Personality change as defensive responses of patients evaluated for liver transplant.

Patients affected by endstage liver disease and awaiting liver transplant suffer very stressful conditions. The aim of this study was to evaluate the person ality and behavioral responses of a group of liver transplant candidates, 95 men (M age 50 yr.) and of a group of 18 normal men (M age 49 yr.). The 16 Personality Factor Questionnaire of Cattell, and the PSY Inventory for Behavioral Assessment were administered to assess personality and behavior. On the 16PF Questionnaire, patients had significantly different mean scores from normal subjects on Scale B- (low mental capacity), G (conformity), N (shrewdness), and Q1- (conservatism). They also showed a somewhat lower but not a statistically significant mean on Scale E (submissiveness). In addition, on the four second-order factors of the 16PF (Anxiety, Control, Pathemia, and Extraversion) patients had a significantly higher mean on Control. With respect to PSY Inventors factors, patients showed impairment in energy, sleep, sexual disturbances, and obsessive behaviors. It appears these patients with endstage liver disease, who were evaluated for liver transplant, showed psychological regressive functioning, i.e., high control and dependency on medical staff, submissiveness, which are interpretable as defensive responses to upcoming transplant.

Cattell's 16 PF and PSY inventory: relationship between personality traits and behavioral responses in patients with acute myocardial infarction.

The aim of this study was to investigate the relationships between personality and behavioral responses in patients with acute myocardial infarction. In a first step, a new instrument (PSY Inventory) for assessment of six behavioral characteristics (Sense of Responsibility, Energy and Competitiveness, Obsessive Behavior, Anger and Hostility, Stress-related Disturbances, Time Urgency) was developed by using factor analysis on intercorrelations of responses from 524 subjects of the general population. Internal consistency reliability for each of the PSY subscales was estimated by Cronbach alpha coefficients. In a second step, the PSY Inventory was administered with the Cattell 16 PF Questionnaire to 838 patients affected by acute myocardial infarction. Significant correlations although relatively low in magnitude for PSY Inventory subscales and certain scales of the Cattell 16 PF were found. With factor analysis on 22 variables (including the six PSY Inventory subscales and the 16 scales of the Cattell 16 PF), five second-order factors were identified, namely, Extraversion, Neurotic Anxiety, Superego Strength, Pathemia, and Neurotic Hostility. While a Pathemia Factor (characterized by sensitivity, imagination, and self-sufficiency) was factorially independent of scales of the PSY Inventory, Extraversion, Neurotic Anxiety, Superego Strength, and Neurotic Hostility Factors were composed of the PSY Inventory scales and Cattell 16 PF scales combined. These relationships would reflect the concordance of internal constructs for behavioral measures of the PSY Inventory and those of personality traits of the 16 PF Questionnaire in patients with acute myocardial infarction.

The second-order factor structure of Cattell's 16 PF in patients with coronary heart disease.

The second-order factor structure of the 16 Personality Factor Questionnaire (16 PF) was validated on a sample of 940 patients hospitalized for coronary heart disease. The purpose of this investigation was the evaluation of second-order factor structure, already confirmed for normal subjects, of a selected pathological population. With factor analyses, oblique promax rotation, five second-order factors were identified, namely, Anxiety, Extraversion, Pathemia, Control, and an unidentified factor. These results were compared with those of Cattell's and Krug's studies. As a high congruence coefficient was shown, a good replication of Cattell's originally published second-order factors was achieved.

[Personality and acute myocardial infarction: distinctive traits]. / Personalitè ed infarto miocardico acuto: tratti discriminanti.

AIM OF THE STUDY: Aim of this study is to evaluate the presence of peculiar personality traits in patients with acute myocardial infarction as compared with normal subjects. METHODS: The Sixteen Personality Factor Questionnaire (16 PF) by Cattell (D form) is administered to 654 patients (558 males, 96 females) hospitalized for acute myocardial infarction in 16 coronary care units and to 398 normal subjects (261 males, 137 females). The diagnosis of myocardial infarction is made according to the presence of at least two of the following criteria: prolonged chest pain, elevation of CPK and CPKMB (twice the upper normal values), Q wave on the electrocardiogram. The normality of the control group is assured by specific exclusion criteria (cardiac or psychiatric disease, metabolic and endocrine disease, continued therapeutic treatment for any organic disease, or continued assumption of hypnotic and/or anxiolytic drugs). RESULTS: In comparison with the control group, infarcted males result significantly different for factors C, N, Q1, Q4 (p < 0.001), for factors B, O (p < 0.01) and A, H, I (p < 0.05). Females with myocardial infarction differ significantly for factors C, O and I (p < 0.05). Four second-order factors is obtained from Cattell's 16 PF by factorial analysis: QI (anxiety), QII (extroversion), QIII (sensitivity), QIV (superego strength). The infarcted population shows statistically significant differences compared with controls: infarcted males show higher QI (p < 0.001) and lower QII and QIII (p < 0.05) while infarcted females have higher QI (p < 0.05). CONCLUSIONS: These differences confirm that peculiar personality traits can be found in patients with acute myocardial infarction. In particular, infarcted males are emotionally unstable, anxious, rigid and depressed, and have problems in communication with others; infarcted females differ from the normal population for being emotionally unstable, anxious and for having a less flexible mental disposition. The higher anxiety level in patients with acute myocardial infarction may be related to the neuroticism that, in other studies, has been often found to be associated with cardiovascular disease. In conclusion, with respect to the normal population, patients with acute myocardial infarction appear to be anxious introverts, with conflictual personality.

Internal biliary diversion improves glucose tolerance in the rat.

The gastrointestinal tract is known to generate hormonal and neural signals that can affect the endocrine function of the pancreas ("enteroinsular axis"). The physiological circumstances under which this connection is operative are still a matter of debate. We investigated the influence of bile flow on glucose homeostasis in an experimental model of internal biliary diversion. After laparotomy in 2-mo-old rats, bile flow was diverted from the duodenum into the second jejunal loop with the use of a plastic minicannula. Rats in which the cannula was implanted but not connected with the common bile duct (sham operation) and rats receiving no treatment were used as control groups. After surgery, the rats with the biliary bypass weighed 10% less than the controls for 3 wk; afterwards and until 9 mo later, operated and nonoperated animals had similar growth curves. After the operation, fasting plasma glucose concentrations fell significantly in the treated rats compared with both sham-operated and control rats; likewise, the glycemic response to orally administered glucose was lower in the treated group 1 wk after surgery. In contrast, no significant difference was found in either the fasting or the glucose-induced plasma insulin levels. Nine months after surgery, the same three groups of animals received an oral glucose tolerance test, an intravenous glucose tolerance test, and a fasting-refeeding test (24 h of fast followed by standard, mixed feeding for another 24 h). On all three tests, bile-diverted rats showed lower plasma glucose responses than either sham-operated or control rats in the face of essentially similar plasma insulin responses.(ABSTRACT TRUNCATED AT 250 WORDS)

On the effect of magnesium on the PTH secretion in uremic patients on maintenance hemodialysis.

The Mg, Ca and immunoreactive parathyroid hormone (PTH) serum levels were determined in 22 uremic patients on chronic hemodialysis with different Mg concentrations in the dialysate. Baseline levels of PTH, Ca and Mg were obtained over a 4-month-period whilst on Mg dialysis of 1.5 mEq/l. Patients were then divided into three groups: 10 patients were dialyzed for 6 months with 0.5 mEq/l of Mg, 7 patients with 1.5 mEq/l, and 5 patients wih 2.5 mEq/l Mg. At the end of the 6-month period with differentiated Mg dialysis the three groups were characterized by significantly different Mg serum levels. On the contrary, no significant changes were observed in the PTH or the Ca serum levels. The results of this study indicate that PTH secretion in uremic patients on regular hemodialysis is not appreciably influenced by the Mg serum levels.

Serum levels of PTH, Mg, Ca, inorganic phosphate and alkaline phosphatases in uraemic patients on differentiated Mg dialysis.

The serum levels of PTH, Mg, Ca, inorganic phosphate (Pi) and alkaline phosphatases (AlkPase) were determined in 22 uraemic patients on chronic haemodialysis with different Mg levels in th dialysate, in an attempt to clarify the pathogenesis of uraemic osteodystrophy. Baseline levels of all the considered parameters were obtained over a four month period whilst on standard Mg concentration in the dialysis solution (1.5 mEq/L). Patients were then divided into three groups: 10 patients were dialysed for six months with 0.5mEq/L of Mg, seven patients with 1.5mEq/L and five patients with 2.5mEq/L in the dialysate. At the end of the six months with differentiated Mg dialysis, the three groups had significantly different Mg serum levels, whereas no significant changes were observed in the PTH and Ca serum levels. All the patients on high-Mg dialysis showed a significant reduction of the Pi serum levels, whereas a significant increase of AlkPase was observed in the low-Mg dialysis group. The overall results obtained in the present study indicate a possible beneficial effect of low-Mg dialysis on the progression of uraemic osteodystrophy of patients on maintenance haemodialysis.