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1.
J Affect Disord ; 203: 332-338, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27318533

RESUMO

BACKGROUND: There is evidence of olfactory deficits in patients with major depressive disorder (MDD) but causes and mechanisms are largely unknown. METHODS: We compared 728 patients with current MDD and 555 non-depressed controls regarding odor identification impairment taking into account the severity of acute symptoms and of the disease course. We assessed current symptom severity with the Hamilton Depression Rating Scale, and disease course severity based on admission diagnosis (ICD-10, F32/F33) and self-reported hospitalization frequency, defined as infrequent (<2) and frequent (≥2) depression-related hospitalizations under constant disease duration. A score of <10 on the Sniffin' Sticks-Screen-12 test determined the presence of odor identification impairment. RESULTS: Compared to non-depressed controls patients with frequent (rapidly recurring) hospitalizations had an elevated chance of odor identification impairment, even after adjustment for smell-influencing factors, such as age and smoking, (OR=1.7; 95% CI 1.0-2.9). Patients with recurrent MDD (F33) also had an elevated odds of odor identification impairment compared to those with a first-time episode (F32, OR=1.5; 95% CI 1.0-2.4). In patients with a first-time episode the chance of odor identification impairment increased by 7% with each point increase in the Hamilton Score. LIMITATIONS: Cross-sectional study. Variation in the use of psychotropic medication is a potential bias. CONCLUSION: Odor identification impairment was evident in MDD patients with first-time high symptom severity and in patients with a severe disease course. Whether odor identification impairment is a marker or mediator of structural and functional brain changes associated with acute or active MDD requires further investigations in longitudinal studies.


Assuntos
Transtorno Depressivo Maior/complicações , Transtornos do Olfato/complicações , Olfato/fisiologia , Adulto , Idoso , Estudos Transversais , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Odorantes , Transtornos do Olfato/diagnóstico , Transtornos do Olfato/fisiopatologia , Índice de Gravidade de Doença
2.
Psychiatr Prax ; 39(3): 109-15, 2012 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-22422160

RESUMO

OBJECTIVE: There is a lack of a psychometrically sound screening questionnaire that assesses important dimensions of traumatic experiences during childhood and adolescence in a time-efficient way. Based on the German version of the "Childhood Trauma Questionnaire" (CTQ, 28 items) we developed a five-item self-report childhood trauma screener (CTS) that covers sexual, emotional and physical abuse and emotional and physical neglect. METHOD: The data set of the SHIP-LEGEND study (n = 1668) was used to extract five items of the CTQ that optimally covered the five dimensions and showed a high correlation with the total score. In two validation samples (clinical sample [n = 211] and subjects from the BiDirect study [n = 288]) the psychometric properties of the CTS were evaluated. RESULTS: The correlations between the five CTS Items and the corresponding dimensions from the CTQ were r = 0.55 to 0.87 (p < 0.0001) within the clinical sample. Furthermore, we found high correlations (r = 0.88; p < 0.0001) with the total CTQ score. The internal consistency was 0.757 (Cronbachs α). CONCLUSION: The CTS is a reliable, valid and economic screener for the retrospective assessment of adverse childhood experiences especially in large epidemiological studies.


Assuntos
Abuso Sexual na Infância/diagnóstico , Maus-Tratos Infantis/diagnóstico , Interação Gene-Ambiente , Acontecimentos que Mudam a Vida , Programas de Rastreamento , Transtornos Mentais/diagnóstico , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Inquéritos e Questionários , Adolescente , Adulto , Idoso , Criança , Maus-Tratos Infantis/psicologia , Abuso Sexual na Infância/psicologia , Feminino , Alemanha , Humanos , Entrevista Psicológica , Masculino , Transtornos Mentais/genética , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Estudos Prospectivos , Psicometria/estatística & dados numéricos , Reprodutibilidade dos Testes , Transtornos de Estresse Pós-Traumáticos/genética , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto Jovem
3.
Stroke ; 42(12): 3403-9, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21903965

RESUMO

BACKGROUND AND PURPOSE: Early decompressive surgery in patients with malignant middle cerebral artery (MCA) infarction improves outcome. Elevation of intracranial pressure depends on both the space occupying brain edema and the intracranial volume reserve (cerebrospinal fluid [CSF]). However, CSF volume was not investigated as a predictor of malignant infarction so far. We hypothesize that assessment of CSF volume in addition to admission infarct size improves early prediction of malignant MCA infarction. METHODS: Stroke patients with carotid-T or MCA main stem occlusion and ischemic lesion (reduced cerebral blood volume [CBV]) on perfusion CT were considered for the analysis. The end point malignant MCA infarction was defined by clinical signs of herniation. Volumes of CSF and CBV lesion were determined on admission. Receiver-operator characteristics analysis was used to calculate predictive values for radiological and clinical measurements. RESULTS: Of 52 patients included, 26 (50%) developed malignant MCA infarction. Age, a decreased level of consciousness on admission, CBV lesion volume, CSF volume, and the ratio of CBV lesion volume to CSF volume were significantly different between malignant and nonmalignant groups. The best predictor of a malignant course was the ratio of CBV lesion volume to CSF volume with a cut-off value of 0.92 (96.2% sensitivity, 96.2% specificity, 96.2% positive predictive value, and 96.2% negative predictive value). CONCLUSIONS: Based on admission native CT and perfusion CT measurements, the ratio of ischemic lesion volume to CSF volume predicts the development of malignant MCA infarction with higher accuracy than other known predictors, including ischemic lesion volume or clinical characteristics.


Assuntos
Infarto da Artéria Cerebral Média/diagnóstico por imagem , Acidente Vascular Cerebral/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Circulação Cerebrovascular , Feminino , Humanos , Infarto da Artéria Cerebral Média/patologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Radiografia , Estudos Retrospectivos , Sensibilidade e Especificidade , Acidente Vascular Cerebral/patologia
4.
Crit Care ; 15(2): 129, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21418552

RESUMO

Endothelial progenitor cell (EPC) mobilization from the bone marrow was considered to improve outcome after ischemic stroke. Erythropoietin (EPO) might be a potential candidate stroke drug that increases the number of circulating EPCs. In the previous issue of Critical Care, Yip and colleagues investigated the effect of EPO in stroke patients on both clinical outcome and EPC stimulation. Although beneficial effects of EPO were observed, several issues regarding EPO's suitability as a stroke drug remain.


Assuntos
Células Endoteliais/metabolismo , Eritropoetina/uso terapêutico , Hematínicos/uso terapêutico , Células-Tronco/metabolismo , Acidente Vascular Cerebral/tratamento farmacológico , Feminino , Humanos , Masculino
5.
J Neurol Sci ; 283(1-2): 149-52, 2009 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-19304296

RESUMO

Vascular pathology impairs cognition and impaired cognition increases the risk of dementia. Hypertension is arguably the vascular risk factor that can be reverted best. Here we estimated the effect magnitude of hypertension by determining the variance in cognition explained by systolic blood pressure (sBP) in non-demented community-dwelling individuals. We recruited 525 individuals (mean age 65, range 40-85) selected from the city registry of Muenster, Germany, measured cognitive performance with a comprehensive test battery and assessed vascular risk based on glycosylated hemoglobin, serum cholesterol, high sensitive C-reactive protein, body mass index, smoking pack years, and blood pressure. Including gender and education as well as the vascular risk factors, multiple linear regression analysis for different age groups showed that in midlife age groups systolic blood pressure explained up to 11% of the variance in cognitive performance. These findings suggest that in non-demented community-dwelling individuals hypertension may account for one tenth of cognitive impairment and thus for an increased risk for dementia.


Assuntos
Transtornos Cognitivos/epidemiologia , Cognição , Hipertensão/psicologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Pressão Sanguínea , Transtornos Cognitivos/etiologia , Estudos de Coortes , Estudos Transversais , Educação , Feminino , Humanos , Hipertensão/epidemiologia , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Fatores de Risco , Fatores Sexuais
6.
Neuroepidemiology ; 31(1): 39-47, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18535399

RESUMO

BACKGROUND: Healthy lifestyle has been associated with a decreased risk of developing cardiovascular disease, but its relationship with memory functions is still inconclusive. This study aims to analyze the association between a composite lifestyle index and memory performance. METHODS: In this cross-sectional survey, 198 healthy individuals (aged 65-84 years) underwent tests of verbal episodic memory. A composite lifestyle index was calculated that included the following lifestyle dimensions: physical exercise, dietary habits, BMI, smoking and alcohol consumption. The healthiest behavior was defined as: a BMI <22; a diet high in fruits, vegetables, wholemeal/low-fat foods and unsaturated fatty acids; energy expenditure through physical activity >13,000 kcal/week; a history of never smoking; an alcohol consumption of 4-10 drinks per week. RESULTS: Linear regression analysis revealed that a high lifestyle index score was associated with a better memory score (after adjusting for age, sex, education and blood pressure). The composite index had a stronger relationship with memory scores than single factors. CONCLUSIONS: This cross-sectional study revealed that a healthy lifestyle, assessed by a simple composite index, is related to better memory performance in healthy elderly individuals. Our findings point to the importance of a comprehensive modulation of lifestyle factors when finding ways to preserve memory functions in the elderly.


Assuntos
Estilo de Vida , Memória , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Índice de Massa Corporal , Estudos Transversais , Exercício Físico/fisiologia , Exercício Físico/psicologia , Comportamento Alimentar/fisiologia , Comportamento Alimentar/psicologia , Feminino , Humanos , Masculino , Memória/fisiologia , Fatores de Risco , Fumar/epidemiologia , Fumar/psicologia
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