Personality disorders and opiate addiction: a descriptive analysis by SPECT in dual pathology patients / Trastornos de personalidad y adicción a opiáceos: un estudio descriptivo mediante SPECT en pacientes con patología dual

2010 ◽  
Vol 10 (2) ◽  
Author(s):  
César Mateu ◽  
Ana Benito ◽  
Josep Pena-Garijo ◽  
José Ferrer ◽  
Juan Barea ◽  
...  

Introducción: Los sujetos dependientes de sustancias presentan algunos rasgos de personalidad comunes, pero no se ha podido demostrar que la presencia de estas características determine la adicción. Se pretende analizar la actividad cerebral en un grupo de pacientes con dependencia de opiáceos más Trastorno Límite de Personalidad (TLP) o Trastorno de Personalidad No Especificado (TPNE).Método: Se comparó una muestra de 25 sujetos con patología dual con 17 sujetos sanos. Se obtuvieron imágenes SPECT utilizando como trazador radioactivo el Tc99m-ECD por vía intravenosa. Los datos se analizaron con el paquete de software Entegra.Resultados: Al comparar el grupo de adictos con TPNE con el grupo de control, se apreciaron diferencias estadísticamente significativas en el número de cuentas registradas en el tálamo ( =9043,26; p<0,029) lo que evidencia una menor actividad talámica en estos sujetos respecto a aquellos que no presentaban patología. No se observaron diferencias estadísticamente significativas en el resto de comparaciones.Conclusión: Los pacientes con adicción a opiáceos y TPNE presentan un patrón de hipoactividad talámica comparados con un grupo de sujetos normales. Este hecho nos puede ayudar en el entendimiento de la etiología de estos trastornos, al menos en el subgrupo de pacientes con patología dual. AbstractIntroduction: Patients with substance abuse show some common personality characteristics but it has not been possible to demonstrate that the presence of these characteristics determines their addiction. In the present investigation we tried to analyze cerebral activity in a group of patients with dependency on opiates and Borderline Personality Disorder (BPD) or Personality Disorder Not Otherwise Specified (PDNOS).Method: Cross-sectional study of an observational type with descriptive and analytical components in a sample of 25 subjects with dual pathology in comparision with 17 healthy subjects. SPECT images were acquired using 99mTC-ECD (Tcm-Ethyl Cysteinate Die-thylester) by intravenous route as a radioactive tracer. Data were analyzed with the software package Entegra.Results: When we compared subjects with PDNOS to the control group, statistically significant differences in the number of counts registered in the thalamus were noticeable ( =9043.26; p<0.029), which demonstrates less thalamic activity in PDNOS subjects with respect to healthy subjects. Statistically significant differences in the rest of comparisons between groups were not observed.93 Trastornos de personalidad y adicción a opiáceos: un estudio descriptivo Health and Addictions / Salud y Drogas 2010, Vol. 10, nº 2, pp. 91-110Conclusion: Pacients with PDNOS and adiction show a thalamic hypoactivity pattern. This conclusion could help us in the understanding of the pathogenesis of this disorder and its differentiation from the other PD, like BPD, at least in patients with dual pathology. 

2013 ◽  
Vol 33 (3) ◽  
pp. 316-324 ◽  
Author(s):  
Kultigin Turkmen ◽  
Orhan Ozbek ◽  
Mehmet Kayrak ◽  
Cigdem Samur ◽  
Ibrahim Guler ◽  
...  

BackgroundThoracic peri-aortic fat tissue (PFT) and epicardial adipose tissue (EAT) are metabolically active visceral fat deposits surrounding the thoracic aorta and the heart, respectively. Various studies have demonstrated a positive predictive value of both PFT and EAT for coronary artery disease in the general population. In the present study, we aimed to investigate PFT thickness and the independent predictors of PFT in peritoneal dialysis (PD) patients.MethodsOur cross-sectional study enrolled 35 PD patients (10 women, 25 men) and 30 age-and-sex-matched healthy subjects (15 women, 15 men). We measured PFT, thoracic artery calcification (TAC), EAT, and coronary artery calcification (CAC) by electrocardiogram-gated 64–multi-detector computed tomography.ResultsThe measured PFT, EAT, CAC, and TAC were significantly higher in the PD group than in the healthy subjects ( p < 0.05 each). In the PD group, PFT and TAC were significantly correlated ( r = 0.33, p = 0.007). Also, PFT measurements were positively correlated with EAT and total CAC in the PD and the control group alike ( r = 0.58, p = 0.001 and r = 0.54, p = 0.01 respectively). A stepwise linear regression analysis revealed that age, duration of hypertension, and being a PD patient were independent predictors of PFT.ConclusionsMeasured PFT was higher in PD patients than in healthy subjects and, in the PD population, was also shown to be related to calcification scores and EAT.


Author(s):  
Kashish Narula ◽  
Narendra Kumar Dara ◽  
Shyam Lal Meena

Background: Thyroid hormones influence nearly all major metabolic pathways. Their most obvious and well-known action is the increase in basal energy expenditure obtained by acting on protein, carbohydrate and lipid metabolism. The lipid metabolism is more influenced by the thyroid hormone. Methods: A cross-sectional study was conducted on 100 patients with suspicion of thyroid disorders were taken as cases. One hundred patients with normal thyroid profile and no history of other chronic diseases were taken as control group. Results: The serum TC, TG and LDL levels in hypothyroid individuals (both overt and subclinical) were significantly higher than euthyroid subjects but the levels were comparable between hyperthyroid and euthyroid group. Conclusion: Dyslipidemias are associated with thyroid disorders, so biochemical screening for thyroid dysfunction in all dyslipidemic patients. Therefore, patients presenting with dyslipidemia are recommended for investigation to explore thyroid dysfunction. Keywords: Thyroid profile, Total cholesterol, Triglycerides and LDL


2013 ◽  
Vol 40 (2) ◽  
Author(s):  
Ni Ketut Susilawati ◽  
Wayan Sudana ◽  
Eka Putra Setiawan

Background: Noise pollution or noise is an unwanted sound which is disturbing to human beings.However small or soft the sound, if it is undesirable it is considered as noise. Noise induced hearingloss is a sensorineural hearing loss that is commonly encountered second to presbycusis. Purpose: Toknow the effect of traffic noise exposure on hearing impairment to the employees of the Parking DistrictCompany of the Denpasar city and to improve diagnostic detection on hearing impairment caused bynoise. Method: A cross sectional study was conducted at the Parking District Company office. Thepopulations of this study were the employees of the Parking District Company. Samples of this study were the employees who were exposed to traffic noise and control samples were an employee who was unexposed. Samples were selected by simple random sampling. Results: From 40 parking attendants,27 persons (67.5%) aged above 35 years old. The parking attendants who had been working for ten to fifteen years were 36 persons (90%) and no history using ear protection when working. Seven persons(17.5%) had referred DPOAE upon examination with increase hearing threshold on audiogram result.In this study the parking attendants who had hearing deficit induced by noise were 7 persons (17.5%)and only one person (2.5%) in control group. There was a statistically significant effect of traffic noiseto hearing function deficit (p<0.05). Conclusion: Traffic noise has effect in hearing function deficit onthe parking attendants.ORLI Vol. 40 No. 2 Tahun 2010Key words: NIHL, parking attendant, audiometry, DPOAE.


2019 ◽  
pp. 68-73
Author(s):  
Trong Nghia Nguyen ◽  
Thi Nhan Nguyen ◽  
Thi Dua Dao

Background: The metabolic syndrome is a constellation of cardiometabolic risk factors that tend to cluster together in affected individuals more often than predicted by chance. The presence of the metabolic syndrome substantially increases the risk of developing type 2 diabetes and cardiovascular disease, and is associated with a range of adverse clinical outcomes, many of which are closely associated with aging. Current estimates suggest that approximately 20 - 25% of the world’s population is affected by the metabolic syndrome. The prevalence of the metabolic syndrome rises with age and more than 45% of people aged over 60 years have the metabolic syndrome. Recent studies show that low vitamin D status is very common in the world and this is a risk factor of metabolic syndrome. Objective: (1) Plasma 25-hydroxyvitamin D concentration in subjects with metabolic syndrome. (2) Cut off value of plasma 25-hydroxyvitamin D concentration for predicting metabolic syndrome. Material and method: A cross-sectional study with control group on 318 adult subjects for health examinations at International Medical Center at Hue Central Hospital, including 139 subjects with metabolic syndrome and control group of 179 healthy subjects. Metabolic syndrome was defined according to the IDF, NHLBI, AHA, WHF, IAS, IASO (2009). Plasma hydroxyvitamin D concentration was measured using chemiluminescent microparticle immunoassay. Reciever operating characteristic (ROC) curve were generated to assess sensitivity and specificity for different cut off value of 25-hydroxyvitamin D concentration for predicting metabolic syndrome. Results: Plasma 25-hydroxyvitamin D concentration in subjects with metabolic syndrome was 26.4 ng/ml, incidence of plasma 25-hydroxyvitamin D deficiency (59.7%) was significantly higher than in control group (23.5%) (p < 0.001). The optimal cut off point for 25-OH-D concentration for predictor of metabolic syndrome as 26.4 ng/ml (AUC=0.657, sensitivity=53.4%, specificity=71.6%). Conclusion: In 139 subjects with metabolic syndrome, the plasma 25-hydroxyvitamin D concentration was 26.4 ng/ml and the incidence of 25-hydroxyvitamin D deficiency in the metabolic syndrome group was 59.7%. The optimal cut off point for plasma 25-hydroxyvitamin D concentration for predictor of metabolic syndrome as 26.4 ng/ml. Key words: Metabolic syndrome, 25-hydroxyvitamin D


2020 ◽  
Vol 9 (3) ◽  
pp. 207-211
Author(s):  
Sidra Sarwar ◽  
Sara Khalid ◽  
Tahir Mahmood ◽  
Hadeeqa Jabeen ◽  
Shahid Imran

Background: Musculoskeletal disorders are not only becoming prevalent among health care professionals in our country but are affecting their health and performance adversely. They are caused by poor ergonomics and awkward posture during work activities. The purpose of this study was to determine the frequency of neck and upper limb musculoskeletal disorders in dentists of Lahore, Pakistan. Material and Methods: This cross-sectional study was conducted during October 2017 to March 2018. The data was collected using convenient sampling technique from 162 Dentists including 52 males and 110 females of Children hospital Lahore, Punjab Dental hospital and Fatima Memorial Hospital, Lahore. Data was collected by using Mangalore Questionnaire for identification of musculoskeletal disorders. Descriptive analysis of the data was done using SPSS version 22.0. Results: Of 162 dentists, 115 (71%) suffered from musculoskeletal disorders. Shoulder was the most commonly affected region (30.9%) followed by neck (25.9%), arm (6.2%), wrist (4.3%), elbow (3.1%) and forearm (0.6%). Pain (45.7%) was found to be the most common complaint followed by muscle weakness (20.4%), paraesthesia (3.7%) and swelling (1.2%). Conclusions: It was concluded that majority of the dentists were suffering from musculoskeletal disorders with shoulder as the most affected region and pain as the most frequent complaint. Key words: Dentists, Musculoskeletal disorders, Neck pain, Upper extremity


Author(s):  
Quratul-Ain Zafar

Objective: The purpose of this study was to evaluate the impact of the COVID-19 pandemic on frontline healthcare workers in Pakistan in terms of psychological factors emotional distress, insomnia, and burnout. Study Design: Observational cross-sectional study. Place and Duration of Study: This study was conducted at different hospitals across Pakistan and data collection was carried out from 15th June 2020 till 15th August 2020. Material and Methods: This was a questionnaire-based study aiming to compare the levels of burnout and emotional distress between frontline COVID-19 and non-COVID-19 healthcare workers. Any physician, nurse, and other healthcare workers were recruited from emergency care units and Covid-19 care units (target group), and non-COVID-19 care units (control group). Participation was voluntary and participants had to complete self-reported questionnaires and scales. A mixed-mode data collection was carried out, either in paper or web-based form to ensure maximum participation. Results: The independent t-test showed a statistically significant difference between the two groups regarding depression, stress, and insomnia. The study group showed higher scores for these factors than the control group. Chi-square test of association revealed significant scores of burnout and professional fulfillment in both groups. There was a higher prevalence of burnout in the study group than in the control group. Conclusion: This study concludes that there was a significant psychosocial impact of the Covid-19 pandemic in the frontline healthcare workers measured in terms of emotional distress, insomnia, and burnout.


Author(s):  
Fatih Öner Kaya ◽  
Yeşim Ceylaner ◽  
Belkız Öngen İpek ◽  
Zeynep Güneş Özünal ◽  
Gülbüz Sezgin ◽  
...  

Aims: The etiopathogenesis of Rheumatoid Arthritis (RA) is not clearly understood. However, the role of the cytokines takes an important part in this mechanism. We aimed to bring a new approach to the concept of 'remission' in patients with RA. Background: RA is a chronic, autoimmune, inflammatory disease that involves small joints in the form of symmetrical polyarthritis and progresses with exacerbations and remissions. Pain, swelling, tenderness and morning stiffness are typical of the joints involved. Although it is approached as a primary joint disease, a wide variety of extra-articular involvements may also occur. It is an interesting pathophysiological process, the exact cause of which is still unknown, with many environmental, genetic and potentially undiscovered possible factors in a chaotic manner. Objective: In this cross-sectional study, sedimentation rate (ESR), C- Reactive protein (CRP), Tumor necrosis factor (TNF)-α, soluble-TNF-α receptor (TNF-R), Interleukin (IL)-1B and IL-10 were measured in three groups which were healthy volunteers, patients with RA in the active period, and patients with RA in remission. Disease activity score-28 (DAS-28) was calculated in active RA and RA in remission. Methods: This study included 20 healthy volunteers, 20 remission patients with RA and 20 active RA patients. Venous blood samples were collected from patients in both healthy and RA groups. Results: RA group consisted 43 (71.6%) female and 17 (28.4%) male. Control group consisted 11 (55%) female and 9 (45%) male. TNF-R was significantly high only in the active group according to the healthy group (p=0.002). IL-10 was significantly high in active RA according to RA in remission (p=0.03). DAS-28 was significantly high in active RA according to RA in remission (p=0.001). In the active RA group, ESR and TNF-R had a positive correlation (r:0.442; p=0.048). In the active RA group, there was also a positive correlation between TNF-R and CRP (r:0.621; p=0,003). Both healthy and active RA group had significant positive correlation between ESR and CRP (r: 0.481; p=0.032 and r: 0,697; p=0,001 respectively). Conclusion: TNF-R can be the main pathophysiological factor and a marker showing activation. TNF-R can be very important in revealing the effect of TNF on the disease and the value of this effect in the treatment and ensuring the follow-up of the disease with CRP instead of ESR in activation.


2019 ◽  
Vol 19 (6) ◽  
pp. 803-808 ◽  
Author(s):  
Luigi Vimercati ◽  
Luigi De Maria ◽  
Francesca Mansi ◽  
Antonio Caputi ◽  
Giovanni M. Ferri ◽  
...  

Background: Thyroid diseases occur more frequently in people exposed to ionizing radiation, but the relationship between occupational exposure to ionizing radiation and thyroid pathologies still remains unclear. Objective: To evaluate the prevalence of thyroid diseases in healthcare workers exposed to low-level ionizing radiation compared with a control group working at the University Hospital of Bari, Southern Italy, and living in the same geographical area, characterized by mild iodine deficiency. Methods: We ran a cross-sectional study to investigate whether healthcare workers exposed to ionizing radiation had a higher prevalence of thyroid diseases. Four hundred and forty-four exposed healthcare workers (241 more exposed, or “A Category”, and 203 less exposed, or “B Category”) and 614 nonexposed healthcare workers were enrolled during a routine examination at the Occupational Health Unit. They were asked to fill in an anamnestic questionnaire and undergo a physical examination, serum determination of fT3, fT4 and TSH, anti-TPO ab and anti-TG ab and ultrasound neck scan. Thyroid nodules were submitted to fine needle aspiration biopsy when indicated. Results: The prevalence of thyroid diseases was statistically higher in the exposed workers compared to controls (40% vs 29%, adPR 1.65; IC95% 1.34-2.07). In particular, the thyroid nodularity prevalence in the exposed group was approximately twice as high as that in the controls (29% vs 13%; adPR 2.83; IC95% 2.12-3.8). No statistically significant association was found between exposure to ionizing radiation and other thyroid diseases. Conclusion: In our study, mild ionizing radiation-exposed healthcare workers had a statistically higher prevalence of thyroid diseases than the control group. The results are likely due to a closer and more meticulous health surveillance programme carried out in the ionising radiation-exposed workers, allowing them to identify thyroid alterations earlier than non-exposed health staff.


2021 ◽  
pp. 036354652098781
Author(s):  
Mathias Paiva ◽  
Lars Blønd ◽  
Per Hölmich ◽  
Kristoffer Weisskirchner Barfod

Background: Tibial tubercle–trochlear groove (TT-TG) distance is often used as a measure of lateralization of the TT and is important for surgical planning. Purpose: To investigate if increased TT-TG distance measured on axial magnetic resonance images is due to lateralization of the TT or medialization of the TG. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 84 knees (28 normal [NK], 28 with trochlear dysplasia [TD], and 28 with patellar dislocation without TD [PD]) were examined. The medial border of the posterior cruciate ligament (PCL) was chosen as the central anatomic landmark. The distance from the TT to PCL (TT-PCL) was measured to examine the lateralization of the TT. The distance from the TG to the PCL (TG-PCL) was measured to examine the medialization of the TG. Between-group differences were investigated by use of 1-way analysis of variance. Results: The mean values for TT-TG distance were 8.7 ± 3.6 mm for NK, 12.1 ± 6.0 mm for PD, and 16.7 ± 4.3 mm in the TD group ( P < .01). The mean values for TT-PCL distance were 18.5 ± 3.6 mm for NK, 18.5 ± 4.5 mm for PD, and 21.2 ± 4.2 mm in the TD group ( P = .03). The mean values for TG-PCL distance were 9.6 ± 3.0 mm for NK, 7.1 ± 3.4 mm for PD, and 5.1 ± 3.3 mm in the dysplastic group ( P < .01). Conclusion: The present results indicate that increased TT-TG distance is due to medialization of the TG and not lateralization of the TT. Knees with TD had increased TT-TG distance compared with the knees of the control group and the knees with PD. The TT-PCL distance did not differ significantly between groups, whereas the TG-PCL distance declined with increased TT-TG.


Author(s):  
Ella Nissan ◽  
Abdulla Watad ◽  
Arnon D. Cohen ◽  
Kassem Sharif ◽  
Johnatan Nissan ◽  
...  

Polymyositis (PM) and dermatomyositis (DM) are autoimmune-mediated multisystemic myopathies, characterized mainly by proximal muscle weakness. A connection between epilepsy and PM/DM has not been reported previously. Our study aim is to evaluate this association. A case–control study was conducted, enrolling a total of 12,278 patients with 2085 cases (17.0%) and 10,193 subjects in the control group (83.0%). Student’s t-test was used to evaluate continuous variables, while the chi-square test was applied for the distribution of categorical variables. Log-rank test, Kaplan–Meier curves and multivariate Cox proportional hazards method were performed for the analysis regarding survival. Of the studied 2085 cases, 1475 subjects (70.7%) were diagnosed with DM, and 610 patients (29.3%) with PM. Participants enrolled as cases had a significantly higher rate of epilepsy (n = 48 [2.3%]) as compared to controls (n = 141 [1.4%], p < 0.0005). Using multivariable logistic regression analysis, PM was found only to be significantly associated with epilepsy (OR 2.2 [95%CI 1.36 to 3.55], p = 0.0014), whereas a non-significant positive trend was noted in DM (OR 1.51 [95%CI 0.99 to 2.30], p = 0.0547). Our data suggest that PM is associated with a higher rate of epilepsy compared to controls. Physicians should be aware of this comorbidity in patients with immune-mediated myopathies.


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