The verbal learning and fluency of patients with unipolar and bipolar depression were compared to those of normal controls and patients with Huntington's disease. The data demonstrated that the recall and recognition performance of both groups of depressed patients were impaired relative to the performance of normal control subjects. The bipolar patients, however, were more impaired than the unipolar patients on both tasks (P less than 0.024 and P less than 0.022, respectively). In addition, the unipolar patients generated more correct responses on a test of verbal fluency (P less than 0.04). The performance of the bipolar patients was, in fact, similar to that of patients with Huntington's disease, a progressive degenerative disorder that primarily affects subcortical areas.

Adult↗

PubMedDate not supplied

Coronary heart disease in African Americans.

African Americans have the highest overall mortality rate from coronary heart disease (CHD) of any ethnic group in the United States, particularly out-of-hospital deaths, and especially at younger ages. Although all of the reasons for the excess CHD mortality among African Americans have not been elucidated, it is clear that there is a high prevalence of certain coronary risk factors, delay in the recognition and treatment of high-risk individuals, and limited access to cardiovascular care. The clinical spectrum of acute and chronic CHD in African Americans is similar to that in whites. However, African Americans have a higher risk of sudden cardiac death and present more often with unstable angina and non-Q-wave myocardial infarction than whites. African Americans have less obstructive coronary artery disease on angiography, but may have a similar or greater total burden of coronary atherosclerosis. Ethnic differences in the clinical manifestations of CHD may be explained largely by the inherent heterogeneity of the coronary syndromes, and the disproportionately high prevalence and severity of hypertension and type 2 diabetes in African Americans. Identification of high-risk individuals for vigorous risk factor modification-especially control of hypertension, regression of left ventricular hypertrophy, control of diabetes, treatment of dyslipidemia, and smoking cessation--is key for successful risk reduction.

Age Factors↗

PubMedDate not supplied

Updating drug formularies to serve a changing patient population.

Explore the source record for details and available documents.

Formularies as Topic↗

PubMedDate not supplied

Efficacy and tolerability of enalapril and sustained-release verapamil in older patients with mild to moderate essential hypertension.

The study involved 113 patients over age 50 years with mild to moderate essential hypertension, randomly assigned to treatment with enalapril (n = 54) or sustained-release verapamil (n = 59). During an eight-week titration period, doses were adjusted to achieve supine diastolic blood pressures (DBP) below 90 mmHg; patients were then given maintenance doses for eight weeks. Mean blood pressures were reduced significantly from 147.7/93.9 mmHg at baseline to 137.7/84.5 mmHg at the end of the maintenance period in the enalapril group and from 155.1/95.1 to 142.4/86.2 mmHg in the verapamil group. In the patients who completed treatment, the mean daily doses required to maintain DBP below 90 mmHg were 9.6 mg of enalapril and 244.9 mg of verapamil. There were 11 treatment failures in the enalapril group and 22 in the verapamil group: eight of the enalapril and 17 of the verapamil patients did not attain goal blood pressures and three and five were withdrawn because of side effects. It is concluded that both enalapril and sustained-release verapamil were generally effective and well tolerated in the treatment of mild to moderate hypertension in the middle-aged and older patients.

Aged↗

PubMedDate not supplied

Neonaticides following "secret" pregnancies: seven case reports.

Seven neonaticides were reported during a 14-month period in the State of Iowa. This is an alarming number considering that only one such case was reported in the previous year. The majority of cases involved the birth of a live infant to an adolescent who had reportedly kept her pregnancy secret from family and friends. The death of the infants resulted from exposure or drowning. Efforts were made by the mother to hide or dispose of her infant's body. Basic information about each of the reported cases is presented, as well as the sentences given the adult mothers charged with the crime of child endangerment. The dynamics of these cases are reviewed in the context of earlier studies dealing with the phenomenon of neonaticide. Infanticide has deep roots in several cultures. It was practiced in some primitive societies and was decreed a capital offense as early as 1643. Its occurrence recently prompts suggestions for activities by professionals to prevent these tragedies. More research and further attention to this problem is warranted.

Adolescent↗