Worry and anger rumination in fibromyalgia syndrome.

The aim of the present study was twofold: 1) to investigate the psychological profile of patients with fibromyalgia syndrome (FS) as compared to patients with other chronic pain syndromes (CP) and healthy subjects (HS); 2) to examine the associations between anxiety, depression, worry and angry rumination in FS patients. FS patients (N=30), CP patients (N=30) and HS (N=30) completed measurements of anxiety, depression, worry and angry rumination. FS patients showed higher levels of state and trait anxiety, worry and angry rumination than CP patients and HS, and higher levels of depression than HS. Worry and angry rumination were strongly associated in the FS group. FS patients may use worry and rumination as coping strategies to deal with their negative emotional experience, which might impair their emotional wellbeing. Findings from the present study add to our understanding of the psychological profile of FS patients, and have important implications for developing a tailored CBT protocol for pain management in FS patients.

Alcohol consumption and health-promoting behavior in a U.S. household sample: leisure-time physical activity.

OBJECTIVE: Hypothesizing that people who moderate their alcohol intake engage in other health-promoting cardioprotective behavior, this research explored associations between alcohol consumption and leisure-time physical activity. METHOD: Data representative of the U.S. population (N = 41,104; 52.5% women) were derived from the 1990 National Health Interview Survey, which employed a multistage probability design. Multivariate logistic regression analyses were performed, using lifetime abstainers as the reference group. RESULTS: An inverted J-shaped curve characterized the association between estimates of alcohol consumption and leisure-time physical activity, in which likelihood of displaying a physically active lifestyle (odds ratios) increased from abstinence (1.00) to moderate drinking (1.84), then declined at heavier consumption (1.61). Stratified analyses yielded similar results with peaks at light or moderate consumption for current smokers, persons aged 55 and over, and those with cardiovascular risk conditions. As activity intensity increased, the inverted J-shaped curve persisted with more pronounced peaks at moderate drinking. CONCLUSIONS: Robust findings of an association between cardioprotective leisure-time physical activity and moderate alcohol consumption provide evidence for a health-promoting lifestyle that may play an explanatory role in the alcohol-coronary heart disease relationship.

[Multifocal Langerhans cell granulomatosis. Report of a clinical case]. / Granulomatosi a cellule di Langerhans multifocale. Presentazione di un caso clinico.

Langerhans' cell granulomatosis is a rare disease whose incidence on adults is valued about one case out of 3.000.000. The multifocal form is rarer than the single eosinophilic granuloma of the bone. It mainly affects males during childhood and it is usually localized in the long bones, hands, feet, and in the skull. We present the case of a young woman affected by multifocal Langerhans cell granulomatosis with bones and skin involved. Unusual in the presented clinical case is the age in which the disease come out. There is the highest incidence of multifocal lesions during childhood, while the monofocal kind is more typical of the years of adult age. Bone localization in the sternum is also quite unusual. In fact it is impossible to find reports of it in recent literature. As the patient refused to undergo chemotherapy she was treated with radiant therapy as for as bone localization concerned and with mecloretamin for local administration on skin lesion. Eleven months after the diagnosis we have not noticed the appearance of new lesions.

Alcohol involvement in fatal traffic crashes in the United States: 1979-90.

Trends in alcohol-related traffic crash fatalities for the United States were examined with data from the Fatal Accident Reporting System for the years 1979-90. Alcohol-related traffic crash fatalities have decreased 10% over the 12 years studied, from 20,245 in 1979 to 18,279 in 1990. Fatality rates per 100 million vehicles miles traveled, and per 100,000 population, registered vehicles and licensed drivers have decreased even more sharply. Rates of blood alcohol testing of fatally injured drivers rose substantially among the States, with the nationwide rate increasing from 44% in 1979 to 75% in 1990. Factors that may be affecting these trends are discussed.

Differential effects of forced locomotion, tail-pinch, immobilization, and methyl-beta-carboline carboxylate on extracellular 3,4-dihydroxyphenylacetic acid levels in the rat striatum, nucleus accumbens, and prefrontal cortex: an in vivo voltammetric study.

In vivo voltammetry with carbon fiber electrodes was used to assess extracellular 3,4-dihydroxyphenylacetic acid (DOPAC) levels in striatum, nucleus accumbens, and anteromedial prefrontal cortex of freely moving rats subjected to altered motor activity or anxiogenic stimuli. Forced locomotion on a rotarod for 40 min caused an increase in extracellular DOPAC levels in the striatum and to a lesser extent in the nucleus accumbens but not in the prefrontal cortex. Subcutaneous injection of the anxiogenic agent methyl-beta-carboline carboxylate (10 mg/kg) increased extracellular DOPAC levels to a similar extent in prefrontal cortex and nucleus accumbens. Immobilization for 4 min augmented dopamine (DA) metabolism preferentially in the nucleus accumbens and to a lesser extent in the prefrontal cortex. Tail-pinch caused a selective activation of DA metabolism in the nucleus accumbens. None of these stimuli altered extracellular striatal DOPAC levels. These results confirm the involvement of dopaminergic systems projecting to the striatum and nucleus accumbens in motor function and suggest that mesolimbic and mesocortical dopaminergic systems can be specifically activated by certain kinds of anxiogenic stimuli; the relative activation of either of these latter systems could depend primarily on the nature (sensory modality, intensity) of the acute stressor.

Mesocorticolimbic dopaminergic systems and emotional states.

We have used the technique of in vivo voltammetry with carbon fibre electrodes to investigate further the involvement of ascending mesencephalic dopaminergic systems in emotional states in freely moving rats. In Sprague-Dawley rats, forced locomotion caused an increase in extracellular DOPAC levels in the striatum and nucleus accumbens but not in the prefrontal cortex. Immobilization (4 min) or systemic injection of the anxiogenic agent methyl-beta-carboline carboxylate enhanced extracellular DOPAC in both prefrontal cortex and nucleus accumbens but not in striatum whereas tail-pinch provoked a selective increase in this parameter in the nucleus accumbens. These data suggest that mesolimbic and mesocortical dopaminergic systems can be specifically activated by certain kinds of anxiogenic stimuli. To evaluate the relationship between emotional status and the response of mesocortical dopaminergic neurons to stress, we investigated the effects of stressful conditions on dopamine metabolism in the prefrontal cortex of 2 genetically selected lines of rats which differ drastically in their level of emotionality. Introduction of the animals into an unfamiliar environment, application of a high-intensity loud noise or immobilization were associated with an increase in extracellular cortical DOPAC levels in the hypoemotional (RHA) but not in the hyperemotional (RLA) line. These results suggest that the increase in cortical dopamine metabolism induced by stress is not connected to the emotional reaction caused by the aversive nature of the stressor but may reflect activation of cognitive processes in an attempt to cope with the stressor.

Differential alcohol-related mortality among American Indian tribes in Oklahoma, 1968-1978.

Tribal differences in alcohol-related mortality were examined among 11 Indian tribes living in Oklahoma. Data on alcohol-related deaths from 1968 to 1978 were compiled and assigned to various tribes on the basis of population distributions by county. Results showed significant differences in alcohol-related mortality among the various tribes. Of the 267,238 total deaths in Oklahoma during the study period, 9.3% of Indian deaths were alcohol-related while only 3.2% of those among blacks and 2.4% of those among whites were classified as such. Indian males and females are far more likely to die of alcohol-related deaths than their black and white counterparts. Cheyenne-Arapaho, Comanche and Kiowa areas (located in the western++ part of the state) have higher alcohol-related deaths than Cherokee, Choctaw, Creek, Seminole and Pawnee areas (located in eastern Oklahoma). Indian residents of the Seminole area have the lowest percentage of deaths identified as alcohol-related. The patterns which emerge may be due to different cultural and historical factors among the Indian tribes.

Drinking levels, knowledge, and associated characteristics, 1985 NHIS findings.

Several questions in the 1985 Health Promotion and Disease Prevention Questionnaire, which was part of the 1985 National Health Interview Survey, addressed respondents' consumption of alcohol. Sociodemographic characteristics, knowledge of health risks related to heavy drinking, health practices, and the prevalence of certain health conditions were examined in relation to drinking levels. Although cause-effect relationships should not be inferred from the associations, the findings suggest some provocative areas for prevention and research. Heavier drinkers were more commonly found among men than women. Level of drinking was associated positively with years of education and family income, but was inversely related to age. Compared with light drinkers, heavier drinkers were much more likely to drive after they had had too much to drink. While more than 90 percent of the population knew that heavier drinking increases the risk of 'liver cirrhosis, less than half knew about the increased risk of throat cancer and cancer of the mouth. Most respondents aged 18-44 years (80 percent or more) knew that heavy drinking increases the chance of adverse pregnancy outcomes, and more women than men (62 versus 49 percent) had heard of fetal alcohol syndrome (FAS). However, 70 percent or more of those who had heard of FAS described the syndrome as a newborn addicted to alcohol rather than a child born with certain birth defects. Heavier drinkers of both sexes were less likely than others to be nonsmokers, and moderate drinkers were more likely than others to exercise or play sports regularly. Moderate drinkers also tended to have lower lifetime prevalence rates than others for hypertension and heart trouble.

Correlates of acting-out behaviors among young adult chronic patients.

The authors studied how the abuse of alcohol and other drugs and the failure to take prescribed medications are related to behavior problems shown by young adult mentally ill persons at home and in the community. The study was based on information provided by case managers for 1,471 clients in the community support program (CSP) sponsored by the National Institute of Mental Health. The study found that alcohol abuse was strongly related to acting out among young CSP clients, but that drug abuse affected their behavior even more adversely. Failure to comply with prescribed medication regimens accounted for a considerable share of the behavior problems exhibited by the young clients, particularly acting out in the community. Age was found to have an attenuating effect on behavior problems. The authors emphasize the need to devise programs to meet the needs of young chronic mentally ill persons.

The influence of alcohol abuse as a hidden contributor to mortality.

Although only about 2-3 percent of annual deaths are attributed to one of the four underlying causes linked to chronic alcohol use, research results suggest that the impact of alcohol is much greater. The recent issue of mortality multiple cause of death tapes from National Center for Health Statistics permit exploration of associations of chronic alcohol abuse with conditions coded as underlying cause of death and provide leads for case-finding. Data analysis is reported from certificates of resident deaths in the United States in 1978. There are 12 groups of underlying causes for which the percentage of pairings with chronic alcohol abuse ranges from 4-16 percent of the number of deaths from the underlying cause. Age, sex, and metropolitan status of residence are associated with a listing of chronic alcohol abuse among decedents of liver cancer, varicose veins, symptomatic heart disease, septicemia, and respiratory system disease. Planners concerned with secondary prevention can use these clues provided by logistic regression modelling as an aid in case-finding.

Uric acid metabolism in two patients with coexistent Down's syndrome and gout.

Two patients with coexistent Down's syndrome and gout are described. Although increased serum urate levels are frequently reported in Down's syndrome, only a few such patients have been described with concomitant gout. In our patients no significant alterations of the purine salvage pathway were found, and the turnover parameters of uric acid, determined by means of a 14C-labeled uric acid study, were consistent with the metabolic findings observed in normoexcretor gouty patients.

Uric acid levels and platelet function in humans. An in-vivo ex-vivo study.

Platelet function (aggregation by ADP, adrenaline, collagen and circulating platelet aggregates) before, during and after dietary induction of hyperuricemia (ribonucleic acid, 3 g/day) was studied in five healthy volunteers to assess the relationship between uric acid level and platelet function. In the same subjects, during a second period of ribonucleic acid diet, the acute and chronic effects of a hypo-uricemizing agent, allopurinol, were assessed. No significant correlation was detected between platelet function and uricemia either in the absence or in the presence of pharmacological treatment with allopurinol. On the basis of these results, the well known relationship between uric acid levels and ischemic heart disease does not appear to be mediated by an exaggerated platelet function.