Impulsivity, Consciousness and Defense Mechanisms of the Ego Among Pathological Gamblers.

Pathological gambling is a growing health problem in Romania, recognized in DSM V (2013) as a form of psychopathology included in the category of addictions. This study aims to find out whether there are differences between gamblers and the control group among the dependent variables (impulsivity, conscientiousness, and defense mechanisms). According to the literature, impulsivity and low conscientiousness are specific features to pathological gamblers. A second goal is to check if there are one or more defense mechanisms defining gamblers. A recent study (Waqas et al., Waqas et al., Psychiatry Research 243:463-468, 2016) about the association of defense mechanisms and the problematic use of the Internet identified the following defense mechanisms: projection, denial, passive aggression, and movement. The present study questionnaire consists of four sections: a) The impulsivity questionnaire (Eysenk et al., Eysenck et al., Personality and Individual Differences 6:613-619, 1985), b) Defense Style Questionnaire-40, c) C-NEO (only the items related to the Conscientiousness factor) and d) SOGS (South Oaks Gambling Screen) test. This questionnaire was applied to 40 gamblers in the full version, and the control group was given the same questionnaire apart from the SOGS test. All data were analyzed in SPSS v20. The research results show that pathological gamblers have higher impulsivity than the control group, their defense mechanisms are predominantly neurotic and immature and their conscientiousness is significantly lower than the control group.

Interferential electrical stimulation for improved bladder management following spinal cord injury.

Patients with spinal cord injury (SCI) with neurogenic bladder (NB) represent a major medical problem, which initiated the search for a non-invasive and effective treatment that is easy to apply and without side effects. A study was performed using interferential medium frequency current electrical stimulation (IMFC ES) on 332 patients shortly after SCI diagnosed with NB dysfunction. All subjects received standard care and patients of the experimental group additionally received IMFC ES. Urinary management results included volitional control of voiding, intermittent catheterization, post-voidance residuum (PVR) quantity and quantity of urine lost (LOSS). Results were assessed based on the American spinal cord injury association impairment scale (AIS). The IMFC ES included two channels of medium frequency stimulation that were marginally different. Within the body, a low frequency field was generated through the interaction of the medium frequencies, which stimulated the urinary structures. In the IMFC ES group, interference stimulation was applied for 10 min with frequencies cycling from 0-100 Hz and back in 10 sec intervals. The strength of the low frequency stimulation, achieved by the interference of the two medium-frequency fields, was adjusted to the patients' vibration sensation. The intensities triggering vibration sensation were between 20-80 mA for patients with AIS levels B, C and D. For patients with AIS level A intensities <20 mA were used for therapeutic effects without causing skin injuries. Safety of IMFC ES was based on occurrence of adverse events of which none were recorded in the experimental group. IMFC ES was effective in patients with AIS levels B and C, significantly decreasing PVR and LOSS compared with patients receiving standard care No significant improvements in urinary management were observed following IMFC ES treatment of patients with AIS level A. Patients with SCI and NB classed as AIS levels B and C that exhibit preserved sensitivity were the best beneficiaries of IMFC ES therapy.

Findings regarding the relationships between sociodemographic, psychological, comorbidity factors, and functional status, in geriatric inpatients.

OBJECTIVE: To assess the impact of socio-demographic and comorbidity factors, and quantified depressive symptoms on disability in inpatients. METHODS: Observational cross-sectional study, including a number of 80 elderly (16 men, 64 women; mean age 72.48 years; standard deviation 9.95 years) admitted in the Geriatrics Clinic of "St. Luca" Hospital, Bucharest, between May-July, 2012. We used the Functional Independence Measure, Geriatric Depression Scale and an array of socio-demographic and poly-pathology parameters. Statistical analysis included Wilcoxon and Kruskal-Wallis tests for ordinal variables, linear bivariate correlations, general linear model analysis, ANOVA. RESULTS: FIM scores were negatively correlated with age (R=-0.301; 95%CI=-0.439 -0.163; p=0.007); GDS scores had a statistically significant negative correlation (R=-0.322; 95% CI=-0.324 -0.052; p=0.004) with FIM scores. A general linear model, including other variables (gender, age, provenance, matrimonial state, living conditions, education, respectively number of chronic illnesses) as factors, found living conditions (p=0.027) and the combination of matrimonial state and gender (p=0.004) to significantly influence FIM scores. ANOVA showed significant differences in FIM scores stratified by the number of chronic diseases (p=0.035). DISCUSSION AND CONCLUSIONS: Our study objectified the negative impact of depression on functional status; interestingly, education had no influence on FIM scores; living conditions and a combination of matrimonial state and gender had an important impact: patients with living spouses showed better functional scores than divorced/widowers; the number of chronic diseases also affected the FIM scores: lower in patients with significant polypathology. These findings should be considered when designing geriatric rehabilitation programs, especially for home--including skilled--cares.

Parental environmental tobacco smoking and the prevalence of respiratory diseases in primary school children.

INTRODUCTION: The inhaling tobacco smoke to which a child is exposed, in a home environmental area, could affect respiratory system. MATERIAL AND METHODS: The aim of the study consists in detecting the prevalence of respiratory diseases in home exposure to secondhand smoke among primary school children. A 6-month prospective case-control study based on questionnaire survey was carried out among school children of "Spiru Haret" Primary School, Medgidia, Romania, with absences for respiratory diseases, related to exposure to parental passive smoking, in their home environmental. 136 school children and their families informed, consented to complete the questionnaire and were surveyed for respiratory diseases and domestic environmental tobacco smoking, from the 1st of October, 2011 to the 31st March, 2012. The method consists in collecting data about any respiratory illness events, correlating them with the questionnaire --reports of parental smoking in home environmental. RESULTS: Participants were divided in 88 cases exposed to SHS (E) and 48 controls without exposure (NE). The most sick children with more than one episode of respiratory illness were among cases (n = 61/88; 69.31% vs 19/48; 39.58%; OR = 3.45; RR = 1.62; chi2 = 12.25; p < 0.0008). The most important source of parental passive smoking is the father (n = 67/88; 76.13%), being a single parent in most of the cases (n = 46/88; 57.95%). The prevalence of bronchial asthma was 0.34% in cases, being related with prenatal maternal smoking exposure (1.11%). CONCLUSION: The prevalence of respiratory diseases is higher among children with environmental parental tobacco exposure, in particular, smoking father.

Progressive intraparenchymal lung nodules dissemination in a heavy smoker and seropositive rheumatoid arthritis suspected of tuberculosis relapse.

Anthony Caplan first described rheumatoid lung nodules associated with pneumoconiosis in coal-miners (Caplan, 1953). Intraparenchymal lung nodules were later described in rheumatoid arthritis (RA) patients who were never exposed to coal dust and/or without pneumoconiosis. Rheumatoid lung nodules are usually detected in unselected patients: 0.2% in chest radiography and 4% in high-resolution computed tomography (Nannini et al., 2008). Patients could be reluctant to perform surgical lung biopsy for an accurate histopathological diagnosis. We present a peculiar association between a seropositive RA and a presumptive active tuberculosis (TB) disease in a 59-year-old male patient, ex-smoker with a previously healed pulmonary TB disease. The purpose of this report is to describe an unusual case of a presumptive relapse of the nodular TB disease, which progressed to an extensive nodular bilateral dissemination under anti-tuberculosis therapy, mimicking a metastatic carcinoma. The diagnosis of rheumatoid necrobiotic lung nodules was confirmed after open biopsy left pulmonary was performed. Formalin-fixed paraffin-embedded pulmonary rheumatoid nodules were processed for histology and stained with Masson's trichrome. Central structure of the removed pulmonary nodules is typical of a rheumatoid nodule with central necrosis surrounded by a palisade of macrophages. The accumulation of anthracotic pigment was noticed inside the pulmonary nodules in a RA patient without professional exposure to coal or mineral dust. This rare entity is an appearance of the rheumatoid nodules lung syndrome and anthracosis in a heavy tobacco former smoker.

Giant left-sided pleuropericardial cyst, mimicking a heart disease.

Mediastinal cysts (MC) mainly have an embryonic origin, are benign and frequently discovered thanks to tomodensitometry, sometimes by magnetic resonance imaging. Rarely symptomatic, excepted in cases of very large cysts, they are mainly pleuropericardic cysts (PPC) that represent 30% of MC Surgery is commonly performed by videothoracoscopy or by video-assisted mini-thoracotomy, mainly for PPC We report the case of a 62-year-old woman, smoker (30 packs years), who is hospitalized in Constanta Pneumology Hospital in June 2011 for slight shortness of breath, sweating, pain in the left hemi thorax, minor hemoptysis, recurrent. In her medical history, there are to be noticed a blood transfusion after hysterectomy for uterine fibroma (1995), arterial hypertension (2006). After admission, X-ray exam of the chest shows cardiomegaly and a few lung nodular lesions in the right upper lobe. An initial differential diagnosis includes congestive heart failure, dilated cardiomyopathy, valvular heart disease, left pleurisy, pericarditis, paracardiac tumor mass, tuberculosis +/- HIV. Following laboratory tests imaging (chest CT and ultrasound performed in June 26th 2011 and 27h) a possible pleuropericardic cyst was suspected. Exploratory thoracentesis was not performed and, a month later, in the Institute of Pulmonology "Marius Nasta" Bucharest, a left open thoracotomy revealed a cystic formation about 10 cm in diameter. Histopathologic exam confirmed the diagnosis of cyst pleuropericardic. The prognosis after surgery was favorable. As a feature of the case are worth mentioning: the large size of pericardial cyst at the upper limit of the data reported in the literature, which mimics cardiomegaly, the hemoptoic onset in a hypertensive patient, heavy smoker; the late suspicion of pleuropericardic cyst through pleural echographic exam; the atypical localization; the facilitated certain diagnosis by surgery and hystological exam; the favorable postoperative prognosis; and all morbidities cofound (Pulmonary Tuberculosis, bronchiectasis, COPD).

The correlation of genetic markers with anatomoclinical and histopathological forms in Hirschsprung's disease.

Hirschsprung's disease is a birth defect that affects about one out of 5000 newborns. It is one of the most common causes of intestinal obstruction at the babies. The objectives of this study are to evaluate the characteristics of Hirschsprung's disease in Dobrogea area, test of genetic markers in families and single cases, estimate the value of the test in the diagnosis and for evolution. We made a case-control study for the period 1995-2006 and analyzed 21 cases of Hirschsprung's disease, which were treated in the Emergency County Hospital, Constanta. The diagnostic methods comprised clinical and paraclinical examination. The chromosomal markers used in the study are represented by four categories of chromosome abnormalities: Trisomy 21, Del 10q, Del 13q, Del 17q. The molecular markers investigated by us are represented by: RET, EDNRB and EDN3. We made the correlation of genetic markers with the anatomopathological and histopathological forms, by measuring the level of association, expressed by the calculated relative risk (OR) and using the correlation index f. Based on data obtained from the group investigated, we found that the indices of association and correlation are consistently higher compared to DNA-markers with chromosomal markers, both for anatomopathological forms as well as histopathological. We noticed that no chromosomes markers were recorded with indices of correlation with negative values, which means that these chromosomal abnormalities are involved with a particular quota to the release of disease.