Prognosis of postpartum psychiatric disorders in a Turkish sample

Objective

The postpartum period represents a time of increased risk for psychiatric disorders. Postpartum depression is especially very common. Many aetiological risk factors have been reported for postpartum psychiatric disorders. The purpose of this study was to evaluate the postpartum psychiatric disorders in a Turkish sample and discuss their course.

Methods

The files of 6000 inpatients who were admitted to Gazi University School of Medicine Psychiatry Department were evaluated retrospectively, and 67 patients were chosen whose psychiatric illness had began puerperally. These patients were grouped according to age of onset of the illness, number of episodes and the type of these episodes, their postpartum psychiatric diagnoses and illness prognosis.

Results

Of 6000 patients, 67 (1.11%) were diagnosed as having a postpartum psychiatric disorder: 56.7% (n=38) were diagnosed as having a postpartum psychotic disorder, while 35.8% (n=24) as having an affective disorder. Forty-seven patients (70.1%) received a diagnosis of major psychiatric disorder during their follow-up.

Conclusion

These results show that postpartum diagnoses may show a chronic course and cause a life-time psychiatric illness and therefore patients should be monitored carefully for psychotic symptoms even after the acute period is over.     

Gender Abuse,Depressive Symptoms,and Substance Use Among Transgender Women: A 3-Year Prospective Study

Objectives. We examined the effects of gender abuse (enacted stigma), depressive symptoms, and demographic, economic, and lifestyle factors on substance use among transgender women.Methods. We conducted a 3-year prospective study (December 2004 to September 2007) of 230 transgender women aged 19 to 59 years from the New York Metropolitan Area. Statistical techniques included generalized estimating equations with logistic and linear regression links.Results. Six-month prevalence of any substance use at baseline was 76.2%. Across assessment points, gender abuse was associated with alcohol, cannabis, cocaine, or any substance use during the previous 6 months, the number of days these substances were used during the previous month, and the number of substances used. Additional modeling associated changes in gender abuse with changes in substance use across time. Associations of gender abuse and substance use were mediated 55% by depressive symptoms. Positive associations of employment income, sex work, transgender identity, and hormone therapy with substance use were mediated 19% to 42% by gender abuse.Conclusions. Gender abuse, in conjunction with depressive symptoms, is a pervasive and moderately strong risk factor for substance use among transgender women. Improved substance abuse treatment is sorely needed for this population.Previous studies and reports have pointed to a high prevalence of substance use among transgender women.1,2 In surveys of this population in large US cities, self-reports of alcohol, cannabis, cocaine, amphetamine, methamphetamine, and opiate use have been 4 to 10 times as high as corresponding reports in the general population.3–6 A recent study of this population in the New York Metropolitan Area observed prevalence estimates of these substances that were, for the most part, marginally higher than previous reports (60.4% for heavy alcohol use, 40.0% for cannabis, 21.7% for cocaine, 3.9% for amphetamines and methamphetamines, and 3.5% for opiates).7Early clinical studies of this population attributed such high percentages of substance use to a gender identity at odds with sexual anatomy,8 with later reports emphasizing more socially based conflict described as “gender-variant living in an often hostile world.”9^(p88) Following minority stress theory,10 the use of alcohol and other drugs in lesbian, gay, bisexual, and transgender populations is now often understood as resulting from internalized stigma (including transgender phobia directed at oneself) or enacted stigma in the forms of discrimination or psychological or physical abuse by others.11–13Enacted stigma and substance use have been described in a few studies of lesbian, gay, bisexual, and transgender populations,14–16 but longitudinal investigations of these associations are rare,17 the findings have not been consistent,18 and no empirical research has focused on stigma and substance use among transgender women.19Recent prospective studies of transgender women by our research team have pointed to gender abuse (enacted stigma) as a pervasive risk factor for a range of interrelated adverse health outcomes. In one study, gender abuse was associated with incident HIV and sexually transmitted infection in part because of the mediating effect of depressive symptoms.20 A subsequent study showed moderately strong associations of psychological and physical gender abuse with incident major depression.21In this study, we furthered this line of inquiry by systematically examining gender abuse, depressive symptoms, and demographic, economic, and lifestyle variables as interrelated risk factors for substance use. We hypothesized that psychological and physical gender abuse (enacted stigma) would be associated with substance use across time. We also hypothesized that these associations would be partially mediated by depressive symptoms (i.e., gender abuse causes depression, which then causes substance use). We have observed associations of gender abuse and depression in our previous studies, and depression, in turn, has been linked to substance use in numerous clinical and population studies.22 One interpretation of the latter link, the self-medication hypothesis, suggests that depressed individuals use certain substances in an attempt to temporarily ameliorate their symptomatology.23Against the background of the previous study,21 which linked 4 background variables (employment income, sex work, social presentation of transgender identity, and hormone therapy) to depression in part because of the mediated effects of gender abuse, we hypothesized that these same background variables would likewise affect substance use in part because of the mediated effects of gender abuse. The link between employment income and gender abuse may reflect the social scrutiny of transgender women’s behavior in a formal workplace environment. Sex work (especially in public venues), social presentation of transgender identity, and physical feminization associated with hormone therapy may increase the public visibility of gender nonconformity and increase the odds of gender abuse as a result.     

Human immunodeficiency virus type-1 Tat protein induces secretory leukocyte protease inhibitor expression in African green monkey but not human cells

African monkeys are resistant to HIV-1 infection due to intrinsic restriction mechanisms found in their cells. However, although they can be infected by monkey-adapted modified HIV-1 particles that are designed to overcome known restriction factors, virus numbers drop to undetectable levels in immunocompetent animals. These results indicate the possibility of the presence of yet unidentified factor(s) that restrict HIV-1 in old-world monkey (OWM) cells after integration of the viral genome into the host cell chromosome. In the light of these findings, we hypothesized that OWMs might have evolved resistance mechanism(s) against HIV-1 by switching specific gene(s) on in response to the synthesis of viral proteins in infected cells. In an attempt to mimic post-infection status, we expressed HIV-1 Tat gene in African green monkey cells and compared the whole proteome with normal cells and identified secretory leukocyte protease inhibitor (SLPI), a protein with known extracellular anti-HIV-1 activity, as an over-expressed protein in the presence of HIV-1 Tat protein by 2D-PAGE and mass spectrometry analysis. We also showed that overexpression of SLPI in the presence of HIV-1 Tat was specific to monkey cells. Our results also suggest that SLPI had a previously undiscovered intracellular anti-HIV activity in addition to its extracellular activity.

     

Effects of metal surface grinding at the porcelain try-in stage of fixed dental prostheses

PURPOSE

This study was to evaluate the effect of grinding of the inner metal surface during the porcelain try-in stage on metal-porcelain bonding considering the maximum temperature and the vibration of samples.

MATERIALS AND METHODS

Ninety-one square prism-shaped (1 × 1 × 1.5 mm) nickel-chrome cast frameworks 0.3 mm thick were prepared. Porcelain was applied on two opposite outer axial surfaces of the frameworks. The grinding was performed from the opposite axial sides of the inner metal surfaces with a low-speed handpiece with two types of burs (diamond, tungsten-carbide) under three grinding forces (3.5 N, 7 N, 14 N) and at two durations (5 seconds, 10 seconds). The shear bond strength (SBS) test was performed with universal testing machine. Statistical analyzes were performed at 5% significance level.

RESULTS

The samples subjected to grinding under 3.5 N showed higher SBS values than those exposed to grinding under 7 N and 14 N (P<.05). SBS values of none of the groups differed from those of the control group (P>.05). The types of bur (P=.965) and the duration (P=.679) did not affect the SBS values. On the other hand, type of bur, force applied, and duration of the grinding affected the maximum temperatures of the samples, whereas the maximum vibration was affected only by the type of bur (P<.05).

CONCLUSION

Grinding the inner metal surface did not affect the metal-porcelain bond strength. Although the grinding affected the maximum temperature and the vibration values of the samples, these did not influence the bonding strength.     

The effect of pentoxifylline on the healing of intestinal anastomosis in rats with experimental obstructive jaundice

The aims of this study were (1) to investigate the effect of experimental obstructive jaundice on the healing of intestinal anastomosis, and (2) to investigate the effect of pentoxifylline on the healing of intestinal anastomosis in rats with obstructive jaundice. Obstructive jaundice was induced in rats by the ligation and division of the common bile duct. Four days after this operation, either pentoxifylline or isotonic saline solution was administered intraperitoneally to these jaundiced rats and controls, and then intestinal anastomosis was performed. The concentrations of serum tumor necrosis factor α (TNF-α) and serum triglyceride of jaundiced and nonjaundiced rats were measured, and the quality of healing was evaluated by measuring the bursting preasure and hydroxyproline content of the anastomoses on the fifth and tenth days of anastomotic healing. Obstructive jaundice resulted in an impaired wound healing of the intestinal anastomosis in the rats. The administration of pentoxifylline to the jaundiced rats resulted in better anastomotic wound healing. The beneficial effects of pentoxifylline on anastomotic healing in rats with obstructive jaundice was attributed to its inhibitor effect on the endotoxin-induced TNF-α release from macrophages and monocytes, and the stabilizing effect on the neutrophils. Received: March 29, 1999 / Accepted: March 24, 2000     

The comparison of the relaxant effects of two methoxylated flavones in rat aortic rings

The vascular effect of salvigenin (6-hydroxyapigenin 6,7,4' -trimethyl ether), a natural flavone, was investigated in comparison with another flavone, 6-hydroxyluteolin 6,7,3',4' -tetramethyl ether in rat aortic rings. Cumulative addition of their increasing concentrations (10(-9)-10(-4)M) produced graded relaxations on rings precontracted with noradrenaline (10(-6) M) and KCl (40 mM). The maximal relaxations induced by flavones were similar, however, based on their pEC50 values salvigenin displayed a higher potency than 6-hydroxyluteolin 6,7,3',4'-tetramethyl ether. Endothelium removal markedly reduced the relaxations to salvigenin while the responses to 6-hydroxyluteolin 6,7,3',4'-tetramethyl ether were partially affected. In addition, a significant decrease was observed in maximal responsiveness and sensitivity to flavones in the presence of L-NOARG, a NO synthase inhibitor. The cyclooxygenase inhibitor indomethacin significantly inhibited the relaxations to salvigenin, but not altered the responses to 6-hydroxyluteolin 6,7,3',4'-tetramethyl ether. Our results provide evidence that salvigenin is an effective flavone in causing vasorelaxation which appears to be mediated by endothelium derived NO and prostacyclin. Whereas, the other flavone, 6-hydroxyluteolin 6,7,3',4'-tetramethyl ether induced relaxant responses are partially endothelium, presumably NO mediated.     

Is a filum terminale with a normal appearance really normal?

INTRODUCTION. Tethered spinal cord is defined as a condition in which the conus medullaris ends at a level below the L1-2 intervertebral space. The spinal cord is considered to be tethered when there is a thick filum terminale or low-lying conus medullaris. It has also been reported that a normal level of the conus medullaris and normal thickness of the filum terminale do not mean that there is no cord tethering. MATERIALS AND METHODS. In this investigation, we examined 21 fila terminalia; 5 of them were taken from cadavers, and these were used as a control group (group 1; n/n), 8 from patients with a normal appearance of the filum terminale but with clinical symptoms (incontinence) and pathologic results of a urodynamic study (group 2; n/ab), and 8 from patients with an abnormal appearance of the filum terminale and with clinical symptoms (group 3; ab/ab). Interestingly, we found that while fila terminalia in the control group were made up mainly of collagen fibers, more connective tissue with dense collagen fibers, some hyalinization and dilated capillaries were noticed in the fila from group 2. RESULTS. Our results suggest that these histological features may reflect a decreased elasticity within the filum terminale, resulting in a tethering effect on the lower conus in otherwise normal physiological conditions. CONCLUSION. These findings lead us to reconsider sectioning of the filum terminale in incontinent patients with normal results in radiological studies, whose condition is called "nonneurogenic neurogenic bladder."