A lthough endocrine abnormalities are recognized in opiate users, very little is known about the range of hormones affected, their pathophysiology and their clinical relevance. Various endocrine abnormalities have been reported in these patients including, increased prolactin levels and abnormalities in sexual hormone. Path physiological mechanism postulated does explain these findings including direct action of heroin or methadone at the hypothalamic pituitary level. The aim of this study was to explore the effects of heroin and methadone maintenance treatment on the plasma prolactin levels and sexual function. Material and methods: We evaluated 20 male narcotic addicts maintained of methadone more than 3 years on oral high dose methadone 60-120 mgr/day. Patients taking neuroleptic therapy were excluded from the study because neuroleptic-included hyperprolactinemia. We also evaluated group of twenty male heroin addicts on the street heroin .The prolactin plasma levels were assayed using the chemiluminescent immunometric essay (CLIA) -high sensitive methods, The normal range of prolactin levels was 1,5-17 ng/ml(53-360 nmol/l) for men and 1,90-25,0 ng/ml for women. The sexual function was assessed using a Questionnaire: International Index of Erectile Function (IIEF) with 15 items in four levels of sexual function. The differences between two examination groups were determined by a student' s t test. The results show that street heroin addicts (55% of them have high level of prolactin) have significantly higher plasma prolactin levels (p=0,006) then the group of methadone maintenance patients (only 15% of them have high prolactin level). In our study, when we compared sexual dysfunction in examination groups in some domains, we did not find statistical significant results (sexual desire p=0,52 and overall satisfaction p=0,087). But in domains of erectile function p=0,011 and orgasm function p=0,033 we got statistical significant results.
The evaluated peripheral markers reflect only state (but not trait) abnormalities in patients with current severe episode of RDD. The observed peripheral α-AR and serotonin abnormalities are mutually not related and they are probably triggered by different mechanisms.
a negative impact on quality of life. The physician should remain vigilant for symptoms of depression as they may be mistaken for the progression of Parkinson's disease itself. The aim of the study was to evaluate the frequency of depression in patients with parkinson's disease.we have recruited 53 patients, 35 males and 18 females aged 36-80 years(mean age 60 years), only 15% of patients have a job, two patints was already treated for depression. Diagnosis of depression was accorded to ICD10 criteria and evaluated by depression hamilton scale. Depression was diaqnosed in 26 patients (49,1%), it was light in 6 patients (23.1%), middle in 14 patients(53,8%), and heavy in 6 patients(23,1%). 15 patients have dysthymia. Depression occurring during Parkinson's disease must be treated; SSRI's are preferred, mainly because of its good tolerance. Next, recognition of the signs and symptoms of depression associated with Parkinson's disease is essential for clinical practitioners. It is important to identify the features of depression associated with Parkinson's disease in order to render early diagnosis and institute practical and efficacious therapy.
Aim of the work: To follow the significance of some psychological risk factors in patients with anxiety and depression symptoms with cardio-vascular diseases. Materials and methods: During the research we included 30 patients with anxiety and depression symptoms diagnosed with cardio-surgical diseases after cardio-surgical intervention. They were chosen randomly, hospitalized and treated in the Specialized cardio-surgical clinic Filip II, Skopje. The patients were of both sexes, aged 30-70. They were evaluated by HAMD and HAMA and non-standardized questionnaire. The patients were tested once two weeks after the cardio-surgical intervention. Results: In 25 patients there was a score increase in HAMD and HAMA in correlation with the psychological risk factors (stressful events: losing the job, losing someone you love, hostility, high professional plans and ambition) Conclusion: Psychologically unfavourable situations are risk factors which lead to anxiety and depression symptoms in cardio-vascular diseases.
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