血液透析病人的述情障碍

“述情障碍”(Ａｌｅｘｉｔｈｙｍｉａ)的主要特征为缺乏描述情感状态的能力 ,少幻想和实用性思维 ,人际关系僵化 ,难以区别情绪状态和躯体感觉[1] 。述情障碍可以发生于心身疾病和其他躯体疾病以及某些精神疾病。因述情障碍与某些疾病的预后和治疗有关 ,故对其进行评估具有一定的临床意义。本文报告了血液透析病人述情障碍的情况。1　对象与方法1.1　对象病例来自 2 0 0 0年 1～ 4月在一所综合医院血液透析中心进行治疗的患者 ,全部为终末期肾病病人 ,共 30例 ,排除精神疾患和神经系统疾病 ,未经其它肾替治疗。血透组病人平均每周治疗三次 …     

产后抑郁症患者的述情障碍与抑郁症状的相关分析

目的探讨产后抑郁症患者的述情障碍与抑郁症状的相关性。方法采用汉密尔顿抑郁量表17项版本(HAMD-17)和多伦多述情障碍量表20项(TAS-20)对60例产后抑郁症患者和60例健康产妇进行评定。结果①产后抑郁症组患者TAS-20总分及3个因子分评分显著高于对照组,差异有统计学意义(t=31.294,21.450,10.006,26.053;P<0.01;);②TAS-20总分及3个因子分与HAMD-17总分、焦虑/躯体化因子(Hf1)、体重因子(Hf2)、认知障碍因子(Hf3)、阻滞因子(Hf4)呈显著正相关(r=0.273～0.638,P<0.01或0.05);睡眠障碍因子(Hf5)与TAS-20总分和3个因子分相关均不显著(r=-0.141～0.030,P>0.05)。结论产后抑郁症患者存在着明显的述情障碍;述情障碍与抑郁症状的严重程度呈显著正相关,产后抑郁症患者的述情障碍与抑郁症状相互影响;有述情障碍的产后抑郁症患者的功能性躯体不适症状更突出。     

综合性医院抑郁障碍100例临床研究

目的　研究综合性医院抑郁障碍患者的临床特征及其与躯体疾病的关系 ,为正确诊断和及时有效地治疗抑郁症提供临床依据。方法　用前瞻性的方法对 1 0 0例抑郁障碍患者进行了临床特点和相关因素分析 ,治疗前后 Zung量表评分分析 ,用氟西汀 ,苯二氮艹卓 类及心理治疗。结果　抑郁患者最主要的躯体症状为睡眠障碍 ,其次为疲乏、胃肠不适、头晕、头痛和心慌。结论　以躯体症状就诊是综合性医院抑郁患者的特点 ,抑郁障碍与躯体疾病互为因果 ,药物治疗与心理治疗不可偏废。     

不孕症患者的述情障碍及其特征研究

目的：调查不孕症患者的述情障碍状况，并对述情障碍的特征及其与焦虑情绪的关系进行探讨。方法：采用多伦多述情障碍20个条目量表中文版对170例不孕症患者及88例正常对照组进行述情障碍状况评定．以状态一特质焦虑量表评定不孕症患者与对照组的焦虑水平。结果：不孕症患者的述情障碍量表总分及因子1的得分明显高于对照组，不孕症患者的状态焦虑和特质焦虑水平均显著高于对照组，经相关分析发现不孕症患者的述情障碍程度与患者状态、特质焦虑存在显著正相关。结论：不孕症患者存在高程度的述情障碍，伴有高的状态和特质焦虑。     

躯体形式障碍患者述情障碍分析

目的探讨躯体形式障碍患者的述情障碍及其心理健康状况。方法采用多伦多述情障碍量表（TAS），症状自评量表（SCL-90）对50例躯体形式障碍患者（研究组）和50例健康者（对照组）进行测评，并进行比较分析。结果研究组TAS、SCL-90量表评分总分及各因子分均显著高于对照组（P〈0．05或〈0．01）。结论躯体形式障碍患者存在明显的述情障碍，其心理健康状况较差。     

述情障碍对冠心病合并2型糖尿病患者应对方式及生活质量的影响

目的:探讨述情障碍对冠心病合并2型糖尿病患者应对方式及生活质量的影响。方法:对符合世界卫生组织冠心病、2型糖尿病诊断标准的70例患者,依据多伦多述情障碍量表(TAS-20)评分分为2组,总分60分为述情障碍组,50分为非述情障碍组,50~60分不做研究。述情障碍组41例,无述情障碍组29例。尔后分别进行医学应对问卷(MCMQ)、生活质量综合评定问卷(GQLI)测评,并进行比较分析。结果:述情障碍组MCMQ面对因子评分显著低于非述情障碍组(t=-8.23,P0.01),而回避、屈从因子评分则显著高于非述情障碍组(t=5.21,4.27;P0.01)。非述情障碍组GQLI总分及躯体健康、心理健康、社会功能因子分均显著高于述情障碍组,差异有统计学意义(t=3.66,3.82,3.66,2.37;P0.01);物质生活维度评分差异无统计学意义(P0.05)。患者TAS-20评分与MCMQ的面对因子评分呈显著负相关(r=-0.34,P0.01),而与MCMQ回避、屈从因子评分呈显著正相关(r=0.32,0.34;P0.01);与GQLI总分、躯体健康、心理健康及社会功能因子分呈显著负相关(r=-0.31,-0.33,-0.30;P0.01),与物质生活维度评分无相关性。结论 :冠心病合并2型糖尿病述情障碍患者多采用回避和屈服的消极应对方式,而较少采用积极应对方式;其生活质量较非述情障碍患者差。     

抑郁症患者的述情障碍与焦虑、抑郁的相关性研究

目的 探讨抑郁症患者的述情障碍以及与焦虑、抑郁的关系.方法 采用多伦多述情障碍量表(Toronto Alexithymia Scale, TAS)、Hamilton焦虑量表(Hamilton Anxiety Scale,HAMA)及Hamilton抑郁量表(Hamilton Depression Scale,HAMD)对100例抑郁症患者和100例正常自愿者进行测评,并对述情障碍与焦虑、抑郁作相关分析.结果 抑郁症组TAS评分显著高于正常对照组0=6.86,P＜0.01);其述情障碍的发生率为43%,亦显著高于对照组的11%(x2=25.98,P＜0.01).抑郁症患者的TAS总分及因子Ⅰ、Ⅱ、Ⅳ评分与HAMA及HAMD评分均呈显著性正相关.结论 抑郁症患者存在着明显的述情障碍,并与焦虑、抑郁有关.     

包头市综合医院医护人员述情障碍调查

述情障碍又称"情感难言征"或"情感表达不能",特指情绪的象征性心理表达能力的缺陷或发展受阻[1].研究发现述情障碍与冠心病、消化性溃疡、神经症、抑郁症、偏头痛、类风湿关节炎等许多心身疾病和各种精神障碍有着特殊的病因学联系[2-4].但述情障碍并非一种独立的精神疾病,一般人群中也存在,述情障碍的发生严重影响个体的生活质量、潜能发展、社会适应能力等诸多方面.     

大学新生述情障碍与心理健康的关系探讨

目的探讨大学新生述情障碍和心理健康的关系。方法采用多伦多述情障碍量表和症状自评量表对191名大学新生进行测查。结果TAS总分及因子Ⅰ、Ⅱ、Ⅲ得分与SCL-90总分及各因子分显著相关（P〈0．05或P〈0．01）。结论大学新生述情障碍状况与心理健康状况有密切的联系。     

白血病患者述情障碍

为探讨白血病患者的述情障碍，应用多伦多述情障碍量表（TAS），对白血病患者进行测评。结果发现，患者TAS总分及因子分均显著高于对照组，男性患者TAS总分及因子IV分显著高于女性。对有述情障碍的白血病患者可适当使用抗抑郁剂、抗焦虑剂或行为治疗。     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

Hypo- und Hypermagnesämie aus kardiologischer Sicht

Zusammenfassung Eine Reihe pathologischer Zustände bedingen Magnesiummangel. Zustände mit Hypermagnesämie sind ebenfalls bekannt, doch wesentlich seltener. Für den Kardiologen beachtenswert ist, daß unter Therapie mit bestimmten Diuretica bei Herzinsuffizienz, bei Herzinfarkt, Kardiomyopathie, Digitalisintoxikation und bestimmten Herzrhythmusstörungen Hypomagnesämie beobachtet wurde. Leider kann in der klinischen Routine nur ein extracelluläres Magnesiumdefizit durch Serumbestimmungen gemessen werden; über Magnesiummangel einzelner Organe kann nichts ausgesagt werden. Hinweise für Magnesiummangel geben aber neben der Messung des Serumspiegels Anamnese, klinischer Befund, bestimmte EKG-Veränderungen wie auch evtl. Hypokalämie, ein Zustand, bei dem sich oft — besonders bei Aldosteronismus — parallele Veränderungen zeigten.Tierexperimente deuten darauf hin, daß infarktähnliche Läsionen unter Magnesiummangel entstehen, doch ob Herzinfarkt beim Menschen durch Magnesiummangel ausgelöst werden kann, ist noch ungeklärt. In Leichenherzen zeigte sich im Infarktgebiet neben Calciumakkumulation signifikanter Magnesiumverlust, wobei unklar blieb, ob sich Ursache oder Folge des Infarktes widerspiegelten. Falls ein ursächlicher Zusammenhang besteht, ist er im Myokardstoffwechsel selbst zu suchen, wie bei der Alkoholkardiomyopathie, wo myokardialer Magnesiummangel zumindest als pathogenetischer Teilfaktor anerkannt wird. Andererseits versucht man aber auch Beziehungen zwischen Atherosklerose, Blutgerinnung und Hypomagnesämie herzustellen, in der Meinung, daß Magnesiummangel auch über den coronaren Pathomechanismus des Herzinfarktes wirken könnte. Sicher scheint, daß gewisse EKG-Veränderungen und Herzrhythmusstörungen durch einen irritierten Magnesiumhaushalt bedingt sein können, da sie bei Gabe bzw. Entzug von Magnesium verschwinden. Daß Magnesiummangel die Glykosidtoleranz verringert, wird tierexperimentell bestätigt. Unter Hypomagnesämie bewirkt Acetylstrophanthidin eher und länger Rhythmusstörungen als ohne, außerdem lassen diese sich durch Magnesiumgaben eliminieren. Da in gewissen Fällen spontane und digitalisinduzierte Herzrythmusstörungen durch Magnesiuminjektionen beseitigt wurden, scheint Magnesium als Therapeuticum angebracht. Einsatz verschiedener Magnesiumsalze bei Angina pectoris, degenerativen Herzerkrankungen und Herzinsuffizienz ohne geprüften und offensichtlich gestörten Magnesiumhaushalt ist fragwürdig, weil keine eindeutigen klinischen Erfolgsbeweise vorliegen. Immerhin mag es aber larvierte, durch Serumbestimmungen nicht erfaßbare Mangelzustände geben. Allgemein erscheint es aus kardiologischer Sicht ratsam, den Magnesiumhaushalt zu überwachen und in entsprechenden Fällen auszugleichen, um möglichen Myokardläsionen oder fatalen Herzrhythmusstörungen entgegenzuwirken.     

Environmental risk factors and their role in the management of atopic dermatitis

Introduction: The etiology of atopic dermatitis (AD) is multifactorial with interaction between genetics, immune and environmental factors.

Areas covered: We review the role of prenatal exposures, irritants and pruritogens, pathogens, climate factors, including temperature, humidity, ultraviolet radiation, outdoor and indoor air pollutants, tobacco smoke exposure, water hardness, urban vs. rural living, diet, breastfeeding, probiotics and prebiotics on AD.

Expert commentary: The increased global prevalence of AD cannot be attributed to genetics alone, suggesting that evolving environmental exposures may trigger and/or flare disease in predisposed individuals. There is a complex interplay between different environmental factors, including individual use of personal care products and exposure to climate, pollution, food and other exogenous factors. Understanding these complex risk factors is crucial to developing targeted interventions to prevent the disease in millions. Moreover, patients require counseling on optimal regimens for minimization of exposure to irritants and pruritogens and other harmful exposures.     

Class II HLA in Georgia Caucasus Tbilisi Georgians and their Mediterranean ancestry: The Usko Mediterranean languages

Georgia (or Sakartvelo in its own language) is a South Caucasus Mts. country with its easternmost part is enigmatically named Iberia, like the Iberian Peninsula, which may refer to rivers “Kura” and “Ebro” or their valleys respectively. Most of their inhabitants speak Georgian which is included within Dene-Caucasian group and Usko-Mediterranean subgroup of languages. The latter includes Basque, Berber, ancient Iberian-Tartessian, Etruscan, Hittite, Minoan Lineal A and others. In the present paper, HLA class II -DRB1 and -DQB1 alleles has been studied and extended haplotypes calculated. Most frequent haplotypes are also of Mediterranean origin (i. e.: (A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*51)-DRB1*13:01-DQB1*06:03, or (A*24-B*35)-DRB1*01:01-DQB1*05:01) and DA genetic distances show that closest world populations to Georgians are Mediterraneans. Georgians also show common extended haplotypes ((A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*13)-DRB1*07:01-DQB1*02:01 and (A*03-B*35)-DRB1*11:01-DQB1*03:01) with Svan people, a secluded population in North Georgia mountains. We can conclude that Georgians belong to a very old Mediterranean substratum according to both linguistics (Usko Mediterranean languages) and HLA genetics.     

HLA genes in Amerindians from Mexico San Vicente Tancuayalab Teenek/Huastecos

Huastecos or Teenek Amerindians are presently living at North East Mexico (San Luis Potosi State). They have probably one of the most ancient culture of Mexico and Central America together with Mayas and Olmec groups with which also show close relationships. Proximity to Atlantic Ocean/Mexican Gulf originated that Spaniards had very early contact with them at about 1519 CE or before. In the present paper we have aimed to study HLA gene profile which may be useful for HLA and disease epidemiology and transplant programs in Teeneks. HLA-DRB1*04:07, -DRB1*14:06 and -DRB1*04:11 have been found in high frequency like in other Amerindian groups. High frequency typical Amerindians HLA extended haplotypes have been found, such as A*02-B*35-DRB1*04:07-DQB1*03:02; A*68-B*39-DRB1*04:07-DQB1*03:02 and A*02-B*39-DRB1*04:07-DQB1*03:02; also new haplotypes have been described, like A*02-B*52-DRB1*04:11-DQB1*03:02, A*68-B*35-DRB1*14:02-DQB1*03:01 and A*68-B*40-DRB1*16:02-DQB1*03:01. Genetic proximity is observed not only to linguistically close Mayans, but also to Mazatecans, Mixtecans and Zapotecans, who speak an altogether different languages; it shows once more that genes and languages do not correlate. This population was greatly diminished after European contact between 1500 and 1600 years CE; in fact, North and South America First Inhabitants population was brought from 80 down to 8 million people because of diseases (i.e.: measles, smallpox or influenza), slavery and war.