Täiskasvanute aktiivsus- ja tähelepanuhäire: kulu vormid ja variandid, diagnoosimine ja ravi

Täiskasvanute aktiivsus- ja tähelepanuhäire (ATH) on viimasel ajal saanud rohkelt tähelepanu, kuid selle kliiniline kulg ja patogenees ei ole veel selge. On kirjeldatud erinevaid ATH vorme, millest sagedaim on tähelepanematusega vorm. ATH farmakoloogiline ravi on tõhus ATH sümptomite vähendamiseks. Ülevaateartiklis on võetud kokku praegused teadmised eelnimetatud teemal

Depressioon Eestis: levimus, seotud tegurid ja tervishoiuteenuste kasutamine

Väitekirja elektrooniline versioon ei sisalda publikatsioone.Käesoleva töö põhieesmärgiks oli määrata depressiooni levimus Eestis, uurida kuidas seostuvad depressioon ja 12-kuu jooksul emotsionaalsete probleemide korral abi otsimine sotsiaalmajanduslike tegurite, terviseseisundi ning sotsiaalse toetuse indikaatoritega Eesti elanike ning depressiooniga isikute seas. Antud uuring oli osa Eesti Terviseuuringust 2006. Uurimisgrupi moodustasid 6105 isikut vanuses 18–84 aastat. Andmed sotsiaalmajanduslike tegurite, terviseseisundi, alkoholi kasutamise, terviseprobleemide tõttu abi otsimise, depressiooni ravi ja sotsiaalse toetuse kohta saadi Terviseuuringu struktureeritud intervjuudest. Käesoleva depressiooniepisoodi määramiseks kasutati MINI neuropsühhiaatrilist intervjuud. Käesolevas töös leiti, et depressiooni levimus Eesti elanikkonna seas on 5,6%. Madal sissetulek ja halb terviseseisund olid sotsiaalmajanduslikest ja terviseseisundi indikaatoritest kõige olulisemad depressiooniga seotud tegurid. Nii sotsiaalse toetuse strukturaalsed kui funktsionaalsed tegurid, samuti kontrollkese olid depressiooniga seotud. Emotsionaalsete probleemide tõttu otsis 12 kuu jooksul abi 4,8% Eesti elanikkonnast ja 34,1% depressiooniga isikutest. Kõige olulisemad abi otsimist ennustavad tegurid emotsionaalsete probleemide korral Eesti elanikkonnas olid käesolev ja eelnev depressiooniepisood, oluline tervisehäire ja puue. Depressiooniga isikute puhul sõltus abi otsimine depressiooni raskusastmest ja kontrollkeskmest ning interaktsioonidest emotsionaalse üksinduse, kontrollkeskme ja vanematega kontaktide sageduse vahel. Depressiooniga isikud kasutasid tervishoiuteenuseid (eelkõige erakorralise meditsiini) kuni 3 korda enam kui mitte-depressiivsed isikud. Kokkuvõttes on depressiooni levimus Eesti elanikkonna seas samas suurusjärgus varasemate levimusuuringutega, olles keskmisest vaid mõnevõrra kõrgem. Enamik Eesti elanikkonnast ja depressiooniga inimestest ei otsi abi emotsionaalsete probleemide tõttu. Meil on alust arvata, et depressiooni aladiagnostika ja ebapiisav ravi viivad tervishoiuteenuste mitte-sihipärase kasutamiseni ja põhjendamatute kulutusteni.Main aim of this study was to estimate the point prevalence of major depression in Estonia and to study how depression and 12-month help-seeking for emotional problems are associated with sociodemographic, health status, and social support factors in the general population, and among depressed persons. The study was part of the Estonian Health Interview Survey 2006 (EHIS 2006). The present study included adults aged 18–84 years (N=6105). The data about sociodemographic, health status, alcohol use, help-seeking, depression treatment and social support factors were derived from the structured interviews of EHIS 2006. A major depressive episode was assessed using the Mini-International Neuropsychiatric Interview. The point prevalence of major depression in Estonian population was 5.6%. Low income and poor health status were most significant associates of depression among health status and sociodemographic factors. Both, structural and functional factors of social support, and locus of control were associated with depression. The prevalence of 12-month help-seeking for emotional symptoms in general population was 4.8% and in the depressed sample 34.1%. 12-month help-seeking was most significantly associated with current and previous depressive episodes, serious health disorder, and disability. Independent associates of help-seeking among depressed persons were severity of depression and locus of control. Interactions of emotional loneliness, locus of control and frequency of contacts with parents significantly predicted help-seeking in the depressed sample. Depressed people used non-mental health services 1.5–3 times more than non-depressed persons. In conclusion, the prevalence of major depression in the Estonian population is comparable with other population surveys, being a little higher than the average. Majority of general population of Estonia and depressed persons do not seek help for emotional problems. Low level of diagnosis and undertreatment leads to an increased use of expensive but non-specific health services by depressed persons

Depressiooni ja ärevuse esinemine Eesti inimestel: depressiivse häire hetkelevimus, depressiivsuse ja ärevuse levimuse muutus kümne aasta jooksul

Eesti Arst 2008; 88(Lisa2):80−8

Current Status and Future Opportunities for Controlling Acromegaly

Growth-hormone (GH) secreting adenomas, including acromegaly, account for approximately one-sixth of all pituitary adenomas and are associated with mortality rates at least twice that of the general population. The ultimate goal of therapy for acromegaly is normalization of morbidity and mortality rates achieved through removal or reduction of the tumor mass and normalization of insulin-like growth factor I (IGF-I) levels. Previously published efficacy results of current treatment modalities (surgery, conventional radiation, and medical therapy with dopamine agonists and somatostatin analogs) are often difficult to compare because of the different criteria used to define cure (some of which are now considered inadequate). For each of these modalities, pooled data from a series of acromegaly studies were reviewed for rates of IGF-I normalization, a currently accepted definition of cure. The results showed overall cure rates of approximately 10% for bromocriptine, 34% for cabergoline, 36% for conventional radiation, 50–90% for surgery for microadenomas and less than 50% for macroadenomas, and 54–66% for octreotide. These cure rates based on IGF-I normalization are generally less than those reported for cure based solely on GH levels. Novel new therapies for acromegaly include the somatostatin analog, lanreotide, Gamma Knife radiosurgery, and pegvisomant, the first in its class of new GH receptor antagonists. Although it does not appear that Gamma Knife radiosurgery results in significantly higher cure rates or fewer complications, it does provide a notable improvement in delivery compared with conventional radiation. Early studies have reported IGF-I normalization in 48% of lanreotide-treated patients and up to 97% of pegvisomant-treated.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47523/1/11102_2004_Article_5120841.pd

Synthesis of new 1- 2-azido-2-(2,4-dichlorophenyl)ethyl -1H/-imidazoles and in vitro evaluation of their antifungal activity

International audienc

A many-analysts approach to the relation between religiosity and well-being

The relation between religiosity and well-being is one of the most researched topics in the psychology of religion, yet the directionality and robustness of the effect remains debated. Here, we adopted a many-analysts approach to assess the robustness of this relation based on a new cross-cultural dataset (N=10,535 participants from 24 countries). We recruited 120 analysis teams to investigate (1) whether religious people self-report higher well-being, and (2) whether the relation between religiosity and self-reported well-being depends on perceived cultural norms of religion (i.e., whether it is considered normal and desirable to be religious in a given country). In a two-stage procedure, the teams first created an analysis plan and then executed their planned analysis on the data. For the first research question, all but 3 teams reported positive effect sizes with credible/confidence intervals excluding zero (median reported β=0.120). For the second research question, this was the case for 65% of the teams (median reported β=0.039). While most teams applied (multilevel) linear regression models, there was considerable variability in the choice of items used to construct the independent variables, the dependent variable, and the included covariates

A Many-analysts Approach to the Relation Between Religiosity and Well-being

The relation between religiosity and well-being is one of the most researched topics in the psychology of religion, yet the directionality and robustness of the effect remains debated. Here, we adopted a many-analysts approach to assess the robustness of this relation based on a new cross-cultural dataset (N = 10, 535 participants from 24 countries). We recruited 120 analysis teams to investigate (1) whether religious people self-report higher well-being, and (2) whether the relation between religiosity and self-reported well-being depends on perceived cultural norms of religion (i.e., whether it is considered normal and desirable to be religious in a given country). In a two-stage procedure, the teams first created an analysis plan and then executed their planned analysis on the data. For the first research question, all but 3 teams reported positive effect sizes with credible/confidence intervals excluding zero (median reported β = 0.120). For the second research question, this was the case for 65% of the teams (median reported β = 0.039). While most teams applied (multilevel) linear regression models, there was considerable variability in the choice of items used to construct the independent variables, the dependent variable, and the included covariates

L'Éducation psychomotrice à l'école élémentaire

Eesti Arst 2011; 90(9):431–44