ABSTRACT
Rheumatoid arthritisis (RA) is a chronic autoimmune disorder that affects ~1-2% of the world's population and damages synovial joints. RA is characterized by inflammation, autoantibody production, cartilage and bone destruction and synovial hyperplasia. Inflammation induces systemic and articular synthesis of pro-inflammatory cytokines, such as tumor necrosis factor alpha and interleukin-6 that play essential roles in joint and other organ damage in this disease. Considering the role of signal transducer and activator of transcription factors (STATs) in signaling of these cytokines, these proteins may be involved in the pathogenesis of RA. The expression and activity of STATs can contribute to the onset, progression and severity of RA. All STAT family members (STAT1, STAT2, STAT3, STAT4, STAT5a, STAT5b, and STAT6) have been associated with autoimmune diseases, as highlighted in several studies. In this review we aim to describe the immunobiology of STATs and its family members and the role of these proteins in the immunopathogenesis of RA.
Subject(s)
Arthritis, Rheumatoid/immunology , STAT Transcription Factors/immunology , Signal Transduction/immunology , Arthritis, Rheumatoid/epidemiology , Arthritis, Rheumatoid/pathology , Autoantibodies/immunology , Biomarkers/blood , Bone and Bones/pathology , Cartilage/pathology , Cytokines/immunology , Global Health , Humans , Inflammation/immunology , Interleukin-6/immunology , Synovial Fluid/immunology , Tumor Necrosis Factor-alpha/immunologyABSTRACT
Parathyroid diseases can present with psychiatric symptoms and can be recognized through determinations of serum electrolytes, especially the calcium level. Psychiatric evaluations should include a serum calcium concentration test, which is also essential in reassessment of patients poorly responsive to mental illness treatment. A magnesium and a phosphate assay may also be diagnostically helpful. Abnormality of divalent cation levels may provide evidence for consideration of, or ruling out, parathyroid disorders. Determinations of parathyroid hormone are performed if clinically indicated, and if abnormal divalent cation quantifications are confirmed. If parathyroid disease is identified, corrective endocrine therapies may diminish or even cure psychiatric aspects of parathyroid pathology. Failure to recognize a parathyroid disorder leaves an endocrine-induced mental dysfunction without proper treatment.
Subject(s)
Neurocognitive Disorders/diagnosis , Parathyroid Diseases/diagnosis , Adult , Diagnosis, Differential , Electrolytes/blood , Female , Humans , Male , Middle Aged , Neurocognitive Disorders/psychology , Parathyroid Diseases/psychology , Parathyroid Hormone/bloodSubject(s)
Aftercare , Mental Disorders/rehabilitation , Patient Compliance , Humans , Outpatient Clinics, HospitalABSTRACT
Depression was prominent among 40 alcoholics in an alcohol treatment program. Untreated depression may increase risk for relapse to problem drinking. The structured diagnostic interview schedules, DIS and Zung, showed good agreement and were effective instruments in the detection of depression in alcoholics.
Subject(s)
Alcoholism/diagnosis , Depressive Disorder/diagnosis , Psychiatric Status Rating Scales , Adult , Aged , Alcoholism/psychology , Alcoholism/rehabilitation , Community Mental Health Centers , Depressive Disorder/psychology , Female , Humans , Male , Middle Aged , Recurrence , RiskSubject(s)
Cerebellar Diseases/chemically induced , Lithium/adverse effects , Humans , Male , Middle AgedSubject(s)
Lithium/analysis , Saliva/analysis , Depression/blood , Humans , Lithium/blood , Psychotic Disorders/bloodABSTRACT
A patient is described who had a personal and family history of rage attacks, mood disturbance, and epileptiform EEGs. The patient achieved a return to emotional stability with the introduction of anticonvulsant drug therapy. Symptoms relapsed and then remitted as anticonvulsants were stopped and then reinstituted.
Subject(s)
Anger , Epilepsy, Temporal Lobe/psychology , Mood Disorders/psychology , Rage , Adult , Affective Symptoms/genetics , Affective Symptoms/psychology , Anticonvulsants/therapeutic use , Depressive Disorder/genetics , Depressive Disorder/psychology , Electroencephalography , Epilepsy, Temporal Lobe/drug therapy , Epilepsy, Temporal Lobe/physiopathology , Humans , Male , Mood Disorders/genetics , ViolenceABSTRACT
Elimination of amitriptyline and/or metabolite after overdoses may be delayed because of impaired metabolism. A case is described where this was possibly related to hepatotoxicity. Metabolite concentrations, including 10-OH-derivatives, were highly elevated. The biological properties and clinical significance of these metabolites merit further study.
Subject(s)
Antidepressive Agents, Tricyclic/poisoning , Adult , Amitriptyline/metabolism , Amitriptyline/poisoning , Antidepressive Agents, Tricyclic/metabolism , Chemical and Drug Induced Liver Injury/physiopathology , Female , Humans , Kinetics , Liver/enzymology , Liver Function Tests , Time FactorsABSTRACT
Principles of sound research design are too often incompletely applied in scientific investigations. Physicians may fail to evaluate journal articles for quality of research, comparability among studies, and clinical relevance. For many investigators quick publishable experiments take precedence over those with rigorous methods. Clinicians and researchers are becoming more aware of these concerns. Students should be taught the skills necessary to interpret scientific reading. Greater attention should be given to correct research design, and authors should fully explain both the procedures of a study, and its relevance. Fewer published articles and more review papers or commentaries might also stimulate better research quality.
Subject(s)
Mental Disorders/therapy , Psychiatry/trends , Forecasting , Humans , Publishing/trends , Research DesignABSTRACT
Rabbit syndrome is an uncommon, tongue-sparing, orofacial movement disturbance, rapid and regular in nature and associated with prolonged use of neuroleptics. Two cases reports illustrate how anticholinergic agents successfully treat the disorder. The syndrome is distinguished from tardive dyskinesia, which tends to be exacerbated by anticholinergic agents.
Subject(s)
Antipsychotic Agents/adverse effects , Basal Ganglia Diseases/chemically induced , Aged , Basal Ganglia Diseases/diagnosis , Basal Ganglia Diseases/drug therapy , Benztropine/therapeutic use , Diagnosis, Differential , Dyskinesia, Drug-Induced/diagnosis , Female , Humans , Male , Middle AgedABSTRACT
The prevalence of alcohol abuse among the fathers, and ADD in family members, of 22 adult psychiatric patients with persistent attention deficit disorder was found to be significantly higher than in 20 matched controls. Further research is necessary to determine the reasons for, and clinical implications of, these associations.