42) in women and 2.30 (95% CI 1.01 to 5.26) in men for passive jobs, and 4.51 (95% CI 1.24 to 16.43) in women and 2.39 (95% CI 1.10 to 5.18) in men for active jobs. Low social support at work was not related to hypertension and did not decrease the association with organisational risk factors. In both hypertensive men and women, obesity was related to hypertension (OR = 13.20 (95% CI 3.34 to 52.14) in women and 6.54 (95% CI 2.99 to 14.29) in men) and the prevalence of recent stressful life events was significantly lower in hypertensive women (OR = 0.32 (95% CI 0.12 to 0.89)) and men (OR = 0.37 (95% CI 0.20 to 0.67) compared with normotensives. Alcohol consumption was a significant risk factor for hypertension in women (OR = 3.47 (95% CI 1.18 to 10.25)). CONCLUSION: A stronger relation between job constraints and hypertension was observed in women compared with men. These findings emphasise the need of addressing more sex-specific concepts of work related stress on the one hand, and of understanding the direct and indirect mechanisms linking psychosocial factors and hypertension in both sexes on the other hand.


Wright RJ. Stress and atopic disorders. J Allergy Clin Immunol. 2005 Dec;116(6):1301-6. Review. Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.

Evidence linking psychological stress to the expression of asthma and atopy continues to grow. Examining the underlying molecular mechanisms linking stress to asthma and other allergic phenomena is an active area of research. Evidence is reviewed for the influence of stress on neuroimmunoregulation and oxidative stress pathways, which, in turn, may affect biological hypersensitivity to environmental stimuli characteristic of atopic disorders. Critical periods of development, including in utero environment, are underscored. The role of genetics and gene-by-environment interactions is also discussed.


14076.     Allmers H.  Frequent acetaminophen use and allergic diseases: is the association clear? J Allergy Clin Immunol. 2005 Oct;116(4):859-62. Review.   

14077.   Jeulin C, Guadagnini R, Marano F. Oxidant stress stimulates Ca2+-activated chloride channels in the apical activated membrane of cultured nonciliated human nasal epithelial cells. Am J Physiol Lung Cell Mol Physiol. 2005 Oct;289(4):L636-46.



14078.     Kuo HK, Yen CJ, Bean JF. Levels of homocysteine are inversely associated with cardiovascular fitness in women, but not in men: data from the National Health and Nutrition Examination Survey 1999-2002. J Intern Med. 2005 Oct;258(4):328-35.

14079.   Lucini D, Di Fede G, Parati G, Pagani M. Impact of chronic psychosocial stress on autonomic cardiovascular regulation in otherwise healthy subjects. Hypertension. 2005 Nov;46(5):1201-6. 

14080.   Lundberg U. Stress hormones in health and illness: the roles of work and gender. Psychoneuroendocrinology. 2005 Nov;30(10):1017-21. Review.

14081.   Olney CM.  The effect of therapeutic back massage in hypertensive persons: a preliminary study. Biol Res Nurs. 2005 Oct;7(2):98-105. 

14082.   Pollock DM, Pollock JS. Endothelin and oxidative stress in the vascular system. Curr Vasc Pharmacol. 2005 Oct;3(4):365-7. Review.

14083.   Stiefel P, Arguelles S, Garcia S, Jimenez L, Aparicio R, Carneado J, Machado A, Ayala A.  Effects of short-term supplementation with folic acid on different oxidative stress parameters in patients with hypertension. Biochim Biophys Acta. 2005 Nov 15;1726(2):152-9. 

14084.   Takase B, Abe Y, Nagata M, Matsui T, Hattori H, Ohsuzu F, Ishihara M, Kurita A.  Effect of betaxolol hydrochloride on heart rate variability indices during exercise stress testing in patients with hypertension. Biomed Pharmacother. 2005 Oct;59 Suppl 1:S158-62.

14085.   Tohme RA, Jurjus AR, Estephan A. The prevalence of hypertension and its association with other cardiovascular disease risk factors in a representative sample of the Lebanese population. J Hum Hypertens. 2005 Nov;19(11):861-8.

14086.   Wilcox CS. Oxidative stress and nitric oxide deficiency in the kidney: a critical link to hypertension? Am J Physiol Regul Integr Comp Physiol. 2005 Oct;289(4):R913-35. Review.

14087.   Zhu H, Poole J, Lu Y, Harshfield GA, Treiber FA, Snieder H, Dong Y. Sympathetic nervous system, genes and human essential hypertension. Curr Neurovasc Res. 2005 Oct;2(4):303-17. Review. 


14088.     Bachar E, Hadar H, Shalev AY. Narcissistic vulnerability and the development of PTSD: a prospective study. J Nerv Ment Dis. 2005 Nov;193(11):762-5.

14089.   Bottonari KA, Roberts JE, Ciesla JA, Hewitt RG. Life stress and adherence to antiretroviral therapy among HIV-positive individuals: a preliminary investigation. AIDS Patient Care STDS. 2005 Nov;19(11):719-27.

14090.   Bruijnzeel AW, Gold MS. The role of corticotropin-releasing factor-like peptides in cannabis, nicotine, and alcohol dependence. Brain Res Brain Res Rev. 2005 Nov;49(3):505-28.  Review.

14091.   Burke HM, Davis MC, Otte C, Mohr DC. Depression and cortisol responses to psychological stress: a meta-analysis. Psychoneuroendocrinology. 2005 Oct;30(9):846-56. Review.

14092.   Douglas SL, Daly BJ, Kelley CG, O'Toole E, Montenegro H. Impact of a disease management program upon caregivers of chronically critically ill patients. Chest. 2005 Dec;128(6):3925-36.

14093.   Dyrbye LN, Thomas MR, Shanafelt TD. Medical student distress: causes, consequences, and proposed solutions. Mayo Clin Proc. 2005 Dec;80(12):1613-22.

14094.   Fortune DG, Richards HL, Griffiths CE. Psychologic factors in psoriasis: consequences, mechanisms, and interventions. Dermatol Clin. 2005 Oct;23(4):681-94. Review.

14095.   Irie M, Miyata M, Kasai H. Depression and possible cancer risk due to oxidative DNA damage. J Psychiatr Res. 2005 Nov;39(6):553-60. 

14096.   Jain MK, Baghel PK, Shrivastava RC. Exercise stress test in newly detected (Less than six months) type-II diabetics. Indian Practitioner. 2005 Mar; 58(3): 139-143.

14097.   Kiecolt-Glaser JK, Loving TJ, Stowell JR, Malarkey WB, Lemeshow S, Dickinson SL, Glaser R. Hostile marital interactions, proinflammatory cytokine production, and wound healing. Arch Gen Psychiatry. 2005 Dec;62(12):1377-84.

14098.   Koh KB, Park JK, Cho S. Development of the somatic stress response scale and its application in clinical practice. Yonsei Med J. 2005 Oct 31;46(5):614-24.

14099.   Lukassen J, Beaudet MP. Alcohol dependence and depression among heavy drinkers in Canada. Soc Sci Med. 2005 Oct;61(8):1658-67.

14100.   Mawdsley JE, Rampton DS.  Psychological stress in IBD: new insights into pathogenic and therapeutic implications. Gut. 2005 Oct;54(10):1481-91. Review.

14101.   McDaid D, Curran C, Knapp M. Promoting mental well-being in the workplace: a European policy perspective. Int Rev Psychiatry. 2005 Oct;17(5):365-73.

14102.   McGuigan WM, Middlemiss W. Sexual abuse in childhood and interpersonal violence in adulthood: a cumulative impact on depressive symptoms in women.  J Interpers Violence. 2005 Oct;20(10):1271-87.

14103.   Mummery K. Essay: Depression in sport. Lancet. 2005 Dec;366 Suppl 1:S36-7. 

14104.   Rao GM, Sumita P, Roshni M, Ashtagimatt MN. Plasma antioxidant vitamins and lipid peroxidation products in pregnancy induced hypertension . Indian Journal of Clinical Biochemistry. 2005 Jan; 20(1): 198-200.

14105.   Seftel A. Sexual, psychological and dyadic qualities of the prostate cancer 'couple'. J Urol. 2005 Nov;174(5):1939. 

14106.   Sher L, Oquendo MA, Conason AH, Brent DA, Grunebaum MF, Zalsman G, Burke AK, Mann JJ.  Clinical features of depressed patients with or without a family history of alcoholism. Acta Psychiatr Scand. 2005 Oct;112(4):266-71.

14107.   Speer JJ, Hillenberg B, Sugrue DP, Blacker C, Kresge CL, Decker VB, Zakalik D, Decker DA. Study of sexual functioning determinants in breast cancer survivors. Breast J. 2005 Nov-Dec;11(6):440-7.

14108.  Wang CH, Tsay SL, Bond AE. Post-traumatic stress disorder, depression, anxiety and quality of life in patients with traffic-related injuries. J Adv Nurs. 2005 Oct;52(1):22-30. 

  Heart Disease:

14109.      Abidov A, Rozanski A, Hachamovitch R, Hayes SW, Aboul-Enein F, Cohen I, Friedman JD, Germano G, Berman DS. Prognostic significance of dyspnea in patients referred for cardiac stress testing.N Engl  J Med. 2005 Nov 3;353(18):1889-98.

14110.  De Smet P, Sans S, Dramaix M, Boulenguez C, de Backer G, Ferrario M, Cesana G, Houtman I, Isacsson SO, Kittel F, Ostergren PO, Peres I, Pelfrene E, Romon M, Rosengren A, Wilhelmsen L, Kornitzer M. Gender and regional differences in perceived job stress across Europe. Eur J Public Health. 2005 Oct;15(5):536-45. 

14111.   Fischbacher CM, White M, Bhopal RS, Unwin NC. Self-reported work strain is lower in South Asian than European people: cross-sectional survey. Ethn Health. 2005 Nov;10(4):279-92.

14112.   Fleet R, Lesperance F, Arsenault A, Gregoire J, Lavoie K, Laurin C, Harel F, Burelle D, Lambert J, Beitman B, Frasure-Smith N. Myocardial perfusion study of panic attacks in patients with coronary artery disease. Am J Cardiol. 2005 Oct 15;96(8):1064-8. 

14113.   Iellamo F, Galante A, Legramante JM, Lippi ME, Condoluci C, Albertini G, Volterrani M.  Altered autonomic cardiac regulation in individuals with Down syndrome. Am J Physiol Heart Circ Physiol. 2005 Dec;289(6):H2387-91. 

14114.   Miller TH, Kruse JE. Evaluation of syncope. Am Fam Physician. 2005 Oct 15;72(8):1492-500. Review.

14115.   Monin JL. Stress haemodynamics for asymptomatic mitral regurgitation: how much does it help? Heart. 2005 Nov;91(11):1383-4.

14116.   Mulcahy DA. The return of silent ischaemia? Not really. Heart. 2005 Oct;91(10):1249-50.

14117.   Paczkowska E, Larysz B, Rzeuski R, Karbicka A, Jalowinski R, Kornacewicz-Jach Z, Ratajczak MZ, Machalinski B. Human hematopoietic stem/progenitor-enriched CD34(+) cells are obilized into peripheral blood during stress related to ischemic stroke or acute myocardial infarction. Eur J Haematol. 2005 Dec;75(6):461-7.

14118.   Rock M.  Diabetes portrayals in North American print media: a qualitative and quantitative analysis. Am J Public Health. 2005 Oct;95(10):1832-8. 

14119.   Seskevich J, Gabert H, Charles A, Cuffe MS. Helping patients with heart failure manage stress. Nursing. 2005 Oct;35(10):23. 

14120.   Tendulkar AP, Victorino GP, Chong TJ, Bullard MK, Liu TH, Harken AH. Quantification of surgical resident stress "on call". J Am Coll Surg. 2005 Oct;201(4):560-4.

14121.   Weber KT. The proinflammatory heart failure phenotype: a case of integrative physiology. Am J Med Sci. 2005 Nov;330(5):219-26. 

14122.   Xu C, Bailly-Maitre B, Reed JC. Endoplasmic reticulum stress: cell life and death decisions. J Clin Invest. 2005 Oct;115(10):2656-64. Review. 



July 2006

Some selected abstracts:


Carpagnano GE, Resta O, Ventura MT, Amoruso AC, Di Gioia G, Giliberti T, Refolo L, Foschino-Barbaro MP. Airway inflammation in subjects with gastro-oesophageal reflux and gastro-oesophageal reflux-related asthma. J Intern Med. 2006 Mar;259(3):323-31.

Institute of Respiratory Diseases, University of Foggia, Foggia, Italy.

STUDY OBJECTIVES: Asthma and gastro-oesophageal reflux (GER) are both characterized by airway inflammation. DESIGN: The purposes of this work were (i) to study airway inflammation in patients troubled by gastro-oesophageal reflux (GER) and GER associated with asthma, (ii) to ascertain whether GER can aggravate asthma by exacerbating the pre-existing airway inflammation and oxidative stress and (iii) to establish the validity of analysing breath condensate and induced sputum when studying the airways of subjects affected by GER. PATIENT S AND METHODS: We enrolled 14 patients affected by mild asthma associated with GER (40 +/-12 years), nine with mild but persistent asthma (39 +/- 13 years), eight with GER (35 +/- 11 years) and 17 healthy subjects (37 +/- 9 years). Sputum cell counts and concentrations of interleukin-4 (IL-4), IL-6 and 8-isoprostane were measured in breath condensate and supernatant. MEASUREMENTS AND RESULTS: GER-related asthma is characterized by an eosinophilic inflammation, as determined by elevated concentrations of IL-4 in breath condensate and sputum supernatant, and by sputum cell analysis. GER alone presents a neutrophilic pattern of inflammation when determined by elevated concentrations of IL-6 in sputum cell analysis. A concomitant increase has been found in 8-isoprostane in GER associated (or not associated) with asthma. CONCLUSIONS: We conclude that GER is characterized by a neutrophilic airway inflammation and by increased oxidative stress. GER does not however aggravate pre-existing airway inflammation in asthma patients. Determinations of inflammatory and oxidant markers in the breath condensate of subjects with GER reflect these measured in the induced sputum.


Hollon SD, Stewart MO, Strunk D. Enduring effects for cognitive behavior therapy in the treatment of depression and anxiety. Annu Rev Psychol. 2006;57:285-315. Review.

Department of Psychology, Vanderbilt University, Nashville, Tennessee 37203, USA.

Recent studies suggest that cognitive and behavioral interventions have enduring effects that reduce risk for subsequent symptom return following treatment termination. These enduring effects have been most clearly demonstrated with respect to depression and the anxiety disorders. It remains unclear whether these effects are a consequence of the amelioration of the causal processes that generate risk or the introduction of compensatory strategies that offset them and whether these effects reflect the mobilization of cognitive or other mechanisms. No such enduring effects have been observed for the psychoactive medications, which appear to be largely palliative in nature. Other psychosocial interventions remain largely untested, although claims that they produce lasting change have long been made. Whether such enduring effects extend to other disorders remains to be seen, but the capacity to reduce risk following treatment termination is one of the major benefits provided by the cognitive and behavioral interventions with respect to the treatment of depression and the anxiety disorders.


Lucas FL, DeLorenzo MA, Siewers AE, Wennberg DE. Temporal trends in the utilization of diagnostic testing and treatments for cardiovascular disease in the United States, 1993-2001. Circulation. 2006 Jan 24;113(3):374-9.

Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, ME 04102, USA.

BACKGROUND: Rates of invasive testing and treatment for coronary artery disease have increased over time. Less is known about trends in the utilization of noninvasive cardiac testing for coronary artery disease. The objective of this study was 2-fold: to explore temporal trends in the utilization of noninvasive and invasive cardiac services in relation to changes in the prevalence of cardiac disease, and to examine whether temporal increases have been targeted to potentially underserved populations. METHODS AND RESULTS: We performed an annual cross-sectional population-based study of Medicare patients from 1993 to 2001. We identified stress testing, cardiac catheterization, and revascularization procedures, as well as hospitalizations for acute myocardial infarction, during each year and calculated population-based rates for each using the total fee-for-service Medicare population as the denominator and adjusting for age, gender, and race. We observed marked growth in the utilization rates of cardiac services over time, with relative rates nearly doubling for most services. Acute myocardial infarction hospitalization rates have remained stable over the study period. Although rates of all procedures except coronary artery bypass increased in all subgroups, differences in rates of cardiac testing and treatment between nonblack men and other subgroups persisted over time. CONCLUSIONS: Temporal increases in the use of noninvasive and invasive cardiac services are not explained by changes in disease prevalence and have not succeeded in narrowing preexisting treatment differences by gender and race. Such increases, although conferring benefit for some, may expose others to risk and cost without benefit.


Meng CQ. Atherosclerosis is an inflammatory disorder after all. Curr Top Med Chem. 2006;6(2):93-102. Review.

AtheroGenics, Inc., 8995 Westside Parkway, Alpharetta, Georgia 30004, USA.

Inflammation has been increasingly recognized as an important player in the pathophysiology of numerous human disorders. Accumulating evidence has led to the conclusion that atherosclerosis is an inflammatory disease, although it was believed to be a disorder of high cholesterol levels in the bloodstream for over a century. Cholesterol does contribute to the pathogenesis of atherosclerosis, but through inflammatory mechanisms. Statins lower cholesterol levels and hence reduce inflammation in the vasculature and prevent heart disease. Statins may also exert anti-inflammatory effects through mechanisms independent of cholesterol lowering. Adhesion molecules, cytokines, oxidative stress, etc. appear to contribute to the inflammatory state of atherosclerosis and therapeutic approaches directed toward these markers or targets have the potential to be effective in reducing inflammation and treating atherosclerosis.


Opie LH, Commerford PJ, Gersh BJ. Controversies in stable coronary artery disease. Lancet. 2006 Jan 7;367(9504):69-78. Review.

Hatter Institute for Heart Research, Cape Heart Centre and Department of Medicine, University of Cape Town Faculty of Health Sciences, Observatory 7925, Cape Town, South Africa.

Ventricular remodelling describes structural changes in the left ventricle in response to chronic alterations in loading conditions, with three major patterns: concentric remodelling, when a pressure load leads to growth in cardiomyocyte thickness; eccentric hypertrophy, when a volume load produces myocyte lengthening; and myocardial infarction, an amalgam of patterns in which stretched and dilated infarcted tissue increases left-ventricular volume with a combined volume and pressure load on non-infarcted areas. Whether left-ventricular hypertrophy is adaptive or maladaptive is controversial, as suggested by patterns of signalling pathways, transgenic models, and clinical findings in aortic stenosis. The transition from apparently compensated hypertrophy to the failing heart indicates a changing balance between metalloproteinases and their inhibitors, effects of reactive oxygen species, and death-promoting and profibrotic neurohumoral responses. These processes are evasive therapeutic targets. Here, we discuss potential novel therapies for these disorders, including: sildenafil, an unexpected option for anti-transition therapy; surgery for increased sphericity caused by chronic volume overload of mitral regurgitation; an antifibrotic peptide to inhibit the fibrogenic effects of transforming growth factor beta; mechanical intervention in advanced heart failure; and stem-cell therapy.


Vaidya V. Psychosocial aspects of obesity. Adv Psychosom Med. 2006;27:73-85. Review

Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA.

Obese patients have many physical limitations and much psychiatric burden to overcome. Several studies have shown that the prevalence of psychiatric morbidity in the obese is similar to those with normal weight. However, in obese patients seeking treatment there is an increased prevalence (40-60%) of psychiatric morbidity, most commonly depression. It is difficult to separate the effects of depression on obesity and, on the contrary, the neuroendocrine changes associated with stress and depression may cause metabolic changes that predispose and perpetuate obesity. The stigma associated with obesity causes bullying in school as well as childhood psychiatric morbidity. Prejudice is not limited to the general public but exists among health professionals too. This chapter discusses the treatment of depression in obesity and the psychiatric evaluation of the pre-bariatric surgery patient. Education of society, starting with schools and including healthcare professionals will reduce bias and stigma as well as assist this vulnerable group of patients to seek help for their obesity and the many problems that come with it. Given that by the year 2025 obesity will be the world's number one health problem with the US leading the way, it is very important that we pursue preventive measures as well as encourage research for treatments of obesity.


14495.   Ball TM, Anderson D, Minto J, Halonen M. Cortisol circadian rhythms and stress responses in infants at risk of allergic disease. J Allergy Clin Immunol. 2006 Feb;117(2):306-11.

14496.  Kean EM, Kelsay K, Wamboldt F, Wamboldt MZ. Posttraumatic stress in adolescents with asthma and their parents. J Am Acad Child Adolesc Psychiatry. 2006 Jan;45(1):78-86.

14497.   Li N, Nel AE. Role of the Nrf2-mediated signaling pathway as a negative regulator of inflammation: implications for the impact of particulate pollutants on asthma. Antioxid Redox Signal. 2006 Jan-Feb;8(1-2):88-98. Review.

14498.  Sanadi RM, Vandana KL. Stress and its implications inperiodontics. J Indian Acad Oral Med Radiol 2005, 17(1), 8-10.


14499.   Barlow J, Powell L, Gilchrist M. The influence of the training and support programme on the self-efficacy and psychological well-being of parents of children with disabilities: a controlled trial. Complement Ther Clin Pract. 2006 Feb;12(1):55-63.

14500.  Bernaards CM, Jans MP, van den Heuvel SG, Hendriksen IJ, Houtman IL, Bongers PM. Can strenuous leisure time physical activity prevent psychological complaints in a working population? Occup Environ Med. 2006 Jan;63(1):10-6.

14501.  Bruggimann L, Annoni JM, Staub F, von Steinbuchel N, Van der Linden M, Bogousslavsky J. Chronic posttraumatic stress symptoms after nonsevere stroke. Neurology. 2006 Feb 28;66(4):513-6.

14502.  Cole DA, Nolen-Hoeksema S, Girgus J, Paul G. Stress exposure and stress generation in child and adolescent depression: a latent trait-state-error approach to longitudinal analyses. J Abnorm Psychol. 2006 Feb;115(1):40-51.

14503.   Deckersbach T, Dougherty DD, Rauch SL. Functional imaging of mood and anxiety disorders. J Neuroimaging. 2006 Jan;16(1):1-10. Review.

14504.   Diepenmaat AC, van der Wal MF, de Vet HC, Hirasing RA. Neck/shoulder, low back, and arm pain in relation to computer use, physical activity, stress, and depression among Dutch adolescents. Pediatrics. 2006 Feb;117(2):412-6.

14505.   Gladstone GL, Parker GB, Malhi GS. Do bullied children become anxious and depressed adults?: A cross-sectional investigation of the correlates of bullying and anxious depression. J Nerv Ment Dis. 2006 Mar;194(3):201-8.

14506.   Hankin BL. Adolescent depression: description, causes, and interventions. Epilepsy Behav. 2006 Feb;8(1):102-14.

14507.   Hill W, Weinert C, Cudney S. Influence of a computer intervention on the psychological status of chronically ill rural women: preliminary results. Nurs Res. 2006 Jan-Feb;55(1):34-42.

14508.   Hoge CW, Auchterlonie JL, Milliken CS. Mental health problems, use of mental health services, and attrition from military service after returning from deployment to Iraq or Afghanistan. JAMA. 2006 Mar 1;295(9):1023-32.

14509.   Holley C, Murrell SA, Mast BT. Psychosocial and vascular risk factors for depression in the elderly. Am J Geriatr Psychiatry. 2006 Jan;14(1):84-90.

14510. Klatzkin RR, Morrow AL, Light KC, Pedersen CA, Girdler SS. Histories of depression, allopregnanolone responses to stress, and premenstrual symptoms in women. Biol Psychol. 2006 Jan;71(1):2-11.

14511.   Nielsen DM. Corticotropin-releasing factor type-1 receptor antagonists: the next class of antidepressants? Life Sci. 2006 Jan 25;78(9):909-19.

14512.   Pearson H. Stress makes medics ever gloomier. Nature. 2006 Jan 19;439(7074):254.

14513.   Pinquart M, Sorensen S. Gender differences in caregiver stressors, social resources, and health: an updated meta-analysis. J Gerontol B Psychol Sci Soc Sci. 2006 Jan;61(1):P33-45.

14514.   Pouwer F, Beekman AT, Lubach C, Snoek FJ. Nurses' recognition and registration of depression, anxiety and diabetes-specific emotional problems in outpatients with diabetes mellitus. Patient Educ Couns. 2006 Feb;60(2):235-40.

14515.  Wessa M, Rohleder N, Kirschbaum C, Flor H. Altered cortisol awakening response in posttraumatic stress disorder. Psychoneuroendocrinology. 2006 Feb;31(2):209-15.


14516. Bacon SL, Ring C, Hee FL, Lip GY, Blann AD, Lavoie KL, Carroll D. Hemodynamic, hemostatic, and endothelial reactions to psychological and physical stress in coronary artery disease patients. Biol Psychol. 2006 Feb;71(2):162-70.

14517. Daly CA, De Stavola B, Sendon JL, Tavazzi L, Boersma E, Clemens F, Danchin N, Delahaye F, Gitt A, Julian D, Mulcahy D, Ruzyllo W, Thygesen K, Verheugt F, Fox KM; Euro Heart Survey Investigators. Predicting prognosis in stable angina--results from the Euro heart survey of stable angina: prospective observational study. BMJ. 2006 Feb 4;332(7536):262-7.

14518. Denollet J, Pedersen SS, Vrints CJ, Conraads VM. Usefulness of type D personality in predicting five-year cardiac events above and beyond concurrent symptoms of stress in patients with coronary heart disease. Am J Cardiol. 2006 Apr 1;97(7):970-3.

14519. Hamer M, Jones J, Boutcher SH. Acute exercise reduces vascular reactivity to mental challenge in offspring of hypertensive families. J Hypertens. 2006 Feb;24(2):315-20.

14520. Isowa T, Ohira H, Murashima S. Immune, endocrine and cardiovascular responses to controllable and uncontrollable acute stress. Biol Psychol. 2006 Feb;71(2):202-13.

14521. Matthews KA, Zhu S, Tucker DC, Whooley MA. Blood pressure reactivity to psychological stress and coronary calcification in the Coronary Artery Risk Development in Young Adults Study. Hypertension. 2006 Mar;47(3):391-5.

14522. Mosca L, Edelman D, Mochari H, Christian AH, Paultre F, Pollin I. Waist circumference predicts cardiometabolic and global Framingham risk among women screened during National Woman's Heart Day. J Womens Health (Larchmt). 2006 Jan-Feb;15(1):24-34.

14523. Paridon SM, Alpert BS, Boas SR, Cabrera ME, Caldarera LL, Daniels SR, Kimball TR, Knilans TK, Nixon PA, Rhodes J, Yetman AT; American Heart Association Council on Cardiovascular Disease in the Young, Committee on Atherosclerosis, Hypertension, and Obesity in Youth. Clinical stress testing in the pediatric age group: a statement from the American Heart Association Council on Cardiovascular Disease in the Young, Committee on Atherosclerosis, Hypertension, and Obesity in Youth. Circulation. 2006 Apr 18;113(15):1905-20.

14524. Shishehbor MH, Litaker D, Pothier CE, Lauer MS. Association of socioeconomic status with functional capacity, heart rate recovery, and all-cause mortality. JAMA. 2006 Feb 15;295(7):784-92.

14525. Vanderkaay MM, Patterson SM. Nicotine and acute stress: effects of nicotine versus nicotine withdrawal on stress-induced hemoconcentration and cardiovascular reactivity. Biol Psychol. 2006 Feb;71(2):191-201.



October 2006


Some selected abstract:


Carvajal C, Dumont Y, Quirion R. Neuropeptide y: role in emotion and alcohol dependence. CNS Neurol Disord Drug Targets. 2006 Apr;5(2):181-95. Review.
Douglas Hospital Research Centre, Dept. of Psychiatry, McGill University, 6875 LaSalle Blvd., Montreal, QC, Canada, H4H 1R3.
Neuropeptide Y (NPY) is considered to be an important neuromodulator in the regulation of emotional behavior. For example, NPY is consistently involved in anxiety-related behaviors and there is increasing support for a role of this peptide in mood disorders such as depression. Furthermore, recent evidence suggests that NPY has a significant role in the neurobiological response to alcohol, including alcohol consumption, dependence, and withdrawal. In addition, NPY is beginning to emerge as an important modulator in the etiology of alcoholism that is independent from the addictive and reinforcing properties of the traditional system commonly associated with dopamine and instead, is strongly associated with innate emotionality. The recent developments elucidating the role of NPY in emotion and alcohol dependence are reviewed and the potential of the NPY system as a novel therapeutic strategy in the treatment of anxiety, depression and alcohol-related disorders is examined.


Holmes A, Picciotto MR. Galanin: a novel therapeutic target for depression, anxiety disorders and drug addiction? CNS Neurol Disord Drug Targets. 2006 Apr;5(2):225-32. Review.
Laboratory for Integrative Neuroscience, Section on Behavioral Science and Genetics, National Institute of Alcoholism and Alcohol Abuse, National Institutes of Health, Bethesda, Maryland 20892, USA.
Galanin is a neuropeptide synthesized in many neuronal types including brainstem norepinephrine-producing cells of the locus coeruleus and the serotonin-producing neurons of the dorsal raphe nucleus. Galanin inhibits the firing of rodent norepinephrine, serotonin and dopamine neurons and reduces release of these neurotransmitters in forebrain target regions. The distribution of galanin and its receptors and its actions on monoamine signaling has fostered interest in this neuropeptide in the field of behavioral pharmacology and the potential role of galanin in the pathophysiology of neurological diseases such as Alzheimer's disease, epilepsy, stroke, and in psychiatric disorders such as anxiety, depression, and drug addiction, particularly withdrawal. In rodent models, expression of galanin in brain is altered by various stressors, while administration of galanin can modulate anxiety-like responses to stress. Emerging evidence further supports a role for galanin in the mediation of depression-related behaviors in rodents. Recently, galanin agonists have been shown to decrease behavioral signs of opiate withdrawal, which are thought to result from hyperactivation of brain stress pathways. Studies using genetically modified mice suggest that galanin normally plays a protective role against opiate reinforcement and withdrawal. The present article reviews current evidence on a potential role for galanin in modulating stress-related neural pathways and behaviors, and speculates on the therapeutic potential of targeting this galanin system for emotional disorders and opiate addiction.


Khan NA, McAlister FA, Rabkin SW, Padwal R, Feldman RD, Campbell NR, Leiter LA, Lewanczuk RZ, Schiffrin EL, Hill MD, Arnold M, Moe G, Campbell TS, Herbert C, Milot A, Stone JA, Burgess E, Hemmelgarn B, Jones C, Larochelle P, Ogilvie RI, Houlden R, Herman RJ, Hamet P, Fodor G, Carruthers G, Culleton B, Dechamplain J, Pylypchuk G, Logan AG, Gledhill N, Petrella R, Tobe S, Touyz RM; Canadian Hypertension Education Program. The 2006 Canadian Hypertension Education Program recommendations for the management of hypertension: Part II - Therapy. Can J Cardiol. 2006 May 15;22(7):583-93.
Division of General Internal Medicine, University of British Columbia, Vancouver, BC, Canada.
OBJECTIVE: To provide updated, evidence-based recommendations for the management of hypertension in adults. OPTIONS AND OUTCOMES: For lifestyle and pharmacological interventions, evidence from randomized, controlled trials and systematic reviews of trials was preferentially reviewed. Changes in cardiovascular morbidity and mortality were the primary outcomes of interest. For lifestyle interventions, blood pressure (BP) lowering was accepted as a primary outcome given the lack of long-term morbidity/mortality data in this field. For treatment of patients with kidney disease, the development of proteinuria or worsening of kidney function was also accepted as a clinically relevant primary outcome. EVIDENCE: MEDLINE searches were conducted from November 2004 to October 2005 to update the 2005 recommendations. In addition, reference lists were scanned and experts were contacted to identify additional published studies. All relevant articles were reviewed and appraised independently by content and methodological experts using prespecified levels of evidence. RECOMMENDATIONS: Lifestyle modifications to prevent and/or treat hypertension include the following: perform 30 min to 60 min of aerobic exercise four to seven days per week; maintain a healthy body weight (body mass index of 18.5 kg/m2 to 24.9 kg/m2) and waist circumference (less than 102 cm for men and less than 88 cm for women); limit alcohol consumption to no more than 14 standard drinks per week in men or nine standard drinks per week in women; follow a diet that is reduced in saturated fat and cholesterol and that emphasizes fruits, vegetables and low-fat dairy products; restrict salt intake; and consider stress management in selected individuals. Treatment thresholds and targets should take into account each individual's global atherosclerotic risk, target organ damage and comorbid conditions. BP should be lowered to less than 140/90 mmHg in all patients, and to less than 130/80 mmHg in those with diabetes mellitus or chronic kidney disease (regardless of the degree of proteinuria). Most adults with hypertension require more than one agent to achieve these target BPs. For adults without compelling indications for other agents, initial therapy should include thiazide diuretics. Other agents appropriate for first-line therapy for diastolic hypertension with or without systolic hypertension include beta-blockers (in those younger than 60 years), angiotensin-converting enzyme (ACE) inhibitors (in nonblack patients), long-acting calcium channel blockers or angiotensin receptor antagonists. Other agents for first-line therapy for isolated systolic hypertension include long-acting dihydropyridine calcium channel blockers or angiotensin receptor antagonists. Certain comorbid conditions provide compelling indications for first-line use of other agents: in patients with angina, recent myocardial infarction or heart failure, beta-blockers and ACE inhibitors are recommended as first-line therapy; in patients with diabetes mellitus, ACE inhibitors or angiotensin receptor antagonists (or in patients without albuminuria, thiazides or dihydropyridine calcium channel blockers) are appropriate first-line therapies; and in patients with nondiabetic chronic kidney disease, ACE inhibitors are recommended. All hypertensive patients should have their fasting lipids screened, and those with dyslipidemia should be treated using the thresholds, targets and agents recommended by the Canadian Hypertension Education Program Working Group on the management of dyslipidemia and the prevention of cardiovascular disease. Selected patients with hypertension, but without dyslipidemia, should also receive statin therapy and/or acetylsalicylic acid therapy. VALIDATION: All recommendations were graded according to strength of the evidence and voted on by the 45 members of the Canadian Hypertension Education Program Evidence-Based Recommendations Task Force. All recommendations reported here achieved at least 95% consensus. These guidelines will continue to be updated annually.


Lehoux S, Castier Y, Tedgui A. Molecular mechanisms of the vascular responses to haemodynamic forces. J Intern Med. 2006 Apr;259(4):381-92. Review.
From the INSERM U589, Hopital Lariboisiere, Paris, France.
Blood vessels are permanently subjected to mechanical forces in the form of stretch, encompassing cyclic mechanical strain due to the pulsatile nature of blood flow and shear stress. Significant variations in mechanical forces, of physiological or physiopathological nature, occur in vivo. These are accompanied by phenotypical modulation of smooth muscle cells and endothelial cells, producing structural modifications of the arterial wall. In all the cases, vascular remodelling can be allotted to a modification of the tensional strain or shear, and underlie a trend to reestablish baseline mechanical conditions. Vascular cells are equipped with numerous receptors that allow them to detect and respond to the mechanical forces generated by pressure and shear stress. The cytoskeleton and other structural components have an established role in mechanotransduction, being able to transmit and modulate tension within the cell via focal adhesion sites, integrins, cellular junctions and the extracellular matrix. Mechanical forces also initiate complex signal transduction cascades, including nuclear factor-kappaB and mitogen-activated protein kinase pathways, leading to functional changes within the cell.


Ricciardolo FL, Nijkamp FP, Folkerts G. Nitric oxide synthase (NOS) as therapeutic target for asthma and chronic obstructive pulmonary disease. Curr Drug Targets. 2006 Jun;7(6):721-35. Review.
Unit of Pneumology, IRCCS Gaslini Institute, Genoa, Italy.
In the respiratory tract, NO is produced by residential and inflammatory cells. NO is generated via oxidation of L-arginine that is catalysed by the enzyme NO synthase (NOS). NOS exists in three distinct isoforms: neuronal NOS (nNOS), inducible NOS (iNOS), and endothelial NOS (eNOS). NO derived from the constitutive isoforms of NOS (nNOS and eNOS) and other NO-adduct molecules (nitrosothiols) are able to modulate bronchomotor tone. NO derived from the inducible isoform of NO synthase, up-regulated by different cytokines via NF-kappaB-dependent pathway, seems to be a pro-inflammatory mediator with immunomodulatory effects. The production of NO under oxidative stress conditions secondarily generates strong oxidising agents (reactive nitrogen species) that may amplify the inflammatory response in asthma and COPD. Moreover, NO can be exhaled and levels are abnormal in stable atopic asthma and during exacerbations in both asthma and COPD. Exhaled NO might therefore be a non-invasive tool to monitor the underlying inflammatory process. It is suggested that NOS regulation provides a novel target in the prevention and treatment of chronic inflammatory diseases of the airways such as asthma and COPD.


14847.  Casalino-Matsuda SM, Monzon ME, Forteza RM. Epidermal growth factor receptor activation by epidermal growth factor mediates oxidant-induced goblet cell metaplasia in human airway epithelium. Am J Respir Cell Mol Biol. 2006 May;34(5):581-91.

14848.  Chen E, Hanson MD, Paterson LQ, Griffin MJ, Walker HA, Miller GE. Socioeconomic status and inflammatory processes in childhood asthma: the role of psychological stress. J Allergy Clin Immunol. 2006 May;117(5):1014-20.

14849.  Ghosh S, Janocha AJ, Aronica MA, Swaidani S, Comhair SA, Xu W, Zheng L, Kaveti S, Kinter M, Hazen SL, Erzurum SC. Nitrotyrosine proteome survey in asthma identifies oxidative mechanism of catalase inactivation. J Immunol. 2006 May 1;176(9):5587-97.

14850.  Li YF, Gauderman WJ, Avol E, Dubeau L, Gilliland FD. Associations of tumor necrosis factor G-308A with childhood asthma and wheezing. Am J Respir Crit Care Med. 2006 May 1;173(9):970-6.

14851.  Tsoumakidou M, Papadopouli E, Tzanakis N, Siafakas NM. Airway inflammation and cellular stress in noneosinophilic atopic asthma. Chest. 2006 May;129(5):1194-202.


14852.  Adelman EM. Mind-body intelligence: a new perspective integrating Eastern and Western healing traditions. Holist Nurs Pract. 2006 May-Jun;20(3):147-51. Review.

14853.  Balaban V. Psychological assessment of children in disasters and emergencies. Disasters. 2006 Jun;30(2):178-98. Review.

14854.  Britton JR. Global satisfaction with perinatal hospital care: stability and relationship to anxiety, depression, and stressful medical events. Am J Med Qual. 2006 May-Jun;21(3):200-5.

14855.  Broad RD, Wheeler K. An adult with childhood medical trauma treated with psychoanalytic psychotherapy and EMDR: a case study. Perspect Psychiatr Care. 2006 May;42(2):95-105.

14856.  Croghan IT, Bronars C, Patten CA, Schroeder DR, Nirelli LM, Thomas JL, Clark MM, Vickers KS, Foraker R, Lane K, Houlihan D, Offord KP, Hurt RD. Is smoking related to body image satisfaction, stress, and self-esteem in young adults? Am J Health Behav. 2006 May-Jun;30(3):322-33.

14857.  Delahanty LM, Conroy MB, Nathan DM; Diabetes Prevention Program Research Group.  Psychological predictors of physical activity in the diabetes prevention program. J Am Diet Assoc. 2006 May;106(5):698-705.

14858.  Fekkes M, Pijpers FI, Fredriks AM, Vogels T, Verloove-Vanhorick SP. Do bullied children get ill, or do ill children get bullied? A prospective cohort study on the relationship between bullying and health-related symptoms. Pediatrics. 2006 May;117(5):1568-74.

14859.  Geracioti TD Jr, Carpenter LL, Owens MJ, Baker DG, Ekhator NN, Horn PS, Strawn JR, Sanacora G, Kinkead B, Price LH, Nemeroff CB. Elevated cerebrospinal fluid substance p concentrations in posttraumatic stress disorder and major depression. Am J Psychiatry. 2006 Apr;163(4):637-43.

14860.  Landgraf R. The involvement of the vasopressin system in stress-related disorders. CNS Neurol Disord Drug Targets. 2006 Apr;5(2):167-79. Review.

14861.  Meiser-Stedman RA, Yule W, Dalgleish T, Smith P, Glucksman E. The role of the family in child and adolescent posttraumatic stress following attendance at an emergency department. J Pediatr Psychol. 2006 May;31(4):397-402.

14862.  Merali Z, Kent P, Du L, Hrdina P, Palkovits M, Faludi G, Poulter MO, Bedard T, Anisman H. Corticotropin-releasing hormone, arginine vasopressin, gastrin-releasing peptide, and neuromedin B alterations in stress-relevant brain regions of suicides and control subjects. Biol Psychiatry. 2006 Apr 1;59(7):594-602.

14863.  Mitani H, Shirayama Y, Yamada T, Kawahara R. Plasma levels of homovanillic acid, 5-hydroxyindoleacetic acid and cortisol, and serotonin turnover in depressed patients. Prog Neuropsychopharmacol Biol Psychiatry. 2006 May;30(3):531-4.

14864.  Moreno A, Piwowarczyk L, LaMorte WW, Grodin MA. Characteristics and utilization of primary care services in a torture rehabilitation center. J Immigr Minor Health. 2006 Apr;8(2):163-71.

14865.  Nakao M, Yano E. A comparative study of behavioural, physical and mental health status between term-limited and tenure-tracking employees in a population of Japanese male researchers. Public Health. 2006 Apr;120(4):373-9.

14866.  Rapkin AJ, Morgan M, Sogliano C, Biggio G, Concas A. Decreased neuroactive steroids induced by combined oral contraceptive pills are not associated with mood changes. Fertil Steril. 2006 May;85(5):1371-8.    

14867.  Roth G, Ekblad S. A longitudinal perspective on depression and sense of coherence in a sample of mass-evacuated adults from Kosovo. J Nerv Ment Dis. 2006 May;194(5):378-81.

14868.  Schwartz L, Drotar D. Posttraumatic stress and related impairment in survivors of childhood cancer in early adulthood compared to healthy peers. J Pediatr Psychol. 2006 May;31(4):356-66.

14869.  Smith MV, Poschman K, Cavaleri MA, Howell HB, Yonkers KA. Symptoms of posttraumatic stress disorder in a community sample of low-income pregnant women. Am J Psychiatry. 2006 May;163(5):881-4.

14870.  Taylor FB, Lowe K, Thompson C, McFall MM, Peskind ER, Kanter ED, Allison N, Williams J, Martin P, Raskind MA. Daytime prazosin reduces psychological distress to trauma specific cues in civilian trauma posttraumatic stress disorder. Biol Psychiatry. 2006 Apr 1;59(7):577-81.

14871.  Vieweg WV, Julius DA, Fernandez A, Beatty-Brooks M, Hettema JM, Pandurangi AK.  Posttraumatic stress disorder: clinical features, pathophysiology, and treatment. Am J Med. 2006 May;119(5):383-90. Review.

14872.  Vollmer-Conna U, Aslakson E, White PD. An empirical delineation of the heterogeneity of chronic unexplained fatigue in women. Pharmacogenomics. 2006 Apr;7(3):355-64.


14873.  Bigi R, Bestetti A, Strinchini A, Conte A, Gregori D, Brusoni B, Fiorentini C. Combined assessment of left ventricular perfusion and function by gated single-photon emission computed tomography for the risk stratification of high-risk hypertensive patients. J Hypertens. 2006 Apr;24(4):767-73.

14874.  Harmsen P, Lappas G, Rosengren A, Wilhelmsen L. Long-term risk factors for stroke: twenty-eight years of follow-up of 7457 middle-aged men in Goteborg, Sweden. Stroke. 2006 Jul;37(7):1663-7.    

14875.  Heistad DD. Oxidative stress and vascular disease: 2005 Duff lecture. Arterioscler Thromb Vasc Biol. 2006 Apr;26(4):689-95.    

14876.  Karalliedde J, Viberti G. Evidence for renoprotection by blockade of the renin-angiotensin-aldosterone system in hypertension and diabetes. J Hum Hypertens. 2006 Apr;20(4):239-53. Review.

14877.  Paridon SM, Alpert BS, Boas SR, Cabrera ME, Caldarera LL, Daniels SR, Kimball TR, Knilans TK, Nixon PA, Rhodes J, Yetman AT; American Heart Association Council on Cardiovascular Disease in the Young, Committee on Atherosclerosis, Hypertension, and Obesity in Youth. Clinical stress testing in the pediatric age group: a statement from the American Heart Association Council on Cardiovascular Disease in the Young, Committee on Atherosclerosis, Hypertension, and Obesity in Youth. Circulation. 2006 Apr 18;113(15):1905-20.    

14878.  Seasholtz TM, Wessel J, Rao F, Rana BK, Khandrika S, Kennedy BP, Lillie EO, Ziegler MG, Smith DW, Schork NJ, Brown JH, O'Connor DT. Rho kinase polymorphism influences blood pressure and systemic vascular resistance in human twins: role of heredity. Hypertension. 2006 May;47(5):937-47.    

14879.  Webb MS, Gonzalez LO. The burden of hypertension: mental representations of African American women. Issues Ment Health Nurs. 2006 Apr;27(3):249-71. 

Heart Disease:

14880.  Beeres SL, Bax JJ, Kaandorp TA, Zeppenfeld K, Lamb HJ, Dibbets-Schneider P, Stokkel MP, Fibbe WE, de Roos A, van der Wall EE, Schalij MJ, Atsma DE. Usefulness of intramyocardial injection of autologous bone marrow-derived mononuclear cells in patients with severe angina pectoris and stress-induced myocardial ischemia. Am J Cardiol. 2006 May 1;97(9):1326-31.  

14881.  Beeres SL, Bax JJ, Dibbets P, Stokkel MP, Zeppenfeld K, Fibbe WE, van der Wall EE, Schalij MJ, Atsma DE. Effect of intramyocardial injection of autologous bone marrow-derived mononuclear cells on perfusion, function, and viability in patients with drug-refractory chronic ischemia. J Nucl Med. 2006 Apr;47(4):574-80.

14882.  Denollet J, Pedersen SS, Vrints CJ, Conraads VM. Usefulness of type D personality in predicting five-year cardiac events above and beyond concurrent symptoms of stress in patients with coronary heart disease. Am J Cardiol. 2006 Apr 1;97(7):970-3.  

14883.  Guttormsen B, Nee L, Makielski JC, Keevil JG. Transient left ventricular apical ballooning: a review of the literature. WMJ. 2006 May;105(3):49-54. Review.

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14885.  Maeder M, Fehr T, Rickli H, Ammann P. Sepsis-associated myocardial dysfunction: diagnostic and prognostic impact of cardiac troponins and natriuretic peptides. Chest. 2006 May;129(5):1349-66. Review.

14886.  Meyer MC, Mooney RP, Sekera AK. A critical pathway for patients with acute chest pain and low risk for short-term adverse cardiac events: role of outpatient stress testing. Ann Emerg Med. 2006 May;47(5):435.e1-3.  

14887.  Mukherjee S, Belbin TJ, Spray DC, Mukhopadhyay A, Nagajyothi F, Weiss LM, Tanowitz HB. Microarray technology in the investigation of diseases of myocardium with special reference to infection. Front Biosci. 2006 May 1;11:1802-13. Review.

14888.  Owen PJ, Rajiv C, Vinereanu D, Mathew T, Fraser AG, Lazarus JH. Subclinical hypothyroidism, arterial stiffness, and myocardial reserve. J Clin Endocrinol Metab. 2006 Jun;91(6):2126-32.  

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14892.  White M, Ducharme A, Ibrahim R, Whittom L, Lavoie J, Guertin MC, Racine N, He Y, Yao G, Rouleau JL, Schiffrin EL, Touyz RM. Increased systemic inflammation and oxidative stress in patients with worsening congestive heart failure: improvement after short-term inotropic support. Clin Sci (Lond). 2006 Apr;110(4):483-9.