The dopamine D3 receptor gene: no association with bipolar affective disorder.

Bipolar affective disorder and schizophrenia share many clinical and genetic characteristics, and are thought by some to be different expressions of the same underlying disorder. A recent study showed an excess of homozygosity at a BalI polymorphism in the dopamine D3 receptor gene in schizophrenic patients compared with controls, from two independent centres. We have found no evidence of such an excess in a comparable sample of patients with bipolar affective disorder compared with matched controls. If these findings are confirmed then at least one genetic distinction between these two disorders will have been ascertained and doubt cast upon theories of a common genetic aetiology

Acute health effects of the Sea Empress oil spill

STUDY OBJECTIVE: To investigate whether residents in the vicinity of the Sea Empress tanker spill suffered an increase in self reported physical and psychological symptoms, which might be attributable to exposure to crude oil. DESIGN: Retrospective cohort study; postal questionnaire including demographic details, a symptom checklist, beliefs about health effects of oil and the Hospital Anxiety and Depression and SF-36 mental health scales. SETTING: Populations living in four coastal towns on the exposed south Pembrokeshire coast and two control towns on the unexposed north coast. PATIENTS: 539 exposed and 550 unexposed people sampled at random from the family health services authority age-sex register who completed questionnaires. MAIN RESULTS: Adjusted odds ratios for self reported physical symptoms; scores on the Hospital Anxiety and Depression and SF-36 mental health scales, in 1089 people who responded out of a possible 1585 (69%). CONCLUSIONS: Living in areas exposed to the crude oil spillage was significantly associated with higher anxiety and depression scores, worse mental health; and self reported headache (odds ratio = 2.35, 95% CI 1.56, 3.55), sore eyes (odds ratio = 1.96, 95% CI 1.06, 3.62), and sore throat (odds ratio = 1.70, 95% CI 1.12, 2.60) after adjusting for age, sex, smoking status, anxiety, and the belief that oil had affected health. People living in exposed areas reported higher rates of physical and psychological symptoms than control areas. Symptoms significantly associated with exposure after adjustment for anxiety and health beliefs were those expected from the known toxicological effect of oil, suggesting a direct health effect on the exposed population.

Infecção pelo HIV: descritores de mortalidade em pacientes hospitalizados Mortality descriptors in HIV inpatients

OBJETIVO: Estudar os descritores clínico-epidemiológicos da mortalidade em pacientes internados por condições clínicas associadas à infecção pelo HIV. MÉTODO: Estudo retrospectivo de todos os pacientes adultos hospitalizados em 1990, 1992 e 1994 em hospital universitário. Os resultados foram descritos como números absolutos, percentagens e médias, sendo a significância estatística entre as diferenças avaliada pelos testes do qui-quadrado, exato de Fisher ou t de Student, conforme o caso. Um modelo de regressão logística foi elaborado visando a identificar os principais fatores associados ao risco de evolução para o óbito. RESULTADOS: Foram incluídos no estudo 240 pacientes. Entre 1990 e 1994 a idade média dos pacientes aumentou de 35,0 para 36,9 anos, a razão entre os sexos masculino e feminino caiu de 9,8 para 2,0, a proporção de não brancos cresceu de 18,5 para 41,3 e registrou-se um aumento do tempo médio entre a descoberta da infecção pelo HIV e a hospitalização de 0,7 para 2,5 anos. Observou-se a redução do número médio de dias de hospitalização de 31,3 para 25,3 e aumento da proporção de pacientes em acompanhamento ambulatorial de 47,8 para 83,3%. As infecções respiratórias representaram a principal causa de hospitalização (58%) e as infecções oportunistas apresentadas com maior freqüência foram: candidíase oral (27,1%), tuberculose (18,3%), pneumonia por Pneumocystis carinii (15,4%) e neurotoxoplasmose (10,4%). Na análise multivariada, apenas o tempo de hospitalização menor ou igual a 7 dias (Odds Ratio [OR]=3,88; p=0,02) e a ausência de acompanhamento ambulatorial (OR=3,29; p=0,01) mostraram-se associados a um maior risco de evolução para óbito. CONCLUSÃO: O conhecimento dos fatores associados a um risco aumentado de morte pode ser útil na tomada de decisão frente a pacientes hospitalizados com infecção pelo HIV.<br>OBJECTIVE: To assess the clinical-epidemiological descriptors of inpatient mortality in persons infected with the human immunodeficiency virus (HIV). METHOD: All adult HIV/AIDS patients hospitalized at a university hospital in 1990, 1992 and 1994 were studied retrospectively. Descriptive statistics for all variables of interest were generated. Chi-square test and Fisher's exact test were performed to compare categorical variables. Means were compared using the Student t test. Stepwise logistic regression was used to identify the odds of dying associated with each risk factor. RESULTS: Two hundred and forty patients were included in the study. Between 1990 and 1994 the mean age rose from 35 to 36.9 years, the male/female ratio decreased from 9.8 to 2.0, the non-white proportion increased from 18.5 to 41.3% and the mean time between detection of HIV infection and hospitalization rose from 0.7 to 2.5 years. In addition, length of stay dropped from 31.3 to 25.3 days and the proportion of patients being followed up in the outpatient clinic of the Universitary Hospital increased from 47.8 to 83.3%. Respiratory infections were the main cause of hospitalization (58.0%). Oral candidiasis (27.1%), tuberculosis (18.3%), Pneumocystis carinii pneumonia (15.4%) and toxoplasmic encephalitis (10.4%) were the most frequent opportunistic infections. Multivariate analysis showed that the factors associated with a worse outcome included the length of stay less than or equal to 7 days (Odds Ratio [OR]=3.88; p=0.02) and no outpatient follow-up at the Hospital (OR=3.29; p=0.01). CONCLUSION: Identification of independent risk factors for death may help in the implementation of more efficient interventions directed towards inpatients with HIV/AIDS