A 53-year-old man with chronic back and leg pain developed recurrent painful ecchymoses after lumbar laminectomy. No hematologic abnormality could be detected, but an ecchymosis developed after subcutaneous injection of his blood into the region of pain. A detailed study of the psychological setting of the illness and his personality revealed this to be an example of psychogenic purpura. This is the third report of the syndrome in a male.

Accident Proneness↗

PubMedDate not supplied

Liaison in reverse: the role of a psychosomatically-oriented internist in a department of psychiatry.

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Diagnosis, Differential↗

PubMedDate not supplied

Relationship of muscle capillary basement membrane thickness and diabetic retinopathy.

We examined the relationship between the thickness of the quadriceps muscle capillary basement membrane and diabetic retinopathy. Basement membrane thickness was measured in two groups of patients with long-standing type II diabetes mellitus. One group of patients (N = 13) had no evidence of diabetic retinopathy on fluorescein angiography, whereas the other (N = 12) had proliferative microvascular disease. All the patients were male, and both groups were of similar ages, duration of diabetes, serum creatinines, and glycemic control as reflected by HbA1 levels. Mean muscle capillary basement membrane width (+/- SE) of the patients with proliferative retinopathy (3346 +/- 262) was significantly greater (P less than .05) than that observed in the patients without retinopathy (2660 +/- 177). The results of this study suggest that there is a relationship between capillary basement membrane thickness in skeletal muscle and the severity of microangiopathy in the eye. However, there was a substantial overlap between the two groups, indicating that for any individual patient the measurement of muscle capillary basement width will probably not be useful in identifying the presence or absence of retinopathy.

Aged↗

PubMedDate not supplied

Emotional response and clinical severity as early determinants of six-month mortality after myocardial infarction.

The literature relating psychic factors to pathogenesis, onset, and complication of acute myocardial infarction was selectively reviewed. A study which suggests that psychic factors affect six-month mortality rate after myocardial infarction was described. Specifically, patients showing a trend toward emotional adjustment early in their hospitalization had a far smaller mortality rate than those who did not show early adjustment trends. Severity of the heart attack, measured by the extent of complication, proved also to be predictive of six-month mortality. The findings were discussed with an emphasis on the acute-care staff's potential for changing patient behavior patterns, and hence, improving eventual patient mortality rates.

Adaptation, Psychological↗