Introduction:It is important to assess the interaction between family psychopathologic history (FH), family dynamics (FD), behavior disorders, substance-use disorders and personality disorders (PD). Methodology: Cross-sectional design. The sample was made up of 350 subjects with substance-use disorders who were assessed for FH including alcoholism and substance-use disorders through an interview; for substance use via a questionnaire; for FD; for PD using the International Personality Disorder Examination (IPDE); for behavior problems in adolescence; and for disocial disorder. Correlated variables were included in logistic regression models. Results: Early age of onset for substance use is related to FH of substanceuse disorders and poorer FD. FH of alcoholism, substance-use disorders and psychiatric disorders are related to poorer FD. Early age of onset for substance use, FH and a disruptive FD are related to behavior problems and disocial disorder. Early age of onset for substance use, FH, disruptive FD, behavior problems and disocial disorder are related to presence of PD. Logistic regression predicted the presence of PD by age of onset for use of methadone (CI (95) RESUMEN ABSTRACTIntroducción: Es importante evaluar la interacción entre los antecedentes psicopatológicos familiares (AF), la dinámica familiar (DF), los trastornos de conducta, los trastornos por uso de sustancias y los trastornos de personalidad (TP). Metodología: Estudio transversal con 350 drogodependientes evaluados los AF psiquiátricos, de alcoholismo y de drogodependencias; la DF; consumo de sustancias; y la presencia de TP, los problemas de conducta (PC) en la adolescencia y el trastorno disocial (TD). Las variables correlacionadas fueron incluidas en varios modelos de regresión logística. Resultados: Una edad de inicio en el consumo más temprana se relaciona con AF de drogodependencia y peor DF. Los AF de alcoholismo, drogodependencias y psiquiátricos se relacionan con peor DF. Edad de inicio en el consumo más temprana, los AF y una peor DF se relacionan con los PC y el TD. Edad de inicio en el consumo más temprana, tener AF, una peor DF, los PC y el TD se relacionan con la presencia de algún TP. Permiten predecir la presencia de algún TP la edad de inicio en el consumo de metadona (IC(95):1,005/3,222; p=0,048) y de otros opiáceos (IC(95):0,233/0,894; p=0,022). La puntuación en AF de alcoholismo permite predecir la presencia de TP límite (IC(95):1,137-2,942; p=0,013), y la edad de inicio en el consumo de cocaína permite predecir la presencia de TP antisocial (IC(95):0,864/0,992; p=0,028). Conclusiones: Los AF de consumo de sustancias y el consumo propio, predicen la presencia de algunos TP.
Bone allografts are often used in reconstructive mandibular surgery, generally after extensive oncologic resection, post-traumatic pseudoarthrosis, or osteomyelitis. Vascularized fibular bone grafts have advantages compared with other bone grafts in the restoration of the contour and function of defective mandibles. Bone scintigraphy is often used to assess bone revascularization, because positive uptake of Tc-99m hydroxy methylene diphosphonate (HDP) reflects patent anastomoses and viability of the grafted bone. Mandibular reconstruction with a free fibular flap was performed in 11 patients. Bone scintigraphy and SPECT were applied in the follow-up of eight patients. The grafts were assessed semi-quantitatively using a six-grade scoring system based on a comparison of tracer uptake in the graft and in the calvarium. Complications were observed in one graft. Planar scintigrams showed a tracer uptake greater than grade 5 in grafts with an uncomplicated course. SPECT was performed in addition to planar imaging in two patients who had greater graft uptake. A lack of tracer uptake was observed in the failed graft. Bone scintigraphy performed within the first week after the mandibular reconstruction is a useful tool to monitor the viability and early complications of microvascularized fibular grafts and plays an important role in the decision-making process during repeated surgical exploration. SPECT is more sensitive than planar imaging for assessing graft viability.
Introducción: Los sujetos dependientes de sustancias presentan algunos rasgos de personalidad comunes, pero no se ha podido demostrar que la presencia de estas características determine la adicción. Se pretende analizar la actividad cerebral en un grupo de pacientes con dependencia de opiáceos más Trastorno Límite de Personalidad (TLP) o Trastorno de Personalidad No Especificado (TPNE).Método: Se comparó una muestra de 25 sujetos con patología dual con 17 sujetos sanos. Se obtuvieron imágenes SPECT utilizando como trazador radioactivo el Tc99m-ECD por vía intravenosa. Los datos se analizaron con el paquete de software Entegra.Resultados: Al comparar el grupo de adictos con TPNE con el grupo de control, se apreciaron diferencias estadísticamente significativas en el número de cuentas registradas en el tálamo ( =9043,26; p<0,029) lo que evidencia una menor actividad talámica en estos sujetos respecto a aquellos que no presentaban patología. No se observaron diferencias estadísticamente significativas en el resto de comparaciones.Conclusión: Los pacientes con adicción a opiáceos y TPNE presentan un patrón de hipoactividad talámica comparados con un grupo de sujetos normales. Este hecho nos puede ayudar en el entendimiento de la etiología de estos trastornos, al menos en el subgrupo de pacientes con patología dual. AbstractIntroduction: Patients with substance abuse show some common personality characteristics but it has not been possible to demonstrate that the presence of these characteristics determines their addiction. In the present investigation we tried to analyze cerebral activity in a group of patients with dependency on opiates and Borderline Personality Disorder (BPD) or Personality Disorder Not Otherwise Specified (PDNOS).Method: Cross-sectional study of an observational type with descriptive and analytical components in a sample of 25 subjects with dual pathology in comparision with 17 healthy subjects. SPECT images were acquired using 99mTC-ECD (Tcm-Ethyl Cysteinate Die-thylester) by intravenous route as a radioactive tracer. Data were analyzed with the software package Entegra.Results: When we compared subjects with PDNOS to the control group, statistically significant differences in the number of counts registered in the thalamus were noticeable ( =9043.26; p<0.029), which demonstrates less thalamic activity in PDNOS subjects with respect to healthy subjects. Statistically significant differences in the rest of comparisons between groups were not observed.93 Trastornos de personalidad y adicción a opiáceos: un estudio descriptivo Health and Addictions / Salud y Drogas 2010, Vol. 10, nº 2, pp. 91-110Conclusion: Pacients with PDNOS and adiction show a thalamic hypoactivity pattern. This conclusion could help us in the understanding of the pathogenesis of this disorder and its differentiation from the other PD, like BPD, at least in patients with dual pathology.
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