RESUMO
OBJECTIVE: To evaluate the incidence of suicidal outcomes and risk factors for short- and long-term recurrence of suicidal behavior (SB) among high-risk borderline personality disorder (BPD) patients during a 24-month prospective follow-up period. METHODS: A multicenter prospective cohort study was designed to compare data obtained from 136 patients admitted to the emergency department for current suicidal ideation (SI) or a recent suicide attempt (SA). Subjects were clinically evaluated and monitored for a new SA or suicide. RESULTS: The incidence of a new SA was 25.63 events/100 persons-year, and one patient died by suicide. Child sexual abuse (CSA) was the only significant predictor throughout the complete follow-up period. The absence of prior psychiatric treatment predicts the recurrence of SB in the first 6 months of follow-up. Patient age, poor psychosocial functioning before hospitalization, age at first SA, and having multiple suicide attempts increased risk of SB recurrence at the long-term period (24th months). In addition, there was an interaction between CSA and poor psychosocial functioning that increased risk of SB. CONCLUSION: The risk of recurrence was higher during the first 6 months. Risk factors at 6 and 24 months vary. These findings are important for implementing suicide strategies.
Assuntos
Transtorno da Personalidade Borderline/psicologia , Abuso Sexual na Infância/psicologia , Tentativa de Suicídio/psicologia , Adulto , Argentina/epidemiologia , Transtorno da Personalidade Borderline/epidemiologia , Transtorno da Personalidade Borderline/mortalidade , Estudos de Casos e Controles , Criança , Abuso Sexual na Infância/estatística & dados numéricos , Feminino , Seguimentos , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Estudos Longitudinais , Masculino , Valor Preditivo dos Testes , Estudos Prospectivos , Recidiva , Fatores de Risco , Ideação SuicidaRESUMO
INTRODUCTION AND METHODS: Hepatitis A remains an important public health problem in low endemicity areas, because of the social and economic high burden of cyclical outbreaks. In this study we described an outbreak of HAV infection occurred in the city of Genoa and in its proximity and the viral circulation in the post-epidemic period. In order to identify risk factors associated to the illness and to determine the source of infection and the dynamics of virus evolution, we conducted an epidemiological and molecular investigation by a case-control study and by sequence analysis of high variable regions of the genome. RESULTS: From May to October 2005, 58 HAV hepatitis cases were notified. The case-control study showed that beach establishment attending is strongly associated with HAV hepatitis (OR = 24.5, p-value < 0.01), at multivariate analysis. The profile of epidemic curve, the clinical onset of primary cases who occurred in few weeks and the geographic distribution of cases clearly indicated a common exposure to a point source: the outbreak can be probably associated with a contaminated food product dispensed in the affected area. The outbreak has been mainly caused by a single variant, confirming the common exposure to a point source; this variant previously circulated within homosexual man (MSM) network in Northern Europe. During the outbreak and in the following months, different variants originating from Southeast Asia, Southern America and Northern Africa, have co-circulated: all these cases were related to international travel and none of these had determined secondary cases. DISCUSSION: The epidemiological picture of hepatitis A in Liguria is characterized by a wide heterogeneity of circulating HAV strains. This pattern could be associated with the increase of imported cases and transmission within network of persons with similar risk factors. Molecular approach coupled to descriptive and analytical epidemiological studies appeared un-replaceable tools for management and control of HAV outbreaks, because of their capacity to recognize infection origin, transmission patterns and dynamics of virus evolution.
Assuntos
Surtos de Doenças , Vírus da Hepatite A/genética , Hepatite A/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Genótipo , Hepatite A/sangue , Hepatite A/virologia , Vírus da Hepatite A/classificação , Vírus da Hepatite A/isolamento & purificação , Humanos , Incidência , Itália/epidemiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Epidemiologia Molecular , Filogenia , Reação em Cadeia da Polimerase , Fatores de Risco , Estações do Ano , Inquéritos e QuestionáriosRESUMO
UNLABELLED: This is an observational survey screening for microalbuminuria in diabetes patients type 2. This survey takes place during the general practioner (GP) consultation in Rhône-Alpes area. It is preliminary survey. Five hundred and sixty three patients were included, consecutively, during the same week, by 185 GP. They were aged from 18 to 80 years and previously research for microalbuminuria was carried out at least one year ago. A questionnaire collecting data concerning age, weight, height, diabetic vintage and HbA1c, arterial pressure, renal function, associated risk factors as (lipids, tabacco, cardiovascular history personal and family, antihypertensive diabetic and lipid treatments. Microalbuminuria as well as urine creatinine was detected with a dipstick to calculate albumin-creatinine ratio. Patients aged 64.66 +/- 11.23, 55% were male; 51% had a microalbumuniria between 30 mL/L and 300 mL/L, but if one consider the albumin-creatinine ratio 59% had a microalbuminuria. In these patients, the diabetes history is longer and body mass index >30 is more frequent 35 vs 27%. HbA1c is similar in the two groups of patients, but patients with microalbuminuria had more often two treatments. Regarding hypertension, there are no difference between the two groups in term of blood pressure control and there is no correlation between blood pressure and albuminuria level. Nevertheless 68% of the patients were uncontrolled for blood pressure. Renal impairment (creatinine clearance <60 mL/min) was present in 26% of the whole group but more frequent in microalbuminuria patients 30 vs 23%. IN CONCLUSION: prevalence of microalbuminuria seems to be higher in this population compared to data previously reported and linked to the vintage of the diabetes mellitus. Comorbidities as well as risk factors were more frequent in patients with microalbuminuria.
Assuntos
Albuminúria/epidemiologia , Albuminúria/etiologia , Diabetes Mellitus Tipo 2/complicações , Idoso , Comorbidade , Estudos Epidemiológicos , Feminino , França/epidemiologia , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , PrevalênciaRESUMO
Methyl methanesulphonate (MMS) was used to test the induction of gene mutation, somatic crossing-over and mitotic non-disjunction in A. nidulans. Gene mutation was tested by inducing mutants resistant to 8-azaguanine and revertants of methG1 in a haploid strain. Somatic crossing-over was tested in heterozygous diploids, both with a selective method, i.e. inducing homozygosis to FPA resistance in a heterozygous fpa A1/+ strain, and with a non-selective method, i.e. identifying the frequencies of colour sectors. This latter method was also used to estimate the induction of non-disjunction because additional markers were present which permitted us to distinguish the two types of colour segregant. Generally, 3 different experimental procedures were used, namely the "plate test", i.e. plating of conidia in agar media containing MMS, and two types of "liquid test", i.e. brief treatment of quiescent or pre-germinated conidia in MMS solution before they were plated on agar media. Point mutations were induced with about equal efficiency with each method, whereas crossing-over was induced preferentially when germinating conidia were exposed to MMS. On the other hand, non-disjunction was induced in germinating and quiescent spores with equal efficiency, but such segregants were not recovered with the selective (fpa) method. The results are discussed for both their practical use in the mutagenic testing procedure and their theoretical implication.
Assuntos
Aspergillus nidulans/genética , Metanossulfonato de Metila/farmacologia , Mutagênicos , Aberrações Cromossômicas , Troca Genética , Relação Dose-Resposta a Droga , Marcadores Genéticos , MutaçãoRESUMO
A simple method capable of detecting recessive lethal damage in a diploid strain of Aspergillus nidulans is described. The method scores the recessive lethals on the 1st, the 3rd and the 5th chromosomes, which represent about 40% of the total map of A. nidulans. Two examples of induced lethals, with ultraviolet irradiation and methyl methanesulfonate are shown. The frequency of lethals may reach 36% of the total population with UV irradiation.
Assuntos
Aspergillus nidulans/genética , Genes Letais , Genes Recessivos , Técnicas Genéticas , DiploideAssuntos
Dípteros/análise , RNA Ribossômico , Animais , Centrifugação com Gradiente de Concentração , Citoplasma/análise , Eletroforese em Gel de Poliacrilamida , Temperatura Alta , Larva/análise , Substâncias Macromoleculares , Peso Molecular , Pâncreas/enzimologia , Ligação Proteica , RNA Ribossômico/isolamento & purificação , Ribonucleases , Proteínas Ribossômicas , Ribossomos/ultraestruturaRESUMO
A strain carrying the ilv0603 mutation has been isolated in E. coli K-12 and its characteristics were found to be very similar to those previously reported by Ramakrishnan and Adelberg (1965a) for other ilv0 mutants. The strain carrying the ilv0603 mutation is resistant to valine inhibition (Valr) and we show that this resistance depends on the expression of a newly recognized gene, ilvG, which is located at min 75, between ilvE and ilvD on the E. coli K-12 map. The ilvG gene causes the expression of a Valr acetolactate synthase, which is detectable only when the ilv0603 mutation is also present in cis on the same chromosome. Under these conditions the Valr acetolactate synthase activity is eluted, on a hydroxylapatite column, at an ionic strength slightly lower than that required for elution of the remaining acetolactate synthase activity (sensitive to valine inhibition). The Valr peak is missing in a strain carrying an ilvG (amber) mutation.
Assuntos
Acetolactato Sintase/metabolismo , Escherichia coli/enzimologia , Genes , Isoenzimas/metabolismo , Mutação , Oxo-Ácido-Liases/metabolismo , Valina/metabolismo , Mapeamento Cromossômico , Cromossomos Bacterianos , Ligação Genética , Genótipo , FenótipoRESUMO
A method is described for the microbiological determination of the protein content of biological materials. This method can also be adopted to titrate the concentration of a single amino acid in the protein and has the following advantages: (1) titration can be done without purification and hydrolysis of proteins; (2) the titration graph is a straight line between 25 and 800 microgram/ml; (3) protein values agree with those obtained using the Kjeldhal method; and (4) each mutant requiring one amino acid may be used to titrate the concentration of a single amino acid of the protein. The leucine content of various kinds of flour was measured with this system.
Assuntos
Aminoácidos/análise , Bacillus/crescimento & desenvolvimento , Bioensaio , Proteínas/análise , Leucina/análise , Leucina/metabolismo , Mutação , Proteínas/metabolismoRESUMO
Anaplastic carcinoma of the thyroid is generally considered a primary condition. Our study, based on ten observations, shows that anaplastic carcinoma of the thyroid with a rapidly fatal course may arise in long-standing goiters. Borderline histologic changes may be encountered; in some differentiated nodules, undifferentiated areas were found. Factors inducing transformation is equally obscure. Anaplastic changes may result from the growth of previously quiescent clones. The time-interval between benignant and malignant lesions varies widely and is difficult to establish unequivocally. In some instances, anaplastic carcinoma occurs after surgical removal of differentiated carcinoma.