Subject(s)
Humans , Male , Female , Radioimmunotherapy/instrumentation , Radioimmunotherapy/methods , Yttrium Isotopes , Yttrium Radioisotopes , Lymphoma, Non-Hodgkin/diagnosis , Nuclear Medicine/methods , Nuclear Medicine/trends , Radioimmunotherapy/ethics , Radioimmunotherapy/statistics & numerical data , Radioimmunotherapy/trends , Lymphoma, Non-Hodgkin , Hodgkin Disease/diagnosis , Radiotherapy/trendsSubject(s)
Antibodies, Monoclonal/therapeutic use , Immunoconjugates/therapeutic use , Lymphoma, B-Cell/radiotherapy , Radioimmunotherapy/methods , Yttrium Radioisotopes/therapeutic use , Antigens, CD20/immunology , B-Lymphocytes/immunology , B-Lymphocytes/radiation effects , Contraindications , Drug Administration Schedule , Humans , Immunoconjugates/administration & dosage , Immunoconjugates/adverse effects , Informed Consent , Medical History Taking , Radiotherapy Dosage , Yttrium Radioisotopes/administration & dosage , Yttrium Radioisotopes/adverse effectsSubject(s)
Arthritis, Infectious/diagnostic imaging , Leukocyte Transfusion , Leukocytes , Osteomyelitis/diagnostic imaging , Radiopharmaceuticals , Technetium Tc 99m Exametazime , Adult , Aged , Aged, 80 and over , Arthritis, Infectious/etiology , Arthritis, Infectious/physiopathology , Bone Plates/adverse effects , Chemotaxis, Leukocyte , Child, Preschool , Diabetic Foot/complications , Diabetic Foot/diagnostic imaging , Diabetic Foot/surgery , Discitis/diagnostic imaging , Female , Humans , Joint Prosthesis/adverse effects , Male , Middle Aged , Osteomyelitis/etiology , Osteomyelitis/physiopathology , Postoperative Complications/diagnostic imaging , Prosthesis-Related Infections/diagnostic imaging , Radionuclide Imaging , Spondylitis/diagnostic imaging , Surgical Wound Infection/diagnostic imagingABSTRACT
Cerebral single-photon emission computed tomography (SPECT) is a sensitive technique for the detection of central nervous system (CNS) involvement in systemic lupus erythematosus (SLE). The objective was to determine whether a relationship exists between cerebral hypoperfusion as detected by cerebral SPECT, cumulative tissue damage and the clinical activity of SLE. Cerebral technetium-99m-L,L-ethyl cysteinate dimer (99mTc-ECD) SPECT was performed in two groups of patients: 10 women with SLE (Group A) who had no previous history of major neuropsychiatric (NPS) manifestations and no minor NPS symptoms in the last six months, and 57 unselected women with SLE (Group B). In the same week that SPECT was performed, the SLE disease activity index (SLEDAI), SLICC/ACR damage index, native anti-DNA antibodies (ELISA) and erythrocyte sedimentation rate (ESR) were determined. In Group A, cerebral SPECT showed moderate or severe hypoperfusion (abnormal SPECT) in five patients without NPS symptoms, unrelated to age (mean 24.8 versus 27.8 years) or disease duration (mean 6.8 versus 9 years). Patients with significant cerebral hypoperfusion had greater clinical disease activity (mean SLEDAI 13.6 versus 7.6) (SLEDAI > 7 in 5/5 versus 1/5; Fisher: 0.023; OR: 33; 95% CI: 2.3-469.8) and ESR (mean 43.6 versus 9.8; P < 0.05). In Group B, the mean age of the 57 unselected women with SLE was 37 years (SD 6.3) and the mean duration of the disease was 9.7 years (SD 6.3). Cerebral SPECT revealed normal perfusion or mild hypoperfusion (normal SPECT) in 30 patients (52.6%), and moderate or severe hypoperfusion in 27 (47.4%). Hypoperfusion was unrelated to age, duration of SLE or concentrations of anti-DNA antibodies and C3 and C4 fractions. Patients with significant cerebral hypoperfusion had more active clinical disease (mean SLEDAI 13.92; SD 8.44 versus 4.56; SD 4.15) (Mann-Whitney, P < 0.005), more cumulative tissue damage (mean SLICC 2.66; SD 2.84 versus 1.03; SD 1.51) (Mann-Whitney, P = 0.035), and higher ESR values (mean 28.7; SD 22.5 versus 17.7; SD 13.3) (Mann-Whitney, P = 0.023) than patients with normal SPECT studies. Significant cerebral hypoperfusion was related both to NPS manifestations present at the time of the study (17 of 27, 63% versus 3 of 30, 10%) (OR: 15.3) and cumulative manifestations (19 of 27, 70.4% versus 8 of 30, 26.7%) (OR: 6.5), whether mild (OR: 5.5) or severe (OR: 8.2). In conclusion, cerebral hypoperfusion detected by SPECT in patients with SLE is related to clinical activity (SLEDAI), cumulative tissue damage (SLICC) and concomitant or previous NPS manifestations.
Subject(s)
Cerebrovascular Circulation , Cysteine/analogs & derivatives , Lupus Erythematosus, Systemic/physiopathology , Tomography, Emission-Computed, Single-Photon , Adolescent , Adult , Aged , Cognition Disorders/diagnosis , Cognition Disorders/etiology , Cognition Disorders/physiopathology , Humans , Lupus Erythematosus, Systemic/complications , Lupus Erythematosus, Systemic/immunology , Lupus Erythematosus, Systemic/pathology , Male , Middle Aged , Neuropsychological Tests , Organotechnetium Compounds , Radiopharmaceuticals , Severity of Illness IndexABSTRACT
El Test de Supresion con Dexametasona (TSD) se ha propuesto como un marcador de estado de la melancolia, aunque existen resultados discrepantes seguin los autores. En nuestro trabajo, realizado con 117 pacientes hospitalizados diagnosticados de transtorno afectivo mayor y subclasificados seguin los criterios de Newcastle en endogenos (67) y no endogenos (50), encontramos una mayor frecuencia de respuestas anormales al TSD, en el grupo endogeno, aunque estos resultados no nos permitem afirmar que esta prueba pueda considerarse especifica de la depresion endogena.
Subject(s)
Depression , Depressive Disorder , Depressive DisorderABSTRACT
The results of the overnight 1 mg dexamethasone suppression test (DST) administered to 26 unipolar delusional depressed patients and 47 unipolar non-delusional depressed controls are reported. There were no significant differences between the rates of abnormal responses in the two groups. However, there was a higher percentage of normal responses in the delusional depressive sample with mood incongruency. While 55% of the mood-congruent depressive patients were non-suppressors, only 12% of the depressed patients with mood-incongruent psychotic features had abnormal DST responses.
Subject(s)
Delusions/diagnosis , Depressive Disorder/diagnosis , Dexamethasone , Adult , Delusions/blood , Delusions/psychology , Depressive Disorder/blood , Depressive Disorder/psychology , Diagnosis, Differential , Female , Humans , Hydrocortisone/blood , Male , Middle Aged , Research DesignABSTRACT
We have studied the suppression of plasma cortisol after dexamethasone (1 mg) and the peak post-dexamethasone cortisol values in 84 hospitalized patients with a diagnosis of primary unipolar depression. The non-suppressor responses in the three familial subgroups (Winokur) were: 11/22 in familial pure depressive disorder (FPDD), 21/49 in sporadic depressive disease (SDD) and 1/13 in depression spectrum disease (DSD) (FPDD vs. SDD, p less than 0.05; SDD vs. DSD, p less than 0.05). When considering the peak post-dexamethasone cortisol value, or the 8.30-9.00-hour values, the results in the DSD group were lower than in the other two groups (p less than 0.05). These results suggest a different behaviour of DSD as compared with FPDD and SDD.
Subject(s)
Depressive Disorder/genetics , Dexamethasone , Hydrocortisone/blood , Adrenocorticotropic Hormone/blood , Adult , Depressive Disorder/blood , Depressive Disorder/diagnosis , Female , Humans , Male , Middle Aged , Psychiatric Status Rating ScalesABSTRACT
Prolactin (PRL) serum levels in a group of patients with acute schizophrenia (AS) and in a group of patients with chronic schizophrenia (CS) have been investigated in order to differentiate the dopaminergic sensitivity in response to chlorpromazine (CPZ) treatment. AS patients show both a greater dopaminergic sensitivity to CPZ and a stronger response in PRL secretion to TRH stimulation after a 14-day CPZ treatment.
