Desipramine 75 mg i.m. was given in the morning to 20 adolescents with major depressive disorder and 23 normal controls. Depressed adolescents secreted significantly less growth hormone (GH) over the next 2 h than did normal adolescents, although a substantial proportion of the differences were accounted for by the depressed adolescents who had a specific suicidal plan or attempt during the episode. Severity of depression or the presence of other depressive symptoms did not predict GH secretion within the depressed group. Age, sex and maturational factors in the control of GH are discussed. It is concluded that these differences in GH secretion probably reflect differences in CNS beta-adrenergic and/or serotonergic function. Suicidality and depression may have different psychobiological correlates in adolescents.

Adolescent↗

PubMedDate not supplied

EEG sleep of young adults with major depression: a controlled study.

The EEG sleep of 75 subjects aged 16-25 years was studied. Thirty-eight were in an episode of RDC major depression, and 37 were normal controls. Only one sleep continuity measure differed between the two groups: sleep latency was significantly longer in the depressive group. REM period latencies and other sleep variables did not differ between the groups. Subgroup analyses, within the depressed group with respect to inpatient status, revealed significantly higher REM density (P less than 0.03) and a marginally shortened REM period latency (P less than 0.07) among the inpatient depressives. Subgroup analysis across suicidal ratings revealed a significantly higher REM density (P less than 0.04) among suicidal depressives. Severity estimates of depression did not correlate with sleep findings. These results parallel another recent report on adolescent depressed subjects, suggesting that inpatient and/or suicidal status is an important variable in the expression of EEG sleep abnormalities in the adolescent/young adult age group.

Adolescent↗

PubMedDate not supplied

Development, implementation, and evaluation of a medical Spanish curriculum for an emergency medicine residency program.

A 45-hour medical Spanish curriculum for an emergency medicine residency program was implemented in response to a need for "functionally bilingual" physicians in our practice setting, and to reduce reliance on translation assistance from nursing and clerical personnel. Course goals were to achieve a vocabulary level of 5,000-10,000 words for participants, and to achieve sufficient language capabilities for basic information exchange, obtaining uncomplicated medical histories, conducting unassisted physical examinations, and giving patient discharge instructions. Feedback obtained from post course interviews and instructor assessment indicated that the curriculum employed resulted in the attainment of the above goals for fully participating physicians.

Curriculum↗

PubMedDate not supplied

Usefulness of the stool Wright's stain in the emergency department.

A prospective study was conducted to determine if a Wright's stain of stool specimen to detect fecal leukocytes was accurate in predicting the presence of a bacterial pathogen on stool culture. Entry criteria were patient age greater than or equal to 3 months and diarrhea of greater than 1 day. The patient population was drawn from an urban county hospital emergency department on the Texas-Mexican border. A total of 69 patients were evaluated by both routine stool culture and stool Wright's stain. Twenty-three were evaluated for parasitic pathogens. There were seventeen cultures positive for bacterial pathogens and twenty-three positive Wright's stains. Bacterial isolates included Shigella, Salmonella and Campylobacter. Also detected were Giardia, Shistosoma, Blastocytis and Cryptosporidium. The sensitivity of a Wright's stain positive for fecal leukocytes for the presence of a bacterial pathogen by culture was 82%, with a specificity of 83%. These were significantly correlated with a positive culture for a bacterial pathogen (P less than .01). The predictive value of a positive result was 61%, and predictive value of a negative result was 94%, for bacterial pathogens. The Wright's stain is a useful tool for the early presumptive diagnosis of infectious bacterial diarrhea in the emergency department.

Adolescent↗

PubMedDate not supplied

Visual evoked potentials of infants.

Explore the source record for details and available documents.

Electroencephalography↗

PubMedDate not supplied

Biomarkers of exposure and potential harm in adult smokers of 3-7 mg tar yield (Federal Trade Commission) cigarettes and in adult non-smokers.

The paper reports levels of 24-h urine nicotine and five of its major metabolites (expressed as nicotine-equivalents) and blood carboxyhaemoglobin as biomarkers of exposure to particulate- and gas-phase cigarette smoke, respectively, from an exploratory pilot study of adult smokers of 3.0-6.9 mg tar delivery (Federal Trade Commission (FTC) method) cigarettes. On multiple occasions over 6 weeks, blood high-sensitivity C-reactive protein (hs-CRP), fibrinogen, HDL- and LDL-cholesterol, and 24-h urine 8-epi-prostaglandin F2alpha (8-epi-PGF2alpha) and 11-dehydro-thromboxane B2 (11-dehydro-TxB2) were also evaluated as biomarkers of potential harm. All the biomarkers examined, except for LDL-cholesterol, discriminated with high sensitivity and specificity between adult smokers and non-smokers overall. Except for HDL-cholesterol, all biomarker medians were greater in adult smokers than in non-smokers: urine nicotine-equivalents 64.514 versus < 0.034 nmol mg-1 creatinine (p<0.001), carboxyhaemoglobin 4.0 versus 0.4% saturation (p<0.001), hs-CRP 0.27 versus 0.12 mg dl-1 (p=0.05), fibrinogen 292 versus 248 mg dl-1 (p<0.001), HDL-cholesterol 46 versus 53 mg dl-1 (p=0.003), LDL-cholesterol 119 versus 109 mg dl-1 (p=0.18), urine 8-epi-PGF2alpha 1935 versus 1034 pg mg-1 creatinine (p<0.001) and urine 11-dehydro-TxB2 973 versus 710 pg mg-1 creatinine (p<0.001). All the biomarkers of exposure and most of the biomarkers of potential harm showed no time of sampling (by visit week) effect.

Biomarkers↗

PubMedDate not supplied

The structure and function of endoscope channels: the inside story.

The GIA who has knowledge of channels in the flexible endoscope can avoid the need for repairs due to channel blockage and will be able to achieve the best possible instrument care. This paper provides a detailed description of the channels of the working endoscope, including location, access and functional interrelation-ships, to help make cleaning, disinfecting and troubleshooting a logical process. Diagrams are included to clarify the descriptions.

Disinfection↗

PubMedDate not supplied

Stimulatory tests of growth hormone secretion in prepubertal major depression: depressed versus normal children.

OBJECTIVE: Blunted stimulation of growth hormone (GH) secretion after pharmacological stimuli has been linked to depressive and anxiety disorders throughout the life span. This study sought to better characterize this dysregulation in prepubertal depression. METHOD: GH regulation was compared in 38 medically healthy prepubertal children with current major depressive disorder and 19 control children who were medically and psychiatrically healthy. The study evaluated GH stimulatory responses to three pharmacological challenge agents: (1) insulin-induced hypoglycemia, using 0.1 IU/kg intravenous regular insulin; (2) 1.3 micrograms/kg intravenous clonidine; and (3) 1.0 microgram/kg intravenous human growth hormone-releasing hormone (GHRH). RESULTS: The results provide replication and extension of earlier findings. GH responses to insulin-induced hypoglycemia and to GHRH stimulation were blunted in depressed children compared to the normal controls. Clonidine stimulation results yielded a similar picture but did not reach statistical significance. CONCLUSIONS: Overall these results further strengthen the evidence showing GH dysregulation in childhood depression. However, the blunted GH response seen with GHRH (which reflects pituitary hyporesponsivity) was in contrast to our original hypothesis and has implications regarding the site (or sites) of dysregulation.

Adolescent↗

PubMedDate not supplied

Extended evaluation of diagnostic skin testing practices in Orange County, California.

In an effort to evaluate conformity with published guidelines for diagnostic allergy skin testing in their locality, a committee of members of the Orange County (California) Society of Allergy and Clinical Immunology surveyed their membership for the number, identity, and rates of sensitization of aeroallergens in a selected patient population. Test data were analyzed on patients who were judged appropriate to undergo immunotherapy. Complete test results of 271 patients were obtained from one third of local allergy specialists. A total of 115 different aeroallergen extracts were identified. By category, tree pollen allergens (32) were followed in declining order by weed pollens (28), molds (22), environmentals (18), and grass pollen extracts (15), for the total of 115. The average number of aeroallergens used by a practice in a comprehensive evaluation was 77 (range, 47-114). When only unequivocally positive reactions were considered (3+ equivalent or greater), Bermuda grass pollen extracts elicited the highest rate, 85%, and the environmental, rat dander, was the lowest at 1.8%. At least 20% of the patients reacted strongly on skin tests to 97% of the extracts. The disparity between the recommendations of a maximum of 30 aeroallergens for a comprehensive evaluation and actual practice procedures merits efforts at resolution.

Adult↗