RESUMO
We investigated the usefulness of the laboratory marker of alcohol consumption carbohydrate-deficient transferrin (CDT) in 101 consecutively admitted patients in a surgical and internal medical ward of a hospital in a rural wine-growing area. Four major aspects were considered: the influence of liver disease, the method of expression of CDT values (relative % vs absolute units/1), level and pattern of alcohol consumption and comparison with y-glutamyl transferase (GGT). The results show that %CDT is a more valuable discriminating marker of high alcohol consumption than absolute CDT values and its usefulness in this respect is independent of changes in serum total transferrin levels, as in liver disease. Sensitivity and specificity of % CDT were 70 and 98% respectively, compared with 65 and 83% respectively for GGT.
Assuntos
Alcoolismo/epidemiologia , Programas de Rastreamento , Admissão do Paciente/estatística & dados numéricos , Transferrina/análogos & derivados , Adulto , Idoso , Alcoolismo/diagnóstico , Alcoolismo/enzimologia , Áustria/epidemiologia , Biomarcadores/análise , Feminino , Hospitais Gerais , Hospitais Rurais , Humanos , Hepatopatias Alcoólicas/diagnóstico , Hepatopatias Alcoólicas/enzimologia , Hepatopatias Alcoólicas/epidemiologia , Testes de Função Hepática , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Valores de Referência , Transferrina/análise , Vinho/provisão & distribuição , gama-Glutamiltransferase/sangueRESUMO
Discussions on the nosological position of delusional parasitosis (DP) have resulted in a wide range of opinions. In the present study in 34 patients with DP, the various and contradictory opinions concerning DP positioning in psychiatric nosology were examined through clinical, psychopathological, and polydiagnostic analyses using VRC, DSM-III, DSM-III-R and ICD-9. The psychopathological analyses with VRC as well as the polydiagnostic comparisons with other classification systems indicated that DP is neither a nosological entity nor due to a specific psychiatric illness. As our results showed, DP is a nosologically unspecific syndrome, which may occur superimposed on all psychiatric disorders.
Assuntos
Delusões/classificação , Transtornos Neurocognitivos/classificação , Doenças Parasitárias/psicologia , Escalas de Graduação Psiquiátrica , Transtornos Psicóticos/classificação , Delusões/diagnóstico , Delusões/psicologia , Demência/classificação , Demência/diagnóstico , Demência/psicologia , Humanos , Transtornos Neurocognitivos/diagnóstico , Transtornos Neurocognitivos/psicologia , Psicometria , Transtornos Psicóticos/diagnóstico , Transtornos Psicóticos/psicologiaRESUMO
Proceeding from the hypothesis that auditory hallucinations in psychotic patients have another biological basis than hallucinations provoked by hypnotic suggestion in healthy persons, we performed a symptom-comparative study by means of 99mTc-HMPAO single photon emission computed tomography. The results confirm the importance of pathogenesis in symptom-oriented psychiatric research.
Assuntos
Percepção Auditiva/fisiologia , Alucinações/classificação , Transtornos Psicóticos/classificação , Adulto , Encéfalo/diagnóstico por imagem , Dominância Cerebral/fisiologia , Feminino , Lobo Frontal/irrigação sanguínea , Alucinações/diagnóstico por imagem , Alucinações/psicologia , Humanos , Hipnose , Masculino , Pessoa de Meia-Idade , Compostos de Organotecnécio , Oximas , Transtornos Psicóticos/diagnóstico por imagem , Transtornos Psicóticos/psicologia , Fluxo Sanguíneo Regional/fisiologia , Tecnécio Tc 99m Exametazima , Tomografia Computadorizada de Emissão de Fóton ÚnicoRESUMO
Drug use in a given population, whether justified by a medical prescription or not, is a subject that is often emotionally rather than objectively discussed. In this study, objective data from the Austrian population are collected in order to provide a more comprehensible view of that complex phenomenon: drug use, abuse or addition seem to relate to various factors such as gender, age, profession and local differences. Physician's role in drug use in more or less important, depending on the nature of the substance. Indeed, tranquillizers and hypnotics are medically prescribed drugs although laxatives, geriatric and homeopathic medicines are rarely prescribed by a physician. However, these factors could account for only a part of this subject and other research should focus on the relations between physician, patient and the drug.
Assuntos
Uso de Medicamentos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Fatores Etários , Áustria/epidemiologia , Demografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ocupações , Automedicação , Fatores SexuaisRESUMO
In 34 patients suffering from delusional parasitosis the relevance of an accurate differential diagnosis with respect to pharmacological treatment was investigated. Under a psychopharmacological therapy of the delusion's additional psychiatric symptomatology in 17 patients (50%) a full remission and in other 5 patients an improvement of the delusional symptoms was observed. The unexpected high recovery-rate is explained by the fact that all of the patients with additional depression showed a reduction also of the delusional symptomatology after a treatment with antidepressants. In contrast to that, patients with organic brain syndromes underlying the delusions had a significant worse outcome, which seems to be caused by the considerable lack of effective psychopharmacological treatment of such states. The results indicate that an accurate psychiatric differential diagnosis is of great importance for the psychopharmacological therapy of patients suffering from delusional parasitosis. In this context the Viennese decision-tree for delusional syndromes is discussed.
Assuntos
Delusões/tratamento farmacológico , Ectoparasitoses/psicologia , Psicotrópicos/uso terapêutico , Adulto , Idoso , Antidepressivos/uso terapêutico , Antipsicóticos/uso terapêutico , Transtorno Bipolar/tratamento farmacológico , Terapia Combinada , Transtorno Ciclotímico/tratamento farmacológico , Delusões/psicologia , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Neurocognitivos/tratamento farmacológico , Psicoterapia , Encaminhamento e Consulta , Esquizofrenia/tratamento farmacológico , Psicologia do EsquizofrênicoRESUMO
From the supposition that there exists a possible connection between certain psychopathological symptoms, and/or syndromes (e.g., hallucinations) and regional cerebral dysfunction, patients suffering from auditory and tactile hallucinations were investigated, in a symptom-oriented study, using the method of technetium-99m-Hexamethyl-propylenamine Oxime (99m-Tc-HMPAO)-Single Photon Emission Computed Tomography (SPECT) and compared with normal controls. The results support Jackson's hypothesis to the effect that hallucinatory phenomena will primarily occur when the normally inhibitive influence of the upper cortical centers over the lower brain structures diminishes, resulting in relative hyperactivity in the basal regions. In addition to the brain activity-changes generally observed in hallucinating patients, it was possible to identify regional cerebral blood flow (rCBF)-distribution patterns characteristic in certain forms of hallucinatory phenomena, i.e., a significant increase of activity in the hippocampal regions (including hippocampus, parahippocampus, and amygdala) only in patients with auditory hallucinations, and a significant reduction of rCBF in the inferior temporal regions in patients with tactile hallucinations.
Assuntos
Percepção Auditiva/fisiologia , Circulação Cerebrovascular , Alucinações/diagnóstico por imagem , Tomografia Computadorizada de Emissão , Tato/fisiologia , Adulto , Córtex Cerebral/irrigação sanguínea , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Neurocognitivos/diagnóstico por imagem , Compostos Organometálicos , Oximas , Projetos Piloto , Fluxo Sanguíneo Regional , Tecnécio Tc 99m ExametazimaRESUMO
In a symptom-oriented study 17 patients suffering from chronic auditory hallucinations were investigated by means of 99mTc-HMPAO-SPECT and compared with healthy controls. The results confirm the relative frontal hypoactivity in junction with a relative hyperactivity in the basal ganglia and mesial limbic structures in both hemispheres found in a previous pilot study in auditorily hallucinating patients. Our results should fortify the symptom-oriented approach in psychiatric research.