Symptoms of anxiety, panic, depression, hypochondriasis and phobias were recorded serially over a 2-year period in 78 psychiatric patients with depressive, anxiety and phobic neuroses. It was hypothesised that if there was a clear-cut relationship between symptom type and diagnosis the current classification of neurotic disorder would be supported. The results showed great temporal variability of anxiety and depressive symptoms. These symptoms were also poorly related to diagnosis. Phobic symptoms, however, were relatively consistent over time. The findings suggest that classifications of neurotic disorder based on presenting anxiety and depressive symptoms are unsatisfactory and that many patients could be classified as a single mixed disorder.

Adult↗

PubMedDate not supplied

A longitudinal study of short latency somatosensory evoked responses in healthy newborns and infants.

Maturational changes in short latency somatosensory evoked responses (SERs) were studied in 18 healthy full-term newborns in the first week of life and consequently repeated at 2-3 and 6-7 months of age. Both median nerves were electrically stimulated individually and evoked responses were recorded at 3 levels: Erb's point (EP), second cervical vertebra (CII), and contralateral parietal scalp (C'c). In the neonatal period, results of 32 stimulated nerves were obtained in all cases at the EP and CII levels. At the parietal level, potentials were present in 85% of cases, absent in 9% and questionable in 6%. Parietal potentials were occasionally noted on one side only. Repeat examinations at 2-3 and 6-7 months of age demonstrated significant maturational changes in the SERs. These changes were most prominent in the neonatal period and 2 months of age. They included decreased interpeak latencies, increased amplitude and markedly diminished dispersion of parietal potentials. Minimal changes in wave form configuration and latency were noted at the EP and CII level. These findings most likely reflect myelination and increased synaptic efficiency predominantly in the central sensory pathway. The purpose of this investigation was to delineate a reliable technique for SERs in newborns and infants that could be applied both to research and clinical settings. Normative data were established in newborns and infants as this will help us in accurately differentiating a normal from an abnormal group of neonates and infants.

Electroencephalography↗

PubMedDate not supplied

Somatosensory evoked response abnormalities in high-risk newborns.

In a previous study from our laboratory, the prognostic significance of the auditory brainstem evoked response was assessed in high-risk neonates. An abnormal auditory brainstem evoked response predicted neurologic deficits at age 1 year; however, a normal result did not predict a normal outcome. In order to evaluate the prognostic utility of examining other sensory pathways, somatosensory evoked responses were elicited following median nerve stimulation. Testing was performed at 37-44 weeks conceptional age (defined as gestational age plus chronologic age) and at 2 and 6 months conceptional ages. Those patients studied included 34 high-risk neonates and 18 healthy, term infants as controls. Ten of the 34 patients had abnormal somatosensory evoked responses. Abnormalities included increased absolute (N19, P22) and interwave (N13-N19, N19-P22) latencies and flat potentials, alone or in combination. Three children with flat potentials demonstrated a persistence of this abnormality on subsequent examination and they later presented clinically with spastic quadriparesis. Four infants with increased latencies manifested normal responses on subsequent examination. Recently, these 4 patients exhibited tone abnormalities and mild developmental deficits; developmental outcome, however, will be assessed in a blind study at 1 year of age as part of this ongoing prospective study. Preliminary results suggest that somatosensory evoked responses may be valuable as an electrophysiologic predictor of outcome.

Brain Damage, Chronic↗

PubMedDate not supplied

A turning point.

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Adult↗

PubMedDate not supplied

Management of renal angiomyolipoma in patients with tuberous sclerosis complex.

Renal angiomyolipomas are common in patients with tuberous sclerosis complex (TSC), and the risk of severe haemorrhage from these angiomyolipomas can become substantial. This case illustrates a potentially life-threatening condition due to the development of a large aneurysm within an angiomyolipoma, which was discovered within 14 months of her screening renal ultrasound scan. Renal arterial embolisation and renal sparing surgery resulted in good recovery. Clear guidelines for the screening, surveillance, and treatment of angiomyolipomas in patients with TSC are required. This includes the appropriate frequency of surveillance for patients in different age groups and at different stages of angiomyolipoma development, based on a growing knowledge of the natural history of this condition, since growth of renal angiomyolipomas can be rapid and asymptomatic. Computed tomography or magnetic resonance imaging may be required to demonstrate complications in large lesions, as three ultrasound examinations in this patient failed to detect the large aneurysm which had developed. Angiogenesis inhibitors could potentially play a role in preventing the development of angiomyolipomas, which could improve the prognosis for patients with TSC and therefore warrants investigation through phase II/III clinical trials.

Adult↗

PubMedDate not supplied

Introducing RUS--a link between research and service.

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Rehabilitation↗

PubMedDate not supplied

Recommend changing answers on multiple choice examinations.

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Choice Behavior↗