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Biomedical subjects

H Moldofsky

Publications and source records attributed to H Moldofsky.

At least 91 records · Page 5Linked to original sources
PubMed1980

The heterogeneity of anorexia nervosa. Bulimia as a distinct subgroup.

Bulimia is a poor prognostic sign in anorexia nervosa. This raised the question of whether bulimia represented an "end stage" of chronic anorexia nervosa or whether bulimic patients were a distinct subgroup. All subjects seen by us personally from 1970 to 1978 were included in this study provided they met modified criteria of Feighner et al (1972). Of this group, 68 experienced bulimia and 73 did not (restricters). Bulimic patients had a history of weighing more and were more commonly premorbidly obese. Bulimic patients were those who vomited and misused laxatives. The bulimic group displayed a variety of impulsive behaviors, including use of alcohol and street drugs, stealing, suicide attempts, and self-mutilation. With regard to family history, the high frequency of obesity in the mothers of bulimic patients was noteworthy. The two groups share features common to patients with primary anorexia nervosa. However, these results suggest a different group of women are predisposed to have anorexia nervosa develop with bulimia.

Adult↗
PubMed1980

The relationship of alpha and delta EEG frequencies to pain and mood in 'fibrositis' patients treated with chlorpromazine and L-tryptophan.

Aspects of sleep stage evaluation and analysis of alpha and delta EEG frequencies in sleep were shown to be related to musculo-skeletal pain and mood disturbance in patients with 'fibrositis syndrome'. Patients were treated at bedtime for 3 weeks with either chlorpromazine, 100 mg (8 patients), or L-tryptophan, 5 g (7 patients). Chlorpromazine, but not L-tryptophan, was associated with increased slow wave sleep and amelioration of pain and mood symptoms. Mean percent time/min or mean percent power/min of alpha frequency during NREM and REM sleep corrlated with overnight increase in pain measures, hostility, and decrease in energy. On the other hand, mean percent time/min of delta in NREM sleep was related to overnight decrease in pain and mean percent delta power/min was associated with decreased anxiety and hostility, and increased energy.

Adult↗
PubMed1979

Videotape educational program for people with asthma.

A videotape educational program was produced for use in adults with asthma. The program provided an overview of lung function, the physiologic abnormalities and treatment of asthma, and the approach to common problems encountered by the patients. Its benefits were examined in a randomized controlled study. The efficacy of the program in 62 patients whose mean duration of illness was 17 years was assessed by comparing the level of knowledge of the experimental group immediately after viewing the tape with that of the controls, who had not seen it; the experimental group scored significantly higher than the control group. Retention of knowledge attributed to the program was assessed after a mean interval of 16 months. The knowledge test score of the experimental group was found to have decreased to the level of the control group. The main areas in which the experimental group lost knowledge were self-care and drug therapy for asthma. The medical status of the two groups did not change appreciably over the period of the study.

Activities of Daily Living↗
PubMed1979

The stability of perceptual disturbances in anorexia nervosa.

Patients with anorexia nervosa have previously been shown to display disturbances in visual self-perception and interoception. In the present investigation we wished to determine the stability of these disturbances and the effects of weight gain on them. We studied 29 females, 16 patients with primary anorexia nervosa and 13 controls, who had also been studied one year previously. Each subject took part in investigations of body image, using a distorting photograph technique, and interoception, using a satiety aversion to sucrose test. We found that some anorexic subjects tend to overestimate body size and have an absence of aversion to repeated sucrose tastes. Moreover, these disturbances were stable over the year and were not affected by weight change.

Adult↗
PubMed1978

Withdrawal from long-term high-dose desipramine therapy. Clinical and biological changes.

Investigation was undertaken on a patient whose long-term intake of desipramine hydrochloride was amongst the highest reported. Desipramine treatment instituted at a daily dosage of 75 mg for depressive equivalents of head, chest, and abdominal pain was increased to 1,000 mg daily over a 12-year interval with minimal side effects. Plasma desipramine level dropped immediately on withdrawal, and urinary metabolite values dropped over the subsequent five days. The electrocardiographic abnormalities of first-degree atrioventricular block and incomplete left bundle branch block rapidly disappeared on cessation of medication. Electroencephalographic changes with symmetrical generalized irregular 5- to 7-cps theta activity and 18- to 28-cps beta activity also improved. Longitudinal polygraphic sleep studies showed prolonged rapid eye movement rebound and increased delta sleep coincident with withdrawal. It took ten days after cessation of desipramine for urinary 3-methoxy-4-hydroxyphenylglycol concentration to increase substantially. Although catecholamines are involved in growth hormone (GH) and cortisol regulation, no abnormalities were found in GH or cortisol levels.

Adult↗
PubMed1978

A spectral method for removing eye movement artifacts from the EEG.

A frequency-domain technique for compensating for eye artifacts in mid-line scalp EEG when power spectra are to be calculated is reported. It has been tested in 12 subjects during voluntary and random eye movements. The method which involves calculating the ratio of EEG and EOG spectra adequately controls for low-frequency components in the EEG due to eye artifacts and allows recovery of the dominant peaks in the scalp EEG spectrum.

Electroencephalography↗
PubMed1978

Hypothalamic function as related to body weight and body fat in anorexia nervosa.

Percentage body fat is predictive of the onset of menstruation at puberty. In anorexia nervosa a relationship between luteinizing hormone (LH) levels and percentage weight loss has been reported. In the current study the relationship of percentage body fat and of percentage weight loss to LH and LH reactivity was examined in anorexia nervosa. Fifteen women with anorexia nervosa were studied. The resting levels of LH were measured, and in seven of the subjects LH response to luteinizing hormone releasing hormone (LHRH) and clomiphene was tested. The increment in plasma LH was measured in response to a 100 microgram dose of LHRH, and also to a 5-day course of clomiphene 100 mg. The resting LH levels were found to correlate with percentage fat, body weight, and percentage weight loss. Correlations were also found between the response to either LHRH or clomiphene and percentage weight loss, percentage fat, and absolute body weight. Other pituitary hormones measured did not show a relationship to body fat or weight. It is concluded that in addition to being predictive of the onset of menstruation, percentage body fat is significantly related to resting LH and LH reactivity in anorexia nervosa. Although percentage body fat, percentage weight loss, and absolute body weight are all significant correlates of LH reactivity, we cannot at this time conclude that any one in particular is the superior.

Adipose Tissue↗
PubMed1978

Growth hormone and cortisol responses, tranquillizer usage, and their association with survival from myocardial infarction.

Sixty-six patients consecutively admitted to a Coronary Care Unit with a diagnosis of myocardial infarction were evaluated physically, psychologically, and neuroendocrinologically. Records were also kept of appetite and drug intake. Serum cortisol and growth hormone, physical, and mood variables were evaluated daily and the neuroendocrine measures were also taken serially at the time of removal from the cardiac monitor. At the end of the 2 years the patient's functional status was evaluated and the outcome correlated with the aforementioned indices. Three factors emerged as being significantly related to outcome. Survivors' appetites were significantly better than the appetities of nonsurvivors. Those who were alive at follow-up had taken significantly more minor tranquilizers than those who had died. Survivors had consistently lower levels of growth hormone than nonsurvivors and these differences were statistically significant for those samples taken at the time of removal from the monitor. The findings are incorporated in two new indices predictive of both survival and functional outcome.

Acute Disease↗
PubMed1978

Body awareness in anorexia nervosa: disturbances in "body image" and "satiety".

Patients with anorexia nervosa have been shown previously to display distortions in body image perception. Bruch has postulated that these disturbances as well as disturbances in interoception are meaningfully related to the development of the syndrome. We hypothesized that disturbances in body image, as measured by a distorting photograph technique, and interoception, as measured by a satiety-aversion to sucrose test, should be demonstrable in anorexic patients vs. normal controls. Furthermore, these disturbances should be modifiable by external cues (looking at one's image in a mirror and ingesting isocaloric "high" and "low" calorie connotation meals). We also hypothesized that body image and interoceptive disturbances would be interrelated in the same individuals. Results indicated that patients with anorexia nervosa (N = 26) differed from normal controls (N = 16) in overestimating their body sizes (p = 0.06) and in failing to develop an aversion to the sucrose tastes (p less than 0.001). However, neither viewing one's image in a mirror nor ingesting both "high and "low" calorie connotation meals altered body size perception. Intrasubject body size estimates were very stable from week to week for the anorexic subjects (r = +0.75, p less than 0.001) but less for the controls (r = +0.45, p less than 0.05). The data revealed that overestimation of body size was closely related to the failure to develop an aversion to sucrose tastes in anorexic patients.

Adult↗
PubMed1978

A comparison of pimozide and haloperidol in the treatment of Gilles de la Tourette's syndrome.

In a double-blind placebo-controlled study, both pimozide and haloperidol significantly decreased tic frequency in nine patients with Gilles de la Tourette's syndrome. These findings are consistent with the catecholamine hypothesis of tic generation. Pimozide was associated with significantly fewer complaints of lethargy. Follow-up 4-20 months later showed that six of seven patients receiving pimozide and one of two receiving haloperidol had had greater than 75% improvement in symptoms.

Adolescent↗
PubMed1978

Perceptual experiences in anorexia nervosa and obesity.

There is increasing evidence suggesting that the perceptual-cognitive experiences of people with anorexia nervosa and juvenile onset obesity may differ from those of people without eating disorders. The research related to several perceptual-cognitive dimensions is critically examined. These include body image perceptions; perception of hunger and satiety cues; perception of external cues; and certain personality variables which may be related to self-perception. The implications of these perceptual-cognitive variables for the treatment of anorexia nervosa and obesity are discussed. The relative efficacy of some behavioural and medical therapies may be related, in part, to their effects on perceptual-cognitive parameters. Recommendations are also made for investigations to further delineate the role of perceptual-cognitive difficulties in people with eating problems.

Adolescent↗
PubMed1978

EEG frequency patterns associated with hallucinations in schizophrenia and "creativity" in normals.

This study attempts to define EEG power spectral patterns associated with hallucinatory behaviors in schizophrenia. Six unmedicated schizophrenics with Schneiderian criteria were interviewed and their tongue potentials were monitored and recorded on FM tape. Eye movements and tongue potentials were monitored and segments with artifacts were not used. Consecutive 4-sec intervals of EEG were analyzed in the frequency domain using fast Fourier transorm methods and serial power spectra plots obtained. The intrusiveness of the hallucinatory experience may be similar to the sudden internal experience of perceptual resolution in a creative task. Six normal controls were similarly monitored and analyzed while responding to tests of "creativity." In the 4-sec interval prior to reports of hallucinatory experiences, a frequency pattern of predominatly delta and theta power was found in 71.7% of the EEG segments. In the control group, 78.1% of the EEG segments preceding a creative response demonstrated a similar low frequency pattern which also differed significantly from the base line EEG frequency pattern.

Adult↗
PubMed1977

Prognosis in anorexia nervosa as influenced by clinical features, treatment and self-perception.

The use of behaviour modification in the treatment of anorexia nervosa has been controversial and has not undergone controlled studies. An investigation of 42 patients with anorexia nervosa treated a mean of 31.7 months earlier was conducted to determine factors related to prognosis. The three areas studied were (a) clinical features, (b) treatment (behaviour modification versus medical and psychologic therapy) and (c) self-perception (with a distorting photographic technique). Clinical outcome was assessed as "excellent" in 7, "much improved" in 14, "symptomatic" in 13 and "poor" In 8. Analysis of variance showed that vomiting (P less than 0.01), bulimia (P less than 0.01), poor educational/vocational adjustment (P less than 0.01) and higher global clinical score (P less than 0.001) were associated with a poor prognosis. There were no differences at follow-up between patients treated by behaviour modification and those treated by other methods; the data suggest that behaviour modification, while not harmful, does not provide long-term benefits. Self-estimates of body size were highly predictive of outcome (P less than 0.002); all patients with a poor outcome overestimated their size. Patients with only marginal improvement might be helped by treatment directed to self-perceptual disturbances.

Adolescent↗
PubMed1977

Mechanics of the rib cage and diaphragm during sleep.

The pattern of motion of the rib cage and abdomen/diaphragm was studied in three normal subjects during sleep. Sleep state was monitored by electroencephalograph and electrocculograph. Intercostal electromyographs (EMG's) were recorded from the second interspace parasternally. Abdominothoracic motion was monitored with magnetometers and these signals calibrated by isovolume lines either immediately before going to sleep, or if there was movement, on awakening. Respiration was recorded using a jerkin plethysmograph. In the awake subject in the supine position, the rib cage contributed 44% to the tidal volume and had essentially the same contribution in quiet sleep. However, in active or rapid eye movement sleep the rib cage contribution fell to 19% of the tidal volume. This was accompanied by a marked reduction in the intercostal EMG. With the subject in the upright position the rib cage appears to be passively driven by the diaphragm. However, the present data suggest that active contraction of the intercostal muscles is required for normal rib cage expansion in the supine position.

Abdomen↗