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P Thuras

Publications and source records attributed to P Thuras.

At least 19 recordsLinked to original sources

Human influenza viral infection in utero alters glial fibrillary acidic protein immunoreactivity in the developing brains of neonatal mice.

Epidemiological reports describe a strong association between prenatal human influenza viral infection and later development of schizophrenia. Postmodern human brain studies, however, indicate a lack of gliosis in schizophrenic brains presumably secondary to absence of glial cells during the second trimester viral infection in utero. We hypothesized that human influenza infection in day 9 pregnant mice would alter the expression of glial fibrillary acidic protein (GFAP, an important marker of gliosis, neuron migration, and reactive injury) in developing brains of postnatal days 0, 14 and 35 mice. Determination of cellular GFAP immunoreactivity (IR) expressed as cell density in cortex and hippocampus of control and experimental brains showed increases in GFAP-positive density in exposed cortical (P = 0.03 day 14 vs control) and hippocampal cells (P = 0.035 day 14, P = 0.034 day 35). Similarly, ependymal cell layer GFAP-IR cell counts showed increases with increasing brain age from day 0, to days 14 and 35 in infected groups (P = 0.037, day 14) vs controls. The GFAP-positive cells in prenatally exposed brains showed 'hypertrophy' and more stellate morphology. These results implicate a significant role of prenatal human influenza viral infection on subsequent gliosis, which persists throughout brain development in mice from birth to adolescence.

Aging↗

Binge eating and other psychopathology in patients with type II diabetes mellitus.

OBJECTIVE: Type II diabetes mellitus (DM), a common disease with many potential complications, is strongly associated with obesity. Alterations in food consumption can dramatically alter glucose control in individuals with Type II DM. Binge eating disorder (BED) is also closely associated with obesity. The nature of the relationship, if any, between Type II DM and BED is unclear. METHODS: Forty-three individuals (23 females, 20 males) with Type II DM were assessed using the Structured Clinical Interview for DSM-IV (SCID-I), the Three-Factor Eating Questionnaire (TFEQ), and the Impact of Weight Scale. The most recent hemoglobin A1c level was recorded. Height and weight were also measured. RESULTS: Eleven subjects (25.6%) were diagnosed with BED. Individuals with BED had higher body mass index (BMI) scores, higher TFEQ Disinhibition and Hunger scores, and higher scores on all Impact of Weight subscales (except eating) compared with those without BED. Glycosylated hemoglobin levels did not differ between the two groups (8.1% vs. 8.4%; p = 0.553). DISCUSSION: Rates of BED in subjects with Type II DM were substantial. Other types of psychopathology were also common. Although glycosylated hemoglobin levels were similar in patients with and without BED, the presence of BED was associated with greater obesity. Assessment for BED is an important aspect of the management of patients with Type II DM.

Adolescent↗

Urine electrolytes as markers of bulimia nervosa.

OBJECTIVE: The diagnosis of bulimia nervosa (BN) is often delayed because patients are frequently secretive about the illness. Prior work has examined several potential diagnostic markers, none of which has been both highly sensitive and specific. Little is known about the utility of urine electrolytes in detecting BN symptoms. METHOD: Seventy-seven women with BN and 53 control women participated in the study. Urine and serum electrolytes and urine phenolthalein screens were obtained. Subjects with BN also completed a self-report instrument (the Eating Behaviors IV) regarding vomiting during the week prior to assessment. Receiver operating characteristic analysis was used to examine the predictive abilities of urine and serum electrolytes. RESULTS: Bulimic and control subjects differed significantly on most electrolyte measures. The ratio of urine sodium to urine chloride was the best predictor of bulimic behavior; selecting individuals with a ratio of >1.16 identified 51.5% of BN subjects with a 5% false-positive rate. Fractional excretion of sodium (FENA), urine anion gap (UAG), and serum potassium values were also predictive of BN but serum hypokalemia was not more common in BN than in control subjects (4.1% vs. 0%; p =.15). Vomiting frequency was correlated with an abnormal UAG (r(2) =.2231) but not FENA, nor serum potassium. CONCLUSION: The ratio of urine sodium to urine chloride is a useful predictor of bulimic behavior that appears to be more powerful in detecting BN than traditional screening measures such as serum hypokalemia.

Adult↗

Self-help versus therapist-led group cognitive-behavioral treatment of binge eating disorder at follow-up.

OBJECTIVE: The purpose of this study was to evaluate the longer-term outcome of three group cognitive-behavioral therapy (CBT) delivery models for the treatment of binge eating disorder (BED). METHOD: Fifty-one participants were assigned to one of three conditions. In the therapist-led condition (TL; n = 16), a psychologist provided psychoeducational information for the first half hour and led a group discussion for the second half hour of each session. In the partial self-help condition (PSH; n = 19), participants viewed a 30-min psychoeducational videotape, followed by a therapist-led discussion. In the structured self-help condition (SSH; n = 16), participants watched a psychoeducational videotape and led their own discussion. RESULTS: Reductions in binge eating episodes and associated symptoms were observed for all three treatments at post, 1-month, 6-month, and 1-year follow-up, with no significant differences among the three conditions. DISCUSSION: These findings suggest that CBT for BED can be delivered successfully using videotape and a structured self-help group format and that improvements in binge eating are maintained up to 1 year follow-up.

Adult↗

Attachment style classification and posttraumatic stress disorder in former prisoners of war.

Adult attachment style and post-traumatic stress disorder (PTSD) symptomatology were investigated in 107 former prisoner of war veterans. Those with secure attachment styles scored significantly lower on measures of PTSD than did those with insecure styles, and attachment style was a stronger predictor of PTSD symptom intensity than was trauma severity. The suggested association between attachment style and PTSD's development and persistence are discussed in relation to research and clinical practice.

Aged↗

Weight loss and gender: an examination of physician attitudes.

OBJECTIVE: The purpose of this study was to investigate physician attitudes toward the treatment of overweight and obese individuals and to evaluate potential gender differences in treatment recommendations. RESEARCH METHODS AND PROCEDURES: A survey describing several hypothetical patients was sent to 700 randomly selected physicians; 209 (29.9%) returned the survey. Two versions of the questionnaire (one for men and one for women) described three hypothetical patients at three levels of body mass index (BMI) (32, 28, and 25 kg/m(2)). One-half of the physicians received a version of the questionnaire describing the patients as women, and one-half received a version describing the patients as men. Respondents answered questions about attitudes toward treatment and specific interventions and referrals they would view as appropriate. RESULTS: Physicians were more likely to encourage women with a BMI of 25 kg/m(2) to lose weight than men with the same BMI, and indicated that they would suggest more treatment referrals for women than men. Men with a BMI of 32 kg/m(2) were more likely to be encouraged to lose weight than women with the identical BMI. Physicians were more likely to encourage weight loss and see treatment referrals as appropriate for patients with higher BMIS: DISCUSSION: This study indicates that physicians treat male and female patients differently, with physicians more likely to encourage weight loss and provide referrals for women with a BMI of 25 kg/m(2) than for men with an identical BMI and less likely to encourage weight loss for women than men with a BMI of 32 kg/m(2).

Adult↗

Effects of childhood physical abuse on course and severity of substance abuse.

The present study sought to assess the course and severity of Substance Related Disorder (SRD) in relation to childhood physical abuse (CPA) using retrospective data on CPA and current indices of substance use, abuse, and related morbidity. A total of 642 patients were assessed, of whom 195 (30.4%) experienced CPA, were assessed in two university medical centers with Alcohol-Drug Programs located within departments of psychiatry. A research assistant obtained demographic data, family history of substance abuse, problems related to substance abuse, and treatment of substance abuse. Data on severity included two measures of SRD-associated problems (one patient-rated and one psychiatrist-rated), substance abuse vs. dependence, self-help activities, and previous treatment. The study found that patients with CPA were more likely to be women, have lower socioeconomic status, and have more extended family members with substance abuse. Their substance abuse was more severe on five out of six severity measures. Patients with CPA showed more lifetime treatment on three out of four measures. Physical abuse during childhood resulted in a more morbid course of substance abuse later in adulthood. Although female gender and lower SES were both associated with CPA, the relationships were separate (i.e., women did not have lower SES).

Adult↗

Self-help strategies among patients with substance use disorders.

The objective of this study was to determine (1) the type and extent of self-help efforts among patients presenting for treatment of substance use disorders, and (2) the association of self-help with demographic and clinical characteristics. A retrospective report of life self-help methods, current demographic characteristics, and current and lifetime clinical characteristics was used. Six hundred and forty-two patients in treatment for substance use disorder were interviewed at one of two university medical centers with Alcohol-Drug Programs located within departments of psychiatry. A research associate (RA) interviewed patients regarding seven types of self-help involving specific, mutually exclusive behaviors and rated the patient's lifetime self-help methods. The patient, RA, and addiction psychiatrists provided demographic, familial, and clinical information. Most patients (78%) had tried one or more types of self-help, with a mean of 2.7 methods per patient. They more frequently chose methods related to the substance (decreasing amounts or frequency, or changing substance type) or joining a self-help group than methods that involved changing friends, residence, or occupation/job/school. Certain patterns of self-help tended to occur together (e.g., changing substance frequency and dose), whereas others appeared more independent (e.g., joining a self-help group). Some self-help approaches occurred mostly in association with other methods rather than alone (e.g., changing occupation/job/school). More self-help was associated with higher socioeconomic class, more relatives with substance use disorder, greater severity of substance use disorder, and more treatment for substance use disorder. Self-help tends to occur more often after exposure to addicted relatives or addiction treatment. Clinicians and public adult education should promulgate self-help methods in the general population.

Adult↗

Prenatal viral infection causes alterations in nNOS expression in developing mouse brains.

Epidemiological evidence points to prenatal viral infection being responsible for some forms of schizophrenia and autism. We hypothesized that prenatal human influenza viral infection in day 9 pregnant mice may cause changes in the levels of neuronal nitric oxide synthase (nNOS), an important molecule involved in synaptogenesis and excitotoxicity, in neonatal brains. Brains from 35- and 56-day-old mice were prepared for SDS-gel electrophoresis and Western blotting using polyclonal anti nNOS antibody. Quantification of nNOS showed time and region-dependent changes in the levels of nNOS protein. Mean rostral brain area value from prenatally infected animals showed a significant (p=0.067) increase of 147% in nNOS levels at 35 days postnatally, with an eventual 29% decrease on day 56. Middle and caudal brain areas showed reductions in nNOS in experimental mice at 35 and 56 days, with a significant 27% decrease in nNOS in the middle segment of day 56 brains (p=0.016). Significant interactions were found between group membership and brain area (Wilks lambda=0.440, F(2.9)=5.72, p=0.025); there was also a significant interaction between brain area, group and age (Wilks lambda=0.437, F(2.9)=5.79, p=0.024). These results provide further support for the notion that prenatal viral infection affects brain development adversely via the pathological involvement of nNOS expression.

Animals↗

Individual differences predictive of drinking to manage anxiety among non-problem drinkers with panic disorder.

BACKGROUND: Alcohol problems co-occur with anxiety disorders at a rate that far exceeds chance ("comorbidity"). One view suggests that risk for developing a comorbid alcohol use disorder is increased when alcohol is used routinely to cope with anxiety symptoms ("self-medication"). Indicating that this view is overly broad, however, the literature suggests that only a subgroup of anxiety-disordered individuals tend to drink to manage their symptoms. Therefore, we set out to identify psychological characteristics that might mark those for whom drinking to cope with anxiety is most likely. Our survey of the literature identified several possibilities, including anxiety-related personality traits (anxiety sensitivity, self-consciousness and Trait Anxiety); higher-order personality dimensions (Harm Avoidance, Reward Dependence, and Novelty Seeking); and, finally, alcohol outcome expectancies (specifically, those related to tension-reducing effects from alcohol). METHODS: In a sample of nonproblem drinkers with panic disorder, we regressed predictor variables on several alcohol use measures, including drinking aimed at the control of anxiety symptoms ("self-medication"). RESULTS: Although each variable related positively to a self-medicating style of drinking, expectancies for tension reduction from alcohol use accounted for about twice as much variance as did the other predictors. With simultaneous entry in a step-wise regression analysis, only tension-reduction alcohol outcome expectancies and the Harm Avoidance personality dimension were retained as significant predictors. CONCLUSIONS: Findings suggest that development of a self-medicating style of drinking among individuals with panic disorder is predicated, in part, on specific psychological characteristics of the individual. Alcohol outcome expectancies emerged as the single most important predictor of drinking behavior in this anxiety-disordered sample.

Adult↗

Mortality from eating disorders--a 5- to 10-year record linkage study.

PURPOSE: Previous research has found elevated mortality rates from anorexia nervosa (AN) and perhaps bulimia nervosa (BN). This study was performed using computerized record linkage to examine mortality rates in a cohort of patients with eating disorder (ED) diagnoses seen in an emergency room (ER) by a psychiatry service. METHODS: ER records were retrieved for 122 consecutive ED patients seen over a 5-year period from 1985 to 1990. Demographic data, identifiers including social security number and date of birth, and clinical information were recorded; record linkage to a computerized vital status database, MINNDEX, through 1995 was then performed. Death certificates were subsequently obtained and reviewed to identify cause of death. RESULTS: The average age at time of ER visit was 25.7 (SD 7.4); 91.8% were female, 8.2% male. The most common diagnosis was AN (44.3%); 34.4% were diagnosed with BN, and 21.3% with eating disorder not otherwise specified (EDNOS). Five subjects died in the 5 to 10-year follow-up period (all female). One deceased subject carried a diagnosis of BN, the other 4 had AN. Three subjects with AN were listed on death certificates as having died of that illness; the fourth died of emphysema. The deceased subject with BN died of traumatic causes. The crude mortality rates were 7.4% for AN and 2.4% for BN. The standardized mortality ratio for AN was 8.35. CONCLUSIONS: This study confirms and extends prior reports of high mortality rates in AN, using an epidemiologic database with high ascertainment rates. While the crude mortality rate for BN was also high, the small sample size makes it difficult to draw conclusions.

Adult↗

Quantitative EEG findings associated with chronic stimulant and cannabis abuse and ADHD in an adult male substance use disorder population.

QEEG was studied in a population of chronic male PSUD/ADHD (psychoactive substance use disorder/attention deficit hyperactivity disorder) subjects vs. a matched sample of non-ADHD subjects with PSUD. Our first interest in conducting this study was to determine if the Thatcher University of Maryland database and complex demodulation method could replicate the specific QEEG findings reported for cocaine and cannabis using the John-NYU database and Fourier Transform method. The effects of cannabis and stimulants were also studied both separately and together to see if there were interactions and to see if the QEEG changes associated with chronic stimulant dependence were predicted by childhood ADHD status. Eyes-closed QEEGs were obtained and two independent artifacted 60 second samples were compared for reliability. The Thatcher database was used to analyze QEEG data from 56 subjects with mixed substance use disorder. Results showed that the Thatcher database replicates the John database for chronic stimulant dependence findings. Because of confounding variables of alcohol and polysubstance abuse, the findings related to cannabis and stimulant interaction were difficult to assess. Cannabis and stimulant dependence together produced more QEEG changes than either alone. More right temporal abnormalities were observed with stimulant dependence. In the absence of stimulant use, the QEEG effects of cannabis were relatively small; however, sample selection and methods used precluded comparison to previous studies. The persistent QEEG abnormalities associated with chronic stimulant dependence were independent of ADHD status in this sample using the methods of this study. Further research is needed to clarify the relationship of stimulant dependence with QEEG changes and ADHD status, and to clarify the interactions of chronic stimulant and cannabis abuse on QEEG.

Adult↗

Differential expression of synaptosome-associated protein 25 kDa [SNAP-25] in hippocampi of neonatal mice following exposure to human influenza virus in utero.

We investigated the role of maternal exposure to human influenza virus [HI] in C57BL/6 mice on day 9 of pregnancy on the hippocampal expression of SNAP-25 in postnatal day 0 neonates, and compared them to sham-infected pups. The expression of SNAP-25 in infected neonates varied along the septotemporal axis of hippocampus and in various anatomic layers. Quantitative densitometric analysis of specific immunogold silver-enhanced SNAP-25 immunoreactivity [IR] showed increases of 40-347% over control in all septal-dorsal hippocampal layers except for the subplate layer. In mid septo-temporal hippocampus, SNAP-25 IR increased by 10-114% over control in all layers, except for the hippocampal plate, but the extent of this increase was smaller than in the dorsal-septal area. Finally,in temporal-ventral levels, SNAP-25 expression was reduced in all infected layers by 21-33% below control except for mild increases of 8.8 and 10% in subplate and hippocampal plate layers. Additionally, the infected SNAP-25 maximal density bin shifted to lower values dorsally and to higher values medially, with ventral maximal bins remaining unchanged when compared to controls. The differential expression of SNAP-25 in the hippocampi of infected neonates indicates a variable degree of vulnerability across the septo-temporal axis of hippocampus. It is surmised that while viral infection may induce excitotoxicity in the ventral hippocampus, it may cause reactive synapto-genesis in the medial and dorsal sectors of the developing brains of postnatal day 0 neonates.

Animals↗

Human influenza viral infection in utero increases nNOS expression in hippocampi of neonatal mice.

We investigated the role of maternal exposure to human influenza virus (HI) in C57BL/6 mice on day 9 of pregnancy on hippocampal expression of nNOS in day 0 neonates and compared that to sham-infected pups. Qualitative analysis using polyclonal antibody to nNOS showed overall increases in immunoreactivity (IR) in hippocampal and dentate layers of day 0 infected neonates when compared to sham-infected animals. These increases in nNOS immunoreactivity were pronounced in hippocampal plate, intermediate, molecular, subplate, and dentate areas. Quantitative analysis of specific immunogold silver-enhanced nNOS IR via densitometry showed nNOS IR increases of 26-71.6% in all layers, i.e., hippocampal plate (35.1%), dentate area (71.6%), molecular area (43.75%), subplate (45.7%), and intermediate zone (26%) in infected neonatal brains vs. controls. The changes in levels of nNOS expression in hippocampi of neonates born to mothers exposed to HI virus during the second trimester of pregnancy may reflect the potential for glutamatergic excitotoxicity via activation of NMDA receptors in the developing brains of these neonatal mice.

Animals↗

Diagnostic stability of ADHD in a community sample of school-aged children screened for disruptive behavior.

A large school-based sample of children in Grades 1, 2, 3, and 4 were screened for disruptive behavior and subsequently assessed over a 5-year period for DSM-III-R symptoms of attention deficit hyperactivity disorder (ADHD) and other externalizing and internalizing behavior disorders. Parents completed structured diagnostic interviews in Years 1, 4, and 5, and teachers completed Behavioral Assessment for Children-Teacher Rating Scales behavioral ratings annually. For parent-derived diagnostic data, both inattention and hyperactivity/impulsivity symptom groups declined from Year 1 to Year 4, with hyperactivity showing more significant decline. For teacher-rated behavioral dimensions, the Attention Problems scale declined from Year 1 to Year 3 and stabilized thereafter. The Hyperactivity scale showed stability during the first 3 years before declining in Year 4. Of those children diagnosed with ADHD in Year 1, 69% still met criteria for ADHD in either Year 4 or 5. Persisters were more likely to exhibit coexisting conduct disorder in Year 1 and oppositional defiant disorder in Years 1, 4, and 5. Parents of persisters reported more psychosocial adversity on measures of parenting and marital satisfaction.

Analysis of Variance↗

Fluoxetine in treatment of adolescent patients with autism: a longitudinal open trial.

Retrospective chart reviews of seven adolescent and young adults with autistic disorder treated with fluoxetine alone or in combination with other medications were performed. Patient's ages varied from 9-20 years (M +/- SD, = 16 +/- 3.87). Fluoxetine doses ranged from 20-80 mg per day (M +/- SD of final doses 37.14 +/- 21). Duration of treatment ranged from 1.3-32 months (M 18.04 +/- 10.39). Patients' symptoms were monitored using the Aberrant Behavior Checklist (ABC) rating scale during every visit. Side effects included initial appetite suppression, vivid dreams, and hyperactivity. Improvement from baseline was seen in four subscales: irritability (21%), lethargy (37%), stereotype (27%), and inappropriate speech (21%). Lethargy subscales improved significantly during treatment (p < .029). Hyperactivity subscale increased by 14% but did not attain statistical significance. Fluoxetine appears to have important behavioral effects in treatment of clinic-referred autistic children. Future double-blind placebo controlled studies evaluating core and associated symptom response with fluoxetine are warranted.

Adolescent↗

Leptin in anorexia nervosa.

Serum leptin levels are low in untreated anorexia nervosa, but studies of the exact relationship between leptin and body weight and the impact of refeeding in anorectics are limited. Therefore, we studied serum leptin, insulin-like growth factor I, and other endocrine parameters in female anorectics before and after gaining weight and in female normal body weight controls. Leptin levels in untreated anorectics were significantly lower than those in normal body weight controls (3.6 +/- 1.6 vs. 12.0 +/- 6.9 ng/mL; P < 0.001), and they uncoupled from body weight in a nonlinear relationship, suggesting a threshold effect at lowest body weights. Leptin increased significantly with refeeding (5.6 +/- 3.8 ng/mL; P < 0.01). The significant linear correlations of leptin with body mass index in the anorectics after weight gain and in normal body weight controls (r = 0.69; P < 0.001 and r = 0.76; P < 0.001, respectively) are consistent with a normal physiological increase in leptin with weight gain. Leptin and insulin-like growth factor I were highly correlated, even after controlling for body weight (r = 0.63; P = 0.001) during starvation, but were no longer significantly correlated after body weight gain in the anorectics or the normal body weight controls. Further studies are necessary to elucidate the relationship of leptin to neuroendrocrine abnormalities seen in starvation and to determine a possible contribution of leptin to difficulties with weight restoration in anorexia nervosa.

Adolescent↗

Lamotrigine in rapid-cycling bipolar disorder.

BACKGROUND: We evaluated the antidepressant and mood-stabilizing effects of lamotrigine, a novel anticonvulsant, in a group of rapid-cycling bipolar patients. Most were already nonresponders or poor partial responders to other conventional mood-stabilizing agents. METHODS: This open, naturalistic, and prospective study was conducted with five rapid-cycling bipolar patients (DSM-IV). Each received lamotrigine titrated to a minimum dose of 150 mg/day as monotherapy or in combination with other psychotropic agents. Patients were assessed with the Global Assessment Scale (GAS), Beck Depression Inventory (BDI), and Young Mania Rating Scale (YMRS) for evidence of cycling mood. RESULTS: Lamotrigine was used at a mean +/- SD dose of 185.0 +/- 33.5 mg/day for 225.8 +/- 28.0 days. Random regression modeling of data showed significant dose- and time-dependent improvements in depressive symptoms and social function of patients taking lamotrigine (Dose: z = 2.17, p < .03 for BDI, z = 4.44, p < .001 for GAS; Time: z = -3.79, p < .001 for BDI, z = 2.16, p < .03 for GAS). Further random regression modeling analysis of change over time in symptoms prior to lamotrigine compared with symptoms during lamotrigine treatment showed a significant treatment by time effect for GAS (z = 2.40, p < .016) and a trend for BDI scores (z = -1.79, p < .073). No significant time or dosage effect or time by treatment effect was observed for YMRS. Finally, t statistics showed a significant reduction in mean BDI scores following treatment with lamotrigine (t = -5.26, p < .006). Lamotrigine was well tolerated by all patients; only one patient experienced several side effects, which were probably due to interaction between several psychotropic medications. CONCLUSION: Lamotrigine augmentation therapy and monotherapy appeared to have mood-stabilizing and antidepressant efficacy in the treatment of five rapid-cycling bipolar patients. The effect persisted for an average of 7.5 months.

Adult↗