Objectives: Suicide is best studied by deconstructing the psychological experiences preceding suicidal death. We assessed the characteristics of tedium vitae (feeling tired of life) after first ever stroke in Nigerian survivors.
Methods: Using the Schedule for Clinical Assessment in Neuropsychiatry, tedium vitae was assessed in 130 stroke survivors attending rehabilitation in a large Nigerian university hospital. Global cognitive and executive dysfunctions were evaluated, respectively, using the Mini Mental State Examination and the modi?ed Indiana University Token test. All participants had their index stroke 3 to 24 months before recruitment into the study. We also examined a comparative group of 130 age, gender, and education matched apparently normal persons who were unrelated to the stroke survivors. Associations were explored using univariate and multivariate logistic regression analyses.
Results: Tedium vitae was experienced by 16 (12.3%) stroke survivors compared with 5 (3.9%) in the comparative group (O. R = 3.5, 95% C. I = 1.3–9.9, p = 0.018). Among stroke survivors, those who were retired were more likely to experience tedium vitae (56.2%, p = 0.045). In analyses adjusting for the effect of systemic hypertension, cognitive dysfunction, retirement and marital separation, there was a 3.5-fold increase in the odds of experiencing tedium vitae after surviving a stroke (O. R = 3.5, 95% C. I = 1.1–11.6, p = 0.042).
Conclusions: Tedium vitae is a common suicidal experience after stroke and may be among the earliest perceptible pointer to impending poststroke suicide. It is easy to assess and may be less costly to obtain an adequate sample size in studies aiming to understand the phenomenon of suicide in the stroke population. 相似文献
Tranilast is an antiallergic drug that interferes with proliferation and migration of vascular smooth muscle cell induced by platelet-derived growth factor (PDGF) and transforming growth factor-beta1 (TGF-beta1). We investigated the local effect of tranilast on neointimal hyperplasia using tranilast-coated prosthetic grafts. The inner sides of the thin-walled polytetrafluoroethylene (PTFE) grafts were coated with chitosan and tranilast containing chitosan solution. Wistar albino rats (32) were used in the study. Patches (1 x 2 mm) for vascular grafts were prepared. Three groups were tested: group 1 (n = 12; tranilast coated), group 2 (n = 10; adhesive-only film-layer-coated), and group 3 (n = 10; normal ePTFE patch grafts sutured to the carotid arteries of the rats). Recipient sites of the carotid arteries were excised 4 weeks after surgery. All sections were examined histologically for graft patency, thrombus formation, and neointimal thickness. Expression of PDGF, fibroblast growth factor, and TGF-beta1 on cross-sections of the neointima were evaluated by immunohistochemistry. No significant differences were found regarding mean neointimal thicknesses. PDGF and TGF-beta-1 expressions were significantly lower in group 1. Although a decrease in local effect of tranilast was observed for growth factor expressions at a drug concentration of 0.05 mg/cm(2), a significant reduction in neointimal hyperplasia was not achieved. The coating concentration of 0.05 mg/cm(2) may have been too low to produce an antiproliferative effect. Given our promising results, further studies are recommended and planned using different drug concentrations and time intervals. 相似文献
Changes in plasma amino acids, 24-h nitrogen balances, and resting metabolic expenditures (RMEs) were measured in 10 geriatric patients (aged 70-92 y) with hip fracture 1 d after surgical fixation during both a 24-h fasting state and while receiving total peripheral parenteral nutrition (TPPN) for 24 h at 1.5 g amino acids.kg-1.d-1 and 29-30 kcal.kg-1.d-1 and compared with 19 healthy volunteer subjects (aged 70-84 y). RME and 24-h urinary nitrogen losses were also elevated in the trauma patients during both fasting and TPPN. Positive nitrogen balances were evident in both groups during TPPN. Plasma total amino acid concentration was significantly lower in the trauma patients because of lower plasma concentrations of the nonessential amino acids. Phenylalanine and methionine concentrations were significantly higher and lysine lower in the trauma group. In addition, evaluation of the essential amino acid ratios after fasting and TPPN reveal that there are no limiting amino acids during TPPN. 相似文献
BACKGROUND: We aimed to determine whether serum concentrations of anti-Müllerian hormone (AMH) can be used as a tool for prediction of the efficacy of sperm retrieval. METHODS: This was a prospective cohort observational study. AMH levels were determined in 47 men presenting for infertility evaluation. Group 1 consisted of 24 infertile patients diagnosed with non-obstructive azoospermia. Group 1 was further divided into two subgroups. The patients with spermatozoa in their testicular samples constituted group 1a (n = 13), while the patients with absence of spermatozoa constituted group 1b (n = 11). Twenty-three normozoospermic fertile men constituted group 2. Serum AMH was measured before obtaining testicular specimens. RESULTS: Testicular spermatozoa were recovered in 13 out of the 24 patients (54%). Demographic characteristics of the three groups were similar. The difference between serum AMH levels among the three groups did not reach statistical significance. CONCLUSIONS: We speculated that although AMH is secreted predominantly into the seminiferous tubules, studying serum samples might be more advantageous than seminal plasma because the presence of seminal proteases could influence AMH levels in the latter. However, our results did not demonstrate differences in serum concentrations of AMH between the studied groups. Studies with extended patient populations focusing on seminal plasma concentrations of AMH are warranted. 相似文献
The purpose of this study was to present our experience with combined use of CO2 laser and cold instrumentation for Reinke’s edema surgery and to evaluate 1-year follow-up results of the technique in a
series of professional voice users. Fifteen patients with Reinke’s edema who underwent microlaryngoscopic surgery were included.
Videolaryngostroboscopy, perceptual and acoustic voice analyses were performed before and after surgery. During the 1-year
follow-up, no recurrence of Reinke’s edema was encountered. Significant postoperative improvement was obtained in the quality
of voice, in terms of GRBAS scores, Fo, jitter, shimmer and NHR. No evidence of laryngeal cancer was found on the histological
examinations. Combined use of CO2 laser and cold instrumentation provides a reliable and safe method for Reinke’s edema surgery, and cessation of smoking,
voice rest and control of the laryngopharyngeal reflux contribute to the success of surgery. We consider that the removal
of redundant mucosa of the vocal fold reduces the risk of the recurrence of Reinke’s edema and provides better quality of
voice. However, it does not imply that our method is superior to others’, but this procedure constitutes an effective treatment
of choice for Reinke’s edema patients, including professional voice users. 相似文献
Background. It is known that Helicobacter
pylori (Hp) plays an important role in gastritis and peptic
ulcer disease in the general population. Although dyspeptic complaints are
frequent in haemodialysis (HD) patients and renal transplant recipients,
there are few reports regarding the prevalence of Hp and its possible
effects on this group of patients. This study was performed to examine the
prevalence of Hp infection in patients on regular HD treatment and to
detect its role in the pathogenesis of dyspepsia in this group of patients.
Methods. Two hundred and one patients with dyspeptic
complaints were included in the study. The groups consisted of 47 HD, 54
renal transplant recipients, and 100 non-renal disease patients. Upper
gastrointestinal endoscopies were performed and gastric antral biopsies
were obtained for urease test in all patients.
Results. Twenty-eight (60%) of the 47 HD and 28 (70%)
of the 54 RTR were positive for Hp. Sixty-four (64%) of the 100 patients
with various gastrointestinal complaints and known to have no renal
dysfunction were positive for Hp. The Hp prevalences among the three groups
were not significantly different (P <0.05). The prevalence of Hp
infection did not correlate with the haemodialysis duration nor the
post-transplantation duration (P <0.05). There was no correlation
between the prevalence of Hp infection and duration of haemodialysis
therapy or time post-transplantation. Conclusion.
These findings suggest that HD patients are not protected against Hp
infection as the Hp prevalences are as high as that for the non-renal
disease group. The increased dyspeptic complaints may be partly related to
Hp infection. 相似文献