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Epithelial ovarian cancer has the highest mortality rate among the gynecologic cancers and spreads beyond the ovary in 90% of the women diagnosed with ovarian cancer. Detection before the disease has spread beyond the ovary would significantly improve the survival from ovarian cancer, which is currently only 30% over 5 years, despite extensive efforts to improve the survival. This study describes initial investigation of the use of optical technologies to improve the outcome for this disease by detecting cancers at an earlier and more treatable stage. Women undergoing oophorectomy were recruited for this study. Ovaries were harvested for fluorescence spectroscopy, confocal microscopy, and optical coherence tomography. Fluorescence spectroscopy showed large diagnostic differences between normal and abnormal tissue at 270 and 340 nm excitation. Optical coherence tomography was able to image up to 2mm deep into the ovary with particular patterns of backscattered intensity observed in normal versus abnormal tissue. Fluorescence confocal microscopy was able to visualize sub-cellular structures of the surface epithelium and underlying cell layers.Optical imaging and/or spectroscopy has the potential to improve the diagnostic capability in the ovary, but extended systematic investigations are needed to identify the unique signatures of disease. The combination of optical technologies supported by modern molecular biology may lead to an instrument that can accurately detect early carcinogenesis.Key word: Ovarian cancer imaging. IntroductionOvarian cancer goes undetected in both developed and developing countries because adequate technology does not exist to detect preinvasive or early stage disease. There are approximately 25,600 new cases of ovarian cancer in the United States per year, and an estimated 16,000 deaths from ovarian cancer in 2004 (1, 2). Although ovarian cancer accounts for only 4% of all new cancer cases, it is the fifth leading cause of cancer-related mortality in women, and the leading cause of death from gynecologic malignancies (3). High prevalence of late-stage disease and the poor prognosis associated with these later stages are the major factors that give ovarian cancer patients such a dismal prognosis. Women with disease localized to the ovary have a 5-year survival of 80-90%, while women with Stage III disease have a 5-year survival of 30% or less. With our current screening and diagnostic abilities, 70% of women will continue to be diagnosed with FIGO Stage III or IV disease (widespread intra-abdominal disease) and the majority of them will die of their disease (3). The conservative cost of treatment for ovarian cancer is estimated at least $15 billion dollars/year (4-6), due primarily to the late stage of diagnosis, the high morbidity associated with treatment, and the high rate of recurrence.Large cancers are easily detected at the time of surgery. However, occult cancers, which are only seen when ovaries are carefully sectioned and cannot be detected by visual assessment at the time of surg...

Research on traumatic stress (TS) among adolescent substance users is limited, with research indicating that not all adolescents who experience trauma are substance users and not all adolescent substance users report symptoms of TS. In the general adolescent population, research on TS symptoms indicates gender differences, with more females reporting traumatic life events and more symptoms associated with traumatic stress. A gap in research exists, however, with regard to gender differences among adolescent substance users who report low versus acute levels of TS symptoms. This study included 274 male and 104 female adolescents enrolled in four drug treatment programs in Arizona. Comparisons between males and females and those with low versus acute levels of TS symptoms were examined with regard to substance use, mental health, physical health, and HIV risk-taking behavior. Results indicate significant differences between males and females and between those reporting low versus acute TS. In general, females and those with acute levels of TS symptoms had higher levels of substance use, mental health, and physical health problems as well as greater HIV risk behaviors when compared to males and those with low levels of TS symptoms. Results of this study indicate the need to assess adolescents for TS, including victimization and maltreatment histories, when entering substance abuse treatment and the need to simultaneously address issues of substance use, TS, and related mental health, physical health, and HIV sex risk behavior while in treatment.

Objective: Violence and HlV are emerging as interconnected public health hazards among drug users and their families. The purposes of this study are to (1) determine the prevalence of sexual and physical abuse of non-drug-using female sex partners of male drug users, and (2) ascertain the association between such violence and HIV-related risk behaviors. Methods: From 11/93 to 11/95, 208 female sex partners of injection drug or crack users in Collier County, FL, Tucson, AZ, and Portland, OR, were interviewed as part of a NIDA-hnded HIV risk reduction project. Their mean age was 30 years (range 18-54);

Study Objectives: To examine whether change in total sleep time during an integrative, behavioral sleep intervention is associated with aggression. Specifically, we tested whether adolescents who reported experiencing aggressive thoughts or actions after treatment had worse treatment trajectories (e.g., less total sleep time across treatment) than adolescents with no aggressive thoughts or actions after treatment. Design: Nonpharmacologic open trial with 9 weeks of weekly assessment. Setting: University of Arizona Sleep Research Laboratory Patients or Participants: Twenty-three adolescents recently treated for substance abuse in outpatient community centers. Intervention: Six-week integrative, behavioral sleep intervention. Measurements and Results: Weekly sleep-summary indexes were calculated from daily sleep diaries and entered as dependent variables in a series of growth-curve analyses. Statistically significant Session × Post-treatment Aggressive Ideation interactions emerged when predicting changes in total sleep time, γ13 = 9.76 (SE = 4.12), p < .05, and time spent in bed, γ13 = 10.08,(SE = 4.33), p < .05, even after controlling for aggressive ideation and the frequency of substance use, as assessed at baseline. A similar pattern of results was seen for self-reported aggressive actions occurring during conflicts. Conclusions: These pilot data suggest that inadequate sleep in substance-abusing adolescents may contribute to the experiencing of aggressive thoughts and actions. Limitations include a small sample size and a restricted assessment of aggression. Nonetheless, these findings lend preliminary support to the breadth of therapeutic effectiveness of an integrative, behavioral sleep-therapy program for adolescents with a history of substance abuse and related behaviors. Citation: Haynes PL; Bootzin RR; Smith L et al. Sleep and aggression in substance-abusing adolescents: results from an integrative behavioral sleep-treatment pilot program. SLEEP 2006;29(4): 512-520.

Many adolescents entering substance abuse treatment have coexisting mental health problems and are criminally involved. Examination of the complexities of substance use, mental health, and criminal justice involvement along with changes in these issues following treatment is needed. This study includes 941 males and 266 females enrolled in seven drug treatment programs located in geographically diverse areas of the United States. Comparisons between males and females at treatment entry and three, six, 12 and 30 months later were examined with regard to substance use, mental health, and criminal justice involvement. Results indicate that females showed significantly greater severity in substance use, problems associated with use, and mental health related variables at intake while males had significantly more days on probation/parole. With respect to change over time, the rate of change in mental health and days on probation/parole differed between the sexes. Results indicate that while rate of change is different for males and females on most variables, there was positive change following treatment for both groups with regard to substance use, mental health, and probation/parole status. The high severity levels of females at intake calls for gender-specific outreach and identification along with gender-specific treatments.

This research investigated the utility of single-indicator measures of sexual orientation in examining group differences. Adolescents and young adults reported their sexual orientations, preferences, and partners. Results indicate that, (a) depending on the measure of sexual orientation, 10% to 22% cannot be categorized into a sexual orientation group using a single-indicator measure; (b) self-identified sexual orientation is often incongruent with preference and behavior; (c) incongruity differs by gender and self-identified sexual orientation; and (d) detected differences in gay/lesbian, bisexual, and straight individuals vary by measure of sexual orientation. These results indicate that classification of sexual orientation by single-indicator measures can lead to inconsistent conclusions across studies.

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