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Biomedical subjects

D Rosenthal

Publications and source records attributed to D Rosenthal.

At least 235 records · Page 13Linked to original sources
PubMed1980

A symptom schedule for the diagnosis of borderline schizophrenia: a first report.

The concepts of 'borderline' and 'borderline schizophrenia' remain a confusing area in psychiatry. In its functional use, the word 'borderline' refers to a hypothesized level of functioning on a continuum which extends from normality to psychosis, e.g. borderline personality organization. In the phenomenological use 'borderline' qualifies a psychiatric diagnosis, referring to a milder form of the disease process, e.g. borderline schizophrenia. In this paper we attempted to define and validate the concept of borderline schizophrenia using case records from the Danish Adoption study with this diagnosis and rating the cases on a new instrument: the Symptom Schedule for the Diagnosis of Borderline Schizophrenia, found reliable, and discriminating cases of borderline schizophrenia from cases of neurosis and personality disorder.

Adult↗
PubMed1980

Reduction of venous thrombosis complicating phlebography.

Patients who underwent radiographic phlebography were studied to determine the frequency of postphlebographic venous thrombosis. In a group of 23 patients who had negative phlebograms performed with standard contrast agent (60% sodium methylglucamine diatrizoate), nine had positive 125I-fibrinogen leg scans. On repeat phlebography, three had confirmed deep vein thrombosis, six overall developed deep or superficial thrombosis, and three had positive scans without demonstrable thrombi. In a second group of 34 patients studied with the contrast material diluted to 45%, only three developed positive scans, one due to deep venous thrombosis and two to superficial thrombosis. There was also a reduction in the incidence of postphlebographic symptoms of pain, tenderness, and erythema, but no apparent sacrifice in diagnostic accuracy.

Diatrizoate↗
PubMed1979

Prophylactic interruption of the inferior vena cava: immediate and long-term hemodynamic effects.

Two hundred patients were evaluated retrospectively to determine the clinical effects of prophylactic inferior vena cava (IVC) interruption in association with aortic reconstruction. No pulmonary embolism occurred in the group with IVC interruption, but embolisms did occur in seven of 68 patients who had aortic reconstruction performed without IVC interruption. In two patients, the pulmonary embolism was fatal. Postoperative incidence of deep vein thrombosis was fatal. Postoperative incidence of deep vein thrombosis was 9% in both groups. Clinical and hemodynamic effects of prophylactic IVC interruption were studied in 20 additional patients. Venous hemodynamics (maximum venous outflow, inferior vena cava pressure, and ambulatory venous pressure) showed no change following interruption in 19/20. Sixteen patients from the original group of patients with prophylactic interruption were studied hemodyamically. No pulmonary embolism was clinically evident. One new case of deep vein thrombosis was seen. Again, venous hemodynamics showed no change as a result of IVC interruption. Prophylactic IVC interruption is a safe means of decreasing the incidence of pulmonary embolism without increasing venous-related morbidity.

Aorta↗
PubMed1979

Positive blood culture as an aid in the diagnosis of secondary aortoenteric fistula.

The successful management of aortoenteric fistula (AEF) requires early diagnosis. To evaluate the accuracy of our diagnostic approach, the hospital course of seven patients with AEF was reviewed. In six patients, the initial bleeding episodes were of the low volume type characterized by hematemesis and melena or by melena alone. All patients were febrile. In six patients, blood cultures obtained preoperatively were positive for enteric organisms identical to those found in cultures obtained intraoperatively from the AEF site. Roentgenographic examination of the upper gastrointestinal (GI) tract performed in three patients was diagnostic for AEF in only one. Endoscopy in seven patients revealed a bleeding suture line in one. Angiography was not diagnostic in the six patients in whom it was performed. When patients are seen with the triad of GI bleeding, a history of aortic surgery, and fever, aerobic and anaerobic blood cultures should be obtained. If blood cultures are positive for enteric organisms, the diagnosis of AEF should be strongly suspected, and early surgical intervention is indicated.

Aged↗
PubMed1979

Prophylactic interruption of the inferior vena cava. A retrospective evaluation.

One hundred sixty patients were retrospectively evaluated to determine the effect of prophylactic inferior vena caval interruption in association with aortic surgery. Sixty-three patients underwent aortic procedures without inferior vena caval interruption and ninety-seven patients underwent placement of an Adams-DeWeese clip as prophylaxis against pulmonary embolism. Pulmonary embolism occurred in 10 per cent of the group without the clip and in no patients in the group with the clip. The incidence of deep vein thrombosis was identical in both groups (10 per cent). The 6 per cent rate of early (within 6 months) postoperative leg edema in the group with the inferior vena caval clip was a significant problem in only one patient after twenty-four months. Prophylactic interruption of the inferior vena cava has been shown to be a safe method of decreasing the incidence of pulmonary embolism without increasing the incidence of venous-related complications.

Aged↗
PubMed1979

Was Thomas Wolfe a borderline?

The distinction between the two types of borderline proposed by Spitzer, Endicott, and Gibbon--the Schizotypal Personality type of borderline and the Borderline Personality type of borderline--suggests an advance in our thinking about the borderline concept. However, it can be shown, at least in the case of Thomas Wolfe, that an appreciable amount of overlap exists between the two borderline types, in the sense that the same person can load substantially on items from both types. Such findings may tend to blur the distinction between the two types. Also, Wolfe, hailed as a genius, manifested unusual behaviors which are rarely observed and may constitute a form of borderline condition that challenges current diagnosis.

Adult↗
PubMed1979

Quantitative determination of delta 9-tetrahydrocannabinol in cadaver blood.

We have described a highly sensitive, accurate, and selective method for the determination of delta 9-THC in postmortem blood. Although the method requires the use of fairly complex and sophisticated equipment, the procedure is straightforward and has been reproduced many times in our laboratories. It is thought that this procedure will serve as a useful adjunct to the forensic scientist in his armamentarium for determining physiological levels of important, abused drugs in postmortem analysis.

Adult↗
PubMed1979

Interposition grafting with expanded polytetrafluoroethylene for portal hypertension.

If an interposition graft for the decompression of esophageal varices is necessary, Gore-Tex may be the graft material of choice. It is intert, nonthrombogenic and, possibly, thrombo-resistant. These characteristics of Gore-Tex explain the ease with which a graft thrombectomy was performed in one patient when necessary. Final appraisal of a synthetic venous prosthesis requires many months, if not years, of in vivo evaluation. Nevertheless, when an interposition graft is necessary for the decompression of esophageal varices, it appears that a clinical trial of Gore-Tex is reasonable in view of its characteristics.

Adult↗
PubMed1979

Fibromuscular dysplasia of the external iliac arteries: surgical treatment by graduated internal dilatation technique.

A case of fibromuscular dysplasia of the external iliac arteries treated by graduated internal dilatation is presented. At follow-up extending to 7 years, the external iliac arteries are patent with no evidence of recurrent disease by arteriography, and the patient remains asymptomatic. The recently reported successes with percutaneous balloon catheter angioplasty offers a nonsurgical alternative in the treatment of external iliac fibromuscular disease. A consideration of balloon catheter angioplasty in future similar cases is suggested. If balloon catheter angioplasty is unsuccessful, the option of operation remains available.

Arterial Occlusive Diseases↗
PubMed1978

Cutaneous vasculitis.

In this paper the current concepts of cutaneous vasculitis are reviewed, with emphasis on clinical patterns, strict pathologic criteria and mechanisms of injury. A plea is made to classify vasculitis not as syndromes but (a) according to organ involvement (limited cutaneous or complicated multisystem), (b) by cause, (c) by pathologic description and (d) by anatomic depth and type of vessel involvement.

Adult↗
PubMed1978

Percutaneous paraquat absorption. An association with cutaneous lesions and respiratory failure.

Striking cutaneous lesions and death owing to respiratory failure occurred in a middle-aged woman eight weeks after initial cutaneous contact with the herbicide paraquat (1,1'dimethyl-4,4'dipyridylium dichloride). While similar changes have been described in animals, to our knowledge, serious morbidity or mortality owing to percutaneous absorption has not been described in man. This case report illustrates the extreme toxicity of this herbicide and demonstrates that lethal quantities of the drug may be absorbed from apparently trivial skin wounds. Stricter precautions, including the mandatory use of protective clothing, should be recommended whenever this material is used.

Accidents↗
PubMed1978

MMPI assessment of psychopathology in the adopted-away offspring of schizophrenics.

Previous studies completed in Denmark show a higher frequency of schizophrenia-related psychopathology in the adopted offspring of schizophrenics than in matched controls. This study adds a psychometric dimension to the earlier reports with an analysis of psychopathology in the adopted offspring of schizophrenics based on the Minnesota Multiphasic Personality Inventory (MMPI). A combination of MMPI criteria and interview-based diagnosis identifies 22% of the index cases and 6% of the control cases (P less than .01) as having a schizophrenia spectrum disorder. The findings support a genetic hypothesis, but the use of the MMPI does not fully clarify some issues raised in the earlier reports.

Adult↗