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Biomedical subjects

A Weizman

Publications and source records attributed to A Weizman.

At least 163 records · Page 9Linked to original sources
PubMed1998

Reliability and validity of the Family Eating and Activity Habits Questionnaire.

OBJECTIVE: The purpose of this work was to develop and test an instrument that will identify the factors that facilitate childhood obesity and monitor the environmental changes and family behavior modifications associated with weight loss. DESIGN AND METHODS: The relevant factors that affect obesity and weight loss in children were divided into four scales: activity level, stimulus exposure, eating related to hunger, and eating style. We designed a questionnaire to be completed by the parents of the obese child aged 6-11 years. Scores accumulated were calculated separately for each member of the family. Higher numerical scores reflected less appropriate eating patterns. The questionnaire reliability (test-retest), internal consistency and ability to discriminate obese vs normal-weight children's behaviors was tested using a pilot population of 40 mothers not enrolled in a formal weight loss program. The questionnaire reliability (parents' report and spouse report) and predictive validity was tested using a selective population: 60 parents of obese children enrolled in a clinical intervention intended to treat childhood obesity with an environmental approach vs a dietary approach. RESULTS: The content validity of the questionnaire was evaluated by a team of ten experts. Cronbach's alpha was calculated to test internal consistency. Mean r was 0.83. Pearson's correlation coefficients were computed between test and retest scores for individual items and for the total score, and ranged from 0.78 to 0.90 (median 0.84) (P < 0.01 for all). Total score test-retest r was 0.85 (P < 0.01). The total family score was also higher in the families with an obese child compared to families with a normal-weight child, P < 0.01. No significant differences were noted between parent report and spouse report scores. The construct validity of the questionnaire was also supported by its high sensitivity to weight loss treatment. Weight loss in the child correlated highly with improvement in questionnaire score. CONCLUSIONS: The Family Activity and Eating Habits Questionnaire is reliable and internally consistent, and it is useful as an optional tool for planning an intervention program for childhood obesity.

Behavior↗
PubMed1998

Role of behaviour modification in the treatment of childhood obesity with the parents as the exclusive agents of change.

OBJECTIVE: This study examined the reduction in overweight and changes in eating-related behaviours in obese children treated with a family-based approach, in which the parents were the exclusive agents of change. Results were compared to the conventional approach in which children are responsible for their own weight loss. DESIGN: A one-year longitudinal prospective design was used. Participants were randomly allocated for the experimental (parents as the agents of change) or the conventional (children as the agents of change) intervention. METHODS: Sixty obese children (20% over ideal weight for age, height and gender) aged 6-11 y (mean+/-s.d. 9.2+/-1.0 y) were included in the study. Anthropometric measurements and biochemical tests were performed on the children and their parents before and after the programme, and both parents completed a sociodemographic and a family eating and activity habits questionnaire. Hour-long support/educational sessions were conducted by a clinical dietitian-14 sessions for the parents in the experimental intervention and 30 for the children in the conventional intervention. Individual sessions were held for members of both groups, when necessary. RESULTS: Significant differences were found between the two groups in the reduction of exposure to food stimuli and changes in eating habits (eating while standing, watching TV, reading or doing homework, eating following stress and eating between meals). Mean weight reduction (by percentile) was significantly greater in the experimental intervention group (parent-only treatment) in comparison to the conventional intervention group (child-only treatment). CONCLUSIONS: Treatment of childhood obesity with the parents as the exclusive agents of change, induces more behavioural changes as well as greater weight loss, than the conventional approach.

Behavior Therapy↗
PubMed1998

HLA-B38 and clozapine-induced agranulocytosis in Israeli Jewish schizophrenic patients.

To further substantiate reports of an association between the major histocompatibility complex subtypes and clozapine-induced agranulocytosis, HLA typing was performed in 61 Jewish Israeli schizophrenic patients, in 11 of whom agranulocytosis developed following clozapine treatment and in 50 (controls) of whom it did not. Of the 11 agranulocytosis patients, seven (63%) were of Ashkenazi origin and four (37%) of Sephardi origin. There was no difference in ethnic origin between the arganulocytosis and non-agranulocytosis groups (chi 2 = 2.4, d.f. = 1, P = 0.11), although the agranulocytosis patients had a higher frequency of the HLA B38 antigen (8/11 or 72% vs. 6/50 or 12%; chi 2 = 18.7, d.f. = 1, P < 0.001). These results suggest that major histocompatibility complex gene products could be involved in clozapine-mediated haematological complications.

Adult↗
PubMed1998

Parents as the exclusive agents of change in the treatment of childhood obesity.

BACKGROUND: Excessive weight in childhood is a serious public health concern because of its costly health consequences and its increasing prevalence. OBJECTIVE: Our objective was to compare the efficacy of a family-based approach for the treatment of childhood obesity, in which the parents served as the exclusive agents of change, with that of the conventional approach, in which the children served as the agents of change. DESIGN: This study had a randomized, longitudinal prospective design and lasted 1 y. Sixty obese children aged 6-11 y were randomly allocated to the experimental (parents as agents of change) or control (children as agents of change) group. Anthropometric and biochemical measurements were determined at the start and end of the study. A sociodemographic questionnaire and a family eating and activity habits questionnaire were completed by both parents. Hour-long support and educational sessions were conducted by a clinical dietitian: 14 sessions for the parents in the experimental group and 30 sessions for the children in the control group. RESULTS: The dropout rate was nine times greater in the control group (n = 9) than in the experimental group (n = 1). Mean percentile weight reduction was significantly (P < 0.03) higher in children in the experimental group (14.6%) than in the control group (8.1%). CONCLUSIONS: Treatment of childhood obesity with parents as the exclusive agents of change was superior to the conventional approach, as indicated by the dropout rate and the percentage weight loss of the children during the 1-y intervention.

Adult↗
PubMed1998

Clinico-tremorgraphic features of neuroleptic-induced tremor.

Instrumental tremorgrams have been used to improve the diagnostic accuracy of various movement disorders, including tardive akathisia. The aim of the present work was to evaluate their place in the diagnosis of neuroleptic-induced tremor and to determine whether they can help to differentiate this disorder from other neuroleptic-induced movement disorders and from other types of tremor. Fourteen psychiatric patients treated with various neuroleptic medications were diagnosed as having neuroleptic-induced tremor on the basis of clinical criteria. They underwent accelerometric recordings following diagnosis. All patients demonstrated upper-limb tremor; four also had involvement of the lower limbs, jaw or tongue. Most demonstrated both resting and postural tremor, the latter being the more prominent. The tremor was mainly rhythmic, regular and sinusoidal. It did not significantly interfere with activities of daily living in the majority of patients, but four did exhibit some degree of impairment. Repeated accelerometric recordings showed constant and regular waveforms and frequencies (between 4 and 7 Hz) in each patient. We conclude that the presence of repeated constant waveforms and frequencies on accelerometric tracings may serve as confirmation of the diagnosis of neuroleptic-induced tremor. In light of the findings of this and other studies, we suggest that tremorgrams may be helpful in differentiating neuroleptic-induced tremor from other neuroleptic-induced movement disorders (e.g., tardive dyskinesia and tardive akathisia) and from psychogenic tremor. Although these techniques may also assist in the differentiation of neuroleptic-induced tremor from some tremor disorders (e.g., asterixis or ataxic tremor), their overall potential to distinguish it from other types of organic tremor is more limited.

Adult↗
PubMed1998

Olanzapine treatment in patients with typical and atypical neuroleptic-associated agranulocytosis.

Two cases are reported of patients who developed agranulocytosis after treatment with typical and atypical antipsychotics. The patients were successfully treated with olanzapine. We suggest the consideration of olanzapine as a safer treatment in patients who require immediate continuation of antipsychotic medication and have a prior history of classic and atypical neuroleptic-induced agranulocytosis.

Adult↗
PubMed1998

Elevated serum creatine kinase activity in adolescent psychiatric inpatients on admission.

Studies in adults have indicated a significant relationship between high serum creatine kinase levels on admission and acute psychosis. However, data on children are sparse. The files of 183 hospitalized children and adolescents (93 boys, 90 girls) with severe psychiatric disorders were reviewed for serum creatine kinase activity on admission, psychomotor agitation, Clinical Global Impression Score, need for intramuscular injection, number of neuroleptic medications and presence of neuroleptic malignant syndrome. Serum creatine kinase levels > 201 IU/ml were considered abnormal. Boys had significantly higher creatine kinase activity than girls. Division of the cohort by diagnosis yielded significantly higher levels in those with schizophrenia, affective disorders and mental retardation. Higher levels were also associated with higher Clinical Global Impression score on admission, use of injections and physical restraint, and nonresponse to neuroleptic medication. There were no cases of neuroleptic malignant syndrome. This first large-scale investigation of serum creatine kinase activity in young psychiatric inpatients shows a significant association between high creatine kinase activity and acute psychosis, similar to that in adults. Furthermore, high creatine kinase levels on admission are predictive of the severity of the psychosis, but are not associated with neuroleptic malignant syndrome. Because psychotic adolescents with high admission creatine kinase levels tend to be nonresponders, clinicians should consider the early use of atypical antipsychotics in this subgroup.

Adolescent↗
PubMed1998

Belief in transmigration of the soul and psychopathology in Israeli Druze. A culture-sensitive psychotherapeutic approach.

One of the central tenets of the Druze religion is the transmigration of the soul. In rare cases this belief may be related to psychopathology or cause a temporary inability to function normally. We report on 5 Druze patients whose preoccupation with transmigration was the basis of their pathological behavior. These cases illustrate the interaction between cultural and religious beliefs, and psychopathology, and emphasize the importance of employing a culture-specific psychiatric approach in the management of this type of patients.

Adult↗
PubMed1998

Use of atypical neuroleptics in child and adolescent psychiatry.

BACKGROUND: This article reviews the published clinical experience with atypical neuroleptics in children and adolescents. METHOD: A computerized literature search was conducted (MEDLINE, 1974-1998) to retrieve all reports on the use of atypical neuroleptics in children and adolescents. A hand search was performed as well. All relevant clinical data were collated by type of drug. RESULTS: We found 5 blind placebo-controlled clinical trials (105 patients), 24 open-label clinical trials (387 patients), and 33 case series (115 patients) describing the use of the atypical neuroleptics clozapine, risperidone, olanzapine, sulpiride, tiapride, amisulpride, remoxipride, and clothiapine in children and adolescents. Some of these agents, especially clozapine, risperidone, and olanzapine, were found to be efficacious in the treatment of schizophrenia, bipolar disorders, and pervasive developmental disorders. The role of atypical neuroleptics as augmenters of serotonin reuptake inhibitors in obsessive-compulsive disorder is unclear. Risperidone appears to possess anti-tic properties in patients with Tourette's disorder. CONCLUSION: The most convincing evidence of the efficacy of atypical neuroleptics in children and adolescents concerns clozapine in the treatment of schizophrenia. Data on other atypical neuroleptics in other disorders are still sparse, and further research is needed. Some of the atypical neuroleptics may become the first-line treatment for childhood schizophrenia and pervasive developmental disorders.

Adolescent↗
PubMed1997

Velocardiofacial manifestations and microdeletions in schizophrenic inpatients.

Velocardiofacial syndrome (VCFS) is associated with an increased frequency of schizophrenia and other types of psychiatric morbidity. In this study, we tried to identify a subgroup of schizophrenic patients with deletions in the VCFS region of the long arm of chromosome 22. For that purpose, we screened the records of two major general hospitals for patients with abnormalities characteristic of VCFS, such as cardiac anomalies and cleft palate, and cross-checked the data with the register of psychiatric hospitalizations in four psychiatric hospitals. Of the 24 patients that qualified, only seven patients could be studied. An additional eight schizophrenic inpatients were ascertained clinically, based on a working VCFS Clinical Scale. FISH studies and molecular analyses, using polymorphic markers from the VCFS region, documented hemizygosity of 22q11 in three out of 15 patients (20.0%). Increased awareness of psychiatrists to signs of VCFS among patients with psychiatric illnesses is encouraged, in order to direct molecular studies effectively. In order to cut down the cost of testing, we suggest screening suspected patients with a single marker, such as D22S941, and to study further only those who have a single electrophoretic band.

Abnormalities, Multiple↗
PubMed1997

Elevated levels of serum interleukin-1 beta in combat-related posttraumatic stress disorder.

Levels of serum interleukin-1 beta (IL-1 beta) and soluble interleukin-2 receptor (sIL-2R) were assessed in 19 male patients with combat-related posttraumatic stress disorder (PTSD) in comparison to 19 age- and sex-matched healthy volunteers. Serum IL-1 beta levels (but not sIL-2R) were significantly higher (p < .001) in the PTSD patients than in the controls. IL-1 beta levels did not correlate with cortisol levels, severity of PTSD, anxiety, depressive symptoms, or alexithymia score; however, they did correlate significantly (r = .54, p < .005) with the duration of PTSD symptoms. It is possible that desensitization of the hypothalamic-pituitary-adrenal axis in chronic PTSD patients counteracts the stimulatory effect of IL-1 beta on cortisol secretion.

Adult↗
PubMed1997

Opposite modulatory effects of ovarian hormones on rat brain dopamine and serotonin transporters.

The present study was designed to investigate the modulatory effect of gonadal steroids on brain dopamine (DA) and serotonin (5-HT) presynaptic transporters in female and male rats. Female and male rats were castrated and treated with either vehicle or gonadal hormones. The pharmacodynamic characteristics of the DA and 5-HT transporters were analyzed by [3H]BTCP and [3H]imipramine binding respectively. Ovariectomy (OVX) resulted in an upregulation of the striatal DA transporter and this alteration was prevented by estradiol (E2) or E2 + progesterone (P) treatment but not by P alone. In contrast to the DA transporter, the hypothalamic 5-HT transporter was down-regulated by OVX in female rats and this decrease was reversed by the administration of E2, P or their combination. The striatal DA transporter and the hypothalamic 5-HT transporter in male rat were not affected by orchidectomy or by administration of testicular hormone. Our findings indicate that ovarian, but not testicular, steroid hormones may play an important role in the regulation of brain DA and 5-HT transporters. It appears that ovarian hormones modulate rat brain 5-HT and DA transporters in opposite directions. These interactions between ovarian steroids and presynaptic transporters may be relevant to DA- and 5-HT-related neuropsychiatric disorders.

Animals↗
PubMed1997

Role of lipid-induced changes in plasma membrane in the biophysical shunt theory of psychopathology.

The existence of a lipid factor that either causes faulty lipid metabolism or directly contributes to the emergence of a biophysical shunt in neuronal membrane ionic flow propagation is proposed. The neuronal membrane contains a remarkable amount of phospholipids, glycolipids and cholesterol. It is assumed that, under certain unfavorable intrinsic states, the plasma membrane's lipid order and composition and, consequently, its cholesterol-to-phospholipid ratio, may change. This, in turn, may significantly modify membrane fluidity, altering the essential physical properties in the affected portions of the membrane and causing a disarray in the adjacent ion channels, leading to the establishment of a biophysical shunt in a loop-like operation, forming the basis for a variety of mental disorders. The present model offers a diet-induced lipid correction for the relief of psychopathological problems.

Animals↗