RESUMO
OBJECTIVE: A polymorphism in the angiotensin-converting-enzyme gene (ACE I/D) has been associated with abdominal aortic aneurysm and a link between aortic aneurysm and aortic stiffness has been suggested. This study aimed to explore the links between ACE I/D polymorphism, circulating ACE and abdominal aortic wall integrity as reflected by abdominal aortic wall stiffness. MATERIAL: A total of 212 men and 194 women, aged 70-88 years, were studied. METHODS: Mechanical properties of the abdominal aorta were determined using the Wall Track System, ACE genotype using the polymerase chain reaction (PCR) and circulating ACE level by enzyme-linked immunosorbent assay (ELISA). RESULTS: In men, pulsatile diameter change differed between genotypes (II 0.70, ID 0.55 and DD 0.60 mm, P = 0.048), whereas a tendency was seen for distensibility coefficient (DC) (II 10.38, ID 7.68 and ID 8.79, P = 0.058). Using a dominant model (II vs. ID/DD), men carrying the ACE D allele had lower pulsatile diameter change (P = 0.014) and DC (P = 0.017) than II carriers. Multiple regression analyses showed additional associations between the D allele and increased stiffness ß, and reduced compliance coefficient. CONCLUSION: Men carrying the ACE D allele have stiffer abdominal aortas compared with II carriers. Deranged abdominal aortic stiffness indicates impaired vessel wall integrity, which, along with other local predisposing factors, may be important in aneurysmal disease.
Assuntos
Aorta Abdominal/diagnóstico por imagem , Aneurisma da Aorta Abdominal/genética , Peptidil Dipeptidase A/genética , Idoso , Alelos , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Ensaio de Imunoadsorção Enzimática , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Peptidil Dipeptidase A/sangue , Polimorfismo Genético , UltrassonografiaRESUMO
The peninsula of Oknö is located on the Baltic in Southern Sweden. It was here a 14 year-old girl "fell asleep" around Christmas time in the year 1875 - she woke up on April 3rd, 1908. She was then 46 years of age and had slept for 32 years. Except for numerous newspaper articles this unusual case has been described by the Swedish psychiatrist Harald Fröderström in 1912. The present article is based on his review and the investigation of the medical records at the hospital of the city of Oskarshamn where the woman in question was hospitalized for one month in 1892. At the city hospital she was given the diagnosis dementia paralytica - a diagnosis which was obviously wrong. When the woman woke up in 1908 she assumed a normal life and remained healthy until she died in 1950 through a brain hemorrhage. Fröderström, who except for an article written in French, wrote several extensive articles for Swedish newspapers about the sleeping girl. These articles are here reviewed from a modern psychiatric point of view.
Assuntos
Transtornos Mentais/história , Sono , Adolescente , Adulto , História do Século XIX , História do Século XX , Humanos , SuéciaRESUMO
The prognosis of 221 patients first admitted in 1941-1954 for dependence on sedative-hypnotic drugs was determined in a record-linkage and interview study concluded in 1984. Different outcomes were related to admission characteristics by means of the Cox proportional hazards regression model. An excess of unnatural deaths was noted; suicides in 11% of the men and 23% of the women. Of those with primary sedative-hypnotic dependence, 46% continued to abuse drugs till death or follow-up, and of those with a primary or concomitant alcohol abuse 72%. An unfavorable outcome was significantly related to primary psychiatric symptoms before the first admission, concomitant alcohol abuse, familial drug and alcohol abuse and health care occupation.
