The Research Diagnostic Criteria (RDC) define endogenous depression by the presence of a particular subset of depressive symptoms. This typological approach to classification implicitly assumes that endogenous and non-endogenous patients differ only or primarily in this subset of symptoms, rather than simply in severity of all depressive symptoms. We tested this assumption in a sample of 80 patients with a current episode of major depressive disorder. Whereas RDC endogenous patients (n = 53) had significantly higher levels of most criterial symptoms than did non-endogenous patients (n = 27), they differed on almost no non-endogenous symptoms. These findings support the concept of a specific endogenous symptom cluster.

Adult↗

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Patient compliance and therapeutic coverage: amlodipine versus nifedipine (slow-release) in the treatment of angina pectoris. Belgian Collaborative Group.

Patient compliance with therapy is often poor and overestimated by the treating physician; it is particularly important in cardiovascular diseases such as hypertension and angina pectoris. Compliance was studied in an open parallel study in out-patients with stable angina pectoris, given either amlodipine (5 mg, once daily) or slow-release nifedipine (20 mg, twice daily) for 12 weeks. Compliance was assessed using pill counting and using an electronic device, the medication event monitoring system, to record the time and date of each opening and closure of the pill container. There was no difference between the two groups in pill count or in 'taking compliance' (the percentage of prescribed doses taken as indicated by the monitoring system). Compliance was significantly better (P < 0.001) with amlodipine, however, for 'correct dosing' (the percentage of days on which the correct dose was taken) and for 'timing compliance' (the percentage of doses taken at the prescribed time interval after the last dose). 'Therapeutic coverage' (the estimated proportion of treatment time for which the drug was active) was also significantly better for amlodipine (P < 0.001). There was no difference in reported side-effects between the two therapies.

Aged↗

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Pharmacokinetics of oral cibenzoline in arrhythmia patients.

The pharmacokinetics of oral cibenzoline were studied in 30 arrhythmia patients as part of an ascending multiple-dose efficacy study. The elimination half-life of the drug following repetitive dosing ranged from 7.6 to 22.3 hours, with a harmonic mean of 12.3 hours (n = 24), and increased with age and decreasing renal function. The drug exhibited apparent dose proportional and linear pharmacokinetics over the range of doses studied. Multivariate analysis revealed that the patients' age and serum creatinine concentration accounted for 71% of the variability in the range of beta values (terminal elimination rate constant), and that 69.5% of the intersubject variability in the steady-state trough plasma concentrations could be accounted for by the patients' age, weight and serum creatinine concentration. These data suggest that, although there is some intersubject variability in the elimination and accumulation of cibenzoline, much of the variability can be explained by the patients' age, weight and renal function.

Administration, Oral↗

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Recurrent pulmonary embolism: importance, diagnosis, management and prevention.

Pulmonary emboli, even small, cause irreparable lung damage. Recurrent pulmonary emboli further increase the amount of non functional lung tissue and may result in incapacitating respiratory disease or death. It is therefore mandatory that the disease be correctly diagnosed and adequately treated. As prevention is better than cure, every patient presenting with clinical signs of deep venous thrombosis (DVT) should be correctly explored. The site and size of thrombosis must be visualized preferably with contrast venography with imaging of the veins of the limbs, iliac veins and vena cava. Risk factors such as obesity, immobilization etc. must be taken into account. Underlying disease such as heart disease and venous insufficiency must be treated. Malignancy must be looked for as in a recent series of patients with primary DVT which were studied, 15% presented with an up till then unknown malignant disease. In patients presenting with recurrent DVT this percentage rose to 20%. When a patient presents with DVT of the femoro-iliac vena cava axis, aggressive treatment must be adopted. Fibrinolysis or if this is contra-indicated, thrombectomy will be used. A vena cava filter may be necessary and longterm anticoagulation is mandatory. The same rationale is applicable in cases of pulmonary embolus whether it is a primary event or a recurrence.

Angiography↗

PubMedDate not supplied

[New aspects of effort electrocardiography (author's transl)].

Explore the source record for details and available documents.

Adult↗

PubMedDate not supplied

Physicians' interactions with families of terminally ill patients.

BACKGROUND AND OBJECTIVES: This study assessed how the attitudes and anxieties of family practice residents about death affect the care they give the families of terminally ill patients. METHODS: Sixty family practice residents completed a death anxiety scale as well as scales regarding physicians' reported attitudes about and behavioral responses to their dying patients and their families. RESULTS: Anxieties about the death of patients correlate with attitudes reflecting discomfort about handling patients' death. However, physicians' anxiety did not lead to decreased amounts of empathic behaviors with families. Rather, attitudes about the physician's role, ability, and willingness to become personally involved with a family's grief were related to the amount a resident addressed the future with the family and engaged in follow-up behaviors. CONCLUSIONS: Residents' professionalism was more important than their personal anxieties about their work for determining their response to families. Family physicians have an important role in helping families of dying patients cope with their grief. More effort at education and support for this role during training would help physicians feel more comfortable with and succeed at this aspect of their professional functioning.

Adult↗