Related Symptomatology Research Articles

Neuropsychological sequelae of head injury in a New Zealand adolescent sample

The purpose of this study was to determine the nature and extent of any difficulties experienced by students after head injury, and the degree to which these were recognized by their parents and teachers. All year 10 students at a co educational high school in New Zealand were surveyed for information regarding incidence, aetiology and severity of head injury related symptomatology and general everyday competency. A proportion of students reporting injury (mostly mild) and a matched control group were studied in more detail. Information was obtained through a self report question naire, neuropsychological measures, and teacher and parent rating forms. Apart from trials 5 and 6 of the AVLT, in which the head injured group scored significantly lower than the control group, there were no other significant differences between the two groups on neuropsychological measures. There was a low level of agreement between students, teachers and parents with regard to behavioural and cognitive difficulties that the students were experiencing.

Results of a Brief Nutrition Survey of Outpatients Infected With HIV

LEARNING OUTCOME: To assess nutrition related symptomatology and nutrition information needs of HTV infected outpatients.A nutrition questionnaire was distributed to 29 HIV positive patients seen in an Infectious Diseases clinic not currently staffed by a Registered Dietitian (RD). The questionnaire sought to obtain four pieces of information: a) weight loss history, b) the presence of disease symptoms that could interfere with nutrient intake, c) nutrition information needs identified by the patient and d) from whom the patient had received nutrition information in the past. Results of the survey show that 28% were <96% of usual (pre-diagnosis) body weight. Twenty-eight percent had lost ≥10 pounds in the previous six months. Of the symptoms experienced, fatigue was the most common (79%), followed by loss of appetite (52%), diarrhea (48%), sore mouth (21%) and difficulty swallowing (21%). There was a dependency (P=0.05) between diarrhea and weight loss and sore mouth and weight loss. Nutrition information needs identified by patients were: vitamin/mineral supplements (55%), gaining weight (45%), oral supplements (31%), basic nutrition information (31%), and preparing easy meals (10%). Thirty-eight percent had received nutrition information in the past from friends, health food stores, doctors, nurses and RDs. This survey shows that the symptoms of diarrhea and sore mouth in HIV positive outpatients should be monitored and controlled to prevent weight loss. It also shows that this patient population desires additional nutrition information especially about whether to take vitamin/mineral supplements and how to gain or maintain weight. Without easy access to a RD, the patients seek this nutrition information from nurses, doctors, health food stores and friends.

Immunological reactivity in ranitidine factory workers.

The involvement of immunological reactivity to ranitidine base (R-b) and ranitidine hydrochloride (R-HCl) in the development of occupationally related symptomatology was analyzed in 40 subjects employed in a pharmaceutical plant producing ranitidine and in 33 nonexposed controls, using a specific dose-response lymphocyte proliferative test (lymphocyte transformation test: LTT). Of the 40 workers, 11 (28%) gave positive reactions to LTT: 3/11 to R-b, 4/11 to R-HCl, and 4/11 to both compounds. None of the controls gave positive reactions. Cutaneous, oculonasal, or respiratory work-related symptoms were cited by 23 of the 40 (58%) subjects; ten of these 23 subjects (43%) were LTT positive. One asymptomatic case was LTT positive. The present results indicate that specific immune reactivity to ranitidine, analyzed by LTT, is associated with the presence of occupational symptomatology; R-HCl and R-b seem to share some antigenic determinants, because of the partial cross-reactivity shown by the examined compounds. Nonimmunological, probably irritative, mechanisms are also present in some of the symptomatic subjects.

Cardiac awareness before and after cognitive-behavioral treatment for panic disorder

Recent cognitive-behavioral theories of panic disorder (PD) suggest that PD patients experience heightened anxiety over, and hypervigilance for, specific physical sensations. Researchers have recently begun to examine whether PD patients evidence heightened interoceptive awareness, relative to normals, with inconclusive results. The present study examined changes in cardiac awareness in 15 PD patients following cognitive-behavioral treatment. Before and after treatment, cardiac awareness was evaluated by having patients count heart beats during specified intervals while actual heart rate was monitored. Despite significant reductions in panic attacks and related symptomatology, cardiac awareness did not change on average, although some individual subjects showed dramatic changes in either direction. As was the case with the entire sample, a subgroup of patients who showed the greatest reduction in anxiety over panic sensations did not evidence significant changes in heart beat awareness. The implications of these results are discussed.

Initial experience with beta blockers in dilated cardiomyopathy

In early 1973, Waagstein administered bolus intravenous injections of practolol and, subsequently, alprenolol, 50 mg twice daily, to reduce the heart rate of a 59-year-old woman with refractory, idiopathic dilated congestive cardiomyopathy (DCCM) and resting tachycardia. The patient's condition improved dramatically and continued to improve during subsequent oral therapy. This experience, combined with increasing interest in the role of β blockade in myocardial protection, led to investigation of oral practolol, 50–400 mg twice daily, for 2–12 months in 6 additional patients with advanced DCCM. These findings, published in 1975, indicated improved ventricular function for all participants. In a 1980 open-label follow-up study, 28 patients with DCCM received alprenolol, metoprolol, practolol, or propranolol. Treatment was associated with improvements in myocardial function as well as in related symptomatology. These effects were reversed following drug withdrawal. The findings suggested that β blockers possessed potential value in treatment of idiopathic DCCM.

Global self-evaluations and perceived instability of self in early adolescence: a cohort longitudinal study.

A cohort longitudinal design with four adjacent cohorts of students (n = 1689) followed over two years was used to study key issues identified in the research literature on the development of self-evaluations in early adolescence. There was no clear relationship between age/grade and self-evaluations. We found no support for a "stressful periods" hypothesis with respect to self: Possible changes were very gradual and quite small. However, there was a consistent "relative age" effect implying that younger students within a grade had more negative self-evaluations. There were small but consistent sex differences in self-evaluations in favor of the boys; more detailed analyses of very negative self-evaluations suggested that the early adolescent years are the period in which a sex difference in depression related symptomatology begins to emerge. Finally, the usefulness of some kind of effect size measure and advantages and problems associated with a cohort longitudinal design were discussed.

The Gulf War and its impact on burnout and well-being of working civilians.

Burnout signifies the chronic depletion of coping resources following prolonged exposure to emotionally charged demands. It is manifested by symptoms of emotional, physical and cognitive exhaustion, and is usually studied in relation to occupational stressors. We hypothesized that the major life crisis engendered by missile attacks would give rise to burnout or exacerbate preexisting burnout symptoms. We also hypothesized that individuals suffering from prewar burnout would appraise the war as being more threatening and would be more vulnerable to upper respiratory infections (URI). Wartime and pre-war (baseline) levels of burnout and related symptomatology (cognitive weariness, listlessness, tension and somatic complaints) were compared among 162 Israeli civilians who carried on with their employment duties throughout the Gulf War. We found that the war impacted primarily on younger individuals (age < 45). All the pre-war levels of the above measures increased significantly (except for a marginal increase in tension). The impact of the war was mediated by threat appraisal, as indicated by worry and apprehension. Worry was positively associated with pre-war burnout, and negatively with age and education. Pre-war burnout was associated positively with wartime URIs. It was concluded that the war accelerated the depletion of coping resources and that burnout may be affected by factors other than occupational stress.

Cocaine and speedball users: Differences in psychopathology

Affective distress and related symptoms associated with co-injected cocaine and opioid (“speedball”) use are incompletely explored, and the extent to which they diverge from problems shown by cocaine abusers who do not prefer opioids is unknown. This investigation compared groups of speedball and non-speedball cocaine users on global measures of depression and anxiety and modal groupings of personality characteristics measured by the MMPI. Compared to men who use cocaine without opioids, compulsive speedball users evidenced significantly greater problems with depression, trait anxiety, and related symptomatology, and were more uniformly characterized by modal profiles reflecting severe psychopathology and maladjustment. These results agree with descriptions of severe pathology associated with speedball use.

Intractable Sneezing in Children: A Case Report and Review of the Literature

Intractable sneezing is rare and may not be familiar to many physicians. A 10-year-old girl had a mild viral illness that culminated in uncontrollable sneezing without any other symptoms. She sneezed with her eyes either opened or closed, and her sleep usually was not interrupted by sneezing. Routine physical and rhinoscopic examination as well as laboratory investigations were normal. Multiple oral and topical medications were ineffective in providing long-term relief from sneezing. The patient had no obvious school or home problems, but evaluation by a child psychiatrist revealed significant internal conflicts. Educationally, she was a "gifted child," yet she displayed infantile behavior, manifested by her continued sleeping with her parents. Family psychotherapy was recommended. Common features of psychogenic intractable sneezing are presence in an adolescent female, sneezing with eyes open, quiescence during sleep, nonresponse to medical therapy, normal physical examination, lack of related symptomatology, underlying psychologic stress, and good response to psychiatric techniques. Early consideration of a psychogenic origin and prompt psychiatric intervention for intractable sneezing may forestall exhaustive diagnostics and result in complete symptom resolution.

Treatment with Intravenous Colchicine

This article studies 27 patients with resistant temporomandibular related symptomatology. It evaluates them comparing both their dental and medical diagnosis after the treatment with intravenous and oral colchicine. Modern medicine has used this drug in the treatment of gouty arthritis. It is, however, the oldest medication used in recorded history. Colchicine is a potent drug with potential side effects. Intravenous colchicine's major complication is the possible painful chemical burn to the injection site which may occur if the drug extravasates from the vein.

The evolution of a therapy group for vietnam veterans on a general psychiatry unit

The evolution of a therapy group for hospitalized Vietnam veterans with post-traumatic stress disorder (PTSD) and related symptomatology is described. The literature on group treatment for this population is briefly reviewed and discussed in relation to an inpatient psychiatry setting. The prevailing conditions at the time of group inception are recalled along with the initial goals of the therapeutic intervention. Problems encountered are also discussed, along with the changes made in response to these identified difficulties. The results of three and one-half years of experience with this group are described in detail.

Abuse of benzodiazepines in western European society--incidence and prevalence, motives, drug acquisition.

A nation-wide survey on the abuse of benzodiazepines in Switzerland showed an average morbidity (incidence) of 0.0006 per year for isolated abuse of benzodiazepines. The exposure risk was, independently of the benzodiazepine compound used. 0.00002 per prescription. The afflicted population differed demographically in no way from the population of "normal" benzodiazepine consumers, legitimate therapeutic use of a benzodiazepine being the only visible risk factor for development of an abuse. The motivation for abuse, too, was in about 90% of the case self-medication of anxiety and/or insomnia and related symptomatology. Main source of the drug was new prescriptions by the treating physician. The majority of patients were medically in a good state of health and socially well adjusted; 52 out of 180 patients, however, showed negative consequences. Withdrawal syndromes were reported in about one quarter of the detected cases, but detection was mostly due to the increased frequency of prescriptions of confession of the patient. Because of the low frequency of severe negative consequences and the mostly unobtrusive behaviour of the patients, differing in many ways from the accustomed picture of an "abuser of (illicit) drugs", the physician's attitude towards abuse of benzodiazepines was in many cases ambivalent, resulting in a tacit acquiescence and continued prescription. From the data presented it is concluded that the most appropriate measure against abuse of benzodiazepines would be, rather than international control, education of medical professionals and the public, according to internationally accepted medical knowledge and to national law and prescription regulations.

Estrogen predisposes to cholecystectomy but not to stones

The effect of estrogen treatment on risk for cholecystectomy, cholelithiasis, peptic ulcer, and other disorders was investigated using autopsy data from a study of patients randomized to hormonal therapy for prostatic cancer. Treatment with diethylstilbestrol, a nonsteroidal estrogen, was associated with an increased number of cholecystectomies but was unrelated to the presence of cholelithiasis at autopsy. These findings support previous reports of an association between steroidal estrogen use and cholecystectomy, but the risk estimate was more than three times that previously reported. Despite this risk and ample experimental evidence demonstrating that estrogen increases bile lithogenicity, no relationship between estrogen use and cholelithiasis was observed. The absence of such a relationship could not be readily explained by the study size, dose, or duration of estrogen treatment, treatment after leaving the study, or the frequency of preexisting stones. Given these findings the increased cholecystectomy risk may have resulted from estrogen related symptomatology mimicking gallbladder disease or an actual pathophysiologic effect of estrogen on the gallbladder, perhaps involving impaired emptying. In addition, estrogens, orchiectomy, or both were associated with a decreased frequency of peptic ulcer, supporting reports of the efficacy of estrogen in the treatment of peptic ulcer.

Prevention of hypoglucosemia by fructose in infants of diabetic mothers.

HYPOGLUCOSEMIA occurs consistently in infants of insulin-dependent diabetic mothers during the initial hours of life.1 2 3 4 Previous studies have not clearly related symptomatology to the level of blood glucose.5 6 7 Furthermore, the effect of hypoglucosemia on mortality, morbidity and ultimate mental development is not well defined. The following observations suggest that subtle as well as overt symptoms regularly occur in the initial hours of life in association with hypoglucosemia. Fructose administration was found to alleviate symptoms and to alter the course of blood glucose. Methods In addition to the methods and material previously described4 7 infants received fructose directly into the umbilical . . .

Juvenile osteochondreal (chondro-epiphysitis) hypothyroidism

A consecutive group of twenty-seven cases of juvenile osteochondritis is presented. Of the twenty-seven patients two males were classified as Perthes' disease; one male and one female as slipped upper femoral epiphyses, seven males and three females as Osgood Schlatter's disease, 5 males and 1 female as apophysitis, two males as Köhler's disease and three males and two females as epiphysitis of the spine. The age range was from five to fifteen years. All displayed definitely related symptomatology. The Roentgen diagnoses in all were unbiased as they were made by a cross-section of able roentgenologists. Every patient routinely received desiccated thyroid orally in a full, therapeutic dose. In addition, those patients displaying other signs of endocrine dysfunction, such as the late descent of testicles and delay in adolescence, were treated with the pituitary sex-like hormone. An attempt was made to correct obesity when present. All cases were ambulatory. No immobilization was necessary except for Case IX under Osgood Schlatter's disease whose knee was immobilized for only two weeks. No hospitalization was required. The expense was reduced to a minimum. Normal ossification of the epiphyses was hastened as indicated from the subsequent x-ray findings. Clinical cure was affected more rapidly. It is our belief that the pre-accepted orthopedic methods of treatment are fundamentally incorrect and present many disadvantages. The period of immobilization is long. It can lead to restriction of joint function, muscular atrophy and loss of school and play time. The expense of hospitalization and convalescent care may rise to considerable proportions. Open operations requiring even more detailed care have not produced the desired result either etiologically or functionally because the lacking tissue differentiating factor is not supplied. While immobilization can and does relieve pain, there is no stimulation of the true etiological factor involved without thyroid therapy.

ACUTE BENIGN INFECTIOUS MYELITIS

During the World War, and in the following decade, there appeared in the literature reports of cases of infections of the cerebrospinal nervous system, with quite a related symptomatology. While the brunt of the infection seemed to have been borne by the cord, roots and peripheral nerves, the rest of the nervous system was not spared. The disease was ushered in by an upper respiratory or general systemic infection, with pain in the chest, back, abdomen and extremities, radicular in its distribution. Presently there developed paresis in one or more of the lower extremities, resulting in flaccid paraplegia and even in quadriplegia. Occasionally the paralysis was of an ascending nature, with medullary involvement resulting in death. There occurred marked reduction and even abolition of the deep tendon reflexes. There was also disturbance in the control of the sphincters. There were subjective as well as objective sensory disorders, both deep as