The dynamic relationship of parental personality traits with the personality and psychopathology traits of anorectic and bulimic daughters

Objective

Parenting and family dynamics influence the emergence, development, and maintenance of eating disorders (EDs). Although family interventions are relevant for therapeutic programs, knowledge of the relationship between parental personality traits and the eating psychopathology of daughters is scarce. This study explored the personality and psychopathology of women with EDs and correlated them with parental personality traits.

Method

The personality and eating psychopathology traits of 38 restricter anorectics, 30 bingeing/purging anorectics, 37 bulimics, and their parents' personality traits (87 fathers and 97 mothers) were measured with the Temperament and Character Inventory, the Clinical Global Impression Scale, the Eating Disorders Inventory-2, and the Beck Depression Inventory. The results were compared with matched controls (54 women, 50 fathers, 54 mothers). Personality and psychopathology were correlated with multiple regression.

Results

Women with ED displayed high harm avoidance and low self-directedness, whereas restricter anorectic women had high persistence. Low persistence was common in fathers of daughters across all EDs. Fathers of restricter anorectics were highly harm avoidant. Fathers of both anorectic subtypes and mothers of bulimic women displayed low self-directedness. Parental personality traits were linearly correlated with their daughter's personality and psychopathology, but the correlation differed among EDs.

Conclusion

Parents of eating-disordered participants displayed personality characteristics that differed from controls and, among ED subgroups, these differences were related to their daughter's personality and psychopathology. The linear correlation did not fully explain the relationship of the parental personality traits to the presence of their daughter's ED, suggesting that a more complex personality-based family dynamic is involved. A Temperament and Character Inventory profile of the entire family may be used in the planning of family treatment.     

Do anorectic men share personality traits with opiate dependent men? A case-control study

BACKGROUND: Eating disorders (ED) and substance use disorders (SUD) display clinical and psychodynamic analogies. The co-diagnosis of a substance use disorder in male ED patients is frequent. Nevertheless, knowledge about the mutual predisposing factors or personality analogies is currently scarce and hypotheses are controversial. METHODS: The Temperament and Character Inventory (TCI) was used to assess 21 anorectic men, 79 heroin-dependent men, and 75 control men matched for age and education. RESULTS: Anorectic and opiate-addicted patients displayed higher Harm Avoidance and lower Self-directedness and Cooperativeness. Anorectic men displayed lower Reward Dependence and higher Persistence. Opiate addicts had higher Novelty Seeking and Self-transcendence. DISCUSSION: Anorectic and heroine-dependent subjects share personality traits related to anxiety, fearfulness and antisocial features. Nevertheless, the personality profile does not completely overlap and this could influence the choice of the "substance" of abuse and the related clinical differences between anorexia and heroin dependence.     

L-carnitine inhibits a subset of platelet activation responses in chronic uraemia.

BACKGROUND: Activated uraemic platelets expose the aminophospholipid phosphatidylserine (PS) at their outer surface, which generates a cell procoagulant phenotype and seems at least partly due to an increase in cell caspase-3 activity. L-carnitine (LC) may decrease surface-exposed PS in stored apheresis platelets and inhibit the activity of recombinant caspases, but its effects on platelet activation response with PS externalization have not been ascertained in chronic renal failure. In the present study, we investigated in vitro and in vivo the effects of LC on PS exposure in platelets from chronic uraemic patients. METHODS: Platelet PS-exposure was assayed by flow cytometry using annexin V. Caspase activity in platelets was determined by the cleaving activity of the specific substrate DEVD-pNA and by a flow cytometric assay using rhodamine-fluorescence. The effects of LC in vivo were examined in a prospective cross-over trial including 10 patients on maintenance haemodialysis (HD) who were randomly allocated to two different treatment groups: LC (2 g i.v.) for 4 months followed by placebo (2 g i.v.) for another 4 months (group A), or placebo followed by LC (group B). RESULTS: PS-exposing platelets in blood samples obtained from HD patients were significantly higher than in healthy subjects (P<0.001) under both unstimulated and agonist-stimulated conditions. When uraemic platelets were pre-incubated with LC before agonist stimulation, platelet PS exposure proved to be significantly reduced (-13.7% for 0.5 mM LC and -25% for 5 mM LC). Pre-incubation of uraemic platelets with LC again significantly decreased the cells' caspase activity (P<0.05). In HD patients (Group A), LC supplementation was associated with a significant decrease (P<0.05) in platelet PS exposure followed by a progressive increase during treatment with placebo. In the other group of patients, while no change in platelet PS exposure was observed during the first 4 months of treatment with placebo, a significant reduction (P<0.05) in PS-positive platelets occurred after 2 and 4 months of LC therapy. CONCLUSION: Our data show that LC may reduce, possibly via inhibition of caspase activity, the exposure of PS in activated uraemic platelets. These findings may have implications for the thrombophilic tendency of uraemia.     

A New Cell-penetrating Peptide That Blocks the Autoinhibitory XIP Domain of NCX1 and Enhances Antiporter Activity

The plasma membrane Na⁺/Ca²⁺ exchanger (NCX) is a high-capacity ionic transporter that exchanges 3Na⁺ ions for 1Ca²⁺ ion. The first 20 amino acids of the f-loop, named exchanger inhibitory peptide (XIP_NCX1), represent an autoinhibitory region involved in the Na⁺-dependent inactivation of the exchanger. Previous research has shown that an exogenous peptide having the same amino acid sequence as the XIP_NCX1 region exerts an inhibitory effect on NCX activity. In this study, we identified another regulatory peptide, named P1, which corresponds to the 562–688aa region of the exchanger. Patch-clamp analysis revealed that P1 increased the activity of the exchanger, whereas the XIP inhibited it. Furthermore, P1 colocalized with NCX1 thus suggesting a direct binding interaction. In addition, site-directed mutagenesis experiments revealed that the binding and the stimulatory effect of P1 requires a functional XIP_NCX1 domain on NCX1 thereby suggesting that P1 increases the exchanger activity by counteracting the action of this autoinhibitory sequence. Taken together, these results open a new strategy for developing peptidomimetic compounds that, by mimicking the functional pharmacophore of P1, might increase NCX1 activity and thus exert a therapeutic action in those diseases in which an increase in NCX1 activity might be helpful.     

Acute surgically-treated complications of myocardial infarct. Clinical experience and discussion of surgical indications]

Post-infarction free-wall, papillary muscle and septal myocardium rupture yields a lowering mortality, not only due to the improved surgical technique but also to a more careful selection of surgical candidates. The value of pericardial decompression in cases of free-wall rupture is discussed. Echocardiographic evidence of blood in the pericardium after a myocardial infarction is not a direct indication for a diagnostic sampling, decompression or surgery. Pericardiocentesis is not a risk-free procedure and should be limited to patients with life-threatening acute tamponade. Clinical results of 34 patients operated upon for myocardial rupture, regardless of adopted technique or timing of surgery, confirm that the decision about a patient's operability should follow a careful evaluation of the following risk factors in this order: infarct size, age, cardiogenic shock, multiorgan failure, rupture site, cardiac failure and associated diseases.     

Positive gallium-67 citrate scintigraphy in Wiskott-Aldrich syndrome with malignant lymphoma

This case describes the first detection of solid lymphoma lesions by gallium-67 scintigraphy in a 12-year-old patient with Wiskott-Aldrich syndrome. Gallium 67 uptake was found in multiple sites in the patient who had developed an undifferentiated small, noncleaved cell lymphoma. Response to chemotherapeutic treatment is correlated with findings on the gallium scintigraphy follow-up.     

Measurement of Cardiac Stroke Volume During Cesarean Section: A Comparison Between Impedance Cardiography and the Dye Dilution Technique

Simultaneous determination of cardiac stroke volume by impedance cardiography and the dye dilution technique was compared in ten women undergoing elective cesarean section performed under general or epidural anesthesia. The influence of delivery and the anesthetic procedures used on stroke volume determination by the two methods was evaluated and compared. The correlation coefficients for measurements performed before and during anesthesia showed little variation and were largely unchanged after delivery of the child (r = 0.90-0.97). Mean stroke volume determined by impedance cardiography was significantly (P less than 0.001) lower than mean stroke volume calculated from the dye dilution technique. However, there was no significant difference between the mean change in stroke volume determined by the two techniques during serial measurements. Impedance cardiography was found to be a safe, reliable, non-invasive technique for the measurement of changes in stroke volume during cesarean section. The ability of the impedance method to determine changes in stroke volume was unaffected by the anesthetic procedures employed or by delivery of the child.     

An improved method of epidural analgesia with reduced instrumental delivery rate.

A detailed study on a modified technique of epidural analgesia (EDA) for pain relief in obstetrics has been performed. The aim of the modifications was to reduce the number of instrumental deliveries and at the same time to make the delivery as smooth as possible for the baby. This was achieved by the use of an anaesthetic with a favourable ratio between neonatal and maternal plasma levels (Bupivacaine) in low concentration (0.25%). A special technique of injection enabled us to limit the extent of the blockade. An epidural catheter was inserted between L2 and L3 and moved upwards 20 cm into the epidural space. 8-10 ml of the solution was then injected after a test dose. The blockade was continued by the repeated injection of smaller doses. As judged by the skin anaesthetic zones and by obstetric examinations, the patient was gradually positioned, during labour, from supine to half-sitting. The catheter was withdrawn at the end of the first stage of labour so that the lower sacral segments could be blocked. A group of 100 patients treated with the technique described was followed. The number of instrumental deliveries in the present series (15%) was significantly lower in similar series reported in the literature. The group of 100 patients treated with modified EDA was also compared with 100 control patients who received only conventional treatment without EDA. There was no differences in the number of abnormal presentations, while the number of caesarean sections and cases of atonic post-partum bleeding was insignificantly lower in the EDA group. The difference in the number of instrumental deliveries-although somewhat higher in the EDA group-was not statistically significant. The total length of labour was prolonged in the EDA group but EDA was not necessarily responsible for this undesired effect. The clinical status of the babies was found to be better after EDA than in control group, as judged from Apgar score. Furthermore, fetal bradycardia was significantly reduced with EDA. It is concluded that EDA, as used in this study, not only is a preferable way of achieving pain relif in the mother but also offers a means of facilitating the birth process for the infant, reducing the incidence of pre- and post-natal asphyxia.