Quality of the psychiatric literature.
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Humans↗
Biomedical subjects
J W Thompson
Publications and source records attributed to J W Thompson.
Botulinum toxin for relief of bilateral abductor paralysis of the larynx: histologic study in an animal model.
We previously reported the effectiveness of botulinum toxin injections in the cricothyroid muscle under electromyographic guidance for lateralization of the true vocal cord in the mongrel dog. These additional experiments were performed to substantiate the effectiveness of botulinum toxin injections in laryngeal muscle to overcome airway obstruction produced by bilateral abductor vocal cord paralysis. A predetermined aliquot of the toxin was injected into the cricothyroid muscle of ten dogs, the duration of its effectiveness was noted, and repeated injections were given the animals. Biopsies of the injected muscles were obtained in three of the animals for routine histologic and electron microscopic studies. The effects of the toxin were recorded by cinelaryngoscopy and videotape documentation. In all the dogs, the true vocal cord was lateralized effectively and there was no morbidity, dysphagia, aspiration, or deaths. This study also confirms that the effects of the toxin in the canine larynx are spontaneously reversed and that multiple injections do not cause irreparable damage to the laryngeal muscles.
Airway Obstruction↗
The severely mentally ill in general hospital psychiatric units.
Analysis of data from the NIMH Survey of Discharges from Non-Federal General Hospitals found that severely mentally ill patients (those with schizophrenia, other psychoses, paranoia, and major affective disorders) became an increasingly larger proportion of general hospital discharges between 1970 and 1980, with more change observed between 1975 and 1980. This seems to confirm that general hospital care is replacing at least some of the care previously provided in State mental hospitals. There has been an increase in beds in nongovernment-owned general hospitals and a decrease in beds in state hospitals. In addition, while discharge referrals from government general hospitals for severe patients were made predominantly to state hospitals in 1970, in 1980 this was rarely the case.
Adult↗
Transmastoid encephaloceles. A case report.
Encephaloceles are uncommon abnormalities occurring in the pediatric age group. For the otolaryngologist they are usually encountered in the nasopharynx or nose, but may also be found in other sites adjacent to the brain. Encephaloceles usually develop as a result of prior mastoid surgery, trauma, or infections; but it is extremely rare for large encephaloceles to occur congenitally in the mastoid. It is even more uncommon for there to be a second mastoid defect which would allow the brain to present as a subcutaneous postauricular mass. The case history of a child with congenital subcutaneous transmastoid encephalocele is presented and the management discussed. In this child, the right temporal lobe of the brain herniated through a congenital defect in the tegmen and then through the mastoid cavity to exit through a lateral wall defect in the mastoid cortex. It then presented as a postauricular subcutaneous mass. The initial diagnosis was a subperiosteal abscess. The correct diagnosis was not made until surgery despite a normal preoperative CT evaluation. The world literature is reviewed and similar diagnostic and therapeutic problems are discussed.
Child, Preschool↗
Cortical evoked potentials and clinical rating scales as measures of depressive illness.
Relationships between clinical ratings and cortical evoked potentials were examined before and during antidepressant drug treatment in 32 patients with major depressive disorder (DSM-III). Clinical rating scales included Hamilton Rating Scale for Depression, Beck Depression Inventory, Present State Examination (PSE) and Newcastle Scale. Evoked potentials included contingent negative variation (CNV), post-imperative negative variation (PINV) and auditory evoked potential (AEP) There were close correlations between all rating scales, and factor analysis produced only one component, suggesting that the common variance between them related to severity of depression. CNV magnitude before treatment correlated negatively with severity of depression regardless of diagnostic category. Depressed patients had a prominent PINV which persisted during antidepressant treatment. The amplitude of late components (N1P2) of the AEP was reduced strikingly in patients with a history of suicide attempts.
Adult↗
The use of ambulatory services by persons with and without phobia.
The delivery of ambulatory mental health and general health services to persons with phobias (unweighted n = 1,689) and without phobias during a 6-month period are examined. The phobics were part of a larger study of 18,572 subjects, drawn as a representative sample of the population in five locations, as part of the Epidemiologic Catchment Area Program (ECA). Among phobic conditions, agoraphobia most often leads to use of services related to emotional problems, especially in the specialty mental health sector. There were no significant differences between male and female subjects in their use of the various sectors for a mental health reason. The highest age group of agoraphobics that used health services most often was 25-44 years old, and the group that used them least often was 65 years and older. Agoraphobics with four or more symptoms of panic use services in higher proportions than agoraphobics with zero to three panic symptoms. The authors observe that a very large proportion of phobics report seeking no help from any source.
Adolescent↗
Types of patients served by various providers of outpatient care in CMHCs.
Representative community mental health center (CMHC) survey data showed that psychiatrists differed from other CMHC providers of mental health services by serving the more seriously impaired patients who are admitted and readmitted to outpatient services. Psychiatrists also shared more outpatients with providers from other disciplines than providers in other disciplines shared with one another. The results are consistent with previous research on differences between disciplines and with the flight of psychiatrists from CMHCs but cast doubt on the hypothesis that psychiatrists see sicker patients than psychologists see because of differences in reimbursement between the two disciplines.
Age Factors↗
Treatment of patients with no diagnosable mental disorders in CMHCs.
Community mental health centers (CMHCs) have been criticized for directing resources that should be used to treat the seriously mentally ill to the treatment of less impaired patients. Many of the latter group are assigned one of the DSM-III V codes for conditions that do not meet criteria for a mental disorder. This study compared patients with V-code conditions and those with diagnosed mental disorders on clinical, social, and economic variables. V-code patients were significantly less likely to have had prior care and to rely on third-party payments. They were significantly more likely to have been self-referred or referred by friends or family and to be white, well-educated, female, and married. CMHCs that treated fewer V-code patients reported proportionally more staff hours worked by physicians, indicating a greater medical orientation. The authors believe CMHCs should periodically evaluate whether, by serving patients with less serious conditions, they are diverting badly needed resources away from the seriously mentally ill.
Adolescent↗
Anesthesia management of microlaryngeal laser surgery in children: apneic technique anesthesia.
The purpose of this paper is to describe apneic technique general anesthesia which has been used in children for suspension microlaryngoscopy in the nontracheotomized patient. Apneic anesthesia uses a paralyzing drug in combination with controlled ventilation using halothane or isoflurane, nitrous oxide and oxygen, delivered through an endotracheal tube. Patients are monitored throughout the procedure with end-tidal CO2 levels and a cutaneous oximeter. Surgery is performed without the impediment of an endotracheal tube. This method, used in 240 patients ranging in age from 3 months to 18 years, eliminates the danger of a laser fire, gives an unobstructed view of the larynx, is safe, and is free of complications. All outpatients were discharged from the hospital within a few hours after the surgical procedure.
Anesthesia, General↗
Retropharyngeal abscess in children: a retrospective and historical analysis.
The charts of 65 pediatric patients with the diagnosis of retropharyngeal abscess were reviewed. These represented a 36-year experience with the disease. The findings were compared with those documented at the turn of the century and were also compared with findings over the last four decades. The data suggests that retropharyngeal abscess may be occurring later in childhood and may not always be preceded by a major detectable infection. Classic diagnostic findings of retropharyngeal bulge and neck stiffness were present in less than half of the patients. Gram-negative and anaerobic organisms are being documented on culture more frequently than in the past. We theorize that liberal use of oral antibiotics prior to admission may have brought about these changes.
Abscess↗
More on standard deviation versus standard error.
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Data Collection↗
Use of ECT in the United States in 1975 and 1980.
The authors examined data from the National Institute of Mental Health regarding the use of ECT in the United States in 1975 and 1980. A total of 33,384 hospitalized patients were treated with ECT in 1980, representing 2.4% of all patients hospitalized in psychiatric facilities. The use of ECT decreased by 46% between 1975 and 1980. Of the type of facilities surveyed, only public general hospitals did not decrease their use of ECT. Patients with affective disorders received 69.8% of the ECT given, and patients with schizophrenia received 16.6%. Although more women than men received ECT, diagnosis and age were more important factors than sex.
Adolescent↗
Transcutaneous electrical nerve stimulation produces variable changes in somatosensory evoked potentials, sensory perception and pain threshold: clinical implications for pain relief.
Transcutaneous electrical nerve stimulation decreased early and late somatosensory evoked potential amplitudes and stimulus intensity ratings, and elevated sensory detection threshold, in normal subjects. Effects on pain threshold depended on pre-treatment threshold. These findings are relevant to treatment of clinical pain by transcutaneous electrical nerve stimulation.
Adult↗
Psychiatric services to adolescents: 1970-1980.
A study based on the National Institute of Mental Health's Sample Survey Program for 1970, 1975, and 1980 provides an overview of the services to adolescents supplied by the mental health sector. Data are presented mainly for nonfederal general hospitals, state and county hospitals, private psychiatric hospitals, and, to a lesser extent, outpatient clinics. Among the trends found by the analysis are that private psychiatric and private general hospitals admitted an increasing share of adolescents while state and county hospitals admitted fewer; the overall proportion of younger adolescents admitted for inpatient treatment increased; all types of study facilities except state and county hospitals admitted relatively low proportions of adolescent substance abusers; and the use of psychotropic drugs decreased in some types of facilities, especially for younger adolescents.
Adolescent↗
Cellular uptake and cell-associated activity of third generation cephalosporins.
The ability of the third generation cephalosporins to penetrate human polymorphonuclear leukocytes (PMNs) and their antibacterial activity against cell-associated Staphylococcus aureus (SA) and Haemophilus influenzae, type b (Hib) were studied. Utilizing radioactive uptake experiments, the cellular to extracellular concentration ratios were determined to be less than one for all cephalosporins at 10 and 120 min: cefotaxime (0.08 +/- 0.02, 0.34 +/- 0.08), ceftizoxime (0.21 +/- 0.11, 0.52 +/- 0.18), ceftriaxone (0.12 +/- 0.04, 0.38 +/- 0.23), and N-formimidoyl thienamycin (0.18 +/- 0.09, 0.33 +/- 0.14). Third generation cephalosporins were similar to penicillin in their exclusion from PMNs. The killing of cell-associated SA and Hib were evaluated in a preopsonized cell-associated bacterial assay with radiolabelled SA/Hib (cfu/cpm) comparing activity of PMNs + antibiotics to the PMN cell control (no antibiotics) at 0.5, 2, and 4 h. PMNs alone killed less than or equal to 0.5 log SA/Hib over 4 h. Clindamycin killed significantly more SA (p less than 0.01) than all other antibiotics; nafcillin killed significantly fewer SA (p less than 0.05) than all other antibiotics. Although each third generation cephalosporin showed good activity against cell-associated Hib, chloramphenicol had a significantly greater effect (p less than 0.05). N-formimidoyl thienamycin demonstrated good activity only after the concentration was increased in vitro to 8 micrograms/ml. Although cellular penetration of antibiotics may be important in the eradication of cell-associated pathogens, the overall cellular activity would appear to be multifactorial.
Adult↗
Neural anatomy, chemistry and event-related brain potentials: an approach to understanding the substrates of mind.
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Animals↗
Prospective payment and psychiatric discharges from general hospitals with and without psychiatric units.
For psychiatric patients treated in general hospitals, the prospective payment system does not differentiate between patients treated in medical-surgical wards and patients treated in psychiatric units. In particular, the system uses a single length-of-stay norm for both kinds of patients, even though psychiatric patients in medical-surgical units have shorter stays. The authors document major differences in length of stay and hospital charges for both groups of patients in relation to selected patient and hospital characteristics. They conclude that the current reimbursement procedures systematically overpay for stays in nonpsychiatric units and underpay for stays in psychiatric units, and they suggest mechanisms for partly reducing such inequities.
Adolescent↗
A challenge for the future: coding diagnostic criteria for mental disorders.
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Abstracting and Indexing↗