首次住院重型精神病患者亲属焦虑情绪调查分析

目的探讨住院重型精神病患者亲属焦虑情绪的发生率及其影响因素。方法随机抽取130名住院重型精神病患者亲属采用Zung’s焦虑自评量表及自拟问卷进行测试,并进行单因素和多因素逐步回归分析。结果130名家属中焦虑情绪发生率为48.46%。单因素分析显示患者家属的焦虑情绪与同患者关系、家属自身健康状况、家属性格、性别、年龄、文化程度、对患者态度等7项因素相关;多因素逐步回归分析显示影响患者亲属焦虑情绪的主要因素有5相,依次为患者家属健康状况、家属性格、家属年龄、与患者感情、与患者关系。结论精神分裂症患者家属焦虑情绪发生率很高,其发生率高且受多种因素的影响。     

2型糖尿病患者正常糖耐量一级亲属红细胞膜胰岛素受体变化及与胰岛素抵抗的相关性

目的探讨2型糖尿病患者正常糖耐量一级亲属(NFDR)红细胞膜胰岛素受体变化及与胰岛素抵抗的相关性。方法102例2型糖尿病患者正常糖耐量一级亲属作观察组,60例无糖尿病家族史的非糖尿病患者作对照组,测定空腹血糖(FPG)、胰岛素(FINS)、血脂、餐后2 h血糖(2 h PG)、2 h胰岛素(2 h INS),并检测高、低亲和力红细胞膜胰岛素受体数目(R1、R2)和高、低亲和力常数(K1、K2),同时计算胰岛素抵抗指数(IRI)。结果2型糖尿病患者正常糖耐量一级亲属R1、R2明显低于对照组;2 h PG、三酰甘油、低密度脂胆白胆固醇水平高于对照组,差别有统计学意义(P<0.05,P<0.01);FINSI、RI高于对照组,差别有统计学意义(P<0.05)。多元线性逐步回归分析结果显示,体质指数、三酰甘油、R1、R2是影响2型糖尿病患者正常糖耐量一级亲属胰岛素抵抗独立的危险因素。结论2型糖尿病患者正常糖耐量一级亲属存在明显胰岛素抵抗,且与红细胞膜胰岛素受体数目的减少有一定关系。     

Mykosen bei Patienten mit Psoriasis oder atopischer Dermatitis*

Zusammenfassung. Es wurden die Daten von 44 695 Patienten ausgewertet, welche stationär an der Universitäts-Hautklinik Kiel behandelt wurden. 3006 Patienten wurden wegen einer Psoriasis, 1808 wegen einer atopischen Dermatitis stationär aufgenommen. Mit alters- und geschlechtskorrigierenden Berechnungen wurde untersucht, ob Mykosen bei Patienten mit Psoriasis oder atopischer Dermatitis häufiger als erwartet auftreten. Als Kontrolle dienten alle jemals an der Kieler Universitäts-Hautklinik stationär aufgenommenen Patienten. Patienten mit atopischer Dermatitis hatten vornehmlich eine intestinale Candida-Besied-lung (RR = 1.51, p <0.01). Eine kutane Candidose zeigte sich signifikant häufiger bei Patienten mit Psoriasis (RR = 1.7, p <0.01). Die Aufgliederung nach dem Typ der Psoriasis zeigt, daß die erhöhte Frequenz einer kutanen und oralen Candidose nur bei Typ II Psoriatikern (mit einem Beginnalter < 40 Jahre) festzustellen war. Mit Ausnahme der vermehrten Besiedlung des Intestinaltraktes mit Candida species (RR = 1.45, p <0.05) wiesen Patienten mit Typ I Psoriasis (Beginnalter <40 Jahre) keine signifikanten Abweichungen vom Kontrollkollektiv bezüglich der Candidose auf. Bei diesen Patienten war jedoch eine Tinea signifikant seltener (RR = 0.71, p <0.01). Diese Arbeit gibt für Patienten mit atopischer Dermatitis oder Psoriasis das relative Risiko (RR) an, eine Mykose an den verschiedenen Lokalisationen zu erwerben. Der oft diskutierte Einfluß einer Pilzkrankheit auf das Entstehen oder den Verlauf der Krankheit bei Patienten mit atopischer Dermatitis oder Psoriasis wird durch diese Ergebnisse relativiert. Die häufigere intestinale Candida-Besiedlung und die Erkrankung an atopischer Dermatitis mögen sich schwach gegenseitig beeinflussen, wie es durch das gering erhöhte relative Risiko von RR = 1.51 (p <0.001) belegt wird. Summary. Both, psoriasis and atopic dermatitis are multifactorial diseases with an unknown pathogenesis. To elucidate the influence of fungal infections in the onset or recurrence of those inflammatory skin disease we determined the frequencies of Candida and dermatophyte infections of the skin and orointestinal tract concomitantly seen in patients with psoriasis or atopic dermatitis. We analyzed the files of more than 40 000 in-patients of the Department of Dermatology, Kiel. Sex- and age-adjusted relative risks were calculated. The results demonstrate that patients with psoriasis (N = 3006) presented with a decreased rate of tinea. This was significant for tinea corporis (RR = 0.13, p < 0.01). Candida infections of the skin were seen more often in psoriasis patients compared to controls. Differentiating between Type I (early onset) and Type 11 (late onset) psoriasis only Type I psoriasis patients presented with decreased dermatophyte infections and increased Candida colonization of the intestinum. However, patients with Type I1 psoriasis demonstrated an increased rate of candidosis cutis and candidosis oris as compared to controls. Patients with atopic dermatitis (N = 1808) displayed a decreased overall incidence of tinea and Candida infections. Furthermore, in patients with atopic dermatitis a Candida colonization of the orointestinal tract was found elevated (RR = 1.51, p < 0.0l), whereas tinea corporis (RR = 0.24, p < 0.01) and candidosis cutis (RR = 0.30, p < 0.001) was found decreased compared to controls. Our results show that the influence of fungal infections on the two skin diseases investigated is not as strong as often considered. The increased relative risk in patients with atopic dermatitis to present with Candida colonization in the digestive tract or vice versa may contribute to the pathogenesis of atopic dermatitis.     

Do Subjective Norms Predict the Screening of Cancer Patients’ First-Degree Relatives? A Systematic Review and Meta-Analysis

Background: Early detection and preventive measures can reduce the risk of cancer among first degree relatives (FDRs) of cancer patients.Several studies investigated the effect of subjective norm in relation to FDRs’ tendency to conduct preventive behaviors. Therefore, the purpose of this study was to systematically evaluate the effect of subjective norms on cancer patients’ FDRs as well as their willingness for screening. Methods: PubMed and Scopus were studied to investigate the effect of subjective norms on preventive measures such as breast cancer self-examination, colonoscopy, PSA testing, skin examination, and genetic testing. Odds Ratio (OR), correlation was and confidence intervals were extracted for meta-analysis. After reviewing the studies, only 16 studies met the criteria to be included in this systematic review. Results: The meta- analysis and OR showed that Physician Recommendation (OR=6.98, 95% CI; 2.55–19.09, P<0.001), Health Care Provider (HCP) (OR=2.79, 95% CI; 1.26-6.16; P=0.011), family and friends (OR=1.82, 95% CI; 1.33–2.50, P <0.001) significantly enhanced the likelihood of referring for screening and preventive measures. Conclusions: The results of the current study indicated that subjective norms can significantly increase willingness to screening.     

Machine learning identifies unaffected first‐degree relatives with functional network patterns and cognitive impairment similar to those of schizophrenia patients

Schizophrenia (SCZ) patients and their unaffected first‐degree relatives (FDRs) share similar functional neuroanatomy. However, it remains largely unknown to what extent unaffected FDRs with functional neuroanatomy patterns similar to patients can be identified at an individual level. In this study, we used a multivariate pattern classification method to learn informative large‐scale functional networks (FNs) and build classifiers to distinguish 32 patients from 30 healthy controls and to classify 34 FDRs as with or without FNs similar to patients. Four informative FNs—the cerebellum, default mode network (DMN), ventral frontotemporal network, and posterior DMN with parahippocampal gyrus—were identified based on a training cohort and pattern classifiers built upon these FNs achieved a correct classification rate of 83.9% (sensitivity 87.5%, specificity 80.0%, and area under the receiver operating characteristic curve [AUC] 0.914) estimated based on leave‐one‐out cross‐validation for the training cohort and a correct classification rate of 77.5% (sensitivity 72.5%, specificity 82.5%, and AUC 0.811) for an independent validation cohort. The classification scores of the FDRs and patients were negatively correlated with their measures of cognitive function. FDRs identified by the classifiers as having SCZ patterns were similar to the patients, but significantly different from the controls and FDRs with normal patterns in terms of their cognitive measures. These results demonstrate that the pattern classifiers built upon the informative FNs can serve as biomarkers for quantifying brain alterations in SCZ and help to identify FDRs with FN patterns and cognitive impairment similar to those of SCZ patients.     

Implementation of Screening Colonoscopy amongst First-Degree Relatives of Patients with Colorectal Cancer in Turkey: a Cross-Sectional Questionnaire Based Survey

Objective: To evaluate the implementation of screening colonoscopy amongst first-degree relatives (FDRs)of patients with colorectal cancer (CRC) in Turkey. Materials and Methods: A total of 400 first-degree relatives(mean(SD)age: 42.5(12.7) years, 55.5% were male) of 136 CRC patients were included in this cross-sectionalquestionnaire based survey. Data on demographic characteristics, relationship to patient and family history formalignancy other than the index case were evaluated in the FDRs of patients as were the data on knowledge aboutand characteristics related to the implementation of screening colonoscopy using a standardized questionnaireform. Results: The mean(SD) age at diagnosis of CRC in the index patients was 60.0(14.0) years, while mean(SD)age of first degree relatives was 42.5(12.7) years. Overall 36.3% of relatives were determined to have knowledgeabout colonoscopy. Physicians (66.9%) were the major source of information. Screening colonoscopy wasrecommended to 19.5% (n=78) of patient relatives, while 48.7% (n=38) of individuals participated in colonoscopyprocedures, mostly (57.9%) one year after the index diagnosis. Screening colonoscopy revealed normal findingsin 25 of 38 (65.8%) cases, while precancerous lesions were detected in 26.3% of screened individuals. In 19.0% ofFDRs of patients, there was a detected risk for Lynch syndrome related cancer. Conclusions: In conclusion, ourfindings revealed that less than 20% of FDRs of patients had received a screening colonoscopy recommendation;only 48.7% participated in the procedure with detection of precancerous lesions in 26.3%. Rise of awarenessabout screening colonoscopy amongst patients with CRC and first degree relatives of patients and motivationof physicians for targeted screening would improve the participation rate in screening colonoscopy by FDRs ofpatients with CRC in Turkey.     

Smoking Habits of Relatives of Patients with Cancer: Cancer Diagnosis in the Family is an Important Teachable Moment for Smoking Cessation

Background: In this study we aimed to determine the rate and habitual patterns of smoking, intentions ofcessation, dependence levels and sociodemographic characteristics of relatives of patients with a diagnosis ofcancer. Materials and Methods: This study was designed by the Turkish Oncology Group, Epidemiology andPrevention Subgroup. The relatives of cancer patients were asked to fill a questionnaire and Fagerstrom testof nicotine dependence. Results: The median ages of those with lower and higher Fagerstrom scores were 40years and 42 years, respectively. We found no evidence of variation between the two groups for the remainingsociodemographic variables, including the subject’s medical status, gender, living in the same house with thepatient, their educational status, their family income, closeness to their cancer patients or spending time withthem or getting any help or wanting to get some help. Only 2% of the subjects started smoking after cancer wasdiagnosed in their loved ones and almost 20% of subjects had quit smoking during the previous year. Conclusions:The Fagerstrom score is helpful in determining who would be the most likely to benefit from a cigarette smokingcessation program. Identification of these people with proper screening methods might help us to pinpoint whowould benefit most from these programs.     

Functional capacity after hip arthroplasty: A comparison between evaluation with three standard instruments and a personal interview

The aim of the present study was to compare the information obtained from three standard instruments used in physiotherapy and occupational therapy and with information acquired from an unstructured interview. Ten patients with osteoarthritis of the hip were consecutively picked from the waiting list at an orthopedic clinic. All were examined before and six months after arthroplasty. The study layout is a mixture of quantitative and qualitative evaluation. The three instruments used were SF-36 (self-reported health-related quality of life), FAS (an instrument for evaluation of lower extremity dysfunction), and the COPM (for evaluation of self-experienced activity level). All patients were also interviewed in a free, unstructured interview, and data were analyzed with a phenomenological approach. All methods could describe function and activity status of the patients very well, and they were also responsive to postoperative improvement. Together the three instruments gave such good information that almost no extra information was obtained through the interviews. On the other hand, the interviews served as powerful validation of the three instruments. The information in the three separate instruments is qualitatively different, and one instrument cannot replace another. They cannot be replaced by the interview either, because the instruments provide the therapist with specific and structured information that is important for further treatment planning and follow-up.