Differential associations of conduct disorder, callous-unemotional traits and irritability with outcome expectations and values regarding the consequences of aggression.

BACKGROUND: Previous work has examined the association of aggression levels and callous-unemotional traits with outcome expectations and values regarding the consequences of aggression. Less work has examined the outcome expectations and values regarding the consequences of aggression of adolescents with Conduct Disorder (CD). Also, no studies have examined links between irritability (a second socio-affective trait associated with CD) and these social cognitive processes despite the core function of anger in retaliatory aggression and establishing dominance. METHOD: The current study, investigating these issues, involved 193 adolescents (typically developing [TD; N = 106], 87 cases with CD [N = 87]). Participants completed an adaptation of the Outcomes Expectations and Values Questionnaire and were assessed for CU traits and irritability via the Inventory of Callous-Unemotional traits and the Affective Reactivity Index. RESULTS: While CD was associated with atypical outcome expectations this was not seen within statistical models including CU traits and irritability. CU traits were associated with decreased expectation that aggression would result in feelings of remorse and victim suffering, as well as decreased concern that aggressive acts would result in punishment and victim suffering. Irritability was associated with increased expectations and concern that aggression would result in dominance and forced respect. CONCLUSIONS: The results suggest that CU traits and irritability, often present in youth with CD, are associated with different forms of maladaptive outcome expectations and values regarding the consequences of aggression. This suggests that the atypical social cognitive processes underlying aggressive behavior among youth exhibiting CU traits may differ from those exhibiting problems regulating anger.

Young adults' familiarity with different cannabis product terms: the need for standardized cannabis surveys.

BACKGROUND: Cannabis legalization has resulted in the proliferation of cannabis products. Participants' familiarity with terms for these products may have implications for assessment, as unfamiliarity with particular terms may result in under-reports of use. METHODS: A convenience sample of 861 college students from one U.S. university completed a survey in the spring of 2020 about their familiarity with a variety of cannabis product terms and use of a variety of cannabis products. RESULTS: Participants varied in their familiarity with cannabis product terms. For example, with regard to terms for cannabis concentrates with very high concentrations of THC, 85% of participants reported being familiar with the term "wax pen or THC oil," but only 27% reported being familiar with the term "butane hash oil (BHO)" (i.e., the oil that composes most concentrates). Moreover, of participants who reported use of concentrates based on selecting pictures of the products they had used (n = 324, 40%), 99% (n = 322) reported having seen a "wax pen or THC oil" based on a written list of product terms, whereas only 20% (n = 65) reported having seen "butane hash oil (BHO)." This suggests that asking about use of "butane hash oil" use may result in lower rates of cannabis concentrate use than asking about use of "wax pen/THC oil." With regard to terms for marijuana flower, 29% of participants (n = 248) reported being unfamiliar with the term marijuana "buds or flowers." Of participants who reported use of marijuana flower based on selecting pictures of the products they had used (38% of the sample, n = 329), only 86% (n = 282) reported having seen marijuana "buds or flowers" based on a written list of product terms. This suggests that asking about use of marijuana "buds or flowers" use could result in under-reporting due to lack of familiarity with that term. Finally, when asked to select pictures of the cannabis product(s) that participants thought constituted "marijuana," participants most commonly selected pictures of marijuana flower (93%), followed by wax pen/THC oil (57%) and edibles (49%). CONCLUSIONS: Young adults vary in their familiarity with cannabis product terms, and some may under-report cannabis use in surveys that rely on written cannabis product terms. Young adults also differ in terms of which cannabis products they think constitute "marijuana." Although participants' familiarity with specific cannabis product terms in this sample may not generalize to other populations, results highlight the need for standardized surveys of cannabis use that incorporate pictures of cannabis products to overcome issues related to variability in familiarity with cannabis product terms.

Vaginal Health: Insights, Views & Attitudes survey in Latin America (VIVA-LATAM): focus on Brazil.

OBJECTIVE: A previous survey investigated postmenopausal vaginal atrophy in a sample of women across Latin America. To help implement a tailored approach to improve postmenopausal care and outcomes in Brazil, we consider results from the survey for this country. METHODS: A total of 2509 postmenopausal women resident in Argentina, Brazil, Chile, Colombia, or Mexico completed an online questionnaire. The Brazilian cohort comprised 504 women. RESULTS: Over half of the Brazilian cohort (56%) reported experiencing symptoms of vaginal atrophy; most described them as moderate or severe (76%), and almost half (48%) experienced symptoms for at least 1 year. Three-quarters of the Brazilian cohort (75%) were unaware of the chronic nature of the condition. Upon experiencing symptoms of vaginal atrophy, 92% had visited a health-care provider to discuss treatment options. Overall, 56% were aware of some form of local hormone therapy and 40% of those affected by vaginal atrophy had used such treatment. CONCLUSION: Postmenopausal women in Brazil are likely to benefit from increased awareness of the symptoms of vaginal atrophy. Health-care providers can potentially improve outcomes by helping women to understand the chronic nature of the condition and available treatment options. Women may be open to education pre menopause, before symptoms occur.

Effect of hormone replacement therapy on the bone mass and urinary excretion of pyridinium cross-links.

CONTEXT: The menopause accelerates bone loss and is associated with an increased bone turnover. Bone formation may be evaluated by several biochemical markers. However, the establishment of an accurate marker for bone resorption has been more difficult to achieve. OBJECTIVE: To study the effect of hormone replacement therapy (HRT) on bone mass and on the markers of bone resorption: urinary excretion of pyridinoline and deoxypyridinoline. DESIGN: Cohort correlational study. SETTING: Academic referral center. SAMPLE: 53 post-menopausal women, aged 48-58 years. MAIN MEASUREMENTS: Urinary pyr and d-pyr were measured in fasting urine samples by spectrofluorometry after high performance liquid chromatography and corrected for creatinine excretion measured before treatment and after 1, 2, 4 and 12 months. Bone mineral density (BMD) was measured by dual energy X-ray absorptiometry (DEXA) before treatment and after 12 months of HRT. RESULTS: The BMD after HRT was about 4.7% (P < 0.0004); 2% (P < 0.002); and 3% (P < 0. 01) higher than the basal values in lumbar spine, neck and trochanter respectively. There were no significant correlations between pyridinium cross-links and age, weight, menopause duration and BMD. The decrease in pyr and d-pyr was progressive after HRT, reaching 28.9% (P < 0.0002), and 42% (P < 0.0002) respectively after 1 year. CONCLUSIONS: Urinary pyridinoline and deoxypyridinoline excretion decreases early in hormone replacement therapy, reflecting a decrease in the bone resorption rate, and no correlation was observed with the bone mass evaluated by densitometry.

Religious faith and spirituality in substance abuse recovery: determining the mental health benefits.

Recently, mental health professionals have begun examining the potential value of religious faith and spirituality in the lives of individuals suffering from a variety of acute and chronic illnesses. This study explored the relation between religious faith, spirituality, and mental health outcomes in 236 individuals recovering from substance abuse. We found that recovering individuals tend to report high levels of religious faith and religious affiliation, but choose to rate themselves as being more spiritual than religious. Results also indicate that among recovering individuals, higher levels of religious faith and spirituality were associated with a more optimistic life orientation, greater perceived social support, higher resilience to stress, and lower levels of anxiety. This represents the largest self-report study to date examining the relation between religious faith, spirituality, and mental health outcomes among individuals recovering from substance abuse.

Polycystic ovary syndrome: clinical and laboratory evaluation.

OBJECTIVE: To evaluate clinically, and with laboratory, tests, women with polycystic ovary syndrome (PCO). PATIENTS: One hundred and twelve women with PCO were studied. METHODS: The following data was recorded: Current age; age at menarche; menstrual irregularity, occurrence of similar cases in the family; fertility, obstetric history; body mass index (BMI); and presence of hirsutism. Serum measurements of follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin, free testosterone, and dehydroepiandrosterone sulfate were taken. RESULTS: All patients presented either oligomenorrhea (31 percent), periods of secondary amenorrhea (9 percent), or both alterations (60 percent). The majority of the patients were infertile (75.6 percent). The LH/FSH ratio was higher than 2:1 in 55 percent of the patients and higher than 3:1 in 26.2 percent. The ultrasonographic aspect of the ovaries was considered to be normal in 31 percent. CONCLUSION: The main clinical feature of the PCO is the irregularity of menses since menarche, and that the laboratory tests would be important to exclude other disorders such as hyperprolactinemia or hyperandrogenemia caused by late-onset congenital adrenal hyperplasia.

Serum levels of androstanediol glucuronide, total testosterone, and free testosterone in hirsute women.

OBJECTIVE: To determine the serum levels of androstanediol glucuronide (3 alpha-diol G), total T, and free T in hirsute and nonhirsute women. DESIGN: Controlled clinical study. PATIENTS: Hirsute women with oligomenorrhea, hirsute women with regular ovulatory cycles, and nonhirsute women with regular cycles were selected. MAIN OUTCOME MEASURE: Serum levels of 3 alpha-diol G, total T, and free T were measured in 8 hirsute with oligomenorrhea and 11 hirsute women with regular ovulatory cycles and compared with 20 nonhirsute women with regular cycles (control group). Serum 3 alpha-diol G was also measured during the follicular, periovulatory, and luteal phases in hirsute women with regular cycles. RESULTS: Serum levels of 3 alpha-diol G did not change during the menstrual cycle, in addition we observed that there was no difference between the levels of 3 alpha-diol G, total T, and free T in hirsute women with regular cycles when compared with normal women. These three serum androgens were elevated only in the hirsute women with oligomenorrhea. Besides, there was better correlation between total T and free T (r = 0.81) than total T and 3 alpha-diol G (r = 0.49) or free T and 3 alpha-diol G (r = 0.66). CONCLUSION: The findings suggest that serum 3 alpha-diol G does not provide additional benefit as a marker of hirsutism than serum total or free T.

[Congenital adrenal hyperplasia and pregnancy]. / Hiperplasia adrenal congênita e gravidez.

About 90% of CAH cases are due to 21-hydroxylase (21-OH) deficiency. There are decreased cortisol and increased ACTH secretions; and elevated cortisol precursors and androgens. CAH is an important factor of menstrual disorders and infertility. Pregnancy is very much uncommon in the classic form, and 90% of reported cases belong to the postnatal form. The authors present two patients with classic form of CAH (21-OH deficiency) who became pregnant. They had been treated in early childhood (2-4 years old) with glucocorticoids and had surgical correction of the ambiguous external genitalia. During pregnancy, daily prednisone dose was raised to 5 mg twice, serum levels of 17-hydroxyprogesterone (17-OHP) and androgens were monthly measured. The 17-OHP levels remained high (about 1.6 ng/dl), and androgens (testosterone, androstenedione, SDHEA) levels remained normal. Cesarean section was performed in both cases; newborns were normal and 17-OHP was within normal limits. Adequate early replacement therapy has improved fertility and pregnancy.

Impaired mineralocorticoid hormone responses to adrenocorticotropin stimulation: additional characterization of heterozygosity for the 21-hydroxylase deficiency type of congenital adrenal hyperplasia.

In 12 obligate heterozygotes for the simple virilizing form of congenital adrenal hyperplasia (21-hydroxylase deficiency), basal and ACTH-stimulated levels of aldosterone, corticosterone, deoxycorticosterone, 18-hydroxycorticosterone, and 18-hydroxydeoxycorticosterone were examined. The responses to ACTH were significantly impaired (P less than 0.025 less than 0.001) compared with those of normal subjects. In addition to the often exaggerated stimulation by ACTH of the immediate precursor to 21-hydroxylation, 17 alpha-hydroxyprogesterone, the heterozygotes can now be characterized further by the impaired ACTH responses of mineralocorticoids distal to the block in the zona fasciculata; the ACTH-stimulated 17 alpha-hydroxyprogesterone/18-hydroxydeoxycorticosterone ratio was greater than normal in 94% of the heterozygotes. A limitation of 21-hydroxylation may also exist in the zona glomerulosa.

Padrao de resposta da 17-alfa-hidroxiprogesterona ao estimulo com ACTH em heterozigotos para deficiencia da enzima 21-hidroxilase. / Response standard of 17-alpha hydroxyprogesterone to ACTH stimulation in heterozygotes for 21-hydroxylase deficiency

A resposta de 17-alfa-OHD e cortisol ao estimulo com ACTH em individuos heterozigotos (HTZ) e homozigostos para hiperplasia adrenal congenita por deficiencia da 21-hidroxilase foi comparada com individuos controles. Os niveis basais ou estimulos de conrtisol nao apresentaram nenhuma diferenca entre os HTZ e os controles. A 17-alfa-OHP, por sua vez, nao apresentou diferenca em condicoes basais porem 60 minutos apos estimulos houve um incremento dignificativamente maior que os controles.A relacao 17-alfa-OPH/cortisol, apos estimulo, foi significativamente maior nos HTZ Concomitantemente, foram colhidas amostras de sangue por aspiracao continua que surgeriram uma taxa de incremento mais elevado no intervalo de 0-15 minutos, antingido os valores mais altos no intervalo entre 30-60 minutos.Nas duas metodologias de coleta, observou-se uma resposta de 17-alfa-OHP apos estimulo nitidamente superior nos HTZ que no grupo controle, embora, devido a faixa de superposicao entre os 2 grupos, nao autoriza a padronizacao do teste para detectar portadores de heterozigose na populacao geral

Aplicacao clinica do radioimunoensaio da 17-alfahidroxiprogesterona. / Clinical use of 17-alpha-hydroxyprogesterone radioimmunoassay

Os autores fazem a revisao das aplicacoes clinicas do radiomunoensaio de 17-alfa-hidroxiprogesterona, ressaltando o diagnostico da deficiencia adrenal de 21 hidroxilase