Adherence to oral chemotherapy: Evidence from a randomised clinical trial.

OBJECTIVE: To evaluate the efficacy of a reinforcement message (RM) administered by a hospital pharmacist on adherence, through a randomised study involving patients undergoing oral chemotherapy from which an objective outcome measure and patients' subjective opinions were collected. A secondary aim was to detect which psychological or clinical factors influence adherence. METHODS: Forty patients were enrolled and randomised to an experimental group (EG) or a control group (CG). The EG received a 10-minute RM provided by a hospital pharmacist with a doctor and a nurse. The CG received the standard of care. To measure adherence, plasma drug concentration and subjective evaluation were taken during the visits, in addition to a psychological assessment (coping strategies, psychological distress and personality traits). RESULTS: The EG reported higher drug levels and a statistically significant higher mean score on the subjective evaluation. A linear regression model highlighted statistically significant differences in the plasma drug concentration, after considering toxicity and dose reduction and controlling for the Reward Dependence Scale of the Temperament and Character Inventory between the EG and the CG. CONCLUSION: Adequate information and education on the therapy, using an RM strategy provided by a hospital pharmacist, seems to positively influence adherence to the treatment.

Association of synaptosomal-associated protein 25 (SNAP-25) gene polymorphism with temperament and character traits in women with fibromyalgia syndrome

Abstract Background: Synaptosomal-associated protein 25 (SNAP-25) may be contribute to the pathogenesis of fibromyalgia Syndrome (FMS) by affecting the release of neurotransmitters. Objectives: We aimed to investigate the relationship between the SNAP-25 gen (DdeI = rs1051312 and MnlI = rs3746544) polymorphism and the temperament and character traits. Methods: A total of 85 female patients diagnosed with FMS and 70 age-matched healthy female subjects were enrolled into the study. The Temperament and Character Inventory (TCI) were performed on all the patients. SNAP-25 gene polymorphism was determined in the patients group and controls group. Results: No significant difference between groups was found regarding the distribution of SNAP-25 MnlI polymorphism (p > 0.05), but it was seen that the frequency of TC genotype for DdeI gene was higher in the patients group (p < 0.05). Increased hazard avoidance was found in the patients group (p < 0.05). When TCI scores were assessed in terms of SNAP-25 gene polymorphism, no statistically significant relationship was detected between the TT, TG, GG genotypes for MnlI gen and TCI scores (p > 0.05). However, increased hazard avoidance was detected in patients with TC genotype for DdeI gene compared to patients without such genotype. Discussion: SNAP-25 might be an etiological factor in FMS pathogenesis and might affect personality traits of FMS patients by mediating neurotransmitter release.

Traços de personalidade de pessoas portadoras de hipertensão arterial crônica e doenças associadas / Personality traits of people with chronic hypertension and related diseases

O tratamento para hipertensão arterial crônica deve ser permanente e rigoroso para prevenir complicações, necessitando de alterações nos costumes e rotinas do indivíduo portador que pode ter seus aspectos emocionais também afetados. O objetivo deste trabalho foi compreender a relação entre os traços de personalidade e as características sócio-demográficas e clínicas de pessoas portadoras de hipertensão e doenças associadas. Participaram 33 indivíduos portadores de hipertensão arterial crônica e foram aplicados dois instrumentos para coleta de dados: Questionário de Caracterização e Inventário de Temperamento e Caráter de Cloninger. Através de análises estatísticas, os resultados indicaram que os indivíduos portadores de diabetes mellitus associada à hipertensão arterial são menos impulsivos e pessimistas e mais sociáveis, cooperativos e tolerantes quando comparados com indivíduos que possuem apenas diagnóstico de hipertensão.

Treatment for chronic hypertension should be permanent and strict to prevent complications, requiring changes in the habits and routines of the individual and which may have their emotional aspects also affected. The objective of this study was to understand the relationship between personality traits and socio-demographic and clinical characteristics of people with hypertension and related diseases. 33 individuals with chronic hypertension were included and two instruments for data collection were used: Characterization Questionnaire and Cloninger’s Temperament and Character Inventory. Through statistical analysis, the results indicated that patients with diabetes mellitus associated with hypertension are less impulsive and pessimistic and more sociable, cooperative and tolerant compared to indi-viduals with only hypertension diagnosis.

A positive relationship between harm avoidance and brain nicotinic acetylcholine receptor availability.

Prior research indicates that disturbance of cholinergic neurotransmission reduces anxiety, leading to the hypothesis that people with heightened cholinergic function have a greater tendency toward anxiety-like and/or harm-avoidant behavior. We sought to determine if people with elevated levels of harm avoidance (HA), a dimension of temperament from the Temperament and Character Inventory (TCI), have high α4ß2* nicotinic acetylcholine receptor (nAChR) availability. Healthy adults (n=105; 47 non-smokers and 58 smokers) underwent bolus-plus-continuous infusion positron emission tomography (PET) scanning using the radiotracer 2-[18F]fluoro-3-(2(S)azetidinylmethoxy) pyridine (abbreviated as 2-FA). During the uptake period of 2-FA, participants completed the TCI. The central study analysis revealed a significant association between total HA and mean nAChR availability, with higher total HA scores being linked with greater nAChR availability. In examining HA subscales, both 'Fear of Uncertainty' and 'Fatigability' were significant, based on higher levels of these characteristics being associated with greater nAChR availabilities. This study adds to a growing body of knowledge concerning the biological basis of personality and may prove useful in understanding the pathophysiology of psychiatric disorders (such as anxiety disorders) that have similar characteristics to HA. Study findings may indicate that heightened cholinergic neurotransmission is associated with increased anxiety-like traits.