RESUMEN
Physical activity in schools is declining in many countries and inactivity in childhood has become a recognized risk factor. Data from a program of professionally guided physical exercise in primary school children were collected before and after the academic year of training. Four thousand five hundred children (6-10 years) were enrolled, and conditional and coordinative motor abilities (speed, trunk flexibility, long jumping, somersault, Harre circuit test) were measured. Anthropometric measurements were focused on body mass index (BMI), weight and height. Females never showed a significant variation of BMI, whereas males in the first and fourth grades showed significant differences. On the contrary, when considering the motor abilities studied, all the comparisons were highly significant. At the end of training, both males and females did better than at the beginning, and males were constantly faster than females. Our data, generated on a large number of children, show that professionally guided programs of physical education in the primary school lead to significant progresses in the development of conditional and coordinative abilities, without altering BMI values, thus not interfering with the balanced progression of body weight and height.
Asunto(s)
Ejercicio Físico/fisiología , Actividad Motora/fisiología , Educación y Entrenamiento Físico/métodos , Antropometría , Rendimiento Atlético , Índice de Masa Corporal , Niño , Femenino , Humanos , Italia , MasculinoRESUMEN
AIM: The aim of this study was to evaluate the frequency of carbon monoxide diffusing capacity (DLCO) impairment and microalbuminuria in patients with active ulcerative colitis (UC) and to assess whether these nonexpensive and noninvasive tests correlate with intestinal inflammation. METHODS: A prospective observational study was set up at the Fiorenzuola Hospital and performed during a 4-year period. We enrolled 30 consecutive subjects with clinical and histological diagnosis of active UC and 20 healthy subjects matched for age and sex. After full colonscopic assessment with multiple mucosal biopsies, the clinical disease activity of each patient was quantified. A global spirometry and 24-h urine collection at rest to measure microalbuminuria were performed. Each biopsy specimen was assessed blindly by a histopathologist, who assigned a score according to the severity of enterocyte damage, cryptitis and acute and chronic inflammation of the lamina propria. RESULTS: A latent pulmonary involvement with a reduction in DLCO was present in 20 patients (67%). A subclinical renal involvement with microalbuminuria was detected in 19 subjects (63%). The mean DLCO was 78.2+/-15.2 in Group 1 vs 94.7+/-13.1 in Group 2 (P<0.001). Microalbuminuria was 103.6+/-90.8 in Group 1 vs 57+/-31.7 in the control group (P=0.062). DLCO reduction correlated significantly with intestinal histopathological grading in Group 1 (r = -0.742, P< 0.001), although there was no correlation between microalbuminuria and histological grading (r = -0.273, P= 0.143). CONCLUSION: Our data confirm that latent pulmonary involvement (DLCO impairment) and microalbuminuria are frequent in UC. The DLCO may provide a useful noninvasive indicator of colonic inflammation in subjects with UC and concomitant subclinical lung involvement.
Asunto(s)
Albuminuria/diagnóstico , Colitis Ulcerosa/complicaciones , Capacidad de Difusión Pulmonar , Capacidad Pulmonar Total , Adulto , Albuminuria/etiología , Biopsia , Monóxido de Carbono , Colitis Ulcerosa/diagnóstico , Colitis Ulcerosa/patología , Colonoscopía , Femenino , Humanos , Mucosa Intestinal/patología , Masculino , Persona de Mediana Edad , Estudios Prospectivos , EspirometríaRESUMEN
Testosterone therapy has been reported to be useful in the treatment of hypogonadism and partial androgen deficiency of the aging male (PADAM) syndrome. Testosterone administration is needed in order to maintain secondary sexual characteristics, muscle mass, bone mineral density, cognitive function and sexual drive. Newer testosterone-containing compounds, particularly gel preparations, are known to produce more stable circulating testosterone levels than im-administered drugs, with scarce side-effects and good patient compliance. All patients treated with testosterone must undergo a careful follow-up to prevent the development of the major side effects, such as sleep-apnea, erythrocytosis, cardiovascular diseases and the alterations of hepatic function and plasma lipid concentrations.
Asunto(s)
Terapia de Reemplazo de Hormonas/efectos adversos , Testosterona/efectos adversos , Acné Vulgar/etiología , Anciano , Anciano de 80 o más Años , Alopecia/etiología , Enfermedades Cardiovasculares/etiología , Dermatitis Seborreica/etiología , Ginecomastia/etiología , Humanos , Hipertensión/etiología , Lípidos/sangre , Hepatopatías/etiología , Masculino , Policitemia/etiología , Apnea Obstructiva del Sueño/etiología , Testosterona/deficienciaAsunto(s)
Miocardio/patología , Regeneración/fisiología , Animales , Cardiomegalia/patología , Muerte Celular/fisiología , Diferenciación Celular/fisiología , División Celular/fisiología , Insuficiencia Cardíaca/patología , Insuficiencia Cardíaca/fisiopatología , Humanos , Infarto del Miocardio/patología , Infarto del Miocardio/fisiopatología , Trasplante de Células Madre/métodos , Células Madre/fisiologíaRESUMEN
To address the potential role that tumor necrosis factor-alpha (TNF-alpha) might play in modulation of insulin resistance in healthy, nondiabetic individuals, we compared plasma TNF-alpha and soluble TNF-alpha receptor 2 (sTNF-R2) concentrations, as well as TNF-alpha polymorphisms, in 94 healthy individuals, stratified into insulin-resistant (IR) and insulin-sensitive (IS) groups based on their plasma insulin concentrations 120 minutes after oral glucose on 2 occasions (1993 and 2000). The IR group (n = 50; 29 men and 21 women) was in the upper quartile and the IS group (n = 44; 24 men and 20 women) in the lowest quartile of the distribution of post-glucose challenge insulin concentrations in a large unselected population (>50 v <23 microU/mL). The IR group had significantly higher values for body mass index, waist-to-hip girth, fasting and post-glucose challenge insulin concentrations, and fasting triglyceride concentrations, and lower high-density lipoprotein cholesterol concentrations as compared to the IS group. Despite the fact that they were relatively more obese, and insulin-resistant, plasma concentrations of TNF-alpha were similar in the IR (1.6 +/- 0.6 pg/mL) and IS (1.7 +/- 0.6 pg/mL) groups, as were the concentrations (5.4 +/- 1.4 v 5.8 +/- 2.0 pg/mL) of sTNF-R2. Furthermore, TNF-alpha polymorphisms (detected by polymerase chain reaction [PCR]) were similar in the 2 groups, with essentially identical allelic frequencies of the 238 (10.3% v 9.4%) and 308 polymorphisms (17.9% v 18.7%). In conclusion, plasma TNF-alpha and sTNF-R2 concentrations, as well as TNF-alpha gene polymorphisms, were not different in healthy volunteers stratified into IR and IS groups on the basis of their plasma insulin response to an oral glucose challenge. Given these data, it does not appear that differences in TNF-alpha activity contribute to the marked variations in insulin action that occur in healthy individuals.
Asunto(s)
Resistencia a la Insulina/fisiología , Factor de Necrosis Tumoral alfa/metabolismo , Anciano , Glucemia/metabolismo , ADN/biosíntesis , ADN/genética , ADN/aislamiento & purificación , Ayuno/fisiología , Femenino , Glucosa/farmacología , Hemodinámica/fisiología , Humanos , Insulina/sangre , Masculino , Persona de Mediana Edad , Polimorfismo Genético/genética , Receptores del Factor de Necrosis Tumoral/metabolismo , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Factores de Tiempo , Factor de Necrosis Tumoral alfa/genéticaRESUMEN
The function of the central alpha-adrenergic, serotoninergic and dopaminergic systems was investigated in 30 heroin-dependent subjects, 6 - 8 weeks after detoxification and in 22 psychophysically healthy controls (group C). Twelve heroin-dependent subjects with antisocial personality disorder (ASPD) (group A), 18 heroin-dependent subjects without other Axis I and II pathologies (group B) were included among abstinent substance abusers. The norepinephrine (NE) function was evaluated by the GH responses to acute stimulation with clonidine (clon); the serotonin (5-HT) function by the PRL and cortisol (CORT) responses to acute stimulation with d-fenfluramine (d-fen) and the dopamine (DA) function was investigated by growth hormone (GH) and prolactin (PRL) responses to acute administration of bromocriptine (brom). Alpha-adrenergic sensitivity, as measured by the GH-clon test, was found significantly reduced in A subjects (ASPD), in comparison with B subjects and controls. PRL and CORT responses to d-fen were significantly blunted both in A and B subjects, in comparison with control subjects. DA receptors sensitivity seems to be reduced significantly in ASPD (A subjects); in contrast, heroin addicts without open psychiatric co-morbidity showed unimpaired responses to brom challenge; a significantly lower GH response to brom and a lack of PRL suppression in ASPD subjects could express D2 postsynaptic receptor hyposensitivity possibly related to DA gene variants associated to co-morbid disorder. In sum, the study of central monoamine function revealed an alteration of the 5-HT system in all detoxified heroin-dependent subjects. A significant reduction of alpha-adrenergic receptors sensitivity and the hyposensitivity of postsynaptic DA receptors in ASPD subjects suggest once again that specific biological correlates of psychiatric co-morbidity may characterize substance abusers subtypes.
Asunto(s)
Trastorno de Personalidad Antisocial/metabolismo , Dependencia de Heroína/metabolismo , Agonistas alfa-Adrenérgicos , Adulto , Trastorno de Personalidad Antisocial/psicología , Encéfalo/metabolismo , Bromocriptina , Estudios de Casos y Controles , Clonidina , Dopamina/metabolismo , Agonistas de Dopamina , Fenfluramina , Dependencia de Heroína/psicología , Humanos , Masculino , Sistemas Neurosecretores/metabolismo , Norepinefrina/metabolismo , Serotonina/metabolismo , SerotoninérgicosRESUMEN
Objective measures of experimentally-induced aggressiveness were evaluated in 20 methadone-treated heroin addicts, in comparison to 20 normal healthy male subjects. All the subjects were submitted to preliminary DSM IV interviews, Buss Durkee Hostility Inventory (BDHI) and Minnesota Multiphasic Personality Inventory (MMPI II). During a laboratory task, the point subtraction aggression paradigm (PSAP), subjects earned monetary reinforcers with repeated button presses, and were provoked by the subtraction of money, which was attributed to a fictitious other participants. Subjects could respond by ostensibly subtracting money from the fictitious subject (the aggressive response), or protecting their counter (escape response). Money-earning responses were significantly lower (t=4.38, P<0.001) and aggressive responses significantly higher (t=5.45; P<0.001) in methadone patients in comparison to controls. During the experimentally-induced aggressiveness, plasma adrenocorticotropic hormone (ACTH), cortisol (CORT) and growth hormone (GH) concentrations increased significantly less and norepinephrine (NE) and epinephrine (EPI) levels, together with heart rate (HR), significantly more in methadone subjects than in healthy subjects. PSAP aggressive responses positively correlated with catecholamines changes, BDHI 'direct' and 'irritability' scores, MMPI 'psychopathic deviate' scores both in methadone subjects and controls, and with CORT responses only in healthy subjects. No correlation was found between methadone doses, or exposure extent, and aggressiveness levels. Our findings suggest that heroin dependent patients have higher outward-directed aggressiveness than healthy subjects, in relationship with monoamines hyper-reactivity, also under methadone medication. Aggressiveness in methadone patients seems to be related more to the personality traits than to drug effects. Hypothalamus-pituitary-adrenal (HPA) axis responses, unexpectedly dissociated from catecholamines rise among methadone patients, could be due to a long-lasting inhibitory action exerted by opiates on pro-opio-melanocortin (POMC), or to a premorbid psychobiological condition that exhausted hormonal reactivity.
Asunto(s)
Agresión/efectos de los fármacos , Dependencia de Heroína/tratamiento farmacológico , Metadona/farmacología , Narcóticos/farmacología , Sistemas Neurosecretores/efectos de los fármacos , Adulto , Agresión/fisiología , Agresión/psicología , Análisis de Varianza , Área Bajo la Curva , Presión Sanguínea/efectos de los fármacos , Presión Sanguínea/fisiología , Catecolaminas/sangre , Condicionamiento Operante/efectos de los fármacos , Condicionamiento Operante/fisiología , Frecuencia Cardíaca/efectos de los fármacos , Frecuencia Cardíaca/fisiología , Dependencia de Heroína/sangre , Dependencia de Heroína/psicología , Hormonas/sangre , Humanos , Masculino , Metadona/uso terapéutico , Narcóticos/uso terapéutico , Sistemas Neurosecretores/metabolismo , PsicometríaRESUMEN
The aim of the present study is to evaluate lofexidine and clonidine, in an accelerated opiate detoxification procedure (3 days), without anaesthesia. Forty heroin-dependent individuals were detoxified, evaluating withdrawal symptoms, craving levels, mood changes, urine toxicologic screens, and dropout during therapy with either (1) clonidine, oxazepam, baclofen, and ketoprofene, with naloxone and naltrexone for 3 days (20 subjects) or (2) lofexidine, oxazepam, baclofen, and ketoprofene with naloxone and naltrexone for 3 days (20 subjects). Both clonidine and lofexidine rapid detoxifications were found effective. The subjects treated with lofexidine showed significantly lower levels of withdrawal symptoms, fewer mood problems, less sedation and hypotension. No significant differences in craving levels, morphine metabolites in urine, or dropout rate were evidenced between the two groups. The early use of naltrexone during detoxification in combination with either alpha-2-agonist facilitated the acceptance for long-term naltrexone treatment. Lofexidine appeared to be more useful than clonidine in a 3-day accelerated opiate detoxification, not only to counteract withdrawal symptoms, but also in the treatment of dysphoria and mood changes. Because lofexidine does not produce hypotension, safe outpatient treatment, without hospital support, could be possible.
Asunto(s)
Clonidina/uso terapéutico , Inactivación Metabólica/fisiología , Trastornos Relacionados con Opioides/tratamiento farmacológico , Opio/administración & dosificación , Adulto , Análisis de Varianza , Clonidina/análogos & derivados , Método Doble Ciego , Humanos , Masculino , Naloxona/administración & dosificación , Trastornos Relacionados con Opioides/fisiopatología , Síndrome de Abstinencia a Sustancias/tratamiento farmacológico , Síndrome de Abstinencia a Sustancias/fisiopatología , Factores de TiempoRESUMEN
Neuroendocrinology of chronic stress seems to be characterized by HPA axis hyperactivity and early childhood stressors have been hypothesized to predispose individuals to adult onset depression by means of dysregulation of the HPA axis. Pivagabine (PVG), a hydrophobic 4-aminobutyric acid derivative, has been used experimentally recently in the treatment of different disorders related to stress-maladaptation, because of its possible inhibitory action on corticotrophin releasing factor secretion and HPA axis function. In the present study, 20 healthy male subjects were each exposed twice to the same psychosocial stressor (stroop color-word interference task, public speaking and mental arithmetic in front of an audience) during a first session (day 1) and a second session (day 8). Plasma concentrations of norepinephrine (NE), epinephrine (EPI), adrenocorticotropic hormone (ACTH) and cortisol (CORT), heart rate (HR) and systolic blood pressure (SBP) were measured immediately before the beginning of the tests and at their end, 30 min later, on both experimental days. Utilizing a double blind schedule, the subjects received pivagabine (900 mg, twice a day)(PVG group: nine subjects) or placebo (PBO group: 11 subjects) during the 7 days between the two stress sessions. NE, EPI, ACTH, and CORT levels were significantly elevated after stress exposure on day 1 and day 8 in PBO group subjects. After PVG treatment, on day 8, ACTH, CORT, NE and EPI responses to stress were significantly blunted, together with HR and SBP, in PVG group subjects. These results add to the evidence concerning PVG capacity to inhibit the HPA axis in humans, in response to stressful stimuli, and suggest that the action of PVG may be mediated not only by GABAergic receptors, but also by the suppression of catecholamines response. PVG treatment could modulate HPA hyper-responsiveness to stress in subjects with negative affectivity and depressive traits.
Asunto(s)
Sistema Hipotálamo-Hipofisario/efectos de los fármacos , Psicotrópicos/administración & dosificación , Estrés Psicológico/tratamiento farmacológico , Ácido gamma-Aminobutírico/administración & dosificación , Hormona Adrenocorticotrópica/sangre , Adulto , Presión Sanguínea/efectos de los fármacos , Catecolaminas/sangre , Método Doble Ciego , Frecuencia Cardíaca/efectos de los fármacos , Humanos , Hidrocortisona/sangre , Masculino , Pruebas Neuropsicológicas , Estrés Psicológico/sangre , Estrés Psicológico/fisiopatología , Ácido gamma-Aminobutírico/análogos & derivadosRESUMEN
PURPOSE: Objective measures of experimentally induced aggressiveness were evaluated in 12 male 3,4-methylenedioxy-methamphetamine (MDMA, "Ecstasy") users, in comparison with 20 healthy male subjects. METHODS: All the subjects were preliminarily submitted to DSM-IV interviews and Buss-Durkee Hostility Inventory (BDHI). During a laboratory task, the Point Subtraction Aggression Paradigm (PSAP), subjects earned monetary reinforcers with repeated button presses, and were provoked by the subtraction of money that was attributed to a fictitious other participant. Subjects could respond by ostensibly subtracting money from the fictitious subject (the aggressive response). Escape responses were also possible protecting the counter from monetary subtractions. RESULTS: Money-earning responses were not different in Ecstasy users and controls; aggressive responses were significantly higher in Ecstasy users in comparison with control subjects (F=20.74, P<.001). Baseline adrenocorticotropic hormone (ACTH) and cortisol (CORT) levels were higher in Ecstasy users than in controls. No difference was found in norepinephrine (NE) and epinephrine (EPI) basal levels of the two groups. During the experimentally induced aggressiveness, plasma ACTH concentrations increased significantly less and NE and EPI levels, together with heart rate (HR), increased significantly more in Ecstasy users than in healthy subjects. Despite ACTH-blunted responses, CORT did not increase differently from controls in Ecstasy users. PSAP aggressive responses positively correlated with catecholamines and CORT changes, BDHI Direct Aggression and Irritability scores, both in Ecstasy users and controls. A significant correlation was found between Ecstasy exposure extent and aggressive responses (r=.78, P<.001). IMPLICATIONS: Our findings suggest that Ecstasy users have higher outward-directed aggressiveness than healthy subjects. Aggressiveness in MDMA subjects seems to be associated more with MDMA pharmacological effects than with personality traits: Nevertheless, a premorbid psychobiological proneness to aggressive behavior cannot be excluded. Increased catecholamines reactivity, basal hypothalamus-pituitary-adrenal (HPA) axis hyperactivity, and blunted ACTH responses could be due to MDMA action on monoaminergic pathways and adrenal function.
Asunto(s)
Agresión/psicología , Alucinógenos/efectos adversos , N-Metil-3,4-metilenodioxianfetamina/efectos adversos , Adolescente , Hormona Adrenocorticotrópica/sangre , Adulto , Análisis de Varianza , Epinefrina/sangre , Humanos , Hidrocortisona/sangre , Masculino , N-Metil-3,4-metilenodioxianfetamina/sangre , Norepinefrina/sangre , Pruebas de Personalidad , Escalas de Valoración Psiquiátrica , Factores de TiempoRESUMEN
The functions of the central alpha-adrenergic, serotoninergic and dopaminergic systems were investigated in 28 heroin-dependent subjects 6-8 weeks after detoxification, and in 22 healthy control subjects (group C). Fourteen heroin-dependent subjects with depressive comorbidity (group A), and 14 heroin-dependent subjects without other Axis I and II pathologies (group B) were included among abstinent substance abusers. Norepinephrine (NE) function was evaluated by growth hormone (GH) responses to acute stimulation with clonidine (clon); serotonin (5-HT) function by prolactin (PRL) and cortisol (CORT) responses to acute stimulation with D-fenfluramine (D-fen) and dopamine (DA) function by GH and PRL responses to acute administration of bromocriptine (brom). Central NE activity, as measured by the GH-clon test, seems to be well preserved both in A and B subjects. PRL and CORT responses to D-fen were significantly blunted both in A subjects and in B subjects, in comparison with control subjects (C); the PRL response in A subjects was significantly lower than in B subjects. The DA system of B subjects was found unimpaired; in contrast, a significantly higher GH response to brom in A subjects (depressed) could express D2 post-synaptic receptor hypersensitivity and, therefore, decreased pre-synaptic DA release. In sum, the study of central monoamine function revealed an alteration only of the 5-HT system in detoxified heroin-dependent subjects without psychiatric comorbidity, which might be a trait character of these subjects, possibly involved in the pathogenesis of the disorder. A more significant impairment of 5-HT function and the hypersensitivity of post-synaptic DA receptors in A subjects suggests that specific biological correlates of psychiatric comorbidity may characterize substance abuser subtypes.
Asunto(s)
Trastorno Depresivo Mayor/metabolismo , Dopamina/metabolismo , Dependencia de Heroína/metabolismo , Norepinefrina/metabolismo , Serotonina/metabolismo , Agonistas alfa-Adrenérgicos/farmacología , Adulto , Análisis de Varianza , Biomarcadores , Encéfalo/metabolismo , Bromocriptina/farmacología , Estudios de Casos y Controles , Clonidina/farmacología , Depresión/metabolismo , Trastorno Depresivo Mayor/psicología , Diagnóstico Dual (Psiquiatría) , Agonistas de Dopamina/farmacología , Femenino , Fenfluramina/farmacología , Dependencia de Heroína/psicología , Dependencia de Heroína/terapia , Humanos , Masculino , Escalas de Valoración Psiquiátrica , Receptores Adrenérgicos/efectos de los fármacos , Receptores Dopaminérgicos/efectos de los fármacos , Receptores de Serotonina/efectos de los fármacos , Serotoninérgicos/farmacología , Detección de Abuso de SustanciasRESUMEN
The goal of this study was to compare plasma nitric oxide (NO) concentrations in healthy subjects, defined as either insulin-resistant or insulin-sensitive on the basis of the plasma insulin response to a 75-g oral glucose challenge. For this purpose, 404 healthy subjects were divided into quartiles on the basis of the plasma insulin response to glucose, and 49 individuals were selected from the quartile with the lowest insulin response and 49 from the quartile with the highest insulin response. The two groups of 49 each were selected to be essentially identical in terms of age, gender distribution, body mass index (BMI), and waist to hip ratio (WHR). The quartile with the greatest insulin response also had a significantly higher plasma glucose response to oral glucose, faster heart rate, higher blood pressure, and the combination of higher triglyceride and lower high-density lipoprotein (HDL) cholesterol concentrations. In addition to the latter changes, previously shown to be associated with hyperinsulinemia, NO concentrations were also higher in the hyperinsulinemic group. It is speculated that this increase in the NO concentration in hyperinsulinemic and presumably insulin-resistant, subjects represents a compensatory effort to overcome the untoward effects of insulin resistance and/or hyperinsulinemia.
Asunto(s)
Resistencia a la Insulina/fisiología , Óxido Nítrico/sangre , Glucemia/efectos de los fármacos , Glucemia/metabolismo , Presión Sanguínea/fisiología , HDL-Colesterol/sangre , Femenino , Glucosa/administración & dosificación , Prueba de Tolerancia a la Glucosa , Frecuencia Cardíaca/fisiología , Humanos , Insulina/sangre , Masculino , Persona de Mediana Edad , Triglicéridos/sangreRESUMEN
Studies investigating temperament traits in humans and their biological correlates have found high levels of novelty seeking (NS) linked with dopaminergic system changes, and particularly a deficit of dopamine transporter. Harm avoidance and reward dependence, on the other hand, appeared to be associated, respectively with serotonin and noradrenaline changes. In the present study, we have investigated the dopaminergic (DA), serotonergic (5-HT), and noradrenergic (NE) functions in healthy volunteers by challenging the monoamine systems with the DA agonist bromocriptine, the 5-HT agonist D-fenfluramine, and the NE agonist clonidine, respectively. Parallel to this investigation, we examined the temperament traits of our subjects by measuring NS, harm avoidance (HA) and reward dependence (RD) using the 'Three-dimensional Personality Questionnaire' (TPQ). The aims of the study were to see whether or not the monoamine functions were correlated with temperament traits. Bromocriptine challenge induced a significant GH increase and a significant suppression of PRL. D-fenfluramine test significantly increased PRL and cortisol plasma levels and Clonidine test induced a significant rise in GH values. NS scores showed a significant direct correlation with brom-stimulated GH values (r=0.426, P<0.05) and a significant inverse correlation with brom-inhibited PRL values (r=-0.498, P<0.01). HA scores correlated significantly with D-fen-stimulated PRL and CORT AUCs, (PRL: r=0.424, P<0.05; CORT: r=0. 595, P<0.005). RD scores correlated positively with clon-stimulated GH values (r=0.55; F=8.6; P<0.01) and negatively with brom-inhibited-PRL AUCs (r=-0.439, P<0.05). Our data support Cloninger theory concerning the biological correlates of temperamental traits, and evidence the link between the neuroendocrine responses to dynamic challenges and stable temperament features.
Asunto(s)
Sistemas Neurosecretores/fisiología , Temperamento/fisiología , Agonistas alfa-Adrenérgicos , Adulto , Reacción de Prevención , Bromocriptina , Clonidina , Dopamina/fisiología , Agonistas de Dopamina , Conducta Exploratoria , Fenfluramina , Hormona de Crecimiento Humana/sangre , Humanos , Hidrocortisona/sangre , Masculino , Norepinefrina/fisiología , Prolactina/sangre , Recompensa , Serotonina/fisiología , Agonistas de Receptores de SerotoninaRESUMEN
This study was initiated to evaluate the role of hyperinsulinemia in the regulation of fasting plasma leptin. We measured plasma leptin and insulin concentrations in 404 healthy nondiabetic subjects. For analytical purposes, the population was divided into quartiles on the basis of the lowest (quartile 1) and highest (quartile 4) plasma insulin response to oral glucose, and fasting plasma leptin values in these 2 dichotomous groups were compared. The total plasma integrated insulin response was 4-fold greater in quartile 4, associated with significantly higher (P < .001) fasting plasma leptin (12.60+/-0.85 v8.53+/-0.56 ng/mL). Fasting plasma leptin concentrations remained significantly higher in the hyperinsulinemic quartile when comparisons were made after subdividing the population on the basis of gender, body mass index (BMI), or waist to hip ratio (WHR). These results demonstrate that fasting plasma leptin concentrations are significantly higher in hyperinsulinemic individuals, and this difference is independent of either overall or central obesity.
Asunto(s)
Ayuno/sangre , Insulina/sangre , Leptina/sangre , Administración Oral , Constitución Corporal , Índice de Masa Corporal , Femenino , Glucosa/farmacología , Humanos , Masculino , Persona de Mediana Edad , Concentración Osmolar , Valores de Referencia , Caracteres SexualesRESUMEN
A variety of detoxification methods have been utilized for the treatment of heroin withdrawal before individuals begin long-term opiate-free and naltrexone programs. While methadone in decreasing doses is still widely used for detoxication procedures, rapid and ultrarapid protocols including clonidine and opiate receptors antagonists have been proposed. This study compares the efficacy of different detoxification methods and investigates possible changes in naltrexone compliance. Ninety-eight heroin-addicted individuals were studied to evaluate withdrawal symptoms, craving, mood, urine toxicologic screens, and drop-out rate during therapy with: Group A: clonidine only (5 days); Group B: clonidine, oxazepam, baclofen, and ketoprofene with naloxone and naltrexone (2 days); and Group C: methadone in decreasing doses (10 days). Naltrexone compliance and relapse rates were evaluated during a 6-month follow-up period. Rapid detoxification with opiate antagonists (Group B) induced slight and transient withdrawal symptoms, and resulted in a significantly lower percentage of heroin catabolites in urine controls during the detoxification procedure, lower negative and positive craving, less mood problems, and higher compliance in extended naltrexone treatment. In comparison with clonidine only (Group A) and methadone (Group C), the early use of naltrexone during detoxification in combination with benzodiazepines and clonidine facilitated extended naltrexone acceptance and improved the recovery outcome in outpatients.
Asunto(s)
Agonistas alfa-Adrenérgicos/administración & dosificación , Antiinflamatorios no Esteroideos/administración & dosificación , GABAérgicos/administración & dosificación , Dependencia de Heroína/tratamiento farmacológico , Antagonistas de Narcóticos/administración & dosificación , Narcóticos/administración & dosificación , Síndrome de Abstinencia a Sustancias/prevención & control , Adolescente , Adulto , Baclofeno/administración & dosificación , Clonidina/administración & dosificación , Relación Dosis-Respuesta a Droga , Quimioterapia Combinada , Femenino , Dependencia de Heroína/orina , Humanos , Inactivación Metabólica , Cetoprofeno/administración & dosificación , Masculino , Metadona/administración & dosificación , Naloxona/administración & dosificación , Naltrexona/administración & dosificación , Oxazepam/administración & dosificación , Cooperación del Paciente , Síndrome de Abstinencia a Sustancias/tratamiento farmacológico , Síndrome de Abstinencia a Sustancias/orina , Resultado del TratamientoRESUMEN
BACKGROUND: Fifteen (+/-)3,4-Methylenedioxymethamphetamine (MDMA) users, who did not show other drug dependencies or prolonged alcohol abuse, and 15 control subjects were included in the study. METHODS: Prolactin (PRL) and cortisol (CORT) responses to the serotonergic agonist d-fenfluramine (D-fen), clinical psychobehavioral changes, and psychometric measures were evaluated 3 weeks and then 12 months after MDMA discontinuation. RESULTS: MDMA users showed significantly reduced PRL and CORT responses in comparison with control subjects at 3 weeks (respectively, p < .001; p < .005). The responses of PRL to D-fen were unmodified at 12 months after prolonged abstinence and were significantly reduced in comparison with controls (p < .001). In contrast, CORT responses in MDMA users were restored after 12 months of abstinence, with significantly higher responses to D-fen, in comparison with 3-week responses (p < .05). MDMA users' high scores on the Novelty Seeking (NS) scale on the Tridimensional Personality Questionnaire (TPQ) appeared unchanged by long-term abstinence. In contrast, Buss Durkee Hostility Inventory (BDHI) (Buss and Durkee 1957) direct and guilt scores decreased significantly after 12 months of abstinence. PRL AUCs at 12 months were inversely correlated with the measures of MDMA exposure (r = -.538). CONCLUSIONS: Our data indicate long-lasting 5-HT system impairment in abstinent MDMA users although the hypothesis of serotonergic changes attributable to a premorbid condition cannot be excluded. CORT restored responses to D-fen at 12 months, and the correlation of neuroendocrine changes with MDMA exposure suggest that the neuroendocrine impairment may be due to a partially reversible neurotoxic action of MDMA on the human brain.
Asunto(s)
Fenfluramina/metabolismo , Alucinógenos/farmacología , N-Metil-3,4-metilenodioxianfetamina/farmacología , Agonistas de Receptores de Serotonina/metabolismo , Trastornos Relacionados con Sustancias/metabolismo , Adolescente , Adulto , Conducta Exploratoria/fisiología , Fenfluramina/farmacología , Hostilidad , Humanos , Hidrocortisona/metabolismo , Masculino , Inventario de Personalidad , Prolactina/metabolismo , Agonistas de Receptores de Serotonina/farmacologíaRESUMEN
PURPOSE: Studies investigating temperament traits of drug abusers and their biological correlates have disclosed high rates of novelty seeking (NS) in opiate addicts, possibly based on dysfunctions of the dopaminergic (DA) system. The aims of the present study were to see whether or not the monoamine functions were impaired in detoxified addicts and whether or not these alterations were correlated with temperament traits, given the possibility that impairment of the biological and temperament parameters might be responsible for the development of addiction. METHODS: We have investigated the DA, serotonergic (5-HT), and noradrenergic (NE) functions in 22 abstinent heroin addicts and 22 healthy controls by challenging the monoamine systems with the DA agonist bromocriptine (brom), the 5-HT agonist D-fenfluramine (D-fen), and the NE agonist clonidine (clon), respectively. We examined the temperament traits by measuring NS, harm avoidance (HA), and reward dependence (RD) using the "Three-Dimensional Personality Questionnaire" (TPQ). RESULTS: Addicts showed higher than normal NS scores at TPQ blunted 5-HT function, and normal DA and NE activities, in response to the neuroendocrine challenges. NS correlated negatively with the DA function in both addicts and controls, and negatively with the 5-HT function only in addicts. HA correlated positively with 5-HT function in controls but not in addicts. IMPLICATIONS: The impairment in 5-HT function observed in heroin addicts and the changes in the biological correlates of temperamental traits could increase the proneness to addiction and possible comorbid psychiatric disorders.
Asunto(s)
Nivel de Alerta/fisiología , Dopamina/fisiología , Dependencia de Heroína/fisiopatología , Norepinefrina/fisiología , Serotonina/fisiología , Temperamento/fisiología , Adulto , Dependencia de Heroína/psicología , Dependencia de Heroína/rehabilitación , Humanos , Control Interno-Externo , Masculino , Motivación , Inventario de PersonalidadRESUMEN
OBJECTIVE: This study was conducted to determine the nature of the reaction of nonalcoholic adult children of alcoholic (ACOA) fathers to the experimental induction of aggression. Of particular interest was the relationship between biochemical factors and personality traits during a stressful event experienced by persons at risk for alcoholism. METHOD: Aggression was induced by a modified free-operant procedure in 14 ACOA and 14 non-ACOA subjects between 18 and 19 years of age with men and women represented in equal numbers. Neurotransmitter-hormonal assays from blood drawn immediately before, and 20 and 30 minutes after, starting the test included norepinephrine (NE), epinephrine (EPI), prolactin (PRL), growth hormone (GH) and cortisol (Cort). Personality traits were assessed by the Minnesota Multiphasic Personality Inventory (MMPI) Tridimensional Personality Questionnaire (TPQ) and the Buss-Durkee Hostility Inventory (BDHI). RESULTS: During the aggression induction session, ACOAs gained (F = 4.6, 1/13 df, p < .05) and subtracted (F = 9.2, 1/13 df, p < .005) significantly less money than non-ACOAs, evidence of lower outward-directed aggressiveness among ACOAs. Higher baseline plasma levels of Cort (F = 9.8, 1/13 df, p < .01) and PRL (F = 4.0, 1/13 df, p < .05) and decreased NE (F = 8.5, 1/13 df, p < .005) and GH (F = 10.9, 1/13 df, p < .001) responses during the experimental session were observed. On personality measures ACOAs scored higher than non-ACOAs on MMPI hysteria (F = 10.8, 1/13 df, p < .005), hypochondria (F = 20.1, 1/13 df, p < .001) and paranoia (F = 4.7, 1/13 df, p < 0.5) subscales, on the TPQ reward dependence (F = 10.9, 1/13 df, p < .005) subscale and on BDHI guilt (F = 15.7, 1/13 df, p < .001) and resentment (F = 6.4, 1/13 df, p < .05) subscales. CONCLUSION: These findings, preliminary in nature, support a hypothesis of inhibition of state and trait aggression in ACOAs in association with monoaminergic and endocrine changes.
Asunto(s)
Agresión/fisiología , Agresión/psicología , Alcoholismo/genética , Condicionamiento Operante/fisiología , Estrés Fisiológico/sangre , Adolescente , Adulto , Alcoholismo/sangre , Análisis de Varianza , Área Bajo la Curva , Biomarcadores/sangre , Femenino , Hormona del Crecimiento/sangre , Humanos , Hidrocortisona/sangre , Masculino , Norepinefrina/sangre , Pruebas de Personalidad , Prolactina/sangre , Psicometría , Estrés Fisiológico/psicología , Encuestas y CuestionariosRESUMEN
The study was initiated to evaluate the ability of hyperinsulinemia (as a surrogate measure of insulin resistance) to predict the development in a previously healthy population of three putative outcomes of this abnormality--glucose intolerance, hypertension, and coronary heart disease (CHD). The study involved defining the incidence at which these changes occurred between 1981 and 1993 to 1996 in 647 individuals who were free of any disease when initially studied. The study population consisted of approximately 90% of the subjects evaluated in 1981, divided into quartiles on the basis of the plasma insulin response to a glucose challenge as determined in 1981. The results indicated that the 25% of the population with the highest insulin response in 1981 had significant (P < .001) increases in the incidence of impaired glucose tolerance (IGT) or type 2 diabetes (eightfold), hypertension (twofold), or CHD (threefold). Furthermore, the ability of hyperinsulinemia to predict the three clinical endpoints was independent of differences in age, gender, or body mass index (BMI). Finally, if CHD is considered the clinical endpoint, multiple logistic regression analysis indicates that the values for plasma triglyceride (TG) and mean arterial blood pressure ([MAP] as measured in 1981) also predict the development of CHD. These results indicate that the untoward clinical effects of insulin resistance and/or compensatory hyperinsulinemia, glucose intolerance, hypertension, and CHD clearly can develop in less than 15 years.
Asunto(s)
Enfermedad Coronaria/etiología , Diabetes Mellitus Tipo 2/etiología , Hiperinsulinismo/complicaciones , Hipertensión/etiología , Adulto , Índice de Masa Corporal , Enfermedad Coronaria/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Femenino , Prueba de Tolerancia a la Glucosa , Humanos , Hiperinsulinismo/metabolismo , Hipertensión/metabolismo , Resistencia a la Insulina , Masculino , Valor Predictivo de las PruebasRESUMEN
Correlations between sensation-seeking (SS) personality dimension and plasma concentrations of norepinephrine (NE), epinephrine, and NE-dependent testosterone (T), cortisol and prolactin (PRL) were studied in 74 physically and psychologically healthy male volunteers, in order to see whether or not the noradrenergic system is involved in the modulation of this personality trait. Novelty-seeking scores by the Temperament and Character Inventory and SS scores on a Visual Analog Scale were positively correlated with plasma NE, T and PRL levels, suggesting that NE and the downstream cascade of NE-dependent hormones, together with other monoaminergic changes, might be responsible for the development and the degree of this temperamental character.