Vitamin D receptor gene polymorphism as possible risk factor in rheumatoid arthritis and rheumatoid related osteoporosis

Objective

To study the role of VDR polymorphisms as risk factor for RA and osteoporosis, and whether osteoporosis complicating RA is due to RA or VDR polymorphisms.

Methods

VDR gene polymorphisms ApaI, TaqI, BsmI and FokI were typed by RFLP for 128 RA patients, 30 postmenopausal osteoporotic females and 150 healthy controls.

Results

Significant differences were found between patients and healthy controls in the frequency of BsmI and TaqI (Pc < 0.05) but no significant associations were found for FokI and ApaI polymorphisms except for aa genotype (Pc < 0.001). Titers of RF were higher with aa and bb genotypes. Anti-CCP and CRP levels were higher with aa genotype and more bone loss was associated with Bb genotype. Ff genotype frequency was higher in RA patients with osteoporosis than those without osteoporosis.

Conclusions

The ApaI, BsmI and TaqI polymorphisms may be a susceptibility risk factors for RA and the Ff genotype may be responsible for development of osteoporosis in RA Egyptian patients. However, the present study needs to be replicated in a large number of patients from allover the Egypt and also in multi-ethnic populations.     

BMS患者抑郁、焦虑状况及其与疼痛感受的相关性分析

目的：调查灼口综合征（BMS）患者的心理抑郁及焦虑状况,分析心理状况与疼痛感受的相关性.方法：收集2012年1月～2014年1月期间因灼口综合征就诊患者135例及100名健康志愿者.采用焦虑自评量表（SAS）和抑郁自评量表（SDS）对两组对象进行问卷测试.对BMS患者的主观疼痛程度进行分级.采用SPSS11.0统计分析软件分析BMS患者抑郁、焦虑状况及其与疼痛感受的相关性.结果：BMS患者SAS值及SDS值均高于对照组,差异具有统计学意义（P＜0.01）,SAS值及SDS值在不同疼痛程度的患者中有显著差异（P＜0.01）.结论：BMS患者具有明显的抑郁及焦虑心理,其心理抑郁及焦虑的严重程度与患者临床疼痛的主观感受有关.     

重度脑外伤患者长期功能结局的影响因素

目的 了解重度脑外伤患者1年随访结局及其相关因素。 方法 2015年1月至2018年12月,重度脑外伤患者135例,住院期间记录性别、发病年龄、教育年限、损伤部位、病变侧,并采用残疾等级量表(DRS)、简易精神状态检查(MMSE)、Fugl-Meyer评定量表(FMA)运动和平衡部分,以及改良Barthel指数(MBI)进行评定。出院后随访1年,再次评定DRS。 结果 发病年龄(r = 0.188)、初次DRS评分(r = 0.530)、MMSE评分(r = -0.376)、FMA运动部分评分(r = -0.284)、FMA平衡部分评分(r = -0.425)、MBI评分(r = -0.480)、脑干受损(r = 0.194)、弥漫性脑损伤(r = 0.202)与随访时DRS评分相关(P < 0.05);性别( r = -0.175)、初次DRS评分(r = 0.586)、MMSE评分(r = -0.242)、FMA运动部分评分(r = -0.301)、FMA平衡部分评分(r = -0.228)、MBI评分(r = -0.367)、枕叶受损(r = 0.209)与DRS差值相关(P < 0.05)。 结论 重度脑外伤患者的受伤年龄、早期认知和运动功能障碍程度,影响患者长期结局,仍需进一步研究损伤部位对长期结局的影响。     

Migraine in women. Epidemiological,clinical, genetic,and experimental aspects

Objective: To estimate the validity of the Hamilton Depression Scale (HDS) in a population of patients with chronic obstructive pulmonary disease (COPD). Methods: Forty-nine patients with moderate to severe COPD were examined using the ICD-10 criteria for depression. The mean age of the patients was 71 years and 33 (64%) were women. Forty-six (94%) of the patients were also evaluated using the 17-item HDS including the six-item Hamilton Depression subscale (HDSS). Internal and external validity were measured using factor analysis, Cronbach Coefficient alpha, Loevinger coefficient of homogeneity, correlation analysis and ROC-curves. Results: Twenty-three (47%) of the patients were depressed according to the ICD-10 criteria for depression. The HDSS but not the HDS showed a good internal validity. An acceptable external validity was furthermore shown for the HDSS. Conclusion: The HDSS can be recommended as a suitable depression rating scale for COPD patients.     

The measurement of psychotic acuity by nursing staff

Accurate evaluation of patients' psychotic state is essential to decrease psychotic symptoms and protect the patient and others. The aim of this paper is to conduct a literature review in order to access the utility, reliability and validity of current rating scales that are purported to measure psychotic acuity of inpatient population. A search of a number of electronic databases was undertaken to retrieve potential articles that focus on the measurement of acute psychosis. We identified some conceptual and theoretical problems when using a scale that is monitoring the progress of discharge and assesses the outcome of treatments. The findings revealed a difficulty in finding a commonly agreed definition of acute psychosis and a problem of obtaining frequent measures, and the frequency of measurement and fluctuation in psychosis. The most dominant scales in assessing psychosis were reviewed: the Global Assessment of Functioning Scale, the Brief Psychiatric Rating Scale and the Positive and Negative Symptom Scale. Several issues related to the scales' inter-rater reliability and construct validity remain unexplored. None of these scales addressed the conceptual and theoretical problems that we identified. A new scale that will measure acuity of symptoms in inpatient settings needs to be created.     

A prospective comparison of post-surgical behavioral pain scales in preschoolers highlighting the risk of false evaluations

Four behavioral rating scales (BRS) (CHEOPS, CHIPPS, FLACC and OPS) assessing postoperative pain in children aged 1–7 years were studied to compare their psychometric properties, sensitivity and specificity. One hundred and fifty children included in this prospective longitudinal study were videotaped to analyze retrospectively peri-operative behaviors. Pain and anxiety were evaluated by children or by their parents prospectively. At the end of the study, four observers rated the peri-operative videos using the four BRS. Because self-reporting cannot be used for all the children, facial expression of pain was analyzed from the videos to create a Facial Action Summary Score (FASS) which was considered as a reference for the study of validity of the four BRS. Internal validities were excellent but external validities were mixed. The FLACC seems to be better adapted to assess post-surgical pain in children between 1 and 7 years old. Nevertheless, it was significantly correlated with anxiety measures. Moreover, the analysis of sensitivity and specificity using both self-reporting of pain and FASS showed that some children were still under-evaluated. The multivariate analysis underlines silence as a high risk factor of misevaluating postoperative pain. In conclusion, this study highlights the difficulty of discriminating pain intensity from anxiety when using the four BRS and that postoperatively, nearly one child in 10 was misevaluated.     

Analysis of suicidal behaviour in Israeli veterans and terror victims with post‐traumatic stress disorder by using the computerised Gottschalk‐Gleser scales

The primary objective of this study was to identify the vulnerability factors for suicide attempts in an Israeli sample, with the help of the Gottschalk‐Gleser content analysis scales. The respondents were divided into four groups: suicide attempters; controls; post‐traumatic stress disorder and depressed patients who did not report suicidal behaviour; and suicide ideators. The significant results represent conscious and unconscious psychological states, which suicide attempters have in common and can be seen as potential suicide risk factors. The main recurring risk‐related themes are hopelessness, sickness, deterrents, frustrated dependency strivings, total anxiety and total depression.     

The Influence of Monotherapy with Oxprenolol and Nitrendipine on Ambulatory Blood Pressure in Hypertensives

We investigated whether beta-blockers or calcium-antagonists might be preferred in baseline antihypertensive therapy. In middle-aged male patients with essential BP readings did not differ between patients on Oxpranolol or on Nitrendipine (average BP: 123 12/81 14 vs. 129 17/80 10 mmHg), when clinical casual BP was within the normotensive range. Average BP at work was lower than clinical casual BP taken at the same day (125 14/80 12 vs. 133 12/87 13 mmHg). A linear dependency between SBP at work and level of self reported physical activity (F(3,413) = 7.6; p 0.001) and arousal was found (F(3, 374) = 5.2; p 0.02). Patients on Oxprenolol consistently had lower SBP at a particular level of physical activity and at lower levels of arousal than patients on Nitrendipine. We conclude that both regimen were equally effective as baseline antihypertensive monotherapy.