Disentangling differing relationships between internalizing disorders and alcohol use.

Both internalizing disorders and alcohol use have dramatic, wide-spread implications for global health. Previous work has established common phenotypic comorbidity among these disorders, as well as shared genetic variation underlying them both. We used genomic structural equation modeling to investigate the shared genetics of internalizing, externalizing, and alcohol use traits, as well as to explore whether specific domains of internalizing symptoms mediate the contrasting relationships with problematic alcohol use compared to alcohol consumption. We also examined patterns of genetic correlations between similar traits within additional Finnish and East Asian ancestry groups. When the shared genetic influence of externalizing psychopathology was accounted for, the genetic effect of internalizing traits on alcohol use was reduced, suggesting the important role of common genetic factors underlying multiple psychiatric disorders and their genetic influences on comorbidity of internalizing and alcohol use traits. Individual internalizing domains had contrasting effects on frequency of alcohol consumption, which demonstrate the complex system of pleiotropy that exists, even within similar disorders, and can be missed when evaluating only relationships among formal diagnoses. Future work must consider the broad effects of shared psychopathology along with the fine-scale effects of heterogeneity within disorders to more fully understand the biology underlying complex traits.

Psychiatric comorbidity, depression, and anxiety levels and quality of life of the patients with mycosis fungoides.

Mycosis fungoides (MF) is a chronic disease, causing serious morbidities and mortality. This study was designed to measure depression and anxiety levels in MF patients, and quality of life (QoL) assessments and to compare the results with controls. Fifty-two patients with a diagnosis of MF and 52 age and sex matching healthy controls were enrolled in this study. Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and the 36-Item Short Form Health Survey (SF-36) were administered to all patients and controls. Mean BAI and BDI scores of the patients with MF were significantly higher than controls. In case of the SF-36, general health perception, emotional, and social functioning scores were significantly lower in MF patients. Depression scores of the patients' were positively correlated with the age of disease onset and negatively correlated with physical functioning scores. Significant negative correlation was detected between eight subscales of the SF-36 and BDI and BAI scores. This study has demonstrated that there is significant impairment of QoL in MF patients MF, with higher anxiety and depression levels, when compared to control group. As the disease progresses, level of depression increases and patients' general health perception deteriorates.

Os significados da comorbidade para os pacientes vivendo com TB/HIV: repercussões no tratamento / The meanings of comorbidity for patients living with TB / HIV: implications in the treatment

O objetivo é compreender o processo de construção dos significados atribuídos pelos pacientes em relação à vivência da comorbidade tuberculose e HIV (TB/HIV), e sua repercussão nos respectivos tratamentos. Diante da complexidade do objeto, optou-se em estudá-lo à luz do referencial teórico do construcionismo social. O estudo qualitativo envolveu a realização de entrevista semiestruturada com dez pacientes com TB/HIV, acompanhados em um hospital na cidade do Rio de Janeiro. Os dados coletados foram submetidos à técnica de análise de conteúdo temático, organizados em cinco eixos: a) paciente e suas doenças; b) apoio; c) significados do tratamento; d) relação com o serviço de saúde; e e) estigma, preconceito e discriminação. Os resultados sinalizam que a vivência das duas condições e seus respectivos tratamentos é uma experiência difícil, trazendo sofrimento acentuado à vida dos pacientes. A TB acirra a dor do viver com HIV/Aids. O estigma da TB é reforçado pelo estigma da Aids, aumentando a vivência de medo associado ao preconceito. À família, à religião e ao serviço de saúde é atribuído papel fundamental, como lugar seguro e de preservação da identidade. Apesar do sofrimento físico, psicológico e moral e das dificuldades com ambos os tratamentos, é possível fazer conciliações no cotidiano.

This article aims to understand the construction process of meanings given by patients in relation to the experience of comorbidity tuberculosis and HIV (TB / HIV), and its impact on their treatments. Given the complexity of the subject, it was decided to study it in the light of the theoretical framework of social constructionism. The qualitative study involved the use of semi-structured interviews with ten patients with TB / HIV being treated at a hospital in the city of Rio de Janeiro. Data were examined with content analysis technique, organized into five areas: a) patient and their disease; b) support; c) treatment meanings; d) relationship with the health service; and e) stigma, prejudice and discrimination. The results indicate that the experience of the two conditions and their treatment is a difficult experience, bringing marked distress to patients' lives. TB intensifies the pain of living with HIV / AIDS. The stigma of TB is reinforced by the stigma of AIDS, increasing the fear of living associated with prejudice. To the family, religion and health services are entrusted key role as a safe place and identity preservation. Despite the physical, psychological and moral suffering and difficulties with both treatments, it is possible to make compromises in everyday life.

Habilidades sociais na comorbidade entre dificuldades de aprendizagem e problemas de comportamento:uma avaliação multimodal / Social skills in the comorbidity between learning disabilities and behavior problems: a multimodal assessment / Habilidades sociales en la comorbilidad entre dificultades de aprendizaje y problemas de conducta: una evaluación multimodal

A atual prevalência e comorbidade de problemas de comportamento e de aprendizagem mostram a importância da avaliação precoce na prevenção desses problemas e de questões metodológicas relacionadas. Com base em uma amostra de 50 crianças que apresentavam essa comorbidade, de ambos os sexos, de oito a 12 anos, o presente estudo comparou resultados obtidos por dois instrumentos (IMHSC-Del-Prette e SSRS-BR) bem como avaliações feitas pelas próprias crianças e por seus professores. Os resultados indicaram déficits de aquisição e desempenho nas habilidades sociais das crianças (especialmente habilidades assertivas e empáticas), alta frequência de problemas de comportamento e vieses entre autoavaliação e avaliação do professor. Discutem-se implicações dos resultados na análise das necessidades educativas especiais e no planejamento de programas de intervenção junto a essa clientela.

The ongoing prevalence and co-morbidity of behavior problems and learning disabilities highlight the importance of early evaluation in the prevention of these problems and some methodological issues. Based in a sample of 50 children with this co-morbidity, of both sexes, aged eight to 12 years, the present study compared results obtained by two instruments (IMHSC-Del-Prette and SSRS-BR) and two informants (children and teachers) showing acquisition and performance deficits of social skills (especially assertive and empathic skills), high frequency of behavior problems and biases between student and teacher evaluations. Implications of the findings in the analysis of educational special needs and in the planning of intervention programs for this population were discussed.

El predominio continuado y la co-morbosidad de problemas de conducta y de aprendizaje resaltan la importancia de la evaluación temprana en la prevención de estos problemas así como algunos problemas metodológicos. Basado en una muestra de 50 de estos niños de ambos sexos, de ocho a 12 años, el estudio presente comparó resultados obtenidos por dos instrumentos (IMHSC-Del-Prette y SSRS-BR) y dos informadores (los niños y maestros) mostrando la adquisición y déficits de la actuación de habilidades sociales (especialmente las habilidades asertivas y empáticas), la alta frecuencia de problemas de conducta y sesgos entre las evaluaciones del estudiante y del maestro. Se discuten las implicaciones de los resultados en el análisis de necesidades especiales educativas y en la planificación de programas de la intervención para esta población.

Silicosis among agate workers at Shakarpur: An analysis of clinic-based data.

BACKGROUND: There is a high prevalence of silicosis and other morbid conditions leading to early death among agate workers at Khambhat of Gujarat. AIMS: The present study describes the prevalence of X-ray positive silicosis in a sample of a high-risk group visiting a clinic at Shakarpur of Khambhat. SETTINGS AND DESIGN: A cross-sectional study among 123 clinically suspected cases was conducted over 6 months. MATERIALS AND METHODS: A chest physician and a radiologist independently evaluated the Chest X-rays of 123 clinically suspected patients of silicosis. Silicosis was confirmed if either of them rated the X-ray as positive. STATISTICAL ANALYSIS: Descriptive statistics and logistic regression were done using SPSS software version 14. RESULTS: Out of 123 cases, 85 (69.1%) were confirmed as silicosis. There was no significant difference in the prevalence between males (70.3%) and females (69.4%). Workers with more than 10 years of exposure to silica had an odd ratio of 4.8, 95% CI (1.76, 13.60) compared to those with less than 10 years of exposure. A logistic regression analysis showed that for every extra year of exposure, the odds of getting silicosis increased by about 12%. CONCLUSIONS: This study highlights the catastrophic effects of exposures to silica in agate worker, which calls for urgent protective measures for this population.

The epidemiological dimension of TB/HIV co-infection / La dimensión epidemiológica de la coinfección TB/VIH / A dimensão epidemiológica da coinfecção TB/HIV

This study aimed to analyze the epidemiological indicators of TB/HIV co-infection in São José do Rio Preto, São Paulo, Brazil from 1998 to 2006. Data of new TB cases that initiated treatment between January 1998 and December 2006 were obtained from the TB Notification System (EPI-TB) and 306 cases were reported. The incidence rate was 5.1/100,000 inhabitants in 2006. Most cases were men (72.5 percent) with ages ranging between 20 and 59 years (96.4 percent). The majority (51 percent) had incomplete primary education. Pulmonary TB was the most common type (52.9 percent) and 46.1 percent of the patients received supervised treatment. In 2006, the cure rate was 33.3 percent, 14.3 percent death rate and no patient abandoned the treatment. Diagnosis occurred at the hospital in 60 percent of the cases. Results show the need of improved coordination between the city's Tuberculosis Control Program and the Sexually Transmitted Diseases and HIV Program.

El objetivo fue analizar los indicadores epidemiológicos de la coinfección tuberculosis y virus de la inmunodeficiencia humana (TB/VIH) en el municipio de Sao José del Rio Preto, Sao Paulo, Brasil, en el período de 1.998 a 2.006. Los datos de los casos nuevos de TB, que iniciaron el tratamiento entre enero de 1.998 y diciembre de 2.006, fueron recolectados del Sistema de Notificación de la TB (EPI-TB). Fueron notificados 306 casos. El coeficiente de incidencia fue de 5,1/100.000 hab, en 2006. Hubo predominio de personas del sexo masculino (72,5 por ciento), en el intervalo de edad de 20 a 59 años (96,4 por ciento). La mayoría (51 por ciento) no poseía la enseñanza fundamental completa. La forma clínica pulmonar fue relevante (52,9 por ciento) y recibieron tratamiento supervisado 46,1 por ciento enfermos. En 2.006, la tasa de cura fue de 33,3 por ciento, de muertes 14,3 por ciento, y no hubo ningún caso de abandono. Entre los casos, 60 por ciento fueron diagnosticados en el hospital. Los datos reflejan la necesidad de tener una mayor articulación entre el Programa Municipal de Control de la Tuberculosis y el Programa Municipal de DST/SIDA.

O objetivo foi analisar os indicadores epidemiológicos da coinfecção tuberculose e o vírus da imunodeficiência humana (TB/HIV) no município de São José do Rio Preto, São Paulo, Brasil, no período de 1998 a 2006. Os dados dos casos novos de TB, que iniciaram o tratamento entre janeiro de 1998 a dezembro de 2006, foram coletados do Sistema de Notificação da TB (EPI-TB). Foram notificados 306 casos. O coeficiente de incidência foi de 5,1/100 000 hab, em 2006. Houve predomínio de pessoas do sexo masculino (72,5 por cento), na faixa etária de 20 a 59 anos (96,4 por cento). A maioria (51 por cento) não possuía o ensino fundamental completo. A forma clínica pulmonar era relevante (52,9 por cento) e receberam tratamento supervisionado 46,1 por cento doentes. Em 2006, a taxa de cura foi de 33,3 por cento, óbitos, 14,3 por cento, e não houve nenhum caso de abandono. Dentre os casos, 60 por cento foram diagnosticados no hospital. Os dados refletem a necessidade de maior articulação entre o Programa Municipal de Controle da Tuberculose e o Programa Municipal de DST/AIDS.