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PubMed2005

Borderline personality features predict alcohol use problems.

This study assessed the relation between BPD features and problems associated with alcohol use 2 years later in young adults. Approximately 5,000 nonclinical young adults were screened for BPD features, and two cohorts of participants completed the laboratory phase of the study at Time 1 (total N = 421) and then again 2 years later at Time 2 (total N = 356). Measures included self-report and interview-based assessments of personality disorders, psychopathology in biological parents, Axis I psychopathology, and alcohol use problems. BPD features were found to significantly predict alcohol use problems 2 years later after controlling for parents' substance use disorders, Axis I psycho-pathology (including alcohol abuse/dependence), and non-BPD personality disorders. In addition, the BPD subscale that assesses impulsivity was found to be significantly associated with alcohol use problems once all predictors were entered into the model.

Adult↗
PubMedDate not supplied

[Clinical aspects and dynamics of heroin abuse depending on the premorbid features of personality].

Clinical picture is studied together with the time-related course of heroinism depending on premorbid features of the personality. An association has been demonstrated between the personality premorbid patterns and clinical manifestations of a pathological addiction to heroin, rate of formation and severity of the abstinence syndrome, and tempo of progrediency of the trouble as well. The course of the illness has been shown to be less favourable in excitable type personalities.

Adult↗
PubMed2002

Predictors of treatment utilization among women with anorexia and bulimia nervosa.

OBJECTIVE: The authors sought predictors of treatment utilization among women with eating disorders. METHOD: Women diagnosed with either anorexia or bulimia nervosa (N=246) completed prospective evaluations of eating disorder status, comorbid disorders, global assessment of functioning, and treatment utilization. RESULTS: Women with anorexia nervosa received significantly more inpatient treatment than did women with bulimia nervosa. Predictors of treatment utilization included lower global assessment of functioning scores and presence of personality disorders. CONCLUSIONS: Women with more severe pathology have higher treatment utilization rates. This pattern may explain the seeming lack of treatment efficacy for eating disorders outside of randomized controlled studies.

Adolescent↗
PubMed1999

Concurrent and predictive validity of antisocial personality disorder subtyping among substance abusers.

Three hundred seventy inpatient and outpatient substance abusers were divided according to presence and subtype of antisocial personality disorder (APD) into groups comparing: a) adult antisocial behavior (AAB) versus full APD; b) APD with low versus high sociopathy; c) APD with versus without lifetime depression; and d) APD with versus without other axis II disorders. Multivariate regression was used to predict the unique contribution to the variance in baseline and 12-month follow-up measures of substance use, psychiatric severity, and personality. The presence of comorbid axis II pathology was the strongest predictor of baseline severity in all three domains. APD substance abusers with lifetime depression exhibited greater baseline to follow-up reductions in psychiatric severity than those APD substance abusers without a history of depression. All APD subtypes improved over time with treatment, suggesting that this diagnosis does not necessarily indicate poor prognosis.

Adult↗
PubMed1989

[Surgical treatment of the aging patient].

Surgery in the elderly patient calls for a particular approach, since the physical powers of older persons are generally compromised, age-induced pathological organ alterations are frequent and the structures of skin, mucosa and bone have undergone physiological changes. Regarding the use of anesthetics and premedication, impaired hepatic and renal function will often require considering drugs with a prolonged half life and selecting low dosages. Although the surgical procedures required are basically the same as in the younger age groups, these operations are often considerably complicated by sclerosing of the surrounding bone and the associated risk of a jaw fracture. The majority of the elderly patients treated by the oral surgeon present with painful TMJ arthroses or rheumatoid arthritides, fractures of the visceral cranium accompanied by soft tissue injuries, tumors, or conditions requiring preprosthetic surgery. In older persons all these procedures demand specific indications, operative techniques and aftercare.

Aged↗
PubMed1997

The pathology of asthma.

Asthmatics respond with reversible airway narrowing when stimulated in ways that have no effect on non-asthmatic persons. Studies conducted at the turn of this century established that the pathology present in the airways of asthmatics is based on the inflammatory process. Recent work suggests that this inflammatory response may be driven by a particular group of T cells (Th2 response) that cause an overproduction of IL-4, IL-5 and other cytokines that produce an excessive infiltration of eosinophils and overproduction of IgE. The structural changes produced by the inflammatory process result in an overall thickening of the airway wall with changes in the epithelium, an increase in the interstitial matrix particularly the collagen types that contribute to the light microscopic appearance of the basement membrane, the vasculature, smooth muscle and mucous glands. Contraction of airway smooth muscle results in narrowing of the lumen particularly in the bronchioles where smooth muscle surrounds the entire lumen. An increase in wall tissue thickness as a result of asthma amplifies this normal effect producing a greater reduction in the airway lumen. Computer modelling of airway function and direct measurement of airway resistance in patients suggest that the smaller airways are the site of the greatest increase in airway resistance in asthma. These new data have shifted the emphasis away from the concept that abnormal airway smooth muscle function causes asthma toward the hypothesis that inflammatory-based changes in the airway wall act in series with normal smooth shortening to produce disease. The increased understanding of the role of the inflammatory process provides a basis for treatment of asthma with anti-inflammatory agents.

Animals↗
PubMed1983

Congenital atlanto-axial dislocation.

Report about 105 personally operated cases of congenital atlanto-axial dislocation. This fairly common malformation in India occurs three times more in males than in females, 50% show symptoms before the age of 20 years, the other half during the third decade of life. Transient attacks of cervical cord compression occur with progressive motor and posterior column defect, and sometimes unconsciousness and cerebellar involvement are characteristic. The diagnosis is proved by X-rays including tomograms and dynamic studies. Three types of malformation can be differentiated: Group I with assimilation of the atlas, group II with anomalies of the odontoid process and group III with a normal atlas and axis. The different types and subtypes are described in detail as well as the pathological and pathogenic factors. The treatment and personal experiences show that the early treatment with posterior decompression, sometimes combined with posterior fusion was unsuccessful and resulted in a high mortality and morbidity. The antero-lateral approach, described by the author proved to be the method choice. The prognosis is dependent on the extent of the damage to the cord before treatment. Early diagnosis and treatment lead to excellent results.

Adolescent↗
PubMed1994

[Quality assurance of pathology laboratory, standardization of surgical pathology report and consultation: recent trend].

Three recommendation articles proposed by the Association of Directors of Anatomic and Surgical Pathology in the United States were presented as to serve as the baseline of the quality assurance in the pathomorphological diagnosis. The first article was related to the internal quality assurance in the pathology laboratories. The prospective and retrospective methods were presented for daily and monthly bases. The importance of the turnaround time was stressed in addition to the reliable diagnosis. The second article was concerned about the standardization of the surgical pathology report. This was accepted nationwide in the United States like the Bethesda System in cytology. The third article covered the consultation in surgical pathology. The Association divided the consultation into personal and institutional consultations. The role of the institutional consultation has increased markedly in recent years. This is related to the new trend of the patients and their families seeking the second opinion in the clinical diagnosis. In these situations, the clinician frequently requested the new diagnostic impressions of their own pathologists. The second opinion is very important in recent practice in medicine along with informed consent. The pathologists should also be aware of these subjects.

Clinical Laboratory Techniques↗
PubMed1992

The selfobject function of weapons: a self psychology examination.

Weapons serve a variety of functions, both for individuals and for society. One such function is that of a selfobject for narcissistically vulnerable persons. This selfobject function allows the damaged self to maintain cohesion and to offset feelings of vulnerability and powerlessness. Because the weapon allows the personality to feel in control and to exert dominance over others, it may come to be viewed in an idealized manner. This is very similar to the idealizing selfobject transference described by Kohut. Weapons are more likely to become selfobjects for those personalities suffering from some degree of self pathology. The selfobject function of weapons, however, may have significance beyond individual psychopathology. Groups of individuals, societies, and even nations may utilize weapons to counter feelings of vulnerability and to diminish fragmentation of the group's collective self. Their destructive potential may be unleashed in response to an intense narcissistic injury and narcissistic rage. The importance of weapons can thus be better understood by examining them within the context of self psychology.

Aggression↗
PubMed1999

[Nonverbal communication by the presurgical patient].

Throughout human history, besides oral language, man has used other forms of communication which are known as non-verbal. From the three components of the basic structure of human communication, language, paralanguage and kinesthesia, we have chosen the last one, kinesthesia, to develop our project. Kinesthesia studies the gestures, mannerisms and postures, or in other words all body movements and positions which occur as part of our speech or independent to it. This project proposes to analyze presurgical patients' kinesthetic manifestations. We have observed that some patients do not verbally express their fears, anxieties, nervousness, etc; nonetheless, bodies do respond with similar gestures and movements in persons of varying age, sex, socio-cultural level and pathology. It is difficult to be certain what another human being feels at any given moment. One may ask a person, but he/she can refuse to answer, he/she can lie or maybe he/she does not even know what his/her feeling is. In spite of the fact that the level of information a patient possesses is higher all the time, since this is one of the primary objectives all health professionals have, one doubt remains: Will a person who has all the possible information regarding his/her surgery at his/her disposition feel the same degree of anxiety as the person who does not have such complete information available to him/her?

Adaptation, Psychological↗
PubMed1992

[User's arguments in the use of a hospital emergency unit].

300 cases admitted in a hospital Emergency Unit are studied, corresponding to two weeks of June 1989, with the aim to know user's characteristics and pathology shown. Through a survey addressed to the patient, or person accompanying him/her, it is intended to know the reasons which motivated the election of this type of service. Predominant pathology is the one which groups lesions and adverse effects (52%) and are younger age groups the ones who consult more frequently. Most part of patient (80%) show up with no previous inform or document and 89% of admitted patients were sent to their homes. Geographical proximity explains in most cases the election of the Emergency Unit. Reasons vary according to age, diagnostic and different circumstances. For example during morning hours, and among patients who attend based on their initiative, "familiarity" is the most important reason to adopt the decision to attend Emergency Unit.

Adolescent↗
PubMed2004

[Anogenital mammary type sclerosing adenosis--two case reports and the review of literature].

OBJECTIVE: To describe a rare case of mammary type sclerosing adenosis arising in anogenital, mammary-like adnexal glands. Differential diagnosis is discussed and detailed review of literature is presented. DESIGN: Two case reports. SETTING: Private Biopsy Lab s.r.o. and Sikl's Department of Pathology, Charles University and Faculty Hospital, Pilsen. METHODS: Included are two cases from Breast Registry, Biopsy Lab s.r.o. and from personal consulting registry of Prof. Michal, Sikl's Department of Pathology, Pilsen. Detailed morphology of the lesion is described and documented by pictures. The presence of myoepithelial cell is demonstrated by immunohistochemistry using streptavidin-bioptin detection system (LSAB+, Dako) and three conventional myoepithelial markers (actin S, calponin and CD10). Expression of estrogen and progesteron receptors and apocrine antigen GCDFP-15 were studied too. RESULTS: There were two women at the age of 54 and 60-years with lesion located on vulva and anus; the maximum tumor diameter was 7 and 10 mm, respectively. The histological picture was virtually the same in both cases displaying under hyperplastic epidermis small glands proliferation set in sclerotic fibrous stroma. In spite of relatively sharp circumscription, the chaotic and irregular distribution of the glands imparted the invasive image of the lesion. The luminal cells showed no cytological and nuclear atypia and visible was only minimal regular mitotic activity. The signs of luminal, decapitation-type, apocrine secretion were dispersal seen throughout the lesion. By immunohistochemistry the myoepithelial cells regularly and systematically decorated periphery of the glands and all the composition was similar to sclerosing adenosis in the breast including massive hormonal receptors expression. In the periphery of one lesion an insolated, single, typical anogenital gland was found. Features of conventional papillary hidradenoma were not seen. CONCLUSION: Mammary-type anogenital adnexal glands are regularly present in vulvar and perianal skin; these are considered there as a substrate for analogous lesion occurring in the breast (lactation change, papilloma and fibroadenoma, but also some types of carcinomas including primary extrammary Paget's disease). In these physiological structures there are combined features of both eccrine and apocrine adnexal glands creating a primitive caricature of basic tubulolobular unit in the breast. Their existence dispel historical dogma about running of the embryonal milk lines or mammary ridges and explains the findings of varied scale of neoplasms differing from well known lesion derived from conventional adnexal glands.

Anus Neoplasms↗
PubMed2001

Walking velocity in aged persons: its association with lower extremity joint range of motion.

OBJECTIVE: To measure the association between walking velocity and hip and knee flexion range, ethnic background, anthropometrics, comorbid pathologies, and coimpairments, in a sample of community-dwelling aged persons. METHODS: To reach our objective, we used data from the San Antonio Longitudinal Study of Aging (SALSA), a population-based cohort of Mexican American and European American persons aged 64 to 79. By fitting hierarchical regression models, we measured the variance in the walking velocity over 50 feet explained by hip and knee flexion range, adjusting for the combined influence of demographic and anthropometric variables, coexistent pathologic conditions, impairments, and the examiners who conducted the assessments. RESULTS: The average walking velocity among the 702 subjects for whom data were available was 73.6 meters per minute (range 20 to 121). Bivariate analyses revealed significant associations between walking velocity and age, sex, ethnic background, height, weight, presence of arthritis, diabetes mellitus, stroke, upper leg pain, peripheral vascular disease, left ventricular hypertrophy, and forced expiratory volume at 1 second. The correlation (r) between walking velocity and flexion range of the hip and knee were 0.40 and 0.35, respectively (P < or = 0.001 for each). Multivariate hierarchical models adjusting for demographic and anthropometric characteristics of the subjects, and examiner variation, revealed that hip and knee flexion range explained 6% of the variance in walking velocity. Adjusting for the presence of comorbid conditions and coimpairments reduced the variance attributable to hip and knee flexion range only slightly, to 5%. CONCLUSION: Hip and knee flexion range contribute significantly to walking velocity in the SALSA cohort of community-dwelling aged persons.

Age Factors↗
PubMed1984

[Zoonotic infections in persons working in plants producing meat and bone meal].

The present study has revealed that persons working at offal and bone processing plants show no specific pathology, peculiar to such plants, in the state of their health and severe mass diseases among these persons are absent. Nevertheless, rather frequent occurrence of erysipeloid should be noted. The survey of workers employed at different stages of the production process has revealed the presence of ornithosis, listeriosis and leptospirosis infections. No clinically manifest cases of these diseases have been detected. The infection of individual workers occurs in the process of production as the result of contacts with infected raw materials of animal origin. For preventing the possible spread of infection great attention should be paid to sanitary, hygienic and epidemiological measures.

Absenteeism↗
PubMed1976

[Electroencephalographic changes in transsexualism (author's transl)].

The study's goal was the examination of the hypothesis that transsexualism develops on a diminution of sexual drive which itself is a result of temporal lobe dysfunction. 28 transsexuals were examined. More than 30% of this group showed pathologic findings in EEG recordings. Most of the pathological findings were situated in the temporal region. Four transsexuals with pathologic EEG findings mentioned a brain injury in their personal history. In all but one case this injury had taken place after manifestation of transsexual behavior. There was no correlation between depressed sexual drive and pathologic electroencephalographic changes. Generally genetic male transsexuals showed a diminuation of sexual drive only by taking estradiol. This is interpreted as a hypogonadotropic hypogonadism. The electroencephalographic findings in 9 or 28 cases of transsexualism with an increase of epsilon-waves mostly in the temporal region are discussed in the context of single case studies and regarded as a reference to temporal lobe dysfunction. This dysfunction is interpreted as a biologic factor in the etiology of transsexualism.

Adult↗
PubMed1999

Effectiveness of psychotherapy for personality disorders.

OBJECTIVE: The authors examined the evidence for the effectiveness of psychotherapy for personality disorders in psychotherapy outcome studies. METHOD: Fifteen studies were located that reported data on pretreatment-to-posttreatment effects and/or recovery at follow-up, including three randomized, controlled treatment trials, three randomized comparisons of active treatments, and nine uncontrolled observational studies. They included psychodynamic/interpersonal, cognitive behavior, mixed, and supportive therapies. RESULTS: All studies reported improvement in personality disorders with psychotherapy. The mean pre-post effect sizes within treatments were large: 1.11 for self-report measures and 1.29 for observational measures. Among the three randomized, controlled treatment trials, active psychotherapy was more effective than no treatment according to self-report measures. In four studies, a mean of 52% of patients remaining in therapy recovered--defined as no longer meeting the full criteria for personality disorder--after a mean of 1.3 years of treatment. A heuristic model based on these findings estimated that 25.8% of personality disorder patients recovered per year of therapy, a rate sevenfold larger than that in a published model of the natural history of borderline personality disorder (3.7% recovered per year, with recovery of 50% of patients requiring 10.5 years of naturalistic follow-up). CONCLUSIONS: Psychotherapy is an effective treatment for personality disorders and may be associated with up to a sevenfold faster rate of recovery in comparison with the natural history of disorders. Future studies should examine specific therapies for specific personality disorders, using more uniform assessment of core pathology and outcome.

Clinical Trials as Topic↗
PubMed2004

[Compendium of surgery].

The sane authors of the work titled "Treaty of Pathology and Surgical Clinic" of the Editorial McGraw-Hill Iberoamericana written in three volumes, of those that have been carried out several reprints and a second edition with changes in the structure and contents, that it has been accepted by studious of the surgery in spain and other countries, have the mission of writing this book whose extension constitutes approximately the third part of the Treaty os Surgery mentioned. The object of this work that contains the whole General Surgery and their specialities, as it corresponds to the effective university programs, it is to define the extension of matters at the postgraduates' level, instead of being also good for postgraduates and incipient specialist with the purpose of that the students are not overflowed when facing at the same time with other disciplines in each course. The spirit of this book has much of the one that feeds the persons that write, all of them Professors of Pathology and Surgical Clinic that believe in General Surgery and they exercise it, naturally with personal preferences toward the different sectors of the same one, as it is done in almost all countries.

General Surgery↗
PubMed1990

[Experience using the automated information retrieval system "Biopsy" in the pathology department of a general hospital].

Automatic information retrieval system (AIRS) "Biopsy" has been created on the basis of original programs and personal computer and tested for 3 years in the activity of the pathology department of a big multidisciplinary hospital. AIRS considerably increases the level of the labour organization and facilitates the overall and routine analysis of both biopsy material and the work of a department.

Biopsy↗