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Subjective Feelings (subjective + feeling)
Selected AbstractsSubjective memory decline in healthy community-dwelling elders.ACTA NEUROLOGICA SCANDINAVICA, Issue 3 2010What does this complain mean? Balash Y, Mordechovich M, Shabtai H, Merims D, Giladi N. Subjective memory decline in healthy community-dwelling elders. What does this complain mean? Acta Neurol Scand: 2010: 121: 194,197. © 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard. Objectives,,, Subjective feelings of memory decline are fairly common among the elderly. The causes of this are heterogeneous, and may be related to both affective and cognitive disorders. We attempted to explore the associations between subjective and cognitive measures. Materials and Methods,,, Healthy subjects were studied. They completed questionnaires regarding memory difficulties and lifestyle habits, the Geriatric Depression scale (GDS), and the Spielberger State-Trait Anxiety Inventory. Cognitive functions were tested using the Mini-Mental State Exam and supplemented with NeuroTrax, a computerized neurophysiological battery. Univariate logistic regression model was applied to estimate odd ratios (OR) and 95% confidence intervals of associations. Results,,, Of 341 consecutive non-depressed subjects, 257 participants (75.4%) reported subjective memory decline (SMD). Subjects with and without SMD did not differ in age, gender, education, marital status, employment and life-style. Subjects with SMD had elevated GDS scores (OR = 1.14, 95% CI: 1.003,1.29), white anxiety level showed a tendency to be increased (OR = 1.03, 95% CI: 0.99,1.06). Comparison of cognitive performance has not revealed differences in cognitive domains between subjects with and without SMD. Conclusions,,, SMD in healthy elderly people is associated with sub-clinical depression even among those without objectively measured cognitive decline. [source] Effect of Nigella sativa (black seed) on subjective feeling in patients with allergic diseasesPHYTOTHERAPY RESEARCH, Issue 10 2003Ulrich Kalus Abstract Nigella sativa (black seed) is an important medicinal herb. In many Arabian, Asian and African countries, black seed oil is used as a natural remedy for a wide range of diseases, including various allergies. The plant's mechanism of action is still largely unknown. Due to the lack of study data on its ef,cacy in allergies, four studies on the clinical ef,cacy of Nigella sativa in allergic diseases are presented. In these studies, a total of 152 patients with allergic diseases (allergic rhinitis, bronchial asthma, atopic eczema) were treated with Nigella sativa oil, given in capsules at a dose of 40 to 80 mg/kg/day. The patients scored the subjective severity of target symptoms using a prede,ned scale. The following laboratory parameters were investigated: IgE, eosinophil count, endogenous cortisol in plasma and urine, ACTH, triglycerides, total cholesterol, LDL and HDL cholesterol and lymphocyte subpopulations. The score of subjective feeling decreased over the course of treatment with black seed oil in all four studies. A slight decrease in plasma triglycerides and a discrete increase in HDL cholesterol occurred while the lymphocyte subpopulations, endogenous cortisol levels and ACTH release remained unchanged. Black seed oil therefore proved to be an effective adjuvant for the treatment of allergic diseases. Copyright © 2003 John Wiley & Sons, Ltd. [source] False memories: What the hell are they for?APPLIED COGNITIVE PSYCHOLOGY, Issue 8 2009Eryn J. Newman Recollecting the past is often accompanied by a sense of veracity,a subjective feeling that we are reencountering fragments of an episode as it occurred. Yet years of research suggest that we can be surprisingly inaccurate in what we recall. People can make relatively minor memory errors such as misremembering attributes of past selves and misremembering details of shocking public events. But sometimes these errors are more extreme, such as experiencing illusory recollections of entire childhood events that did not really happen. Why would the memory system fail us, sometimes very dramatically? We examine various false memory phenomena by first considering them to be a by-product of a powerful and flexible memory system. We then explore the idea that a system that is capable of mentally revising the past serves a predictive function for the future. Finally, we consider the possibility that false memories meet self-image and social needs. Copyright © 2009 John Wiley & Sons, Ltd. [source] Optimizing open live-donor nephrectomy , long-term donor outcomeCLINICAL TRANSPLANTATION, Issue 3 2004M Schostak Abstract:, Introduction:, The technique of laparoscopic or retroperitoneoscopic donor nephrectomy has been increasingly propagated in recent years. The central advantage is supposed to be a reduction of perioperative discomfort. However, there have not been many reports describing the subjective feeling associated with an open donor nephrectomy, particularly with respect to the pain level in the perioperative and long-term course. This retrospective study examines the perioperative pain and morbidity and long-term outcome of living kidney donors from 35 yr of experience at the University Hospital Benjamin Franklin of the Free University of Berlin. Methods:, A total of 102 living kidney donors were asked to fill out a questionnaire. Five epidemiological questions were posed and the rest dealt mainly with lasting subjective and objective surgical impairments. There were also questions relating to the perioperative pain level (VAS/NAS-Score). In addition, basic information was obtained regarding the donor's current health status (physical examination, serum creatinine; sometimes also ultrasound, protein IU, blood pressure), and/or examinations were performed. Results:, The mean age at the time of donation was 45.5 and 55% were women. Donor nephrectomies were left-sided in 78 cases and right-sided in 24. There was a total complication rate of 53%, but serious complications only occurred in two cases (1.9%). A total of 53 donors could be reached. Although 41.5% felt they had a lasting impairment, somatic sequelae like respiratory, abdominal or scar problems were rare, affecting a maximum of only four patients in each case. Fifteen patients reported neurological problems such as sensory disturbances. The mean serum creatinine was 89.9 ,mol/L in female and 114.2 ,mol/L in male donors. Microalbuminuria was found in 22.6% of the donors, hypertension in 35.8%. Persistent pain was reported by 20.7%, its occurrence being permanent in two of the donors and very frequent in one. All the others rarely have pain. The median perioperative VAS/NAS score was 8 on the first day after surgery, 5 after 1 wk and 1 after 1 month. The analgesia was rated as good or very good by 71%. Everyday life was managed as well as before surgery after 2,4 wk by the highest percentage (42%) of patients, but working capacity was only regained after 1,3 months by a comparable percentage (44%). Forty-six percent had a very good and 33% a good feeling after the kidney donation. The relationship to the recipient had intensified in most cases. Ninety-one percent would again decide in favor of a donation. Conclusion:, Donor nephrectomy in an open technique is a safe and reliable procedure with low morbidity. After a median post-operative period of 7 yr, however, 42% of the donors still report general impairment due to the intervention, although concrete somatic problems were only detected in a few cases. Nearly all these patients underwent surgery in a full flank position. Wound-healing impairments were also significantly more frequent with this surgical technique. This positioning should thus be avoided. The post-operative pain level was relatively high, but a marked improvement was achieved in the course of the observation period by optimizing analgesic management. [source] Neural activity related to the processing of increasing monetary reward in smokers and nonsmokersEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 3 2003C. Martin-Soelch Abstract This study investigated the processing of increasing monetary reward in nonsmoking and smoking subjects. The choice of the subject populations has been motivated by the observation of differences between nonsmokers and smokers in response to rewarding stimuli in a previous study. Subjects performed a pattern recognition task with delayed response, while rCBF was measured with [\mathrm{H}^{15}_{2}O] PET. Correct responses to the task were reinforced with three different amounts of monetary reward. The subjects received the sum of the rewards at the end of the experiment. The results show that a cortico-subcortical loop, including the dorsolateral prefrontal cortex, the orbitofrontal cortex, the cingulate gyrus and the thalamus is involved in processing increasing monetary reward. Furthermore, the striatal response differentiates nonsmokers from smokers. Thus, we found significant correlations between rCBF increases in striatum and increasing monetary reward and between striatal rCBF increases and mood in nonsmokers, but not in smokers. Moreover, no significant mood changes among the different monetary rewards could be observed in smokers. We infer that the response of the striatum to reward is related to changes in subjective feelings. The differences between smokers and nonsmokers confirm our previous conclusions that the association between blood flow, performance, mood and amount of reward is more direct in nonsmokers. [source] Valuing health: a new proposalHEALTH ECONOMICS, Issue 3 2010Daniel M. Hausman Abstract After criticizing existing systems of health measurement for their unargued commitment to evaluating health states in terms of preferences or well-being, this essay argues that public rather than private values of health states should help guide the allocation of health-related resources. Private evaluation of health states is relative to a prior individual choice of specific activities and goals, while public evaluation is relative to the whole range of important activities and goals. Public evaluation is concerned with securing a wide range of choices as well as with success given one's choice. A reasonable simplification from the public perspective is to focus on just two features of health states: the subjective feelings attached to health states and the limitations that health states imply on the range of important activities that individuals can pursue. Focusing on just these two dimensions permits the construction of a parsimonious classification of health states with regard to what matters most from the public perspective. This classification, which resembles those in the HALex and the Rosser and Kind Disability and Distress Index, might best be built on top of existing health-state classifications, by mapping the health states they define to activity-limitation/feeling pairs. To assign values to these pairs, I propose relying on deliberative groups to make comparisons among the pairs with respect to the relation ,is a more serious limitation on the range of objectives and good lives available to members of the population'. A ranking according to this property, is not a preference ranking, because it is not a ranking in terms of everything that matters to individuals. Working back from the weights attached to the activity-limitation/feeling pairs, one can impute weights for the health states in other classification systems that were mapped to those pairs. If those weights coincide roughly with current weights, then one legitimizes current weights and provides a vehicle for their public discussion and possible revision. If those weights do not coincide, then one has both an argument for revising current views of the cost effectiveness of treatments and policies and a method to carry out such a revision. Copyright © 2009 John Wiley & Sons, Ltd. [source] Neural systems connecting interoceptive awareness and feelingsHUMAN BRAIN MAPPING, Issue 1 2007Olga Pollatos Abstract In many theories of emotions the representations of bodily responses play an important role for subjective feelings. We tested the hypothesis that the perception of bodily states is positively related to the experienced intensity of feelings as well as to the activity of first-order and second-order brain structures involved in the processing of feelings. Using a heartbeat perception task, subjects were separated into groups with either high or poor interoceptive awareness. During emotional picture presentation we measured high-density EEG and used spatiotemporal current density reconstruction to identify regions involved in both interoceptive awareness and emotion processing. We observed a positive relation between interoceptive awareness and the experienced intensity of emotions. Furthermore, the P300 amplitudes to pleasant and unpleasant pictures were enhanced for subjects with high interoceptive awareness. The source reconstruction revealed that interoceptive awareness is related to an enhanced activation in both first-order structures (insula, somatosensory cortices) and second-order structures (anterior cingulate, prefrontal cortices). We conclude that the perception of bodily states is a crucial determinant for the processing and the subjective experience of feelings. Hum. Brain Mapping, 2007. © 2006 Wiley-Liss, Inc. [source] Objective determination of fatigue development following sun exposure using Advanced Trail Making TestINTERNATIONAL JOURNAL OF COSMETIC SCIENCE, Issue 1 2004T. Horikoshi Synopsis Sun exposure during leisure activity evokes fatigue. We employed the Advanced Trail Making Test (ATMT), a recently developed objective method of evaluating brain function performance used to measure mental fatigue, for objective determination of fatigue development caused by solar exposure to the human body. First, a survey of consumer awareness was performed, and fatigue development from solar exposure was generally recognized in both summer and spring. In the field test, 15 males (26,41 years old) received sun exposure equivalent to 100 kJ m,2 of ultraviolet radiation three to four times each day for 3 days, during which the subjects wore a short sleeve shirt and a short pant, and covered their head with a towel. A significant increase in scores for subjective sense of fatigue was observed in the evening of all 3 days following sun exposure and on the fourth day, which had no exposure, as well as in the morning of the third and fourth days, as compared with those periods during the control week, which did not have experimental solar exposure. ATMT showed a significant increase in average value in the evening of the first and second days following sun exposure, as well as in the morning of the third and fourth days. In addition, increases in body temperature and heart rate were observed during the exposure periods. The results of multiple regression analysis of subjective feelings showed that fatigue caused by solar exposure was qualitatively different from that in the control week. These results suggest that brain function performance declined following solar exposure as did fatigue development. ATMT results may be useful for quantitative and objective evaluation of mental fatigue caused by sun exposure, along with development of sun care products for the prevention of solar-caused fatigue. Résumé L'exposition au soleil pendant les activités de loisir provoque la fatigue. Nous avons utilisé la méthode ,Advanced Trail Making Test (ATMT)', une méthode d'évaluation objective de la faculté du fonctionnement du cerveau, récemment développée pour mesurer la fatigue mentale, dans le but de déterminer objectivement le processus de la fatigue du corps humain causée par l'exposition au soleil. Premièrement, nous avons mené un sondage sur la conscience du consommateur, et une évolution de la fatigue venant de l'exposition au soleil a été notée dans l'ensemble au printemps et en été. Lors des expériences sur le terrain, 15 sujets mâles (de 26 à 41 ans) ont été exposés au soleil, 3 à 4 fois par jour, pendant 3 jours. L'exposition était égale à 100 kJ m,2 de radiation ultraviolette. Pendant ces 3 jours, les sujets étaient vêtus d'une chemize à manches courtes et d'un pantalon court, et avaient la tête couverte d'une serviette. Nous avons observé une augmentation considérable du score représentant la sensation subjective de fatigue le soir des 3 jours suivant l'exposition au soleil, et le soir du quatrième jour, sans exposition, de même que le matin des troisième et quatrième jours, en comparaison avec les mêmes périodes de la semaine de contrôle, sans exposition expérimentale au soleil. Les résultats du test de l'ATMT ont montré une augmentation considérable de la valeur moyenne le soir des premier et second jours suivant l'exposition au soleil, aussi bien que le matin des troisième et quatrième jours. De plus, nous avons observé une augmentation de la température du corps et du pouls pendant les moments d'exposition. L'analyse de régression multiple des résultats de la sensation subjective a montré que la fatigue causée par l'exposition était qualitativement différente que celle de la semaine de contrôle. Ces résultats suggèrent que la faculté de fonctionnement du cerveau baisse après l'exposition au soleil, comme le fait la fatigue. Les résultats de l'ATMT peuvent être utiles pour l'évaluation quantitative et objective de la fatigue mentale causée par l'exposition au soleil, ceci allant de pair avec le développement des produits de soin contre le soleil pour la prévention de la fatigue causée par le soleil. [source] Cognitive variables and depressed mood in adults with intellectual disabilityJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 7 2005A. J. Esbensen Abstract Background Cognitive theory forms the foundation for cognitive therapy. There has been little research on cognitive theories and cognitive variables associated with depression in individuals with intellectual disability (ID). The current study examined cognitive variables of automatic thoughts, cognitive triad, hopelessness, attributions and self-esteem associated with two cognitive theories of depression: Beck's Cognitive Triad theory and the Hopelessness theory of depression. Methods Seventy-three adults with ID screened for adequate receptive vocabulary were interviewed as part of a larger study. They reported on cognitive constructs relating to depressed mood. In addition, comparisons were made between 12 adults with ID and diagnosed major depression and a matched group of 12 adults with ID and no psychiatric diagnoses in order to determine if these groups differed on the cognitive constructs associated with the two cognitive theories of depression. Results The cognitive variables examined were all significantly correlated with depressed mood in the direction predicted by their respective cognitive theory. Internal consistencies were good or excellent for most instruments, with the exception of those measuring hopelessness and attributions. In addition, significant differences were obtained between groups of individuals with and without co-morbid major depression on all variables except for hopelessness. Conclusions The results indicate that adults with ID screened for adequate receptive vocabulary are capable of reporting on subjective feelings of depressed mood and associated cognition constructs. The instruments used may be suitable for this population as they generally possessed sound internal consistencies. The results support the further examination of cognitive theories of depression among individuals with ID in order to assess the appropriateness of cognitive therapies for this population. Discrepant findings regarding hopelessness are discussed. [source] The Overlap in Predicting Alcohol Outcome for Two Measures of the Level of Response to AlcoholALCOHOLISM, Issue 3 2009Marc A. Schuckit Background:, Two different measures have been used to establish a person's level of response (LR) to alcohol as a risk factor for alcohol use disorders. LR values established by the alcohol challenge protocol and the Self-Report of the Effects of Ethanol (SRE) questionnaire usually correlate at 0.3 to 0.4, up to 0.6. However, it is not clear how this correlation relates to the ability of each measure to predict alcohol outcomes. This paper evaluates that overlap. Methods:, Sixty-six Caucasian males (mean age = 22 years) from 2 protocols participated in alcohol challenges with 0.75 ml/kg of ethanol, filled out the SRE, and were followed with a structured interview ,5 years later. The relationship between the subjective feelings of intoxication at the time of peak breath alcohol levels from the alcohol challenge and the SRE score for a time early in the drinking career were evaluated regarding predicting the drinks per occasion in the 6 months prior to follow-up. Results:, Cross-sectional correlations between alcohol challenge and SRE LR's ranged from ,0.25 (p < 0.05) to ,0.32 (p = 0.02) for the full sample, and the 2 LR measures correlated with drinking at follow-up (,0.26 and 0.41, respectively). The SRE measure was more robust than the challenge in a regression analysis predicting the outcome in the context of other baseline predictors (e.g., drinking at baseline). As much as 60% of the ability of the more well established (gold standard) alcohol challenge LR to predict outcome was shared with the SRE. The alcohol challenge accounted for as much as 44% of the ability of the SRE to predict outcome. Conclusions:, The SRE-generated LR overlapped considerably with the alcohol challenge LR in the ability to predict future heavier drinking. [source] An Expanded Evaluation of the Relationship of Four Alleles to the Level of Response to Alcohol and the Alcoholism RiskALCOHOLISM, Issue 1 2005Xianzhang Hu Background: Alcoholism is a complex, genetically influenced disorder the cause of which may be better understood through the study of genetically influenced phenotypes that mediate the risk. One such intermediate phenotype is the low level of response (LR) to alcohol. This project used a case-control approach to search for genes that may contribute to LR. Methods: Data were available from alcohol challenges at approximately age 20 and regarding the development of alcohol use disorders over the subsequent 20 years for 85 men, including 40 reported in a previous genetic analysis. LR was evaluated using oral consumption of 0.75 ml/kg of alcohol, after which changes in subjective feelings of intoxication and body sway were measured. Alcohol abuse and dependence were diagnosed by DSM-III-R criteria through structured interviews administered to both the participant and an informant (usually the spouse) 10, 15, and 20 years after initial testing. Four polymorphisms were evaluated, including the serotonin transporter HTTLPR promoter ins/del, GABAA,6 Pro385Ser, NPY Leu7Pro, and catalase 262C>T. Two of these, HTTLPR and GABAA,6 Pro385Ser, had been previously associated with LR and alcoholism in a preliminary study. Results: The HTTLPR L allele was significantly related to both the LR and alcoholism in an allele-dosage (stepwise) manner. Furthermore, the association remained when L alleles were subdivided into recently reported functional subtypes: the lowest LR was associated with genotypes correlated with the highest serotonin transporter expression. The GABAA,6 Ser385 allele showed a nonsignificant trend for association to a low LR, as had been previously observed, although the Ser385 allele is uncommon, and only 18 heterozygotes were in the current group. However, the six men with both LL and Pro385/Ser385 genotypes had the lowest LR, and each had developed alcoholism during follow-up. Neither NPY nor catalase was associated with either LR or alcoholic outcomes, although the sample did not have sufficient power for definitive conclusions. Conclusions: This report strengthens the support for a relationship between the HTTLPR L and GABAA,6 Ser385 alleles to low alcohol LR and to alcoholism in a prospectively studied cohort evaluated for LR in young adulthood and before the onset of alcohol dependence. [source] A Polymorphism of the ,-Opioid Receptor Gene (OPRM1) and Sensitivity to the Effects of Alcohol in HumansALCOHOLISM, Issue 12 2004Lara A. Ray Background: Recent research has implicated the endogenous opioid system in the development of alcohol use disorders. The A118G polymorphism of the OPRM1 gene has been shown to confer functional differences to ,-opioid receptors, such that the G variant binds ,-endorphin three times more strongly than the A variant. The goal of this study was to test whether the A118G polymorphism is associated with sensitivity to the effects of alcohol. Methods: Participants who were either homozygous for the A allele (n= 23) or heterozygous (n= 15) received intravenous doses of alcohol designed to reach three target levels of breath alcohol concentration: 0.02, 0.04, and 0.06. The testing procedure consisted of measures of subjective intoxication, stimulation, sedation, and mood states at baseline and at each of the three target breath alcohol concentrations. Results: The results suggested that individuals with the G allele reported higher subjective feelings of intoxication, stimulation, sedation, and happiness across trials as compared with participants with the A allele. Furthermore, participants with the G allele were almost three times more likely to report a positive family history of alcohol use disorders than participants with the A allele. Conclusions: These findings may help to explain previous research suggesting that naltrexone is more effective among individuals with the G allele. A medication that reduces feelings of euphoria after alcohol consumption may be more successful among individuals with a genetic predisposition to greater feelings of euphoria after consuming alcohol. [source] Findings Across Subgroups Regarding the Level of Response to Alcohol as a Risk Factor for Alcohol Use Disorders: A College Population of Women and LatinosALCOHOLISM, Issue 10 2004Marc A. Schuckit Background: The rates of alcohol dependence, a genetically influenced disorder, are increased among Latino men in the United States and are lower among women across ethnic groups. These analyses explored whether the differential rate of alcohol use disorders (AUDs) might reflect one genetically influenced phenotype related to alcoholism risk: the low level of response (LR) to alcohol. Methods: A questionnaire was mailed to students at two universities to identify drinking but not alcohol-dependent 18- to 29-year-old men and women who had a parent with alcohol dependence. Subjects were subsequently screened with a validated semistructured interview to corroborate the personal and family histories, and they participated in a challenge with alcohol 0.75 ml/kg for women and 0.90 ml/kg for men. LRs to alcohol were determined and compared between genders and between Latino versus Caucasian/Anglo subjects. Results: The data revealed no consistent significant differences between genders regarding either subjective feelings of intoxication or alcohol-induced changes in body sway. A similar lack of differential between groups was observed when Latino and Caucasian/Anglo subjects were compared. However, there was at least a statistical trend for interactions when gender, ethnicity, and time were considered together; there was some evidence for a higher LR in Latina women. Perhaps reflecting the different weights and doses of alcohol used, men demonstrated higher breath alcohol concentrations, but no differences in these values were noted between Latino and Anglo populations. Conclusions: The results indicate that the LR to alcohol is not likely to explain differences in rates of AUDs between genders or these two ethnic groups overall. The possibility that a higher LR might be seen for the subgroup with the lowest AUD rate,Latina women,will require replication in larger samples of well matched groups before definitive conclusions can be drawn. [source] Effectiveness of two conservative modes of physical therapy in women with urinary stress incontinenceNEUROUROLOGY AND URODYNAMICS, Issue 5 2001Tiina Arvonen Abstract Stress incontinence is the most prevalent form of female urinary incontinence and it affects approximately 5% of younger women to nearly 50% of elderly women. Women have traditionally been treated with pelvic floor muscle exercises alone or with the use of vaginal cones. A new treatment mode, vaginal balls, has been developed. The aim of this study was to compare pelvic floor muscle training with and without vaginal balls and to collect information on women's subjective feelings about the two training modes. The study was carried out as a prospective randomized clinical trial. Thirty-seven women aged 25,65 were assigned either to a pelvic floor muscle training program or to a training program using weighted vaginal balls for 4 months. Treatment outcomes were assessed by a pad-test with a standardized bladder volume, vaginal palpation, and by women's self-reported perceptions. The sense of coherence score was compared with the score for a normal population. Ninety-three percent of the women completed the study. Both training modes were effective in reducing urinary leakage: with vaginal balls (P,<,0.0001) and without (P,<,0.019); and increasing pelvic floor muscle strength: with vaginal balls (P,<,0.0039) and without (P,<,0.0002). However, the reduction of urinary leakage after four months of exercise in the training group with vaginal balls was significantly better (P,<,0.03) than the results in the group training with pelvic floor muscle exercises alone. The study found the weighted vaginal balls to be a good alternative for training pelvic floor muscles in women with stress urinary incontinence. Neurourol. Urodynam. 20:591,599, 2001. © 2001 Wiley-Liss, Inc. [source] Prevalence of acute and post-traumatic stress disorder and comorbid mental disorders in breast cancer patients during primary cancer care: a prospective studyPSYCHO-ONCOLOGY, Issue 3 2007Anja Mehnert Abstract This study aimed at the identification of acute and post-traumatic stress responses, and comorbid mental disorders in breast cancer patients. Structured clinical interviews for DSM-IV (SCID) were conducted post-surgery with 127 patients (t1). Screening measures were used to assess post-traumatic stress responses, anxiety, and depression at t1 and at 6 months follow-up (t2). Based on the SCID, prevalence rates were 2.4% for both, cancer-related ASD and PTSD. Experiences most frequently described as traumatic were the cancer diagnosis itself and subsequent feelings of uncertainty. Patients with lifetime PTSD (8.7%) were more likely to meet the criteria for cancer-related ASD or PTSD (OR=14.1). Prevalence estimates were 7.1% for Adjustment Disorder, 4.7% for Major Depression, 3.1% for Dysthymic Disorder and 6.3% for Generalized Anxiety Disorder. Using the screening instruments, IES-R, PCL-C and HADS, we found PTSD in 18.5% at t1 and 11.2,16.3% at t2. The estimates of anxiety and depression reveal rates of 39.6% (t1) and 32.7% (t2) for anxiety, as well as 16.0% (t1) and 13.3% (t2) for depression (t1) (cut-off,8). The diagnosis of a life-threatening illness has been included as a potential trauma in the DSM-IV. However, it has to be critically evaluated whether subjective feelings of uncertainty like fears of treatment count among traumatic stressors, and thus, whether the diagnosis of PTSD is appropriate in this group of cancer patients. However, a large number of women with emotional distress illustrate the need for psychosocial counseling and support in this early treatment phase. Copyright © 2006 John Wiley & Sons, Ltd. [source] Corticosteroids and the cardiovascular response to stress: a pilot study of the 35% CO2 challenge in Addison's diseaseCLINICAL ENDOCRINOLOGY, Issue 3 2006J. M. Kaye Summary Objective, Glucocorticoids play an essential role in the neuroendocrine response to stress, influencing both the hypothalamic,pituitary,adrenal (HPA) axis and the sympatho-adrenomedullary (SAM) axis at several levels. In this pilot study, a clinical model of primary adrenocortical failure (Addison's disease, AD) has been used to evaluate the role of circulating glucocorticoids in both the autonomic and psychological response to stress. Design and subjects, Five subjects with known AD underwent a randomized, double-blind, placebo-controlled investigation in which they received fixed glucocorticoid plus mineralocorticoid hormone replacement or placebo for 48 h prior to a 35% CO2 challenge. Measurement, Psychological responses immediately before and after CO2 exposure were assessed by questionnaire. Systolic blood pressure (SBP) and heart rate were measured automatically at 1-min intervals for 5 min before and 5 min after the CO2 exposure. Results, While on hormone replacement, all subjects had an identical response to CO2 to that recorded in normal volunteers (initial bradycardia, an increase in blood pressure and subjective feelings of anxiety). On no replacement, however, the bradycardia and anxiety responses were not significantly altered, but the pressor response was markedly attenuated (+15·6 ± 5 mmHg on replacement compared with +4·2 ± 3·3 mmHg off replacement; P = 0·043). Conclusions, These data provide further evidence that the CO2 -induced bradycardia is a direct , presumably parasympathetic , response to CO2 independent of the pressor effect, and that the pressor response itself is dependent on the presence of the circulating corticosteroid. [source] Ventilation threshold as a measure of impaired physical performance in adults with growth hormone excessCLINICAL ENDOCRINOLOGY, Issue 3 2002Scott G. Thomas Summary objective Fatigue is a prominent symptom among patients with GH excess and acromegaly. Identifying the physiological basis of such complaints and obtaining objective measures to quantify their severity remains an ongoing challenge. We investigated whether submaximal measures of aerobic performance can be used to assess GH excess-associated fatigue objectively. design and patients To investigate this possibility we examined the relation between physical function and physical capacity in 12 patients with active acromegaly and persistent fatigue before and after 3 and 6 months of treatment with the long-acting somatostatin analogue octreotide (LAR®). measurements Heart rate (HR) and rating of perceived exertion (RPE using Borg's 10-point scale) were measured during a 160-metre self-paced walk test (SPW). Maximum oxygen uptake (VO2max) and ventilation threshold (VeT: a measure of work rate when breathlessness develops) were measured during a progressive treadmill test to fatigue or symptom-limited maximum. The Profile Of Mood States questionnaire (POMS) was used to quantify subjective feelings of fatigue and vigour. Morning fasting levels of GH and IGF-I were measured using immunoassay of serum samples. results SPW speed at a fast pace of 1·69 ± 0·18 m/s was achieved with higher than normal HR (112 ± 15/min; normal = 102) and RPE (2·4 ± 1·2). Similar to GH-deficient adults, VO2max (22·6 ± 6·4 ml.kg,1.min,1; normal ~30 ml.kg,1.min,1) and VeT (13·1 ± 2·9 ml.kg,1.min,1; predicted normal ~16 ml.kg,1(min,1) were low. However, VeT occurred at a normal fraction of VO2max (VeT/VO2max = 0·58). VeT was significantly increased and plasma IGF-I levels reduced following 3 and 6 months of octreotide LAR® treatment. Reduction in circulating IGF-I levels was correlated with improvement in reported vigour (r = 0·85) and VeT (r = 0·65) (P < 0·05). conclusions Our findings demonstrate impairment in physical function and physical capacity consistent with the perception of increased fatigue among acromegalic patients. These objective measures of compromised physical function are similar to the changes that we have reported previously in adults with GH deficiency. Taken together, these data suggest that a narrow window for GH/IGF-I levels is required to maintain optimal physical function. [source] | |||||||||||||