Although T3 exerts major regulatory actions in both animals and humans, most clinical studies of T3 administration have been relatively short term. The present study examined the effects of more than 2 months (63 days) of low dose T3 treatment on nitrogen balance, body composition, 24-h energy expenditure (EE), and protein turnover in seven healthy men studied at an in-patient metabolic unit. Subjects were also randomly assigned to either high or low fat diets to determine the effects of diet composition. T3 treatment produced significant losses in both lean mass (1.5 +/- 0.3 kg) and fat mass (2.7 +/- 0.4 kg) by 6 weeks, with similar reductions in both at 9 weeks. The high fat diet somewhat attenuated the loss of body fat. Nitrogen balance was significantly negative for the first 3 weeks of T3 treatment, but tended to return to baseline thereafter. There were no significant effects of treatment on protein turnover at 9 weeks, although there was a slight increase in leucine oxidation (P = 0.07). Despite the apparent adaptation in nitrogen balance, total 24-h EE and sleeping EE were significantly increased at 9 weeks. We conclude that although healthy men are able to adapt to mild hyperthyroidism in terms of nitrogen balance, they exhibit significant and persistent changes in fat and fat-free mass as well as energy balance.
Delusional parasitosis (DP) is a rare form of somatic delusions where a person believes that he or she is infected with worms, bugs, or other parasites. In the literature, DP has been discussed as a presenting feature of cortical dementias but has not been documented as a presenting feature in subcortical dementias such as HIV-associated dementia. We present a case of a 56-year-old male referred from the dermatology clinic for neuropsychological assessment after presenting with persisting claims that he was infected with "bugs" despite evidence to the contrary. The patient had a history of HIV and substance abuse. The patient was diagnosed with dementia due to HIV disease and psychosis due to dementia (i.e., DP) based on the neuropsychological evaluation. This case report suggests that neuropsychological evaluations may be indicated for patients presenting with DP and risk factors for either cortical or subcortical dementias such as HIV-associated dementia.
Previously developed validity measures are largely lacking in their ability to accurately distinguish malingerers from individuals with genuine intellectual disabilities (ID). The purpose of the present study was to develop a validity index for the Stanford-Binet Intelligence Scales-Fifth Edition (SB-5) aimed at detecting malingered ID. Fifty-four college students were instructed to feign impairment consistent with mental retardation while completing the SB-5. Simulated malingerers performed significantly poorer on the Block Span task of the SB-5 than did individuals with genuine impairment. A Block Span Validity Index (BSVI) cutoff score of less than 10 showed perfect specificity by correctly identifying all persons with true ID and demonstrated 52% sensitivity in identifying persons feigning impairment. For the detection of malingered ID, the BSVI yielded favorable results, although more research is needed to validate the BSVI using a known-groups study design.
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