Assuntos
Ativação Plaquetária , Acidente Vascular Cerebral/diagnóstico , Antígenos CD/análise , Biomarcadores/análise , Plaquetas/metabolismo , Reações Falso-Negativas , Feminino , Citometria de Fluxo , Humanos , Imunofenotipagem , Masculino , Pessoa de Meia-Idade , Selectina-P/análise , Ativação Plaquetária/fisiologia , Glicoproteínas da Membrana de Plaquetas/análise , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Tamanho da Amostra , Acidente Vascular Cerebral/fisiopatologia , Tetraspanina 30RESUMO
The aim of the current study was to investigate the characteristics of Greek inmates that were taking regularly benzodiazepines (BZDs) at therapeutic doses, in the high-security prison of Patras, Greece. Three hundred eighty-four prisoners were included in the study. BZD users (BUs, n = 192), compared with non-BZD users (NBUs, n = 192), were significantly more often unemployed before imprisonment; were significantly more often single, divorced, or widowed; were significantly more often on remand; were taking in significantly greater proportions antidepressant and antipsychotic medications; had significantly more often a history of psychiatric hospitalization; and had significantly more often a history of illicit intravenous (IV) drug use. BUs were significantly more often positive on serum antibodies to hepatitis C (anti-HCV), and scored significantly higher on Hamilton's Rating Scale for Anxiety (HAM-A) and Zung's Self-Rating Depression Scale (SDS). Multivariable logistic regression analysis showed that the history of psychiatric hospitalization, history of illicit drug use, history of unemployment, symptoms of anxiety, and anti-HCV positivity were independently associated with BZD use in this prison. Medical and psychiatric interventions focusing on anxiety problems, depression, drug addiction, and HCV in this group of BUs are warranted.
Assuntos
Ansiolíticos/administração & dosagem , Benzodiazepinas/administração & dosagem , Prisioneiros , Adulto , Transtornos de Ansiedade/epidemiologia , Internação Compulsória de Doente Mental/estatística & dados numéricos , Grécia/epidemiologia , Anticorpos Anti-Hepatite C/sangue , Humanos , Modelos Logísticos , Masculino , Abuso de Substâncias por Via Intravenosa/epidemiologia , Desemprego/estatística & dados numéricosRESUMO
A patient with two episodes of acute polyradiculoneuropathy (Guillain-Barré syndrome) that both occurred during exacerbation of chronic hepatitis B and separated by a 2-year asymptomatic interval is described. The possible causative relation between the neuropathy and the chronic hepatitis B is discussed.
Assuntos
Síndrome de Guillain-Barré/etiologia , Hepatite B Crônica/complicações , Idoso , Complexo Antígeno-Anticorpo/sangue , DNA Viral/sangue , Síndrome de Guillain-Barré/tratamento farmacológico , Síndrome de Guillain-Barré/terapia , Anticorpos Anti-Hepatite B/sangue , Antígenos da Hepatite B/sangue , Vírus da Hepatite B/isolamento & purificação , Vírus da Hepatite B/patogenicidade , Vírus da Hepatite B/fisiologia , Hepatite B Crônica/tratamento farmacológico , Humanos , Imunoglobulinas Intravenosas/uso terapêutico , Imunossupressores/uso terapêutico , Lamivudina/uso terapêutico , Testes de Função Hepática , Masculino , Prednisolona/uso terapêutico , Recidiva , Fatores de Tempo , Viremia/complicações , Replicação ViralRESUMO
Substance use disorders are associated with increased suicidal behavior. The suicidal behavior in patients without a history of illegal substance abuse, who consume benzodiazepines (BZDs) regularly in doses higher than those recommended, has not been previously studied. The aim of this study was to investigate the factors associated with the past history of suicide attempts in high-dose regular BZD users (HDRUs). Fifty-five HDRUs were recruited from inpatient and outpatient psychiatric services, and were compared to 55 psychiatric controls, matched for demographic characteristics and psychiatric diagnoses to HDRUs (Controls A), and to 55 psychiatric controls matched only for demographic characteristics to HDRUs (Controls B). Both control groups were non-BZD users. Patients with previous or current use of illegal substances were excluded. There was a statistically significant difference in the history of suicide attempts, comparing HDRUs (17 attempters, 30.9%) with Controls B (two attempters, 3.6%), while the difference was not significant comparing HDRUs with Controls A (10 attempters, 18.2%). Using logistic regression analysis, it was found that only comorbid borderline personality disorder (BPD), not high-dose BZD use, was independently associated with a history of suicide attempt. The percentage of patients with a history of suicide attempt was significantly higher in HDRUs with comorbid BPD, compared to HDRUs without BPD.
Assuntos
Ansiolíticos/administração & dosagem , Tentativa de Suicídio/psicologia , Adulto , Benzodiazepinas , Transtorno da Personalidade Borderline/psicologia , Estudos de Casos e Controles , Interpretação Estatística de Dados , Relação Dose-Resposta a Droga , Feminino , Humanos , Entrevista Psicológica , Modelos Logísticos , Masculino , Estado Civil , Razão de Chances , Ajustamento Social , Tentativa de Suicídio/estatística & dados numéricosRESUMO
SUMMARY: Under normal conditions, motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation increase in amplitude if the subject exercises the examined muscle immediately before recording. The authors examined the effect of nonfatiguing exercise on the amplitude of MEPs on 42 psychiatric, medicated inpatients (14 with depression, 14 with schizophrenia, and 14 with mania) compared with 14 healthy control subjects. For each subject, a total of 50 baseline and 50 postexercise MEPs were recorded. The mean (+/- standard deviation) postexercise MEP facilitation, expressed as a percentage of mean baseline values, was significantly lower (p = 0.02) in all three patient groups (148 +/- 91% in the depressed, 107 +/- 43% in the schizophrenic, and 143 +/- 63% in the manic patients) compared with the control subjects (268 +/- 223%). There was no clear evidence that psychotropic medication could be fully responsible for the modified MEP response to exercise, but the degree to which they were responsible is impossible to assess. These findings indicate that the reduced postexercise MEP facilitation is not related to any particular psychiatric illness, but rather that it represents a suppressed reaction of cortical excitability shared by patients with either depression, mania, or schizophrenia. The authors propose that, despite the lack of specificity, the study of postexercise MEP alterations could be useful in the neurophysiologic evaluation of motor cortex excitability in some psychiatric illnesses, except in those patients who may have diminished somatosensory input associated with voluntary muscle contraction resulting in decreased cortical excitability.