Key characteristics of women and men suffering from alcohol dependence in the context of auto-agressive behaviour

Aim. To define the clinically and practically significant differences in characteristics of women and men who suffer from alcohol dependency in terms of auto-aggressive behavior associated with alcohol dependence. The article presents the analysis of data obtained in 124 subjects divided into two groups 62 subjects each, women and men suffering from alcohol dependence.Results. The study shows that women and men suffering from alcohol dependence have certain features throughout the course of the disease in the context of the auto-aggressive behavior. Most of the subjects were characterized by a hereditary development of the alcohol dependency represented by the presence of the alcoholism in mothers among 32% of female patients versus 10% among male ones. Women, in general, had more severe alcohol dependence (84% of the female subjects had rapid progression of the disease). The duration of therapeutic remission in most of the cases was less than a year, there were no prolonged therapeutic remissions (3 to 5 years).Conclusion. Women and men have different course of the alcohol dependence, including the auto-aggressive behavioral characteristics, which in turn requires special attention of the medical services that provide narcological and anti-suicidal aid to both female and male patients. Development of gender-specific therapeutic approaches to the treatment of alcohol dependency is also required.

Key characteristics of women and men suffering from alcohol dependence in the context of auto-agressive behaviour

Aim. To define the clinically and practically significant differences in characteristics of women and men who suffer from alcohol dependency in terms of auto-aggressive behavior associated with alcohol dependence. The article presents the analysis of data obtained in 124 subjects divided into two groups 62 subjects each, women and men suffering from alcohol dependence.Results. The study shows that women and men suffering from alcohol dependence have certain features throughout the course of the disease in the context of the auto-aggressive behavior. Most of the subjects were characterized by a hereditary development of the alcohol dependency represented by the presence of the alcoholism in mothers among 32% of female patients versus 10% among male ones. Women, in general, had more severe alcohol dependence (84% of the female subjects had rapid progression of the disease). The duration of therapeutic remission in most of the cases was less than a year, there were no prolonged therapeutic remissions (3 to 5 years).Conclusion. Women and men have different course of the alcohol dependence, including the auto-aggressive behavioral characteristics, which in turn requires special attention of the medical services that provide narcological and anti-suicidal aid to both female and male patients. Development of gender-specific therapeutic approaches to the treatment of alcohol dependency is also required.

Chemotherapy for advanced and recurring basal cell carcinoma (BCC) with docetaxel and cisplatin

16546 Background: Up to 85% of all BCC are localized in head and neck region and can usually be cured by surgery. The recurrent BCC (rBCC) may grow under normal skin and have a more agressive behaviour. Sometimes, when it is discovered could be unresectable or lead to a great deformity if removed. Methods: Between December 2000 and December 2003 we have treated 3 patients (pts), 2 male/1 female with invasive rBCC with osseous involvement in retro-orbital region, invasion of paranasal and ethmoidal sinus, nasal cavity and orbital bone. Medium size 7 cm. Two pts have already received radiotherapy (RXT) one and two years before. Therapy consisted of docetaxel 35 mg/m2 and cisplatin 25 mg/m2 D1,D8 and D15 with one or two weeks interval. Results: They achieved complete response at the 6th cycle and received more 3 cycles- total of nine cycles.The pt that not had RXT before, received 5000 cGy as consolidation. Reconstrutive surgery was not necessary and two pts recovered the vision of the affected eye. Toxicity was mild in all pts with no grade 3 or 4. All pts are in complete remission until now. Conclusions: Contrary to previous reports, advanced BCC is responsive to chemotherapy with a longlasting response even after RXT, improving the quality of life and perhaps survival of pts with rBCC. No significant financial relationships to disclose.

Adult Langerhans’ Cell Histiocitosis (LCH). A Single Institution Experience.

Langerhans’ cell histiocytosis (LCH) is a rare clonal disorder that affects mainly children. Clinical presentation as well as behaviour are heterogeneous and can range from solitary, relatively benign lesions to a fatal disseminated disease. Although the features have been well described in children, they remain poorly defined in adults. We report the clinical characteristics and outcome of 30 adults from a single institution. Clinical presentation: From 1957 to 2003, 30 patients were diagnosed with LCH at MDA. Median age at presentation was 37 years-old, with 60% of being male. Depending on the organs involved and according to the pediatric classification, 17 cases (57%) had a limited form of LCH (single-system) and 13 cases (43%) had disseminated disease (multisystemic). Patients with single-system LCH had mainly bone (76%) and skin (24%) involvement, which was localized to a single site in 10 cases (58%) and multifocal in the remaining. Patients with limited disease were younger (median age 30 yo). Patients with multisystemic LCH were subdivided into a “high risk” category (5 patients) if lung, liver, spleen, or bone marrow was involved, or into a “low risk” category (8 cases), if none of the risk organs was affected. Six patients had pulmonary involvement, typically as bilateral small nodules although diffuse progressive infiltrates were also present in 2 cases. Clinical course: Patients with limited disease were mainly treated with steroids, radiation, or immunomodulatory agents while those with multifocal or multi-systemic disease had a more agressive behaviour and were treated with systemic therapy. Patients with pulmonary nodules usually responded to systemic steroids and stop of smoking habit. Median of 3 treatments were given (range 1 to 7). Sixty-one percent of patients had a 30-year overall survival (OS). Single-system LCH had a more indolent course (79% OS at 30 years) than multi-systemic LCH (median OS of 16 years). Risk organ involvement was the most important adverse prognostic factor (median OS of 2.2 years vs. 65% OS at 30 years, p: 0.007). Figure 1. Global overall survival on LCH patients Figure 1. Global overall survival on LCH patients Figure 2. Overall survival according to the extent of the disease Figure 2. Overall survival according to the extent of the disease

The development of aggressive behaviour during childhood: What have we learned in the past century?

Research on human aggression has been a flourishing industry in the 20th century. As the attention shifted from an instinctual paradigm to a drive paradigm and a social learning paradigm, what have we learned on the development of aggressive behaviour during childhood? Are children born with an aggressive instinct or do they have to learn to aggress?This question has deep philosophical roots, but it also has important practical implications. Should interventions prevent children from learning to aggress or should they help children learn to inhibit aggressive reactions? Since most of the 20th century work on the development of aggression was concentrated on adolescents and elementary school age children, there appeared to be an implicit assumption that aggression is learned during these developmental periods. It is argued that to understand the origins of aggressive behaviour and prevent chronic cases of physical aggression we will need to focus on the development of aggressive behaviour during the first few years after birth, and differentiate among forms of aggressive behaviour. The form of agressive behaviour that is generally considered more “serious” or “socially unacceptable” (physical aggression) is clearly ontogenetically antecedent to less “serious” forms of aggressive behaviour, such as verbal aggression or indirect aggression. Furthermore, as a rule the frequency of physical aggression appears to decrease with age. However, infants’ physical aggression has generally not been considered developmentally significant. This is probably because of “the weakness of their limbs” and the apparent lack of “intentionality”. To have a relatively complete description of the life-span developmental trajectories of human aggressive behaviour by the end of the 21st century, we will need to start recruiting pregnant women very soon.