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At least 19 recordsLinked to original sources
PubMed2006

Dupuytren's diathesis revisited: Evaluation of prognostic indicators for risk of disease recurrence.

PURPOSE: The term diathesis relates to certain features of Dupuytren's disease (DD) and dictates an aggressive course of disease. The initial description of DD diathesis included 4 factors: (1) ethnicity, (2) family history, (3) bilateral DD, and (4) ectopic lesions (DD outside the palm). The degree of diathesis is considered important in predicting recurrence and extension of DD after surgical management. Prognostic indicators of risks associated with surgery are important. We aimed to evaluate these 4 factors and known associated risk factors to formulate a statistical predictive value for DD diathesis. METHODS: Caucasian patients diagnosed with DD between the ages of 25 and 90 years (n = 322) from Northwest England were assessed for DD diathesis with a clinical history and examination. DD diathesis assessment was analyzed by calculating the odds ratios of developing recurrent DD using logistic regression. RESULTS: The observed recurrence rates in the presence of notable risk factors and corresponding odds ratios of recurrent DD were calculated. Of note, recurrent disease was observed in 121 (46%) males, 105 (47%) with bilateral DD, 68 (48%) with a family history of DD, 75 (47%) with age at onset younger than 50 years, 35 (52%) in those with ectopic lesions, and in 26 (63%) with Garrod's pads. CONCLUSIONS: The original DD diathesis factors have been evaluated and modified. The original factors of family history, bilateral DD, and ectopic lesions now include 2 additional factors: male gender and age at onset of younger than 50 years. Family history and ectopic disease have now been modified to specify family history with one or more affected siblings/parents and ectopic lesions in the knuckles (Garrod's pads) alone. The presence of all new DD diathesis factors in a patient increases the risk of recurrent DD by 71% compared with a baseline risk of 23% in those DD patients with none of the earlier-described factors. TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic II.

Adult↗
PubMed2003

Impact of atopic skin diathesis on occupational skin disease incidence in a working population.

Present evidence convincingly indicates that workers with occupational skin disease are more frequently affected by atopic skin diathesis than the general working population. Population-based studies estimating the impact of atopic skin diathesis on occupational skin disease in various occupations have not been reported to date. We analyzed data of all initial reports of occupational skin diseases recorded in the register of occupational skin diseases in northern Bavaria, Germany, from 1990 to 1999. The main outcome measure was the attributable risk of atopic skin diathesis on occupational skin disease within 24 occupational groups that are most hazardous to the skin. Of the 5285 registered cases, 3730 had a confirmed occupational causation. Among these, 1366 workers (37%) presented an atopic skin diathesis. Assuming a prevalence of atopic skin diathesis of 20% in the total population, we found that 21.6% (95% confidence interval 19.4; 23.7) of occupational skin disease cases within 24 occupational groups may be ascribed to this endogenous risk factor. The attributable risk of atopic skin diathesis helped to explain a large proportion of occupational skin diseases. Empirical evidence supports the importance of surveying atopic skin diathesis as part of an occupational skin disease prevention strategy.

Adult↗
PubMed1995

Clinical and biochemical presentation of gouty diathesis: comparison of uric acid versus pure calcium stone formation.

PURPOSE: We compared gouty diathesis with uric acid versus calcium stones. MATERIALS AND METHODS: We retrospectively reviewed clinical and laboratory data from 95 gouty diathesis patients (28 with uric acid and 67 with calcium stones) and 99 normal subjects. RESULTS: Of the gouty diathesis patients gouty arthritis was present in 21% of those with uric acid and 12% of those with calcium stones. Hyperuricemia developed in 43% of those with uric acid and 27% of those with calcium stones, and 2% of controls. Urinary pH was independent of the net gastrointestinal absorption of alkali in the gouty diathesis groups. Urinary pH and citrate increased after potassium citrate treatment. CONCLUSIONS: The characteristic features of primary gout were present in both gouty diathesis groups and both are responsive to treatment.

Adult↗
PubMed1987

Vulnerability to depressive mood reactions: toward a more powerful test of the diathesis-stress and causal mediation components of the reformulated theory of depression.

To provide a more powerful test of the diathesis-stress component of the reformulated theory of depression (Abramson, Seligman, & Teasdale, 1978), we extended and refined the Metalsky, Abramson, Seligman, Semmel, and Peterson (1982) study and examined whether the content of college students' attributional styles (hypothesized attributional diathesis) as measured at Time 1 interacted with the outcomes students received on a class midterm exam to predict their subsequent depressive mood responses. In addition, to test the mediation component of the theory, we examined whether the relation between the hypothesized attributional diathesis and failure students' subsequent depressive mood responses to their low midterm grades was mediated by the particular causal attributions these students made for their low grades. The results partially corroborated the current statement (Abramson, Alloy, & Metalsky, 1986; Abramson, Metalsky, & Alloy, 1986a, 1986b) of the diathesis-stress component of the theory. Whereas students' immediate depressive mood reactions were predicted solely by the outcomes they received on the class midterm exams, their enduring depressive mood reactions were predicted solely by the hypothesized Attributional Diathesis X Outcome on Midterm Exam interaction. The direction and form of the interaction were in line with prediction. The results fully corroborated predictions derived from the mediation component of the theory as they applied to students' enduring mood responses.

Achievement↗
PubMed2002

The etiology of phobias: an evaluation of the stress-diathesis model.

BACKGROUND: We evaluated for phobias the prediction of the stress-diathesis model that the magnitude of stress at onset is inversely proportional to the level of underlying diathesis. METHODS: In more than 7500 twins from a population-based registry, we assessed the personality trait of neuroticism--as an index of phobia-proneness--and the lifetime histories of 5 phobia subtypes (agoraphobia, social, animal, situational, and blood or injury) and their associated irrational fears. Interviewers classified the mode of acquisition of the fear in phobic twins into 5 possible categories: trauma to self (further divided by severity), observed trauma to others, observed fear in others, taught by others to be afraid, and no memory of how or why fear developed. Analyses were conducted by logistic regression and analysis of covariance. RESULTS: The mode of acquisition had moderate test-retest reliability and differed meaningfully across phobia subtypes. None of the 3 tests of the stress-diathesis model was confirmatory: (1) the risk of phobias was not elevated in co-twins of twins who had no memory of their mode of acquisition, (2) the risk of phobias was not decreased in co-twins of twins who had severe trauma to self, and (3) no significant relationship, in phobic twins, was found between levels of neuroticism and mode of acquisition. CONCLUSIONS: These results are inconsistent with the traditional etiologic theories for phobias, which assume conditioning or social transmission. However, they are compatible with nonassociative models, which postulate that the vulnerability to phobias is largely innate and does not arise directly from environmental experiences. The stress-diathesis model may not be an appropriate paradigm for phobic disorders.

Adult↗
PubMed2004

Effect of immunotherapy in myelitis with atopic diathesis.

OBJECTIVE: A recent nationwide survey of myelitis with atopic diathesis in Japan disclosed that the disease frequently shows a chronic persistent course. A neuropathological study of the spinal cord also revealed chronic active inflammation. Since the effects of various immunotherapies have not been studied extensively in this condition, we evaluated the efficacies of various immunotherapies in patients with myelitis with atopic diathesis. PATIENTS AND METHODS: Forty-two treatments in 26 patients with myelitis with atopic diathesis were retrospectively analyzed. One of the following therapies was administered: (1) corticosteroids (CS) (pulse therapy followed by oral administration with gradual tapering); (2) intravenous immunoglobulin (IVIG) (400 mg/kg/day for 5 consecutive days); (3) plasma exchanges (PE); or (4) PE followed by IVIG or CS (PE+IVIG/CS). The therapeutic efficacies were evaluated by thorough neurological examination and laboratory tests including MRI, somatosensory evoked potentials (SEPs) and motor evoked potentials (MEPs). RESULTS: Objective neurological findings improved in 89% of the PE group and 90% of the PE+IVIG/CS group, compared with only 72% of the CS and 60% of the IVIG groups. Improvement determined by laboratory tests was seen in 57% of the PE and 57% of the PE+IVIG/CS groups, compared with only 15% of the CS and none of the IVIG groups. Thus, the improvement rate determined by laboratory tests was significantly greater for therapies including PE than for those without PE (p=0.0187). CONCLUSIONS: These data suggest that immunotherapy is effective in myelitis with atopic diathesis despite a chronic persistent course, and that PE is the most beneficial immunotherapy.

Adolescent↗
PubMed1991

Diathesis-stress theories in the context of life stress research: implications for the depressive disorders.

Advances in the conceptualization and measurement of life stress in the past 2 decades raise several questions concerning traditional diathesis-stress theories of psychopathology. First, comprehensive measures of life stress force investigators to become more precise about the particular stressful circumstances hypothesized to interact with diatheses. Second, the influence of the diathesis on a person's life is typically ignored, which results in several types of possible bias in the assessment of life stress. Finally, information is available on diatheses and stress for specific disorders to provide a foundation for more empirically based hypotheses about diathesis-stress interactions. This possibility is outlined for depression. Such an approach provides the basis for developing broader, yet more specific, frameworks for investigating diathesis-stress theories of psychopathology in general and of depression in particular.

Depressive Disorder↗
PubMed1997

Schizophrenia: a neural diathesis-stress model.

There is a substantive literature on the behavioral effects of psychosocial stressors on schizophrenia. More recently, research has been conducted on neurohormonal indicators of stress responsivity, particularly cortisol release resulting from activation of the hypothalamic-pituitary-adrenal (HPA) axis. This article integrates the psychosocial and biological literatures on stress in schizophrenia, and it offers specific hypotheses about the neural mechanisms involved in the effects of stressors on the diathesis. Both the behavioral and biological data indicate that stress worsens symptoms and that the diathesis is associated with a heightened response to stressors. A neural mechanism for these phenomena is suggested by the augmenting effect of the HPA axis on dopamine (DA) synthesis and receptors. Assuming the diathesis for schizophrenia involves an abnormality in DA receptors, it is proposed that the HPA axis acts as a potentiating system by means of its effects on DA. At the same time, DA receptor abnormality and hippocampal damage render the patient hypersensitive to stress. This neural diathesis-stress model is consistent with findings on prenatal factors and brain abnormalities in schizophrenia, and it provides a framework for explaining some key features of the developmental course and clinical presentation.

Disease Susceptibility↗
PubMed1997

Segregation analysis of ovarian cancer using diathesis to include other cancers.

Despite the recent cloning of BRCA1, BRCA2 and the mismatch repair genes, it will still be a long time before it is possible to specify any individual's risk for ovarian cancer based on her genotype. Most women concerned about their risk on the basis of one or two affected relatives do not belong to extensive ovarian cancer families. Risk calculations depend on a reliable genetic model for ovarian cancer derived, ideally, from the population from which an individual is drawn. We have carried out a segregation analysis using data collected from consecutive ovarian cancer patients in two different centres in the UK. Complex segregation analysis was carried out with the addition of diathesis as a separate parameter allowing other cancers, associated with ovarian cancer, to be taken into account. The use of diathesis in the derivation of this alternative model is described. Analysed under joint likelihood without diathesis, the gene frequency is 0.0028 and penetrance to age 70 years is 50%. This is in agreement with other published models. Incorporating diathesis into the model under joint likelihood gives similar parameters for a single locus model but gives the best fit with a two locus model where both genes are rare.

Adult↗
PubMed2005

Physicochemical metabolic characteristics for calcium oxalate stone formation in patients with gouty diathesis.

PURPOSE: We determined why calcium oxalate stones instead of uric acid stones form in some patients with gouty diathesis. MATERIALS AND METHODS: Gouty diathesis was diagnosed from absence of secondary causes of uric acid stones or low urinary pH, and reduced fractional excretion of urate with discriminant score of the relationship between urinary pH and fractional excretion of urate less than 80. From the stone registry 163 patients with gouty diathesis were identified, including 62 with uric acid stones (GD + UA) and 101 patients with calcium oxalate stones (GD + Ca). Metabolic data and 24-hour urinary chemistry study were compared between the 2 groups. RESULTS: Compared with GD + UA, GD + Ca had significantly greater urinary calcium (196 +/- 96 mg per day vs 162 +/- 82 mg per day, p <0.05) and significantly lower urinary citrate (430 +/- 228 vs 519 +/- 288 mg per day, p <0.05), resulting in higher urinary saturation of calcium oxalate. Both groups had low urinary pH (less than 5.5) and high urinary undissociated uric acid (greater than 100 mg/dl). Urinary calcium post-oral calcium load was significantly higher in GD + Ca than in GD + UA (0.227 vs 0.168 mg/dl glomerular filtrate, p <0.001). CONCLUSIONS: Calcium oxalate stones may form in some patients with gouty diathesis due to increased urinary excretion of calcium and reduced excretion of citrate. Relative hypercalciuria in GD + Ca may be due to intestinal hyperabsorption of calcium.

Adult↗
PubMed1982

A familial hemorrhagic diathesis in a Dutch family: an inherited deficiency of alpha 2-antiplasmin.

This study concerns a case of congenital homozygous deficiency in alpha 2-antiplasmin associated with a severe hemorrhagic diathesis. Heterozygous family members also show a mild bleeding tendency. The propositus is a 17-yr-old male born of white parents and showing a severe hemorrhagic diathesis characterized by spontaneous bleeding in the joints since his early childhood. He was originally suspected of having factor XIII deficiency but was found to have normal functions of the coagulation system and the platelets. Except for alpha 2-antiplasmin, all protease inhibitors showed normal plasma values. With the immediate plasmin inhibition test (synthetic substrate), only 2% of normal functional inhibition was detected, while no reaction with monospecific antisera for alpha 2-antiplasmin was observed. Inhibition of activator-induced fibrinolysis in vitro was reduced. No enhanced spontaneous in vitro fibrinolysis was detected nor were there signs of increased in vivo fibrinolysis during an asymptomatic period. During recovery from a hemorrhagic episode, signs of previous consumption of antithrombin III, alpha 2-macroglobulin, factor XIII, and inter-alpha-trypsin inhibitor were noted. After the diagnosis was made, treatment with tranexamic acid (4 daily doses of 1 g) was effective for about 2 yr. Among the 37 family members studied, a separate group of 16 individuals (including the father and mother of the propositus) with approximately one-half normal plasma levels of alpha 2-antiplasmin both functionally (59% +/- 6%) and immunologically 48% +/- 8%) was discovered. The defect appeared to be inherited as an autosomal recessive gene; no ancestral consanguinity could be shown. The group of apparent heterozygotes as a whole showed increased levels of alpha 1-antitrypsin (142% +/- 39%; p less than 0.01), indicating systemic consequences of the deficiency and reduced binding (+/- 50%) of alpha 2-antiplasmin to fibrin. Six exhibited a mild hemorrhagic diathesis for which no explanation was provided by routine screening of coagulation and platelet functions; also, within the group of heterozygotes, the occurrence of the bleeding tendency did not correlate with differences in residual alpha 2-antiplasmin levels and functions. It is concluded that not only the absence of alpha 2-antiplasmin but also a reduction in its plasma level to +/- 60% of normal may predispose to a hemorrhagic diathesis.

Adolescent↗
PubMed1995

Psychiatric disorders in spouse caregivers of care recipients with Alzheimer's disease and matched controls: a diathesis-stress model of psychopathology.

To test a diathesis-stress model of psychopathology, the authors examined the rates of current and lifetime psychiatric disorders in 82 spouse caregivers of Alzheimer's disease (AD) patients and 86 demographically matched controls. Caregivers and controls did not differ in the prevalence of disorders before the onset of care recipients' AD (or during a similar time period for the controls); caregivers experienced more depressive-anxiety disorders after the onset of patient's AD than controls. This study strongly supported the 3 key components of a diathesis-stress interaction. First, caregivers with a psychiatric history prior to the onset of patient's AD were more likely than caregivers with no history to receive a diagnosis after the onset of AD. Second, a similar relationship existed for controls. Finally, caregivers with a psychiatric history were more likely to experience a recurrence after the onset of AD than controls with a psychiatric history. These findings indicate that the diathesis of psychiatric history and the stress of caregiving interact, resulting in the observed group differences in the prevalence of psychiatric disorders.

Aged↗
PubMed1996

Gender differences in cognitive diathesis-stress domain match: implications for differential pathways to depression.

The frequency of cognitive diathesis-stress match was compared in a sample of depressed women and men to investigate hypotheses positing gender differences in the relation of cognitive diathesis-stress factors to depression. Depressed women were more likely to have experienced a match between a cognitive diathesis and a preonset negative stressor compared with depressed men. Comparisons of women and men on the cognitive and stress variables singly yielded differences in stress variables but not in cognitive variables. Depressed women were more likely to have experienced a negative severe event before the onset of depression and had a greater frequency of negative interpersonal events. Results supported the hypothesis of gender differences in pathways to depression.

Adult↗