ABSTRACT
BACKGROUND: There is evidence that aerobic exercise improves endothelial function in healthy subjects as well as in patients with chronic heart failure. However, it is unknown whether this effect occurs in patients with recent myocardial infarction (AMI). METHODS: Fifty-two patients with a recent first uncomplicated AMI underwent endothelial function evaluation before and after 3 months of moderate aerobic exercise training. We measured brachial artery vasomotor reactivity using flow-mediated dilation (FMD), a cold pressor (CP) test, and sublingual nitroglycerin. Patients were randomized into 2 groups: 28 patients (G1) underwent training, while 24 patients (G2) served as controls. Brachial artery vasomotor reactivity was reassessed after 1 month of detraining (DT). RESULTS: At baseline the FMD was 1.66% +/- 4.11% in G1 and 2.04% +/- 3.4% in G2 (P = NS) and vasoconstriction was evident after a CP test. The diameter reduction was -4.1% +/- 3.89% in G1 and -4.39% +/- 5.67% in G2 (P = NS). At follow-up the FMD had increased to 9.39% +/- 4.87% in G1 (P <.01) and to 4.4% +/- 3.9% in G2 (P <.01 vs G1). Vasoconstriction during a CP test was observed only in G2. Endothelium-independent vasodilation was unchanged in both groups. Effort tolerance increased by 32% in G1 patients (P <.01 versus G2) and was correlated with FMD change (R = 0.51, P <.01). After detraining the FMD was significantly reduced in G1 (P <.01) and a further vasoconstriction was evident after CP testing. CONCLUSIONS: Exercise training improves endothelium-dependent vasodilation in post-AMI patients. This improvement is associated with a significant increase in exercise tolerance. These benefits disappeared after detraining.
Subject(s)
Endothelium, Vascular/physiopathology , Exercise , Myocardial Infarction/physiopathology , Physical Fitness , Vasodilation , Adult , Brachial Artery/physiopathology , Electrocardiography , Exercise Test , Female , Humans , Male , Middle Aged , Myocardial Infarction/prevention & control , Myocardial Infarction/rehabilitation , Physical Education and TrainingABSTRACT
Current classification systems (ICD-10 and DSM-IV) require a quantitative criterion for differentiating depressive states, suggesting a correlation between the number of symptoms, i.e., the pervasiveness of the syndrome, and the subtype of the illness. All the symptoms (within those contained in the diagnostic lists) are assumed to have comparable value. To investigate the relevance of the number and the type of symptoms reported by 196 patients suffering from depression, we compared the symptoms using independent indicators of severity such as the Clinical Global Index (CGI) and the social functioning subscale of the Global Assessment of Functioning (GAF). A second comparison using the same indicators was made between qualitatively distinct categories of DSM-IV and ICD-10 (i.e., melancholic v nonmelancholic, somatic v nonsomatic, and psychotic v nonpsychotic). There was evidence that increasing numbers of symptoms actually reflect higher levels of severity, but the categorizations that were mainly based on qualitative criteria (e.g., melancholia, somatic syndrome, etc.) usually attained better discrimination compared with those based on the number of symptoms. Moreover, certain symptoms (usually those indicated as endogenous) were more likely to be associated with greater severity and pervasiveness. Finally, the results clearly showed that different symptoms had different weight in establishing the gradient of severity.
Subject(s)
Depressive Disorder/diagnosis , Adult , Depressive Disorder/psychology , Female , Humans , Male , Mental Disorders/classification , Mental Disorders/diagnosis , Middle AgedABSTRACT
A recent study has shown a mutation at codon 713 of the amyloid precursor protein (APP) gene in a schizophrenic patient. We have analyzed the MaeIII restriction site caused by that mutation in Italian and Russian families with schizophrenia. No mutations were observed suggesting that the APP713 mutation is unlikely to be linked to the pathogenesis of such a psychiatric disorder.
Subject(s)
Amyloid beta-Protein Precursor/genetics , Schizophrenia/genetics , Alzheimer Disease/genetics , Alzheimer Disease/metabolism , Amyloid beta-Protein Precursor/metabolism , Base Sequence , DNA/analysis , Humans , Italy , Molecular Sequence Data , Mutation , Nervous System Diseases/genetics , Nervous System Diseases/metabolism , Polymerase Chain Reaction , Restriction Mapping , Russia , Schizophrenia/metabolismABSTRACT
Thirty cases of post-partum psychotic disorders occurred between 1973 and 1987 and hospitalized at the Psychiatric Ward of Florence University were studied and followed up. A structured diagnostic interview was used, which explored DSM Ill-R diagnosis both for mood disorders and for psychotic features. The psychotic symptoms had started within 8 weeks of parturition in all cases. Only 36.7% of the patients showed no subsequent pathology after the puerperal symptoms. The diagnoses, both at the index episode and at the follow-up, revealed a great predominance of mood disorders and the absence of schizophrenia. The follow-up survey showed a greater proportion of bipolar disorders than it appeared at the puerperal onset of the disease. A high frequency of puerperal psychotic relapses has also occurred after subsequent deliveries during the follow-up period.
