Protease inhibitors and erectile dysfunction.
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Adolescent↗
Biomedical subjects
A Alciati
Publications and source records attributed to A Alciati.
Has there been a decrease in the prevalence of mood disorders in HIV-seropositive individuals since the introduction of combination therapy?
PURPOSE: The aim of this study was to assess the prevalence of current mood disorders in HIV-seropositive patients treated with combined antiretroviral drug therapy including or not protease inhibitors. SUBJECTS AND METHODS: A random sample of 90 subjects consecutively attending, between February 1 and July 31, 1998, the outpatient unit of the Second Department of Infectious Diseases of the 'L. Sacco' Hospital in Milan was assessed by means of the Structured Clinical Interview for DSMIII-R (SCID) and the Zung Self-Rating Depression Scale (ZSDS). RESULTS: Twenty-three-point-three percent of the subjects were classified in CDC stage A, 32.3% in CDC stage B and 44.4% in CDC stage C. A DSMIII-R psychiatric diagnosis of current mood disorder was found in 4.4% of the recruited sample (dysthymia: 2.2%; adjustment disorder with depressed mood: 2.2%). CONCLUSIONS: Direct and indirect effect of new combination therapies, epidemiological changes in social groups affected by HIV and possible modifications in social perception of people with HIV infection may explain, at least in part, the decreased prevalence of current mood disorders observed in our study as compared to prevalence rates reported in the pre-HAART era.
Adult↗
New-onset delusions and hallucinations in patients infected with HIV.
OBJECTIVE: To assess the relationship between HIV-associated psychotic symptoms (i.e., delusions, hallucinations) and demographic, psychopathological and medical variables by comparing patients with and without cerebral opportunistic infections or metabolic encephalopathy. DESIGN: Cross-sectional study. PATIENTS: 26 patients admitted to hospital with HIV and new-onset psychotic symptoms, defined according to DSM-III-R criteria. OUTCOME MEASURES: A semistructured psychiatric interview using the Psychopathology Assessment Scale (AMDP-4) of the Association for Methodology and Documentation in Psychiatry system. Comprehensive medical assessments, including laboratory tests and computed tomographic scans, were also performed. RESULTS: Patients with cerebral opportunistic infections or metabolic encephalopathy (i.e., "secondary" psychosis, n = 13) were more likely to show disorders of consciousness, disorders of orientation and disturbances of attention and memory than those with no evidence of HIV-related cerebral disease (i.e., "primary" psychosis, n = 13); 10 patients (77%) with cerebral opportunistic infections or metabolic encephalopathy and only 1 (8%) patient without (p < 0.001) were diagnosed with delirium. These associations were stronger for the "secondary" patients with no focal brain lesions than for those with lesions. CONCLUSIONS: These findings suggest that "organic" symptoms of psychosis in those infected with HIV are related to the systemic and cerebral complications of HIV infection rather than to the psychotic process itself.
AIDS Dementia Complex↗
Platelet alpha 2-adrenoceptors in major depression: relationship with urinary 4-hydroxy-3-methoxyphenylglycol and age at onset.
Platelet alpha 2-adrenoceptor number and affinity were measured in 31 drug-free patients with major depressive illness utilizing 3H-clonidine as ligand. A significant negative correlation was found between number of alpha 2-adrenoceptors, baseline urinary 4-hydroxy-3-methoxyphenylglycol (MHPG) excretion, present age and age at onset of the disease. Kd did not correlate with any of these variables not with the Bmax of platelet alpha 2-adrenergic binding. Multiple regression analysis, with MHPG and age at onset as independent variables, explained variance for alpha 2-adrenoceptor density better than single regression (from 19% for MHPG and 30% for age at onset to 40%), with the addition of both these variables being significant.
Adult↗
Three cases of delirium after "ecstasy" ingestion.
Three cases of delirium experienced by three young friends after recreational use of "ecstasy" are reported--a syndrome which, to the best of the authors' knowledge, has not been previously observed in MDMA abusers. Special attention is given to the etiological factors and clinical features of the adverse reaction.
Adult↗
Changes in lymphocyte subsets in depressed HIV-infected patients without antiretroviral therapy.
The authors studied the effects of major depression on lymphocyte subsets by comparing depressed and matched control subjects in a population of HIV-seropositive outpatients not treated with antiretroviral therapy. Twelve patients with major depression, as determined by the Structured Clinical Interview for DSM-III-R, were assessed in comparison with 15 matched nondepressed control subjects. Flow cytometric analysis of peripheral blood lymphocyte subsets together with immunological parameters were performed. In HIV-infected patients, major depression was significantly (P=0.001) associated with a reduction in natural killer cell absolute count and percentage. This report suggests that depression may alter the natural killer cell population that provides a cytotoxic defense against HIV infection.
Adolescent↗
Heterogeneity of major affective disorders. Biological and clinical evidence.
In this paper we summarize the results of our recent and present research focused on analyzing the correlations between neurochemical, pharmacological and clinical parameters in patients with Major Depression. There is evidence that: a) pretreatment urinary MHPG is a useful predictor for clinical response to tricyclic antidepressants and to long-term lithium treatment; b) urinary MHPG is positively correlated to the age at onset of the disease; c) previous responses to tricyclics and age at onset of affective illness are supplementary tools for predicting the effectiveness of lithium and antidepressant drugs; d) platelet alpha-2-adrenoceptor density is inversely correlated with both urinary MHPG and age at onset; e) cerebral ventricular size is positively correlated with urinary MHPG and age at onset and may discriminate between patients with different outcomes on lithium prophylaxis; f) low MHPG excretors are more likely to have suffered from stressful life events in early childhood than normal-to-high excretors. Taken together, these results lend strong support to the hypothesis that Major Affective Disorder is a heterogeneous illness and that inherently different subgroups of affective patients can be recognized.
Antidepressive Agents, Tricyclic↗