"Encourage oral intake"--yes, but how?
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Biomedical subjects
Publications and source records attributed to M Irwin.
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Courts have found psychiatric patients to have the qualified right to refuse treatment. Particularly problematic is whether newly admitted psychiatric patients can comprehend information and give informed consent. The authors examined the ability of voluntary and involuntary psychotic patients to understand information about antipsychotic medication, related this assessment to psychopathology, and evaluated factors involved in hypothetical acceptance or refusal of treatment. Although most patients stated they had understood informed consent material, objective ratings did not support this. Impaired understanding was significantly associated with thought disturbance but did not affect hypothetical acceptance or refusal of antipsychotics. Legal status was not a significant factor.
A review of records form Children's Memorial Hospital (Chicago) between 1960 and 1980 yielded 15 cases of anorexia nervosa in children aged 12 and under. Three of these cases are described herein to point out the clinical characteristics and the possible connection to affective disorder (depression) of this variant of anorexia nervosa.
The 13-year-old boy described herein had an acute psychotic episode as an emotional response to the diagnosis of acute lymphocytic leukemia. Although the final psychiatric diagnosis was brief psychotic reaction, this term does not convey the deep existential dilemma experienced by this child, who had not emotionally dealt with his newly diagnosed disease. The choice of symptoms, the Rubik's Cube, served as a metaphor and an easily understood symbol for his distress. The psychosis allowed this boy to deal with and adjust to his illness.
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The indirect immunofluorescent technique was used to localize a low molecular weight, acid-stable proteinase inhibitor of seminal vesicle origin in the female reproductive tract of mice. In recently inseminated animals (0, 2, and 4 hr postcoitus) the inhibitor was localized in the copulatory plug, on the epithelia of the vaginal fornix and cervix, in the uterine lumen, and on the apical surface of the uterine epithelium. Ten hours postcoitus the inhibitor was found in localized areas on the uterine epithelium, in a sperm-leucocyte mass in the uterine lumen, and in the copulatory plug. The inhibitor was not found in females 24 hr postcoitus. The inhibitor could not be localized in the oviducts of any of the animals tested. The data are interpreted to mean that the inhibitor, transported to the female at ejaculation, coats the surface of the female reproductive tract protecting it from acrosomal enzymes or from invasion by spermatozoa or pathogens.
The indirect immunofluorescent technique was used to localize a proteinase inhibitor isolated from murine seminal vesicles. The inhibitor was found in the lumen and in the apical epithelium of the seminal vesicle but not in the testes, epididymides, ductus deferens or Cowper's glands. It was also associated with the anterior acrosomal region of ejaculated sperm and sperm recovered from the female tract within 5 min of coitus. The inhibitor is removed from uterine sperm between 2 to 4 h postcoitus, however sperm recovered from the uterus 2 h postcoitus will rebind inhibitor. The inhibitor is not normally associated with epididymal or ductus sperm although these sperm will bind purified inhibitor in vitro.
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The authors present the first report, to their knowledge, of hyperserotonemia in children with attentional deficit disorder who had normal intelligence. Hyperserotonemic children had significantly lower levels of plasma total and protein-bound tryptophan and a higher percentage of free tryptophan than those with normal serotonin levels. Plasma kynurenine did not differ, suggesting that the hyperserotonemia is not due to a blockade of the kynurenine pathway but may reflect on increase in tissue tryptophan uptake and use.
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