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Biomedical subjects

M Zimmerman

Publications and source records attributed to M Zimmerman.

At least 127 records · Page 7Linked to original sources
PubMed1988

Diagnosing personality disorder in depressed patients. A comparison of patient and informant interviews.

Personality disorder (PD) diagnosis were made in 66 depressed patients based on independent interviews of the patient and a close informant. The patients and informants markedly differed in their descriptions of the patients' normal personality. The kappa coefficient of agreement for the diagnosis of any PD was .13, and all kappa values for the individual PD diagnoses were below .35. Informants reported more pathologic conditions than the patients, such that PDs were diagnosed in 57.6% (38/66) of the patients, based on the informant interview, and in 36.4% (24/66), based on the patient interview. We also examined dimensional scores. In general, we found only modest correlations between the patient and informant dimensional scores and that the ratings based on the informant interviews were higher. These results varied by specific PD diagnoses. Consensus ratings, which were based on both sources of information, were sometimes more strongly associated with patient information and sometimes with informant information, and this, too, varied among the different PDs.

Adult↗
PubMed1988

The validity of a self-report questionnaire for diagnosing major depressive disorder.

Six hundred thirteen first-degree relatives of schizophrenics, depressives, and normal controls were interviewed with the Diagnostic Interview Schedule (DIS) and completed the Inventory to Diagnose Depression (IDD), a self-report scale to diagnose major depressive disorder (MDD). The current point prevalence of MDD was nearly identical according to the two measures (DIS, 2.8%; IDD, 2.6%). Diagnostic concordance varied according to the Interval between the evaluations. When the two measures were completed within two days of each other the agreement was as high as can be expected between two instruments with less than perfect reliability. We used a family study approach to examine validity and found that both the DIS and IDD cases of depression were two to three times more frequent in the relatives of depressed patients than the relatives of schizophrenics and controls.

Adult↗
PubMed1988

Tendon cell outgrowth rates and morphology associated with kevlar-49.

A rat tendon cell model was used to evaluate the in vitro biocompatibility of kevlar-49. The cell response to kevlar was compared to carbon AS-4 and nylon sutures. Three trials were run and cell growth rates were statistically similar for all the materials tested. A separate experiment was conducted in which the same fiber materials were placed in the same Petri dish. Again, the rates were similar for each material. Finally, the cells were observed with a scanning electron microscope, and the three classic cell morphologies associated with this tendon cell model were observed. Also, cellular attachment to the fiber and cellular encapsulation of the fiber were identical for the three materials tested. Kevlar-49 proved to be comparable to carbon AS4 and nylon sutures in terms of cellular response and cell outgrowth rates.

Animals↗
PubMed1988

Morphologic changes in the renal glomerulus and the juxtaglomerular apparatus in human preeclampsia.

The renal biopsies of ten women with preeclampsia without other underlying renal disease were examined in detail using light and electron microscopy and immunofluorescence. Characteristic preeclamptic glomerular lesions with endocapillary cell swelling, subendothelial and mesangial deposits, and mesangial interposition were detected in each patient. Juxtaglomerular regions were not prominent and were poorly granulated on light microscopy; ultrastructurally, they showed myoepithelioid cells with sparse renin granulation and considerable heterogeneity of granule size and density in association with relatively meagre granular endoplasmic reticulum and Golgi profiles. These morphologic findings suggest that, in patients with clinical and renal biopsy evidence of preeclampsia, there is no significant stimulation of the renin-angiotensin system.

Adolescent↗
PubMed1988

Prognostic validity of the familial subtypes of depression.

We examined the prognostic validity of Winokur's familial subtypes of depression in 184 in-patients with primary unipolar major depression. Patients with familial pure depressive disease had a more favorable hospital course and reported less symptoms during a 6-month follow-up evaluation than patients with depressive spectrum disease or sporadic depressive disease. Consistent with previous studies of the validity of the familial subtypes, the use of stringent thresholds to diagnose the patient's relatives increased the validity of classification.

Antidepressive Agents↗
PubMed1988

Dental health status in two groups of refugees in Sweden.

The aim of this study was to determine dental health status in two separate groups of Chilean and Polish refugees in Sweden. In Scandinavia, Sweden has the largest number of immigrants--1 million out of a population of 8.3 million. Since 1975, most immigrants have been refugees and their families. During 1978-82 Sweden granted residency to 20,000 refugees, the two largest groups being Chileans and Poles. In 1981-83 a sample of 193 Chilean and 92 Polish refugees in the county of Stockholm were selected for this study. The investigation consisted of a questionnaire followed by clinical examination, including roentgenograms. The average age was 34.0 years in the Chilean group and 34.8 years in the Polish group. The Chileans had been in Sweden for 17.3 months on an average and the Poles for 16.0 months. The Chileans had an average of 10.0 carious surfaces, D(s), and the Poles 11.3. Gingivitis was recorded in 87% of the total number of sites examined in the Chilean group. The corresponding figure in the Polish group was 79%. Of the Chileans 36.5% and of the Poles 32.5% had periodontal pockets measuring more than 5 mm. The results indicate that, when compared with Swedish individuals of a corresponding age, the refugee groups have a high prevalence of caries and periodontal disease.

Adolescent↗
PubMed1987

The effect of nicotine on aortic endothelium. A quantitative ultrastructural study.

This study used quantitative electron microscopy to assess ultrastructural features of endothelial injury occurring with exposure to nicotine. Fourteen mice were given nicotine in their drinking water for 5 weeks. The dose (5 mg/kg body wt/day) was equivalent to a human smoking 50-100 cigarettes/day. A control group of mice was unexposed to nicotine over the same period. Stereological analysis of electron micrographs of endothelium from both groups revealed that the nicotine-exposed endothelium showed greater cytoplasmic vacuolation, mitochondrial swelling and subendothelial oedema than the control endothelium. In addition the intercellular cleft morphology was significantly (P less than 0.005) less complex than in the control endothelium. This difference in cleft morphology suggests the nicotine-exposed endothelium is more permeable than the control endothelium. The ultrastructural differences noted in this study are indicative of endothelial damage, and provide structural evidence to support the hypothesis that nicotine contributes to the pathogenesis of arterial disease in smokers.

Animals↗
PubMed1987

HPA-axis abnormalities in psychiatrically well controls.

The considerable divergence in the literature describing dexamethasone suppression test (DST) nonsuppression rates among psychiatrically well controls led the authors to explore screening procedures as a possible source of variance. Using what they judged to be a typical screening procedure, the authors eliminated 69 of 128 subjects responding to an advertisement seeking psychiatrically and physically healthy subjects. Structured interviews for Axis I and II disorders then revealed that 36% of the remaining 59 subjects nevertheless had historical evidence of psychiatric illness; the 38 who passed all phases of screening underwent three monthly DSTs, which demonstrated the stability over time of both normal and abnormal results. Moreover, a family study revealed that relatives of nonsuppressors had a significantly higher morbid risk of affective disorder (20.5% vs. 8.8%), particularly mania and hypomania.

Depressive Disorder↗
PubMed1987

The dexamethasone suppression test in healthy controls.

We have summarized the results of 53 studies which examined the dexamethasone suppression test in normal controls. Only 3.6% of 687 0800 hr postdexamethasone cortisol levels were above 5 micrograms/dl. Corresponding figures for 1600 hr and 2300 hr cortisol levels were 7.4% (85/1144) and 6.3% (28/434), respectively. Neither the type of assay (competitive protein binding or radioimmunoassay) nor mean/median age of the subjects was associated with non-suppression rates.

Adult↗
PubMed1987

The inventory to diagnose depression, lifetime version.

The lifetime version of the Inventory to Diagnose Depression (IDDL) is a 22-item self-report scale designed to diagnose a lifetime history of DSM-III major depressive disorder (MDD). One hundred and sixty-four first-degree relatives of healthy control probands completed the IDDL and were interviewed with the Diagnostic Interview Schedule (DIS). The IDDL had good internal consistency (Cronbach's alpha = 0.92), split-half reliability (Spearman-Brown coefficient = 0.90), and all of the item total correlations were significant. The lifetime prevalence of MDD was nonsignificantly higher in the IDDL than the DIS (14.8% vs. 11.7%). Using the DIS as the criterion measure, the sensitivity of the IDDL was 74% and its specificity was 93% and the chance corrected agreement between the two measures was kappa = 0.60.

Adult↗
PubMed1987

The prognostic validity of DSM-III axis IV in depressed inpatients.

DSM-III suggests that axis IV should have prognostic value--that patients with higher scores will have a better outcome than patients with low ratings. The authors used axis IV to assign scores to 130 depressed inpatients and examined these scores in association with the patients' course during the index hospitalization and at 6-month prospective follow-up. Higher axis IV scores were associated with more depressive symptoms on hospital discharge, but they did not predict follow-up outcome. These results are consistent with other studies of the prognostic value of ratings of psychosocial stress and indicate that, at least for depression, there is little empirical support for DSM-III's suggestion that stress is a favorable prognostic sign.

Adolescent↗
PubMed1987

Progress in the classification of functional psychoses.

The three most widely used diagnostic systems in American psychiatry--the Feighner criteria, the Research Diagnostic Criteria, and DSM-III--appeared sequentially at 4-year intervals. The fact that the latter two systems each incorporated changes in essentially all diagnostic categories implied progress toward greater validity; however, this assumption has rarely been tested directly. To do this, the authors applied each of these three systems to 98 consecutively admitted patients with nonmanic psychoses. Although family history and 6-month follow-up data strongly supported the validity of diagnostic distinctions made in each of the three systems, they did not show increments in validity with successively developed criteria sets.

Diagnosis, Differential↗
PubMed1987

Prognostic validity of the dexamethasone suppression test: results of a six-month prospective follow-up.

In a 6-month prospective follow-up study, the authors located and interviewed 165 (88.2%) of 187 primary unipolar depressed inpatients to whom a 1-mg dexamethasone suppression test (DST) had been given during their first week of hospitalization. Longitudinal ratings of symptoms over the follow-up period and 6-month cross-sectional ratings on the Hamilton Rating Scale for Depression, the Beck Depression Inventory, and the Global Assessment Scale were obtained for each patient. The authors also collected information on rehospitalization after discharge from the index episode. Baseline DST results were not associated with any of the outcome variables.

Adult↗
PubMed1987

An American validation study of the Newcastle Diagnostic Scale. II. Relationship with clinical, demographic, familial and psychosocial features.

We completed the Newcastle Diagnostic Scale on 152 unipolar depressed in-patients: its validity was supported by the findings that endogenous depressives were, in contrast to neurotic depressives, older, more severely depressed, with better social support, fewer life events, less personality disorder, and a lower morbid risk of alcoholism and antisocial personality in their first-degree relatives. The relationship between Newcastle scores and the morbid risk for alcoholism was non-linear, such that a cut-off score of 4, rather than 5, maximised the difference between the endogenous and neurotic groups with respect to familial alcoholism rates as well as other validating variables.

Cognition Disorders↗
PubMed1987

The design and analysis of a laminated partially degradable composite bone plate for fracture fixation.

During the early stages of fracture healing, rigid internal fixation maintains alignment and promotes primary osseous union. Unfortunately, as healing progresses rigid fixation from bone plating can cause bone in the region of the plate to undergo stress protection atrophy. This can result in significant loss of bone mass and osteoporosis. Refracture of the bone upon device removal is a widely reported complication. In an effort to minimize or eliminate stress protection atrophy, we have designed a partially absorbable, fiber-reinforced bone plate. Ideally, such a plate gradually loses rigidity as the fracture heals, increasingly transferring stress to the bone. Stress protection may be avoided and removal of the device after healing may be unnecessary. Composite theory was used to determine an optimum fiber layup for a composite bone plate. Composite analysis suggested the mechanical superiority of a 0 degree/ +/ -45 degree laminae layup. Given this laminated design, a thermoplastic absorbable polymer (polylactic acid polymer) was reinforced with high-modulus carbon fiber to produce a semiabsorbable composite. Implant evaluation included optimizing fabrication techniques, thorough mechanical device testing, and implantation on canine femurs to determine biocompatibility and efficacy. The composite design proved to have superior static and fatigue properties to laminated or random fiber designs used previously. Two techniques for hole fabrication were tested. The production of screw holes during the molding process rather than machining postmolding, improved the mechanical integrity of the finished plate. Although the 0 degree/ +/- 45 degree carbon/polylactic acid composite possessed superior mechanical properties, it was unsuccessful in the in vivo environment. Water absorption and subsequent delamination made the plate flexible. Hypertrophic nonunions developed. Further development to prevent water intrusion and premature loss of mechanical properties is necessary.

Absorption↗