Comorbidade entre abuso/dependência de drogas e o sofrimento psíquico em sete países da América Latina e um do Caribe

Fue realizado estudio multicéntrico en pacientes bajo tratamento por dependencia de alcohol y substancias ilícitas, en ocho países (Brasil, Chile, Guatemala, Jamaica, Nicaragua, Panamá, Paraguay, Uruguay). El objetivo fue investigar la frecuencia de distrés psicológico, diagnóstico actual de comorbilidades, y disfuncionalidad familiar percibida. Fueron incluídos 1.073 voluntarios adultos, que diligenciaron un cuestionario o fueron entrevistados. El distrés psicológico y la disfuncionalidad familiar fueron evaluados por escalas (Kessler K-10 y APGAR-family). Hombres predominaron en todos los lugares (edades entre 18 y 86). En la mayoría de los sitios, el diagnóstico actual de ansiedad varió entre 30% y 40% y el de depresión entre 20% y 35%. Niveles altos u muy altos de distrés psícológico fueron reportados por más de 70% en Uruguay, Nicaragua, Guatemala y Brasil. La disfuncionalidad familiar severa fue mayor en Panamá 34.7% seguida de los sitios de Nicaragua 20-25%. La prevalencia de distrés psicológico sugiere niveles altos de comorbilidad. __________________________________________________________________________________________________________________ ABSTRACTA multicenter study among patients in treatment for alcohol and illicit drugs abuse were conducted in eight countries (Brazil, Chile, Guatemala, Jamaica, Nicaragua, Panama, Paraguay, Uruguay). Our objective was to ascertain the frequency of psychological distress, current diagnosis of comorbidities and perceived familiar dysfunction. It was recruited 1,073 adult volunteers and they filled out a questionnaire or were interviewed. Psychological distress was evaluated through the Kessler's K-10 scale and family dysfunction by the APGAR-family scale. Male individuals predominated at all study sites (age range: 18-86). Current diagnosis of anxiety ranged from 30.0% to 40.0% in most sites. Current diagnosis of depression ranged from 20% to 35% in most sites. High and very high levels of psychological stress were higher than 70% in Uruguay, Nicaragua, Guatemala, and Brazil. Severe family dysfunction was higher in Panamá 34.7% followed by Nicaraguan cities 20-25%. The prevalence of psychological distress suggests higher rates of comorbidity. __________________________________________________________________________________________________________________ RESUMOFoi realizado um estudo multicéntrico em pacientes sob tratamento para dependência de álcool e substâncias ilícitas em oito países (Brasil, Chile, Guatemala, Jamaica, Nicarágua, Panamá, Paraguai, Uruguai). O objetivo foi averiguar a frequência de sofrimento psíquico, diagnóstico atual de comorbidades, e disfuncionalidade familiar percebida. Foram incluídos 1.073 voluntários adultos, que preencheram um questionário ou foram entrevistados. O sofrimento psíquico e a disfuncionalidade familiar foram avaliados por escalas (Kessler K-10 e APGAR-family). Os homens predominaram em todos os locais (idades entre 18 e 86). Na maioria dos locais, o diagnóstico atual de ansiedade variou de 30% a 40% e o de depressão, de 20% a 35%. Níveis altos e muito altos de sofrimento psíquico foram relatados por mais de 70% em Uruguai, Nicarágua, Guatemala e Brasil. Disfuncionalidade familiar severa foi maior no Panamá 34,7%, seguida da Nicarágua 20-25%. A prevalencia de sofrimento psíquico sugere níveis mais altos de comorbidade

Association of SNPs of CD40 Gene with Multiple Sclerosis in Russians

<div><p>Multiple sclerosis (MS) is a serious, incurable neurological disease. In 2009, the ANZgene studies detected the suggestive association of located upstream of CD40 gene in chromosome 20q13 (p = 1.3×10⁻⁷). Identification of the causal variant(s) in the <i>CD40</i> locus leads to a better understanding of the mechanism underlying the development of autoimmune pathologies. We determined the genotypes of rs6074022, rs1883832, rs1535045, and rs11086996 in patients with MS (n = 1684) and in the control group (n = 879). Two SNPs were significantly associated with MS: rs6074022 (additive model C allele OR = 1.27, 95% CI = [1.12–1.45], <i>p</i> = 3×10⁻⁴) and rs1883832 (additive model T allele OR = 1.20, 95% CI = [1.05–1.38], <i>p</i> = 7×10⁻³). In the meta-analysis of our results and the results of four previous studies, we obtain the association <i>p</i>-value of 2.34×10⁻¹², which confirmed the association between MS and rs6074022 at a genome-wide significant level. Next, we demonstrated that the model including rs6074022 only sufficiently described the association. From our analysis, we can speculate that the association between rs1883832 and MS was induced by LD, whereas rs6074022 was a marker in stronger LD with the functional variant or was the functional variant itself. Our results indicated that the functional variants were located in the upstream region of the gene <i>CD40</i> and were in higher LD with rs6074022 than LD with rs1883832.</p></div

Logistic regression association results for SNPs of <i>CD40</i> gene with the development of MS.

<p>Abbreviations: 95% CI, 95% confidence interval; OR, odds ratio; NA, not applicable; RAF, risk allele frequency in control group; SNP, single-nucleotide polymorphism; HWE-p-value of exact test for deviation from Hardy-Weinberg equilibrium in groups; AIC–Akaike Information Criterion. Analysis was performed for four models: co-dominant, dominant, additive and recessive. Significant associations are shown in italic. The best model for each of significant associated SNPs is shown in bold.</p

Meta-analysis of our results with previously published data on the association between rs6074022 and MS.

<p>Abbreviation: GenMSA (NL), GenMSA (US), GenMSA (CH), IMSGC (UK), IMSGC (US), BWH/TT, and ANZgene. In the meta-analysis the total OR for all studies was 1.17 (95% CI = 1.10–1.23) with a statistical significance of <i>p</i> = 2.24×10⁻¹². The heterogeneity test (<i>Q</i>-test) did not find significant differences between the studies (<i>χ</i>² (7) = 12.16, <i>p</i> = 0.10).</p

LD between the SNPs <i>CD40</i> gene.

<p>According to the result of the HapMap Project (v.3). union panel for Utah residents with Northern and Western European (CEU) and Toscans in Italy (TSI). SNPs from our study are shown in red frame.</p