RESUMO
A longitudinal study of young attention-deficit hyperactivity disorder (ADHD) boys has found clear evidence for developmental abnormalities in event-related potential (ERP) waves that reflect cognitive processes associated with selective attentional tasks. Boys alternated attention to auditory or visual modalities in a train of stimuli, in an attempt to detect target stimuli in the attended modality. Results suggest that ADHD boys' attentional difficulties are due to insufficient facilitation of responses to the attended stimuli and not to an inability to block ignored stimuli. Abnormalities in ERPs reflecting cognitive processes associated with both interchannel selection mechanisms (processing negativity) and intrachannel selection mechanisms (P3b) were found. The degree of abnormality in the P3b responses to target stimuli in ADHD boys (lower than normal boys) was found to increase with age. It is suggested that the abnormally low P36 response to attended target stimuli found in ADHD boys may be due in part to insufficient LC noradrenergic activity normally triggered by attended task-relevant or novel stimuli.
Assuntos
Nível de Alerta , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Atenção , Eletroencefalografia , Nível de Alerta/fisiologia , Atenção/fisiologia , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Mapeamento Encefálico/instrumentação , Córtex Cerebral/fisiopatologia , Criança , Eletroencefalografia/instrumentação , Potenciais Evocados Auditivos/fisiologia , Potenciais Evocados Visuais/fisiologia , Seguimentos , Humanos , Masculino , Processamento de Sinais Assistido por Computador/instrumentaçãoRESUMO
Human immunodeficiency virus (HIV) causes a spectrum of immunodysfunction, the most severe of which is the acquired immunodeficiency syndrome (AIDS). We have followed the course of psoriasis in 13 patients over 2 1/2 years in a population of more than 1000 HIV-positive individuals. Four patients had a history of mild psoriasis that became severe and uncontrollable as symptoms of immunodeficiency developed. Psoriasis and HIV positivity, AIDS-related complex, or AIDS simultaneously developed in nine patients. In addition to psoriasis, Reiter's syndrome (arthritis, urethritis, and conjunctivitis) developed in one patient in the first group and three patients in the second group. Opportunistic infections, especially candidiasis and Staphylococcus, drugs, and an altered immune system may contribute to the development or flare of psoriasis in these patients. The appearance of severe psoriasis (especially in a patient with other risk factors for HIV) should prompt evaluation for HIV, and may be a poor prognostic indicator in HIV-positive patients, since nine of our 13 patients have died. Immunosuppressive therapy with methotrexate is contraindicated in this group of patients. Newer forms of drug therapy including etretinate show promising results for the management of AIDS-associated psoriasis.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Artrite Reativa/patologia , Psoríase/patologia , Complexo Relacionado com a AIDS/patologia , Complexo Relacionado com a AIDS/terapia , Síndrome da Imunodeficiência Adquirida/patologia , Síndrome da Imunodeficiência Adquirida/terapia , Adulto , Artrite Reativa/terapia , Soropositividade para HIV/patologia , Soropositividade para HIV/terapia , Humanos , Masculino , Infecções Oportunistas/patologia , Infecções Oportunistas/terapia , Prognóstico , Psoríase/terapia , Pele/patologiaRESUMO
High-risk sex and drug use behaviors are examined among 446 male street youth 14 to 23 years old in Hollywood, California (the area in Los Angeles County with the highest number of AIDS cases). Comparisons are made based on whether the sex behaviors occurred in situations of "survival sex" ("sex you gotta do") and "recreational sex" ("sex you wanna do"). Ninety-seven percent of the males were sexually active, with 27.1% involved in prostitution in the last 3 months. Involvement in prostitution is most common among older, gay identified males. The most prevalent risk factors seen among this group include inconsistent condom use (which also varies by social situation), high-risk sexual behaviors during both survival and recreational sex, large numbers of sexual partners, intravenous drug use, and the use of drugs and alcohol during all sex.
Assuntos
Comportamento do Adolescente , Pessoas Mal Alojadas/psicologia , Assunção de Riscos , Comportamento Sexual , Adolescente , Adulto , Infecções por HIV/prevenção & controle , Humanos , Los Angeles , Masculino , Trabalho Sexual/estatística & dados numéricos , Transtornos Relacionados ao Uso de SubstânciasRESUMO
The scarring alopecias are a diverse group of diseases characterized by the combination of follicular destruction and dermal scarring. In this article we divide scarring alopecias into three broad categories, pediatric diseases, perifollicular lymphocytic diseases, and folliculopustular diseases, and discuss selected entities from each category.
Assuntos
Alopecia/patologia , Cicatriz/patologia , Adulto , Alopecia/etiologia , Alopecia/terapia , Criança , Cicatriz/etiologia , Cicatriz/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Methamphetamine (MA) abuse has been a problem in the western United States for decades. However, recently the incidence of MA abuse has risen to epidemic levels in some regions and among particular subgroups of the population. Recognizing the need to develop effective treatments for MA dependence, the Center for Substance Abuse Treatment (CSAT) established a multisite Methamphetamine Treatment Program (MTP) that compares the Matrix Model treatment program for MA to the treatments as usual at seven community-based clinics in California, Montana and Hawaii. Examination of the clients receiving services though this project provides an opportunity to explore particular issues of diverse special populations who are impacted by the problem of MA dependence. These groups include rural Americans, Native Americans, Hawaiians, gay and bisexual males and drug court participants. Specifically, this article examines cultural, geographic and situational barriers to accessing and completing treatment and presents strategies that have been used to overcome these barriers.