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Plasma discharges with a negative triangularity (δ=-0.4) shape have been created in the DIII-D tokamak with a significant normalized beta (ß_{N}=2.7) and confinement characteristic of the high confinement mode (H_{98y2}=1.2) despite the absence of an edge pressure pedestal and no edge localized modes (ELMs). These inner-wall-limited plasmas have a similar global performance as a positive triangularity (δ=+0.4) ELMing H-mode discharge with the same plasma current, elongation and cross sectional area. For cases both of dominant electron cyclotron heating with T_{e}/T_{i}>1 and dominant neutral beam injection heating with T_{e}/T_{i}=1, turbulent fluctuations over radii 0.5<ρ<0.9 were reduced by 10-50% in the negative triangularity shape compared to the matching positive triangularity shape, depending on the radius and conditions.
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During gait, the trunk and neck are believed to play an important role in dissipating the transmission of forces from the ground to the head. This attenuation process is important to ensure head control is maintained. The aim of the present study was to assess the impact of externally restricting the motion of the trunk and/or neck segments on acceleration patterns of the upper body and head and related trunk muscle activity. Twelve healthy adults performed three walking trials on a flat, straight 65-m walkway, under four different bracing conditions: 1) control-no brace; 2) neck-braced; 3) trunk-braced; and 4) neck-trunk braced. Three-dimensional acceleration from the head, neck (C7) and lower trunk (L3) were collected, as was muscle activity from trunk. Results revealed that, when the neck and/or trunk were singularly braced, an overall decrease in the ability of the trunk to attenuate gait-related oscillations was observed, which led to increases in the amplitude of vertical acceleration for all segments. However, when the trunk and neck were braced together, acceleration amplitude across all segments decreased in line with increased attenuation from the neck to the head. Bracing was also reflected by increased activity in erector spinae, decreased abdominal muscle activity and lower trunk muscle coactivation. Overall, it would appear that the neuromuscular system of young, healthy individuals was able to maintain a consistent pattern of head acceleration, irrespective of the level of bracing, and that priority was placed over the control of vertical head accelerations during these gait tasks.
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Marcha , Cabeça/fisiologia , Pescoço/fisiologia , Tronco/fisiologia , Aceleração , Fenômenos Biomecânicos , Feminino , Humanos , Masculino , Músculo Esquelético/fisiologia , Restrição Física , Caminhada/fisiologia , Adulto JovemRESUMO
Small bowel and colon injury represents a significant portion of injuries sustained during penetrating trauma. These wounds may be tangential or through and through. Low velocity wounds are expected in the civilian setting, but high velocity wounds or shotgun injuries at close range can be seen as well. Most often these patients are explored and the injuries sustained can be managed effectively. Selective non-operative management for penetrating abdominal trauma is indicated only when there is no evidence of on-going hemorrhage or hollow viscus injury. The decision to abandon non-operative care must be made very early during the initial hospital course. In contrast bowel injury in blunt abdominal trauma may be difficult to detect. The clinical assessment and initial imaging will often define the extent of injury. However, patients with associated distracting injuries or subtle clinical signs will provide a greater challenge. This paper reviews the overall approach to patients with small bowel and colorectal trauma. It highlights published literature and makes recommendations regarding care based on injury assessment and the patients overall clinical condition. As surgeons we must use an evidenced based approach to undergird our clinical decision making. By doing so, we hope to bring improved outcomes and safer care to our patients.
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Intestinos/lesões , Traumatismos Abdominais/complicações , Traumatismos Abdominais/diagnóstico , Traumatismos Abdominais/cirurgia , Colo/lesões , Humanos , Procedimentos Cirúrgicos OperatóriosRESUMO
Laser light scattering systems with volume Bragg grating (VBG) filters, which act as spectral/angular filters, have often been used as a point measurement technique, with spatial resolution as low as a few hundred µm, defined by the beam waist. In this work, we demonstrate how VBG filters can be leveraged for spatially resolved measurements with several µm resolution over a few millimeters along the beam propagation axis. The rejection ring, as determined by the angular acceptance criteria of the filter, is derived analytically, and the use of the ring for 1D laser line rejection is explained. For the example cases presented,i.e., for a focused probe beam waist with a diameter of â¼150 µm, the rejection ring can provide resolution up to several millimeter length along the beam propagation axis for a 1D measurement, which is also tunable. Additionally, methods to further extend the measurable region are proposed and demonstrated, using a collimation lens with a different focal length or using multiple VBG filters. The latter case can minimize the scattering signal loss, without the tradeoff of the solid angle. Such use of multiple VBGs is to extend the measurable region along the beam axis, which differs from the commonly known application of multiple filters, to improve the suppression of elastic interferences. 1D rotational Raman and Thomson scattering measurements are carried out on pulsed and DC discharges to verify this method. The system features compactness, simple implementation, high throughput, and flexibility, to accommodate various experimental conditions.
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Electron microscopy of negatively stained myosin has previously revealed three discrete regions within the heads of the molecule. However, despite a probable resolution of approximately 2 nm, it is difficult to discern directly consistent details within these regions. This is due to variability in both head conformation and in staining. In this study, we applied single-particle image processing and classified heads into homogeneous groups. The improved signal-to-noise ratio after averaging these groups reveals substantially improved detail. The image averages were compared to a model simulating negative staining of the atomic structure of subfragment-1 (S1). This shows that the three head regions correspond to the motor domain and the essential and regulatory light chains. The image averages were very similar to particular views of the S1 model. They also revealed considerable flexibility between the motor and regulatory domains, despite the molecules having been prepared in the absence of nucleotide. This flexibility probably results from rotation of the regulatory domain about the motor domain, where the relative movement of the regulatory light chain is up to 12 nm, and is most clearly illustrated in animated sequences (available at http://www.leeds.ac.uk/chb/muscle/myosinhead.htm l). The sharply curved conformation of the atomic model of S1 is seen only rarely in our data, with straighter heads being more typical.
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Miosinas/fisiologia , Miosinas/ultraestrutura , Animais , Galinhas , Processamento de Imagem Assistida por Computador , Microscopia Eletrônica/métodos , Modelos Moleculares , Subfragmentos de Miosina/classificação , Subfragmentos de Miosina/fisiologia , Subfragmentos de Miosina/ultraestrutura , Miosinas/classificação , Tamanho da Partícula , Estrutura Terciária de Proteína , Coelhos , Coloração e RotulagemRESUMO
The original PDF version of this Article had an incorrect volume number of '8'; it should have been '9'. This has been corrected in the PDF version of the Article. The HTML version was correct from the time of publication.
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Drastic miniaturization of electronics and ingression of next-generation nanomaterials into space technology have provoked a renaissance in interplanetary flights and near-Earth space exploration using small unmanned satellites and systems. As the next stage, the NASA's 2015 Nanotechnology Roadmap initiative called for new design paradigms that integrate nanotechnology and conceptually new materials to build advanced, deep-space-capable, adaptive spacecraft. This review examines the cutting edge and discusses the opportunities for integration of nanomaterials into the most advanced types of electric propulsion devices that take advantage of their unique features and boost their efficiency and service life. Finally, we propose a concept of an adaptive thruster.
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In female rhesus monkeys (n = 12) housed in a seminatural environment, serum gonadotropin and steroid levels fluctuated annually in a pattern indicative of a seasonally restricted period of ovulatory cycles in the fall and winter and anovulatory cycles in the spring and summer. This seasonal endocrine rhythm occurred independent of pregnancy and lactation, although the presence of a suckling infant delayed the onset of ovulation in the fall by 81 +/- 3.7 days (Dec. 4 vs. Sept 14). Except for serum PRL, levels of gonadotropin and ovarian hormones were similar in lactating and nonlactating females during the spring and summer anovulatory months. Serum levels of LH (less than 10 ng/ml), FSH (less than 4 micrograms/ml), and 17 beta-estradiol (E2; less than 30 pg/ml) were low throughout the summer anovulatory period, exhibiting a significant rise approximately 20 days before first ovulation. Serum progesterone levels were low throughout the 100 days before ovulation (less than 0.5 ng/ml) and did not rise until ovulation occurred. PRL levels remained elevated (greater than 20 ng/ml) in lactating females until 50 days before the first ovulation of the breeding season, but were low throughout the ovulatory, anovulatory, and ensuing ovulatory periods (less than 10 ng/ml). During the breeding period, females exhibited from two to six ovulations. Although the first ovulation of the breeding season occurred within a 40-day period for all females, a subset (n = 6) ceased ovulations significantly earlier than the remaining six females (Jan. 26 vs. March 3). The early cessation of ovulation for these females was associated with significantly lower body weight. After the last ovulation, FSH and E2 fell and remained low, at levels indistinguishable from those of the ensuing spring-summer anovulatory period. In contrast, in females who ceased ovulations later in the breeding season, the period following the luteal phase of the last ovulation was characterized by E2 and gonadotropin levels that were intermediate between those of the anovulatory months and normal follicular phase values. Serum progesterone levels were slightly but significantly elevated following the last ovulation for both groups of females. These data indicate that low basal levels of gonadotropin secretion during the seasonal anovulatory period may result from diminished GnRH secretion or from an alteration in pituitary sensitivity to GnRH stimulation. These data further suggest that the timing of ovulations and associated changes in the neuroendocrine system controlling gonadotropin secretion may be mediated by an environmental variable.
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Estradiol/sangue , Hormônio Foliculoestimulante/sangue , Hormônio Luteinizante/sangue , Macaca mulatta/fisiologia , Macaca/fisiologia , Ovulação , Periodicidade , Progesterona/sangue , Prolactina/sangue , Animais , Feminino , Lactação , Gravidez , Radioimunoensaio , Estações do AnoRESUMO
A short term incubation of baboon fetal adrenal cells obtained at midgestation and near term was used to determine whether a change in the regulation of androgen formation occurs with advancing gestation. Adrenal glands were removed from baboon (Papio anubis) fetuses on day 100 (mid; n = 7) or day 170 (late; n = 5) of gestation, and cells were dispersed with 0.2% collagenase. Cells (10(5] were incubated at 37 C for 3 h in medium 199 in the presence or absence of 10 nM ACTH, 10 nM ovine PRL, 10 nM ovine GH, 50 nM hCG, or 50 nM human chorionic somatomammotropin. Dehydroepiandrosterone (DHA), DHA sulfate (DHAS), cortisol (F), and androstenedione concentrations were determined in the medium by RIA. At midgestation, ACTH, PRL, and GH elevated (P less than 0.05) DHA (168%, 169%, and 178%, respectively) and DHAS (142%, 210%, and 197%, respectively) formation. Near term, ACTH and PRL retained their ability to stimulate (P less than 0.05) DHA (307% and 220%, respectively), but not DHAS, synthesis. The fetal adrenal at late gestation, however, lost its ability to respond to treatment with GH. hCG and human chorionic somatomammotropin did not stimulate steroidogenesis at either time of gestation. F formation at midgestation was less (P less than 0.05) than that at term and not responsive to ACTH. ACTH stimulated (P less than 0.05) F secretion by 68% in fetal adrenal cells obtained near term. The secretion of androstenedione was not affected by any peptide treatment at either stage of gestation. These data indicate that the responsivity of the baboon fetal adrenal to various pituitary peptides is different at two developmentally distinct stages of gestation. We conclude, therefore, that the regulation of fetal adrenal steroidogenesis changes with advancing gestation.
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Glândulas Suprarrenais/embriologia , Androgênios/biossíntese , Idade Gestacional , Hormônios Hipofisários/metabolismo , Hormônio Adrenocorticotrópico/farmacologia , Androstenodiona/análise , Animais , Desidroepiandrosterona/análogos & derivados , Desidroepiandrosterona/análise , Sulfato de Desidroepiandrosterona , Feminino , Hidrocortisona/análise , Masculino , Papio , Prolactina/farmacologia , Valores de ReferênciaRESUMO
Although estradiol (E2) is thought to facilitate PRL secretion under certain conditions in female primates, the role of E2 or other ovarian products in the control of PRL secretion during puberty is unknown. The present study examined the influence of gonadal status on serum PRL levels in prepubertal monkeys housed in an outdoor environment. Basal levels of PRL were examined in three groups of spring-born females that were studied from 12 to 28 months of age (May 1982 to September 1983): gonadally intact (INT; n = 8), ovariectomized (OVX; n = 5), and ovariectomized and treated chronically with E2 (E2OVX; n = 5). All groups exhibited a significant annual rhythm in PRL levels with peaks (10-20 ng/ml) at 14 and 26 months (June to July) and a nadir (less than 2 ng/ml) at 19 months (November to December). Basal PRL levels were significantly higher from 12 to 15 months (May to August) in E2OVX subjects, with OVX having significantly greater concentrations than INT females. Group differences were not evident during the period of minimal secretion from 16 to 20 months (September to January). Finally, levels were again significantly higher in both E2OVX and OVX subjects during the subsequent period from 21 to 27 months (February to August). Although serum levels of E2 were lower in INT (30.9 +/- 2.3 pg/ml) than E2OVX females (51.4 +/- 4.0 pg/ml), group differences in PRL could not be attributed to E2 since OVX females, with no measurable levels of E2 (less than 15 pg/ml), had intermediate levels of PRL. These data suggest that during primate maturation serum PRL levels are dampened by some product of the ovary. Furthermore, whether age specific or environmentally mediated, this rhythm indicates an annual alteration in PRL release, with absolute levels enhanced by E2 replacement after ovariectomy, for prepubertal monkeys housed outdoors. In addition, a significant maturational increase in PRL levels was observed only in INT females when serum levels of PRL were compared for the ages 12-16 months to 24-28 months corresponding to the period between May and September for 2 successive years. These changes in PRL were not related to age-dependent changes in serum E2. Acute treatment of both E2OVX and OVX females with a single injection of E2-benzoate at three different ages did not induce any changes in serum PRL.(ABSTRACT TRUNCATED AT 400 WORDS)
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Macaca mulatta/fisiologia , Macaca/fisiologia , Ovário/fisiologia , Prolactina/sangue , Maturidade Sexual , Animais , Castração , Estradiol/farmacologia , Feminino , Estações do Ano , Hormônio Liberador de TireotropinaRESUMO
We have reported that ACTH stimulation of dehydroepiandrosterone (DHA) formation by the baboon fetal adrenal at midgestation was suppressed by estrogen. Because fetal adrenal regulation changes with advancing gestation, the action of estrogen on fetal adrenal steroidogenesis may also be dependent on the degree of fetal adrenal maturation. We examined this possibility in the present study by determining the effects of ACTH and estrogen on DHA formation by adrenal cells of fetuses obtained from baboons at mid- and late gestation and from animals administered the antiestrogen MER-25 throughout late gestation. Because low density lipoprotein (LDL) provides substrate for the fetal adrenal, we also determined whether the effect of estrogen was mediated by LDL uptake. Adrenals were removed from baboon fetuses on day 100 (midgestation; n = 7) and day 170 (late gestation; n = 6; term, day 184) of gestation from untreated animals and on day 170 from fetuses whose mothers were treated with MER-25 on days 140-170 (25 mg/kg BW.day; n = 7). Cells were dispersed with 0.2% collagenase and incubated at 37 C for 3 h in 4 ml medium 199 with 10 nM ACTH, 10(-6) M estradiol and/or 500 micrograms LDL. The secretion of DHA into medium was determined by RIA. At midgestation, mean (+/- SE) basal DHA formation (nanograms per 10(5) cells/3 h) was 5.8 +/- 2.1, and DHA was increased (P less than 0.01) by ACTH to 20.0 +/- 5.9. Although estradiol alone had no effect, estradiol prevented the increase in DHA obtained with ACTH. Basal DHA production by adrenals of late gestation (0.7 +/- 0.3 ng/10(5) cells) was lower (P less than 0.01) than at midgestation. ACTH increased (P less than 0.01) DHA in a comparable manner near term in the presence (2.0 +/- 0.4) or absence (1.7 +/- 0.4) of estradiol. Thus, in contrast to day 100, estrogen did not attenuate the action of ACTH on adrenal cells on day 170. In fetal adrenal cells obtained on day 170 from MER-25-treated baboons, DHA formation (1.4 +/- 0.6 ng/10(5) cells) was comparably increased (P less than 0.05) to 2.4 +/- 0.2 and 3.0 +/- 0.5 ng/10(5) cells by ACTH in the absence or presence of estradiol. Thus, ACTH remained effective in enhancing DHA by adrenal cells of fetuses exposed in utero to antiestrogen. DHA formation by adrenals of midgestation was increased (P less than 0.05) to 15.4 +/- 4.8 and 27.4 +/- 7.5 ng/10(5) cells, respectively, by LDL and ACTH plus LDL.(ABSTRACT TRUNCATED AT 400 WORDS)
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Glândulas Suprarrenais/embriologia , Hormônio Adrenocorticotrópico/farmacologia , Desidroepiandrosterona/biossíntese , Estradiol/farmacologia , Glândulas Suprarrenais/efeitos dos fármacos , Glândulas Suprarrenais/metabolismo , Animais , Etamoxitrifetol/farmacologia , Idade Gestacional , Lipoproteínas LDL/farmacologia , PapioRESUMO
BACKGROUND: Preclinical research has shown that the serotonin-1B receptor has important modulatory effects on feeding behavior and thus body weight. In the current study, we examined whether genetic variation of the serotonin-1B receptor was associated with minimum and maximum lifetime body mass indices (BMIs) in a sample of women with bulimia nervosa (BN). METHODS: Ninety-eight women with BN were genotyped based on the G861C polymorphism of the serotonin-1B receptor gene (HTR1B). Minimum and maximum lifetime BMIs were compared across the three genotypic groups using analysis of variance. RESULTS: There was a highly significant difference in minimum lifetime BMI across the three genotypic groups (p =.001). Both the G/C and C/C genotypes were associated with significantly lower minimum lifetime BMIs than was the G/G genotype. Maximum lifetime BMI was not significantly different across groups. These results were not attributable to different lifetime rates of anorexia nervosa across the three genotypic groups. CONCLUSIONS: These preliminary findings suggest a possible association between HTR1B genetic polymorphism and minimum lifetime BMI in women with BN. These findings may shed light on why, in response to dieting, some BN patients achieve lower BMIs, whereas others have a natural limitation to their weight loss. Pending replication in a larger sample, these findings point to a possible genetic factor of fundamental importance to the BN population.
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Índice de Massa Corporal , Bulimia/genética , Polimorfismo Genético/genética , Receptores de Serotonina/genética , Adolescente , Adulto , Anorexia Nervosa/genética , Anorexia Nervosa/psicologia , Peso Corporal/genética , Bulimia/psicologia , Feminino , Variação Genética , Genótipo , Humanos , Fenótipo , Receptor 5-HT1B de SerotoninaRESUMO
OBJECTIVE: The purpose of this study was to examine DSM-III-R axis I and axis II comorbidity in psychiatrically hospitalized young adults with substance use disorders. METHOD: Structured diagnostic interviews were given to 117 consecutive inpatients. Seventy patients with substance use disorders and 47 patients without substance use disorders were compared. RESULTS: High rates of co-occurrence of axis I disorders were observed, but no disorder coexisted in the group with substance use disorders at a significantly higher rate than in the group without substance use disorders. Among axis II disorders, borderline personality disorder was diagnosed significantly more frequently in the group with substance use disorders. CONCLUSIONS: Significant additional diagnostic co-occurrence, defined as comorbidity, was observed only between borderline personality disorder and substance use disorders. The use of a relevant psychiatric comparison group allows for finer distinctions between covariation based on shared severity and comorbidity possibly based on shared pathophysiology.
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Hospitalização , Transtornos Mentais/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Transtorno da Personalidade Borderline/diagnóstico , Transtorno da Personalidade Borderline/epidemiologia , Comorbidade , Estudos Transversais , Feminino , Hospitais Psiquiátricos , Humanos , Masculino , Transtornos Mentais/diagnóstico , Transtornos da Personalidade/diagnóstico , Transtornos da Personalidade/epidemiologia , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Índice de Gravidade de Doença , Transtornos Relacionados ao Uso de Substâncias/diagnósticoRESUMO
OBJECTIVE: The authors examined the frequency of DSM-III-R personality disorders in adolescent and young adult psychiatric inpatients. METHOD: Structured diagnostic interviews were reliably performed with a series of 255 consecutively admitted inpatients (138 adolescents and 117 young adults). RESULTS: Most personality disorders were diagnosed in similar frequencies in the two study groups. Passive-aggressive personality disorder was diagnosed with lower frequency and dependent personality disorder with higher frequency in the young adult than in the adolescent group. CONCLUSIONS: The isomorphism of relative frequencies among psychiatric inpatients suggests that what is seen in adolescents are valid forms of most adult personality disorders.
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Hospitalização , Transtornos Mentais/epidemiologia , Transtornos da Personalidade/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Fatores Etários , Comorbidade , Transtorno da Personalidade Dependente/diagnóstico , Transtorno da Personalidade Dependente/epidemiologia , Feminino , Humanos , Masculino , Transtorno da Personalidade Passivo-Agressiva/diagnóstico , Transtorno da Personalidade Passivo-Agressiva/epidemiologia , Transtornos da Personalidade/diagnóstico , Prevalência , Escalas de Graduação Psiquiátrica/estatística & dados numéricosRESUMO
OBJECTIVE: The authors examined gender differences in DSM-III-R personality disorders in adolescent psychiatric inpatients. METHODS: Structured diagnostic interviews were reliably performed with a series of 138 consecutively admitted adolescent inpatients. To reduce variability due to heterogeneity of axis I diagnoses, a subgroup of 87 patients with major depression was retested for gender differences. RESULTS: Females were significantly more likely than males to meet the criteria for borderline personality disorder. Narcissistic personality disorder was diagnosed only in males. A similar pattern was observed in the subgroup of patients with major depression. CONCLUSIONS: The findings suggest potentially important gender differences in personality disorders in adolescent inpatients.
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Hospitalização , Hospitais Psiquiátricos/estatística & dados numéricos , Transtornos da Personalidade/epidemiologia , Adolescente , Fatores Etários , Criança , Comorbidade , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/epidemiologia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Transtornos da Personalidade/diagnóstico , Escalas de Graduação Psiquiátrica , Fatores SexuaisRESUMO
The influence of gonadal status on the pattern of changes in body weight was examined in three groups of outdoor-housed premenarchial rhesus monkeys (Macaca mulatta) from 1 to 2 years of age. Gonadally intact (n = 8) and ovariectomized oestradiol-treated females (n = 5) gained significantly more weight than ovariectomized untreated females (n = 5). The overall larger weight gains for the intact and ovariectomized oestradiol-treated groups were associated with significantly higher fasting levels of serum insulin. All subjects exhibited two periods of significant weight gain from 12 to 16 months of age between May and September and from 21 to 24 months of age between February and May. Serum GH and somatomedin-C levels were also raised during these periods of accelerated growth. Although the pattern of serum GH was similar among groups, serum somatomedin-C levels were significantly higher in both intact and ovariectomized oestradiol-treated subjects from 21 to 24 months of age, suggesting physiological levels of oestradiol may facilitate somatomedin-C production during periods of increased GH secretion. Thus, absolute changes in body weight in outdoor-housed premenarchial rhesus monkeys are influenced by gonadal status, possibly mediated through increases in serum insulin. Furthermore, dynamic changes in body weight occur during prepubertal development, with the largest increments associated with increased somatomedin-C levels at specific ages synchronized with natural changes in the environment.
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Peso Corporal , Estradiol/sangue , Macaca mulatta/crescimento & desenvolvimento , Macaca/crescimento & desenvolvimento , Maturidade Sexual , Somatomedinas/sangue , Animais , Castração , Estradiol/farmacologia , Feminino , Hormônio do Crescimento/sangue , Insulina/sangue , Fator de Crescimento Insulin-Like I , Estações do AnoRESUMO
Four families were selected randomly on the basis of the occurrence of spina-bifida cystica and/or spina bifida occulta in one or more family members. Sixty-three relatives were studied clinically and roentgenologically; their roentgenograms were evaluated blindly. Twenty-eight were clinically and roentgenologically normal; 35 were diagnosed as having spina bifida occulta (SBO), spina bifida cystica (SBC), vertebral anomalies, and/or external defects usually interpreted as evidence for SBO. Excluding one proband we found the frequency of SBO to be 19/51 (37%) and the frequency of all types of spinal/vertebral defects (excluding five probands) to be 30/58 (52%). The distribution of these defects in the four families was analyzed using likelihood methods corrected for random ascertainment. The log likelihood values for sporadic, recessive, and dominant models were -26.69, -20.95, and -18.90, respectively, indicating a higher likelihood of autosomal dominant inheritance than sporadic occurrence or recessive inheritance. The penetrance probability in this dominant model, estimated by maximum likelihood, is 0.749 +/- 0.100. Further examination of these data suggest that SBO and SBC represent different expressions of the same dominant gene in these kindreds.
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Genes Dominantes , Meningomielocele/genética , Espinha Bífida Oculta/genética , Feminino , Regulação da Expressão Gênica , Humanos , Masculino , Modelos Genéticos , Linhagem , Fenótipo , RiscoRESUMO
OBJECTIVE: To assess DSM-III-R Axis I and Axis II co-occurrence and comorbidity in adolescent inpatients with substance use disorders (SUD). METHOD: A consecutive series of 138 adolescent inpatients were reliably assessed with structured diagnostic interviews for Axis I disorders and Axis II personality disorders. To determine significant co-occurrence of diagnoses, comparisons were between 69 patients with SUD and 69 patients without SUD. RESULTS: Disruptive behavior disorders were diagnosed significantly more frequently in patients with SUD than in those without SUD. Conduct disorder was diagnosed more frequently and oppositional defiant disorder was diagnosed less frequently in the SUD patients than in the non-SUD patients. Anxiety disorders were diagnosed less frequently in the SUD group. Cluster B personality disorders and borderline personality disorder were diagnosed more frequently in the SUD group. CONCLUSIONS: The findings replicate previous research showing high rates of co-occurrence of other psychiatric disorders in adolescent inpatients with SUD. The use of a relevant psychiatric comparison group allows for finer distinctions regarding significant comorbidity and the psychopathological implications thereof.
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Adolescente Hospitalizado , Transtornos Mentais/complicações , Transtornos do Humor/complicações , Transtornos da Personalidade/complicações , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adolescente , Estudos de Casos e Controles , Distribuição de Qui-Quadrado , Análise por Conglomerados , Diagnóstico Duplo (Psiquiatria) , Feminino , Humanos , Masculino , Psicologia do AdolescenteRESUMO
OBJECTIVE: The authors examined the applicability of personality disorder criteria to adolescent inpatients by evaluating internal consistency and criterion overlap. METHOD: Thirty-eight adolescents and 28 adults were assessed with the Personality Disorder Examination. Within-category cohesiveness (internal consistency) of the criteria was evaluated by examining intercriterion correlations as well as coefficient alpha. In addition, between-category criterion overlap was evaluated by examining "intercategory" intercriterion correlations between all pairs of disorders. Separate analyses were conducted for adolescents and adults, and the groups were compared. RESULTS: Internal consistency appeared to be lower in adolescents, as measured by intercriterion correlation and coefficient alpha, with the largest differences being identified for most cluster B disorders. Intercategory analysis indicated that criterion overlap may be greater among adolescents. CONCLUSIONS: Overall, this psychometric analysis suggests that there may be limitations to the DSMs approach to categorizing personality disorders. For both adolescents and adults, modest degrees of within-category cohesiveness (internal consistency) and between-category criterion overlap were observed. Comparatively, personality disorder criteria in adolescents tended to have lower internal consistency and less discriminant validity. The data raise questions about the construct validity of these disorders--or the applicability of these criteria--within this age group.
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Comportamento do Adolescente , Transtornos da Personalidade/diagnóstico , Escalas de Graduação Psiquiátrica/normas , Psicometria , Adolescente , Adulto , Fatores Etários , Criança , Feminino , Humanos , Pacientes Internados , Masculino , Reprodutibilidade dos TestesRESUMO
This study examined the presence of personality disorders in adolescent inpatients with major depression (MDD; n = 45), substance use disorders (SUD; n = 27), or both disorders combined (MDD-SUD; n = 42). A consecutive series of patients were given structured diagnostic interviews for Axes I and II disorders. The groups did not differ with regard to age, gender, ethnicity, socioeconomic status, psychiatric history, or global assessment of functioning. Borderline personality disorder was diagnosed more frequently in the MDD-SUD group than in the MDD or the SUD groups.