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1.
Am J Public Health ; 87(2): 169-75, 1997 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-9103092

RESUMO

OBJECTIVES: The Vietnam and Persian Gulf wars have awakened people to the realization that military service can be traumatizing for women as well as men. This study investigated the etiological roles of both war and sexual trauma in the development of chronic posttraumatic stress disorder among female Vietnam veterans. METHODS: Data from the National Vietnam Veterans Readjustment Study for 396 Vietnam theater women and 250 Vietnam era women were analyzed with structural equation modeling. RESULTS: An etiological model with highly satisfactory fit and parsimony was developed. Exposure to war trauma contributed to the probability of posttraumatic stress disorder in theater women, as did sexual trauma in both theater and era women. Lack of social support at the time of homecoming acted as a powerful mediator of trauma for both groups of women. CONCLUSIONS: Within the constraints and assumptions of causal modeling, there is evidence that both war trauma and sexual trauma are powerful contributors to the development of posttraumatic stress disorder among female Vietnam veterans.


Assuntos
Modelos Psicológicos , Transtornos de Estresse Pós-Traumáticos/etiologia , Veteranos/psicologia , Guerra , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Probabilidade , Delitos Sexuais , Estados Unidos , Vietnã
2.
Am J Med Genet ; 49(3): 323-7, 1994 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-8209894

RESUMO

Two male cousins with Duchenne muscular dystrophy were found to have different maternal dystrophin gene haplotypes and different deletion mutations. One propositus showed two noncontiguous deletions--one in the 5', proximal deletional hotspot region, and the other in the 3', more distal deletional hotspot region. The second propositus showed only the 5' deletion. Using multiple fluorescent exon dosage and fluorescent multiplex CA repeat linkage analyses, we show that the mother of each propositus carries both deletions on the same grandmaternal X chromosome. This paradox is explained by a single recombinational event between the 2 deleted regions of one of the carrier's dystrophin genes, giving rise to a son with a partially "repaired" gene retaining only the 5' deletion.


Assuntos
Distrofina/genética , Deleção de Genes , Distrofias Musculares/genética , Adolescente , Criança , Análise Mutacional de DNA , Feminino , Ligação Genética , Haplótipos , Heterozigoto , Humanos , Masculino , Oligodesoxirribonucleotídeos/genética , Linhagem , Recombinação Genética , Sequências Repetitivas de Ácido Nucleico
3.
J Subst Abuse Treat ; 10(3): 255-61, 1993.
Artigo em Inglês | MEDLINE | ID: mdl-8315698

RESUMO

Alcohol is an increasingly abused substance among psychiatric inpatients, and the extent to which alcohol dependence history is documented and the alcoholism subsequently treated is a compelling issue. This study is a retrospective review of the extent to which alcohol dependence history was obtained, and if applicable, whether a diagnosis and/or treatment plan were made, for acute psychiatric inpatients. For these purposes, an original instrument was constructed. Our results indicate that the predominant focus for acute inpatients is on diagnostic assessment of the severity of the alcohol problem, reflecting the need to deal with those issues requiring the most immediate attention. For patients with schizophrenia, attention to alcoholism diagnosis and treatment was less than that for nonschizophrenic patients. The implications of these findings are discussed with reference to the evaluation and treatment of dually diagnosed patients, along with further directions for research.


Assuntos
Alcoolismo/epidemiologia , Transtornos Mentais/epidemiologia , Admissão do Paciente , Determinação da Personalidade , Adulto , Idoso , Alcoolismo/diagnóstico , Alcoolismo/reabilitação , Terapia Combinada , Comorbidade , Estudos Transversais , Hospitais de Veteranos , Humanos , Illinois/epidemiologia , Incidência , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/reabilitação , Pessoa de Meia-Idade , Unidade Hospitalar de Psiquiatria , Esquizofrenia/diagnóstico , Esquizofrenia/epidemiologia , Esquizofrenia/reabilitação , Psicologia do Esquizofrênico
4.
Am J Hum Genet ; 51(4): 721-9, 1992 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-1415217

RESUMO

We have developed a fast and accurate PCR-based linkage and carrier detection protocol for families of Duchenne muscular dystrophy (DMD)/Becker muscular dystrophy (BMD) patients with or without detectable deletions of the dystrophin gene, using fluorescent PCR products analyzed on an automated sequencer. When a deletion is found in the affected male DMD/BMD patient by standard multiplex PCR, fluorescently labeled primers specific for the deleted and nondeleted exon(s) are used to amplify the DNA of at-risk female relatives by using multiplex PCR at low cycle number (20 cycles). The products are then quantitatively analyzed on an automatic sequencer to determine whether they are heterozygous for the deletion and thus are carriers. As a confirmation of the deletion data, and in cases in which a deletion is not found in the proband, fluorescent multiplex PCR linkage is done by using four previously described polymorphic dinucleotide sequences. The four (CA)n repeats are located throughout the dystrophin gene, making the analysis highly informative and accurate. We present the successful application of this protocol in families who proved refractory to more traditional analyses.


Assuntos
Distrofina/genética , Deleção de Genes , Triagem de Portadores Genéticos , Distrofias Musculares/genética , DNA/sangue , DNA/genética , DNA/isolamento & purificação , Éxons , Feminino , Ligação Genética , Humanos , Masculino , Distrofias Musculares/diagnóstico , Oligodesoxirribonucleotídeos , Linhagem , Reação em Cadeia da Polimerase , Gravidez , Diagnóstico Pré-Natal , Espectrometria de Fluorescência
5.
Biochem Biophys Res Commun ; 182(2): 794-801, 1992 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-1310396

RESUMO

The amino acid sequence of the sodium channel alpha subunit from adult human skeletal muscle has been deduced by cross-species PCR-mediated cloning and sequencing of the cDNA. The protein consists of 1836 amino acid residues. The amino acid sequence shows 93% identity to the alpha subunit from rat adult skeletal muscle and 70% identity to the alpha subunit from other mammalian tissues. A 500 kb YAC clone containing the complete coding sequence and two overlapping lambda clones covering 68% of the cDNA were used to estimate the gene size at 35 kb. The YAC clone proved crucial for gene structure studies as the high conservation between ion channel genes made hybridization studies with total genomic DNA difficult. Our results provide valuable information for the study of periodic paralysis and paramyotonia congenita, two inherited neurological disorders which are caused by point mutations within this gene.


Assuntos
Cromossomos Humanos Par 17 , Músculos/fisiologia , Canais de Sódio/genética , Adulto , Sequência de Aminoácidos , Animais , Encéfalo/fisiologia , Linhagem Celular , Clonagem Molecular , DNA/genética , DNA/isolamento & purificação , Enguias , Órgão Elétrico/fisiologia , Biblioteca Genômica , Humanos , Substâncias Macromoleculares , Dados de Sequência Molecular , Reação em Cadeia da Polimerase/métodos , Ratos , Mapeamento por Restrição , Homologia de Sequência do Ácido Nucleico
6.
Nature ; 354(6352): 387-9, 1991 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-1659668

RESUMO

HYPERKALAEMIC periodic paralysis (HYPP) is an autosomal dominant disease that results in episodic electrical inexcitability and paralysis of skeletal muscle. Electrophysiological data indicate that tetrodotoxin-sensitive sodium channels from muscle cells of HYPP-affected individuals show abnormal inactivation. Genetic analysis of nine HYPP families has shown tight linkage between the adult skeletal muscle sodium channel alpha-subunit gene on chromosome 17q and the disease (lod score, z = 24; recombination frequency 0 = 0), strongly suggesting that mutations of the alpha-subunit gene cause HYPP. We sequenced the alpha-subunit coding region isolated from muscle biopsies from affected (familial HYPP) and control individuals by cross-species polymerase chain reaction-mediated complementary DNA cloning. We have identified an A----G substitution in the patient's messenger RNA that causes a Met----Val change in a highly conserved region of the alpha-subunit, predicted to be in a transmembrane domain. This same change was found in a sporadic case of HYPP as a new mutation. We have therefore discovered a voltage-gated channel mutation responsible for a human genetic disease.


Assuntos
Músculos/fisiologia , Paralisias Periódicas Familiares/genética , Canais de Sódio/genética , Sequência de Aminoácidos , Animais , Cromossomos Humanos Par 17 , Análise Mutacional de DNA , Drosophila , Enguias , Genes Dominantes , Humanos , Proteínas de Membrana/genética , Dados de Sequência Molecular , Linhagem , Potássio/fisiologia , Ratos , Alinhamento de Sequência
7.
Gen Hosp Psychiatry ; 13(1): 19-26, 1991 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-1993515

RESUMO

The relationship among recent life stress, social support, a patient's locus of control, and the control of blood glucose is evaluated in persons with diabetes mellitus, using objective measures of these psychosocial variables. Short-term [fasting blood sugar (FBS)] and long-term [glycosylated hemoglobin (Hgb A-1C)] control measures are taken at two points in time in order to evaluate the effects of the psychosocial variables on change in diabetes control. For life events, a significant positive association was found between the number of recent life events and blood glucose control. Decrease in social support predicted a worsening of longer-term (Hgb A-1C) control over time. An external locus of control within the patient was associated both with poor short-term control at time one and prediction of poorer long-term control over time. The implications of these findings are discussed in support of a biopsychosocial approach to the management of diabetes mellitus.


Assuntos
Glicemia/análise , Diabetes Mellitus/terapia , Hemoglobinas Glicadas/análise , Controle Interno-Externo , Acontecimentos que Mudam a Vida , Apoio Social , Diabetes Mellitus/sangue , Diabetes Mellitus/psicologia , Humanos , Avaliação de Processos e Resultados em Cuidados de Saúde , Estresse Psicológico/psicologia
8.
Am J Drug Alcohol Abuse ; 15(3): 321-37, 1989.
Artigo em Inglês | MEDLINE | ID: mdl-2763987

RESUMO

The attitudes of 100 urban mental health professionals toward alcoholism diagnosis and treatment were assessed using a 23-item questionnaire. A significant number of those sampled, physicians more than other professional groups, looked upon alcoholism as a disease in its own right. Physicians, attendings more than residents, subscribed to a more medical history-taking model. While the majority of those surveyed would advise complete sobriety, a large number would not. Likewise, despite a large percentage of our sample who indicated familiarity with alcohol-related concepts, a significant number did not. Referral to Alcoholics Anonymous was highly endorsed by those advocating sobriety. The meaning of these findings is discussed in relation to the marked improvement noted in professionals' attitudes toward alcoholic patients. Based on these findings, methods of further improving the clinician's awareness of alcoholism are considered.


Assuntos
Alcoolismo/reabilitação , Atitude do Pessoal de Saúde , Adulto , Consumo de Bebidas Alcoólicas/psicologia , Alcoolismo/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Unidade Hospitalar de Psiquiatria , Testes Psicológicos
9.
Biotechnol Bioeng ; 32(6): 733-40, 1988 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-18587778

RESUMO

Plasmid loss kinetics for Saccharomyces cerevisiae transformed with the 2-mum DNA-based-plasmid pUCKm8 were measured in nonselective and selective media. The plasmid pUCKm8 gives the organism two new phenotypes: resistance to the wide spectrum antibiotic G418 sulfate, and the ability to produce the enzyme, beta-lactamase. Plasmid stability was determined using the production of beta-lactamase as a marker. The effect of G418 on the growth rates of all organisms present in the culture and on plasmid stability was also determined. Mathematical models describing plasmid loss kinetics during exponential growth for both nonselective and selective conditions are used to simulate the experimental data. In nonselective medium, over 80% of the cells still exhibited the desired phenotype after 50 doublings. In medium containing G418, improvements in plasmid stability were only marginal due to the appearance of antibiotic-resistant cells.

10.
Prim Care ; 15(2): 409-21, 1988 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-3290927

RESUMO

Among the psychosocial variables to be considered by the primary care physician in dealing with a diabetic patient are the effects of stressful life events, social support, and the patient's locus of control. Literature relevant to each of these is explored. A practical approach is discussed for the primary care doctor to consider in utilizing these psychosocial variables in diabetes management.


Assuntos
Diabetes Mellitus/psicologia , Diabetes Mellitus/terapia , Humanos , Controle Interno-Externo , Acontecimentos que Mudam a Vida , Apoio Social
13.
Gen Hosp Psychiatry ; 8(3): 212-6, 1986 May.
Artigo em Inglês | MEDLINE | ID: mdl-3710157

RESUMO

This study evaluated objectively the relationship between recent life events, social support systems, and blood glucose control in diabetic patients using both short-term [fasting blood sugar (FBS)] and long-term [glycosylated hemoglobin (Hgb A-1C)] measures of control. We found that a higher number of life events was associated with a higher percentage of abnormal FBS and Hgb A-1C results, and that improved social support was associated with a smaller percentage of abnormal Hgb A-1C scores. These pilot findings are discussed in connection with a biopsychosocial approach to the understanding and management of diabetes mellitus.


Assuntos
Diabetes Mellitus/psicologia , Acontecimentos que Mudam a Vida , Cooperação do Paciente , Meio Social , Apoio Social , Adulto , Idoso , Glicemia/análise , Diabetes Mellitus/sangue , Diabetes Mellitus/terapia , Feminino , Hemoglobinas Glicadas/análise , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto
14.
Hillside J Clin Psychiatry ; 8(2): 202-8, 1986.
Artigo em Inglês | MEDLINE | ID: mdl-3557295

RESUMO

A comprehensive investigation into the social support networks of a group of chronic psychiatric patients attending a Supportive Care Clinic was conducted. The results suggest that these patients, while exhibiting weaker support systems than the general population, do have a significant amount of personal support in addition to that received from the treatment center. Furthermore, they perceive the "support" aspect of the Clinic as the most helpful feature as compared to personal growth or medication. The results of these findings are discussed in terms of their practical utility for the ambulatory care of chronic psychiatric patients.


Assuntos
Serviços Comunitários de Saúde Mental , Transtornos Mentais/terapia , Meio Social , Apoio Social , Adulto , Idoso , Transtorno da Personalidade Borderline/terapia , Doença Crônica , Transtorno Depressivo/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Neurocognitivos/terapia , Equipe de Assistência ao Paciente , Esquizofrenia/terapia
17.
Am J Psychother ; 38(1): 35-46, 1984 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-6711708

RESUMO

A female patient with agoraphobia is presented to demonstrate the need for maximal flexibility in designing a treatment program for the agoraphobic patient. This patient required a multimodal approach utilizing pharmacotherapy, marital psychotherapy, and individual psychotherapy, alone and in combination. The paper looks specifically at nodal decision points in treatment at which reassessment was necessary and changes in psychotherapeutic intervention were made. The importance and implications of involving the patient's significant other in treatment are explored with respect to the outcomes such involvement may have on the treatment. A review of the literature on treatments for agoraphobia highlights the conclusion reached, that the agoraphobic patient presents with a biopsychosocial problem which frequently requires the clinician to combine several treatment modalities.


Assuntos
Agorafobia/terapia , Transtornos Fóbicos/terapia , Adulto , Agorafobia/psicologia , Terapia Combinada , Feminino , Humanos , Imipramina/uso terapêutico , Terapia Conjugal , Pânico , Psicoterapia/métodos , Sexo
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