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A widely used psychological test has the potential to gauge how people feel about suicide, possibly giving mental-health workers more insight into what their patients are thinking, a new study suggests.

The Implicit Association Test is used to show whether people automatically associate things with each other. Test takers are shown pairs of words, and the quickness of their reactions to them is thought to show whether they unconsciously link them.

Harvard University psychology student Matthew Nock and colleagues gave a version of the test to people seeking psychiatric treatment at an emergency room. The test version was designed to detect if patients connected death to themselves.

In the study, published in the journal Psychological Science, researchers found that patients who’d previously tried to commit suicide were more likely to strongly link death and self than other patients. They were also more likely to try to kill themselves within the next three months compared to those who made stronger connections between life and self.

“These results are really exciting because they address a long-standing scientific and clinical dilemma by identifying a method of measuring how people are thinking about death and suicide that does not rely on their self-report,” Nock said in a statement.

“We are hopeful that this line of research ultimately will provide scientists and clinicians with new tools for measuring how people think about sensitive clinical behaviors that they may be unwilling or unable to report on verbally,” he said.

SOURCE: Association for Psychological Science, news release.

The chance that a corneal transplant will fail is not affected by the age of the donor, the length of time that the transplanted cornea was preserved or the method of preservation, according to a new study.

The finding came from a study that included 388 people who were followed for up to 20 years after a corneal transplant. During that time, 83 of the grafts failed, including 26 because of late endothelial failure — an increasing thickness and loss of clarity of the cornea.

During the follow-up period, endothelial cell density of transplanted corneas decreased an average of 74 percent. The study found no additional cell loss between 15 and 20 years of follow-up. And, the risk for graft failure was lower in people diagnosed with keratoconus (a degenerative disorder in which the cornea becomes cone-shaped) than in those with endothelial dysfunction (a decrease in the number or performance of endothelial cells), said Dr. Sanjay V. Patel, of the Mayo Clinic in Rochester, Minn., and his colleagues.

Donor corneas with lower endothelial cell density before transplant and higher endothelial cell loss two months after transplant were associated with late endothelial failure among people with endothelial dysfunction but not keratoconus.

The time between donor death and corneal transplant was not found to affect risk, nor was the way donor corneas were preserved.

“The findings in our study provide additional evidence that increased death-to-transplant time has no effect on graft failure, which is important information for surgeons who import donor tissue or accept donor tissue with extended preservation times,” the researchers wrote.

The study is published in the issue of the Archives of Ophthalmology.

Blacks are hit the hardest when it comes to both developing and dying from lung cancer.

A new report from the American Lung Association paints a grim picture of how environmental factors, biological factors, cultural attitudes and biases in the health-care system conspire to make this deadly disease even deadlier among members of this minority group.

“Despite lower smoking rates, African-Americans are more likely to develop and die from lung cancer than whites. African-Americans are more likely to be diagnosed later when the cancer is more advanced. Also, African-Americans are more likely to wait longer after the diagnosis to receive treatment or perhaps to refuse treatment and to die in the hospital after surgery,” Dr. William J. Hicks, professor of clinical medicine at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute in Columbus, said during a Monday news conference.

Black men bear an even more disproportionate share of the burden, being 37 percent more likely to be diagnosed with lung cancer and 22 percent more likely to die of the disease than white men.

Only 12 percent of blacks will be alive five years after their lung cancer diagnosis, compared with 16 percent of whites, the ALA report notes.

The report points to a number of factors that could explain the disparity, including differences in socioeconomic status, big business behavior and environmental exposure.

For instance, thanks to concerted marketing efforts by the tobacco industry, blacks have higher rates of smoking menthol cigarettes than other groups. Smokers of menthol cigarettes tend to have higher blood levels of cotinine, an indicator of how much nicotine a person is absorbing. The U.S. Food and Drug Administration is expected to issue a report on the public health impact of menthol cigarettes in March of 2011.

Education and income levels also play a role. Not only do these factors impact lifestyle choices and access to health care, including health insurance, but they largely determine where blacks are likely to work and live.

According to one study, predominantly black neighborhoods have noticeably higher levels of air pollution than other communities.

And a greater proportion of blacks work in the transportation industry, where they are exposed to diesel fumes, known to contribute to lung cancer risk.

Meanwhile, blacks are less likely to have a gene variant that is targeted by a widely used cancer drug.

The good news is that if individuals, regardless of race, receive equal treatment for lung cancer, their outcomes are likely to be similar.

However, as Hicks pointed out, “the sad truth is that not all patients receive equal treatment and for those who do not, their health outcomes are poorer.”

Blacks are also less likely to be seen by experienced or credentialed doctors and hospitals, less likely to have their disease staged, less likely to have surgery and less likely to undergo chemotherapy.

These problems have to do with both patient and provider attitudes.

“We’re looking not just at system failures but also at issues that are deeply rooted in the history, culture and beliefs of African-Americans,” Hicks said. “This is not post-racial America. For people of color in the United States, race and discrimination are facts of everyday life, and clearly take a toll both mentally and with regard to one’s physical health.”

There is, first of all, the legacy of the Tuskegee (syphilis) and other medical experiments of the past, in which blacks were exploited by the U.S. health-care establishment. That’s made trust in the medical establishment an ongoing issue, the experts said.

And while doctors appear less likely to funnel black patients to the right kind of specialists, blacks are more likely to refuse gold-standard treatment even when it is offered and available, they added.

“This is not an issue that can be solved overnight,” said Chuck D. Connor, president and CEO of the American Lung Association. “We’ve made progress in reducing smoking rates and exposure to secondhand smoke, but there is still much work that needs to be done.”

Hicks said he hoped experts and community members could arrive at a new approach that will “hopefully render this very preventable form of cancer to its state of 125 years ago, when it was a very rarely encountered medical issue, primarily before the advent of widespread cigarette smoking.”

SOURCES: 2010, teleconference with: William J. Hicks, M.D., professor, clinical medicine, Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus; Chuck D. Connor, president and CEO, American Lung Association; Too Many Cases, Too Many Deaths: Lung Cancer in African-Americans

Involuntary crying or laughing can be a common symptom in patients with certain neurological disorders, such as Alzheimer’s, multiple sclerosis or amyotrophic lateral sclerosis (ALS).

However, a combination of drugs could be the first effective long-term treatment for the problem, researchers say.

The new treatment for curbing these unwanted crying/laughing episodes — known to doctors as “pseudobulbar affect” or PBA — uses two drugs, dextromethorphan and low-dose quinidine.

Early indications are that the two drugs do reduce the incidence and severity of PBA episodes and improve quality of life.

“There’s no FDA-approved therapy for pseudobulbar affect,” noted study lead author Dr. Erik P. Pioro, director of the section for ALS and related disorders at the Cleveland Clinic in Ohio, and a member of the American Academy of Neurology (AAN). “The off-label medications that are being used have their own set of side effects and problems. So from a medical and patient care point of view, it would be very worthwhile to have an approved medication that is both safe and effective,” he said.

Pioro presented the findings at a press conference held earlier this week at the AAN’s annual meeting in Toronto.

The study authors note that PBA typically manifests in patients with an underlying neurological illness, including those with multiple sclerosis (MS), ALS (also known as Lou Gehrig’s disease) or Alzheimer’s, as well as patients suffering from other dementias and/or brain infections and injuries.

Pioro said that conservative estimates put the number of Americans with PBA at close to 2 million, although he said the figure might actually be as high as 6 million to 7 million.

Dextromethorphan is a common medication and a principle ingredient of standard cough syrup, according to Dr. Lily K. Jung, medical director of the neurology clinic and chief of neurology at the Swedish Medical Center in Seattle. The drug has previously been shown to have a “significant” effect upon parts of the brain responsible for behavioral control, she said at the press briefing.

Jung, who did not take part in the study, noted that quinidine is sometimes used to treat heart rhythm abnormalities. When combined at very low doses with dextromethorphan, it appears to help prolong that drug’s usefulness.

In the study, Pioro and his colleagues enlisted 283 patients with PBA in an initial drug trial, during which some patients received one of two dosage levels of the two medications, while others received placebos.

After a two-week break, this was followed by a second phase involving 253 of the original study participants.

During the study’s second part, patients were exposed to daily doses of the two-drug regimen for 12 weeks.

Pioro and his colleagues observed “significant improvement” among all the patients — particularly among those who had not been exposed to the drug combo until the second part of the study.

Overall, Pioro noted that “there was an improvement of probably about 30 to 40 percent of symptoms” on average.

“Hopefully, we will soon have a very effective approved therapy to help these patients, which is important because this problem is probably much wider and more prevalent than we realize,” he said.

“Very often patients who have this can be mistaken for having depression,” Pioro explained. “But they’re not depressed. Pseudobulbar affect is actually incongruent usually to the inner mood that the person has. So it can generate a lot of misconceptions. And patients will often be stigmatized, if you will, as a result.”

Jung agreed. “This is exciting,” she said, “because pseudobulbar affect can be so significantly socially disabling.”

Still, further investigation into the drug combo’s potential is warranted, since Pioro’s study was relatively small. “Obviously more studies need to be done in larger groups of patients,” Jung cautioned. “And testing for benefit should be done with other validated measures.”

SOURCES: Erik P. Pioro, M.D., Ph.D., director, section of ALS and related disorders, Cleveland Clinic, Cleveland, Ohio, and member American Academy of Neurology; Lily K. Jung, M.D., medical director, neurology clinic, and chief of neurology, Swedish Medical Center, Seattle; American Academy of Neurology meeting, Toronto.