In order to investigate whether catecholamines play a role in the hyperkinetic child syndrome, we determined noradrenaline and adrenaline plasma levels before and after treatment with methylphenidate. The children were separated into drug responders and non-responders according to the efficacy of methylphenidate on behavioral symptoms. 21 children, 6-13 years of age, participated in this double-blind placebo controlled cross-over study. Conners' questionnaire was used to estimate the extent of the hyperactivity and to assess the drug response. Blood samples were drawn under resting and exercise conditions and plasma catecholamine concentrations determined as an indication of the amine release rate and the reactivity of the sympathoadrenal system. The results may be summarized: The postexercise noradrenaline levels of untreated hyperkinetic children were slightly, but not significantly higher than those of an age-matched control group. After 3-4 weeks of stimulant medication the noradrenaline release induced by physical exercise was significantly lower than after placebo. 12 out of 21 children showed an alleviation of their symptoms during methyl- phenidate therapy and thus could be assumed as drug-responders. When children were separated into drug-responders and non-responders according to the degree of the clinical improvement, both groups showed the same catecholamine release in response to exercise. Methylphenidate reduced the noradrenaline release in 9 out of 11 children in the responder group and in 7 out of 9 children in the non-responder group. In conclusion, catecholamines may be involved in the hyperkinetic child syndrome, but because of the heterogenity of this syndrome the depression of the plasma catecholamines as observed under methylphenidate could not differentiate between drug-responders and non-responders.

Adolescent↗

PubMedDate not supplied

Psychosocial dimensions of epilepsy: a review of the literature.

The literature on psychosocial dimensions of epilepsy has been reviewed utilizing the framework developed by Dodrill et al. (Epilepsia 1980; 21:123-35). Factors considered were family background, emotional adjustment, interpersonal adjustment, vocational adjustment, financial status, adjustment to seizures, and medicine and medical management. The published studies highlighted a number of issues and sometimes rendered varying and contradictory conclusions. In general, epilepsy fosters certain reactions in family members. If negative, these reactions may be detrimental to the person with epilepsy. The association between specific emotional adjustment factors and epilepsy is not conclusive. Studies have been published which support as well as refute this association. Studies indicate that persons with epilepsy experience lower rates of marriage and more sexual difficulties than do nonepileptic persons. Studies report greater unemployment and underemployment in epileptic persons than in the population at large. Studies suggest that some persons with epilepsy manifest an attitude of nonacceptance of self. Some are reluctant to disclose their disability to others. The studies also indicate the presence of a discriminatory attitude by some nonepileptic persons toward epileptic persons. Several factors are associated with successful medical management of epilepsy. The emphasis in research studies with regard to psychosocial aspects of epilepsy focuses predominantly on individual deficiencies rather than on strengths and abilities.

Aggression↗

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The evolution of a distance education initiative into a major telehealth project.

After a five-year collaboration in distance learning, the University of Texas Medical Branch in Galveston School of Nursing and the Lamar University Department of Nursing in Beaumont, Texas, opened discussions during the mid-1990s about working together to establish a cutting-edge telehealth clinic. Other participants in this dialogue were the UTMB Division of Pediatric Special Services (DPSS) and the East Texas Area Health Education Center (ETAHEC). DPSS hoped to provide telehealth services for children who had to commute routinely to receive comprehensive health care. ETAHEC, which specializes in building community-academic partnerships to improve the health of populations in its service region, had already worked with members of the team, providing support for the distance education collaboration between UTMB and LU. Several meetings between representatives from the two universities and ETAHEC resulted in the decision by LU to establish an infrastructure for distance learning that could also support telehealth activities. UTMB, which offered family nurse practitioner education at LU through the earlier distance learning initiative, had extensive experience in both distance education and telehealth. It provided the expertise to ensure that the two types of technology could be provided on the LU campus. Eventually, a third university came on board, and the program expanded to provide services in six public schools. A single telehealth clinic, in operation for two years with over 112 client visits, has grown into a major telehealth initiative linking an academic health science center, universities, and school districts in Texas.

Child Health Services↗

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Fluorescamine in cytodiagnosis of thyroid carcinomas.

Fluorescamine, which reacts with primary amino groups yielding intensely fluorescent products, was found to induce intense fluorescence in cells from medullary and papillary thyroid carcinoma. No fluorescence was detected in cells from follicular or undifferentiated carcinoma or from benign thyroid lesions, except Hürthle cell adenomas, the cells of which exhibited moderate fluorescamine-induced fluorescence. This was demonstrated on fine needle aspiration biopsy smears pretreated with formaldehyde gas. Since the fluorescamine technique is simple and rapid, it may be of value as an aid in the cytodiagnosis of thyroid neoplasms.

Biopsy, Needle↗

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Group practice: the role of the dental hygienist in a health care delivery system.

Explore the source record for details and available documents.

Delivery of Health Care↗

PubMedDate not supplied

Shall poorly HL-A matched cadaveric kidneys be transplanted or discarded?

The study comprises 101 cadaveric kidneys transplanted in the last three years (1971-1974). Twenty-one retransplantations were included since the graft and patient survival in this group were equivalent to primary transplantations. There were 13 compatible grafts (A and B matches), 29 displaying one incompatible antigen (C match), 35 with two (D match) and 24 with 3 or 4 mismatches (E and G matches). At 9 months, there was a significantly lower graft survival in the E and G match group (33%) compared to the rest (p less than 0.01). For reasons discussed we will, however, for the first time being continue to transplant also the badly matched cadaveric kidneys.

Cadaver↗

PubMedDate not supplied

Gastrointestinal complications in 248 kidney transplant recipients.

In 248 kidney transplant recipients, 28 (11%) developed serious gastrointestinal complications after the transplantation. Upper gastrointestinal bleeding was the most common complication and accounted for 19 of the cases. Most of the haemorraging occurred during the first 6 months after transplantation and in conjunction with an episode of graft rejection. The mortality following upper gastrointestinal bleeding was 58%. Other serious complications encountered were lower gastrointestinal bleeding (4 cases), perforation of the colon (4 cases) and mesenteric vascular occlusion (1 case). Overall mortality was 43%.

Adult↗