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Biomedical subjects

B Black

Publications and source records attributed to B Black.

At least 37 records · Page 2Linked to original sources
PubMed1995

Psychiatric characteristics of children with selective mutism: a pilot study.

OBJECTIVE: To ascertain characteristics of children with selective mutism. METHOD: Subjects with selective mutism were evaluated by means of parent and teacher rating scales and structured diagnostic interviews. RESULTS: Thirty children were evaluated. Mutism severity varied markedly in different environmental settings. Ninety-seven percent of the subjects were diagnosed with social phobia or avoidant disorder of childhood or adolescence or both and 30% with simple phobia. No other psychiatric disorders were common. Parent and teacher rating scales showed high levels of anxiety symptoms, especially social anxiety, and low levels of all other psychiatric symptoms. Anxiety and social anxiety severity correlated with mutism severity. First-degree family history of social phobia and of selective mutism, obtained by family history method, was present in 70% and 37% of families, respectively. There was no evidence of a causal relationship between psychologically or physically traumatic experiences and development of selective mutism. CONCLUSIONS: Selective mutism may be a symptom of social anxiety, rather than a distinct diagnostic syndrome. Further study of the characteristics of children with selective mutism and their families is warranted.

Adolescent↗
PubMed1995

Anxiety disorders in children and adolescents.

Anxiety disorders are common in children and adolescents and may be associated with significant suffering, disruptions of normal psychosocial and academic development, disruption of family functioning, and increased utilization of medical services. They are frequently chronic disorders. Effective early interventions for children and adolescents with anxiety disorders may reduce or eliminate potentially life-long suffering and impairment.

Adolescent↗
PubMed1995

Mastoidectomy elimination.

Surgery that eliminates the open radical cavity takes three forms: obliteration (cavity fill-in, reconstruction (canal wall defect repair), or ablation (external canal closure). The evolution of each variety is reviewed in detail and a personal series of 240 cases is discussed. These included obliterations and reconstructions employing porous hydroxylapatite ceramic implants. Larger defects required Grote implants, but high facial ridge cases were managed with attic defect plates and limited canalplasty. Canal repair success rates improved with the use of the middle temporal flap to improve canal wall vascularity Residual cholesteatoma has been prevented by staged surgery, and recurrent disease has been virtually abolished by aggressive prevention techniques which employ drum reinforcement with finely shaven cartilage-perichondrium composite grafts. Ossiculoplasty procedures included 85 Plastipore columellas, 107 Oval-Top hydroxylapatite/Teflon columellas and, more recently, 17 Spanner malleus-stapes/footplate assemblies. Earlier poor results have been succeeded by more satisfactory levels. Since 1990, the air-bone gap has been closed to within 10 dB in 33% of cases and to within 20 dB in 66% of cases. Studies using SPITE (surgical, prosthetic, infection, tissues, and eustachian) adverse indicators have demonstrated high levels of pathology in elimination cases, when compared with nonelimination series. The SPITE studies have also demonstrated the reduction of pathology levels by staged surgery. Elimination surgery now provides permanent relief from the problem cavity in all but a few cases.

Bone Plates↗
PubMed1994

Treatment of elective mutism with fluoxetine: a double-blind, placebo-controlled study.

OBJECTIVE: To evaluate the efficacy of treatment with fluoxetine in reducing symptoms associated with elective mutism. METHOD: Sixteen subjects with elective mutism were treated with placebo (single-blind) for 2 weeks. Fifteen placebo nonresponders were then randomly assigned to double-blind treatment with fluoxetine at a dose of 0.6 mg/kg/day (N = 6) or continued placebo (N = 9) for an additional 12 weeks. Outcome ratings were completed by the treating psychiatrist, parents, and teachers. RESULTS: Significant improvements over time on ratings of elective mutism, anxiety, and social anxiety, rated by clinician, parents, and teachers, were demonstrated in both fluoxetine- and placebo-treated subjects. Subjects treated with fluoxetine were significantly more improved than placebo-treated subjects on parent's ratings of mutism change and global change. Clinician and teacher ratings did not reveal significant differences between treatment groups. Although improved, most subjects in both treatment groups remained very symptomatic at the end of the study period. Side effects were minimal. CONCLUSION: Fluoxetine may be beneficial and safe in the treatment of children with elective mutism. Longer periods of treatment may yield more substantial therapeutic benefits. Further study is indicated.

Adolescent↗
PubMed1994

Spanner malleus-stapes/footplate assembly.

A simply prepared and implanted ossiculoplasty prosthesis is described for use when the malleus is suited to assembly procedures. The one versatile hydroxylapatite and Teflon model is suitable for both the malleus-stapes and malleus-footplate role. Clinical trials of 80 prostheses in place for 5 to 18 months have confirmed excellent surgical handling properties combined with optimal audiological results.

Ear Ossicles↗
PubMed1994

Mastoidectomy reconstruction: revascularizing the canal wall repair.

Blood supply is the key to reconstruction of canal wall defects in cases of prior radical mastoidectomy. Revascularization of the defect is essential to nourish the overlying canal skin and to protect and supply the underlying solid support layer. Prior techniques have relied on free grafts or on local flaps of suspect vascular adequacy. A temporal pericranial flap is described that introduces a vascular bundle directly into the canal wall defect site. The flap is based on the superior and posterior aspects of the pinna and contains the middle temporal artery, which provides axial supply to the flap tip. The tissues of the flap are compact, enabling easy handling in the confines of the new canal. The flap is turned medially into the canal, avoiding compression or kinking of the vascular axis. The technique has been used in over 60 cases, producing excellent clinical results from a simplified technique.

Child, Preschool↗
PubMed1994

Mastoidectomy reconstruction: management of the high facial ridge using hydroxylapatite implants.

A high facial ridge is a common feature of open cavity cases presenting for rehabilitation and was present in 25 percent of a series of 223 cases requiring such surgery. A precise scutumplasty and posterior wall repair is required for optimal results. Prior organic methods have been found to be time-consuming, difficult, or unreliable. Current wall prostheses are unsuited in shape to these limited defects. Reconstruction using semicircular porous hydroxylapatite ceramic attic defect plates, has proved simple and effective when combined with posterior wall repair using autograft cartilage or sheets of porous hydroxylapatite ceramic. Reconstruction results from this group were the best of the larger series. This was attributable to lesser preoperative pathology, precise scutum repair, and more reliable revascularization of the defect area. The last was partly owing to the smaller dimensions involved, but has been improved by enhanced blood supply from the use of the middle temporal flap.

Durapatite↗
PubMed1993

Linkage of pyrethroid insecticide resistance to a sodium channel locus in the tobacco budworm.

Pyrethroids, with their lack of persistence and low mammalian toxicity, have been important insecticides since the early 1970s. However, heavy use has selected for resistance to pyrethroids in populations of many insects, in particular the tobacco budworm Heliothis virescens, a major cotton pest in the Americas. Several studies have identified the voltage-gated sodium channel as the principal target of pyrethroid action, and the sodium channel has been implicated in pyrethroid resistance in Musca domestica and Drosophila melanogaster. We present molecular genetic evidence that pyrethroid resistance is linked to a sodium channel locus in a strain of H. virescens. This is the first such evidence for any major agricultural pest, and is an important step towards understanding the molecular basis of resistance. This in turn will facilitate assessment, modeling, and control of resistance in pest populations, and increase our understanding of sodium channel function.

Alleles↗
PubMed1993

Blunted growth hormone responses to growth hormone-releasing factor and to clonidine in panic disorder.

Blunted growth hormone (GH) responses to growth hormone-releasing factor (GH-RF) and clonidine have been reported in patients with panic disorder. In this study GH-RF and clonidine were administered to 13 patients with panic disorder and 20 healthy volunteers. Compared to the normal subjects, the patients with panic disorder had significantly blunted GH responses after both GH-RF and clonidine.

Adult↗
PubMed1993

Multiple hereditary exostoses. An epidemiologic study of an isolated community in Manitoba.

From 1986 through 1988, 266 persons (149 adults and 117 children) were screened for multiple hereditary exostosis (MHE) in an isolated northern Ojibway community. Physical examination and confirmation by roentgenogram skeletal survey disclosed 21 children (19.4%) and 14 adults (9.5%) affected with MHE. Forty-one percent of children had lesions detectable before ten years of age, some as early as two years of age. Seventy-four percent of the lesions were characteristically sessile. Although lesions about the knee were most common, sites previously thought to be uncommon such as the metatarsals, hand, and spine were involved in 40% of the children. No cases of malignant degeneration have occurred in the adult population. Severity and multiplicity of lesions in successive generations point to an oncogenic gene origin. This study shows striking variance from current literature and provides a unique and valuable baseline assessment of research on the cause and natural history of MHE.

Adolescent↗
PubMed1992

Elective mutism as a variant of social phobia.

To examine the relationship between the syndromes of elective mutism and social phobia, a case of elective mutism associated with social phobia in a 12-year-old girl is presented, and the clinical literature regarding the syndrome of elective mutism is reviewed. Elective mutism or reluctance to speak in unfamiliar social situations may be a symptom of social phobia. Social anxiety is a nearly universal characteristic of children manifesting the syndrome of elective mutism. Elective mutism may respond to treatment with medications that also are effective in the treatment of social phobia. Elective mutism may be a manifestation of social phobia rather than a separate diagnostic syndrome. Pharmacologic treatment may be effective.

Child↗