Myths & facts ... about depression.
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Attitude to Health↗
Biomedical subjects
S Lewis
Publications and source records attributed to S Lewis.
Carbon monoxide exposure in blast furnace workers.
This study investigated the occupational exposure to carbon monoxide (CO) of a group of blast furnace workers from an integrated steelworks, compared to a control group having no significant occupational CO exposure from other areas in the same works. The study was undertaken in 1984 at Port Kembla, New South Wales. Carboxyhaemoglobin (COHb) levels before and after an eight-hour work shift were measured in 98 male steelworkers: 52 from two CO-exposed iron blast furnaces and 46 controls from production areas in the same steelworks. The sample was stratified by smoking habits. Environmental air CO levels had been found to be consistently higher on one furnace than on the other. Absorption of CO from the working environment occurred in workers on the blast furnace with higher CO levels, regardless of smoking habits. On this blast furnace, some readings of COHb levels after a workshift in nonsmokers approached the proposed Australian occupational limit of 5 per cent COHb saturation. Overall, workers with the highest occupational exposure who smoked most heavily had the highest absorption of CO over a work shift. Biological monitoring gives an accurate measure of individual worker 'dose' of CO from all sources. Both environmental monitoring and biological monitoring need to be included as part of a program for controlling occupational CO exposure.
Breath Tests↗
Clinical correlates of sway in elderly people living at home.
Postural sway has been noted to increase with advancing age and to correlate with a wide variety of clinical features. The relationships between sway and various clinical features were explored in a group of elderly subjects living at home and free from neurological illness and severe incapacity. Each subject underwent a thorough physical examination and sway was measured in the anteroposterior and lateral planes with eyes open and closed using a modified Wright's ataxiameter. Vibration sense was the only clinical feature to show a consistent relationship with all 4 measurements of sway in men. Age showed only a weak and inconsistent relationship to sway in both men and women. Weak but inconsistent relationships were noted between sway and mental function, tone, passive joint movement, antidepressant and tranquilliser therapy. This suggests that dorsal column function is of prime importance in the maintenance of balance and that the previously noted increase in postural sway with advancing age may have been exaggerated by the presence of disease processes.
Aged↗
Sex differences in the familial risk of schizophrenia: data from Rüdin's study.
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Female↗
Sex and schizophrenia: vive la différence.
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Adult↗
Relationship between chemical-induced fragile sites and chromosomal breakpoints in malignant cells in children.
Many fragile sites in the human genome occur at or near chromosomal breakpoints reportedly involved in translocations of DNA material in neoplastic cells. This fact has led some investigators to postulate that fragile sites have a pathogenic role in human neoplasia. To learn whether caffeine-induced fragile sites relate to breakpoints found in the neoplastic cells of an individual patient, we studied lymphocytes from the peripheral blood of 32 patients in remission from malignant disease. Lymphocytes were cultured in medium containing either 5-Fluoro-2'-deoxyuridine (FdU) or FdU plus caffeine, and G-banded metaphases were examined for nonrandom breaks. Analyses of completely G-banded malignant cell chromosomes from 31 of the 32 patients were available for comparison. In only once case, a 5-year-old child with acute lymphoblastic leukemia, did a caffeine-induced fragile site (1q44) coincide with a breakpoint in the neoplastic cells [dup(1)(q21-->q44)]. Our findings suggest that chromosomal abnormalities in childhood malignancies cannot generally be explained by the presence of FdU- or FdU plus caffeine-induced fragile sites.
Adolescent↗
Histomorphometry of bone apposition around three types of endosseous dental implants.
Three different types of commercially available dental implants (Nobelpharma, IMZ, and Integral) were implanted in the edentulous mandibles of seven adult mongrel dogs. Twenty-one implants were harvested with block sections after 12 weeks and embedded in polymethyl methacrylate resin. Undecalcified sections were prepared with the sectioning-grinding technique. The percentage of bone contacting the implant surface was measured with a self-designed histomorphometry method using a millimeter grid in a stereomicroscope. The results demonstrated a significantly higher percentage of bone along the hydroxyapatite-coated implant than that seen with the titanium-surfaced implant types.
Alveolar Process↗
Which calcium channel blocker for ischaemic heart disease?
Calcium channel blockers have been available since the early 1960s. Extensive research has been undertaken to evaluate their usefulness in the treatment of patients with ischaemic heart disease. We have reviewed the pharmacology of these drugs and the major clinical trials. In particular, we have examined the effect of calcium channel blockers on the progression of atheroma, and their role in the following clinical settings: following myocardial infarction, following non-Q-wave myocardial infarction, and in unstable angina.
Angina, Unstable↗
Identifying and treating patients with panic attacks.
Panic disorder occurs in up to 3 percent of the population and can be socially, emotionally and occupationally disabling. A thorough clinical evaluation is crucial to exclude illnesses with similar presentations, particularly acute cardiac, gastrointestinal or neurologic disease. The noradrenergic nervous system is involved in panic attacks. These attacks are described as sudden, unexpected episodes of intense fear or discomfort, usually lasting five to 30 minutes. Appropriate medications include benzodiazepines, tricyclic antidepressants and monoamine oxidase inhibitors. Alprazolam and clonazepam are quickly effective in alleviating panic, but they cause significant symptoms upon discontinuation. The best-studied drug in the treatment of panic disorder is imipramine; like other tricyclic antidepressants, it can cause increased jitteriness early in treatment. Monoamine oxidase inhibitors may be particularly helpful in patients with panic disorder who exhibit social avoidance. Behavior therapy, an important component of treatment, involves the patient's confrontation of fears or phobias.
Behavior Therapy↗
An analysis of panel data. The impact of a psychiatric consultation letter on the expenditures and outcomes of care for patients with somatization disorder.
In this study, the cost and health outcomes of a psychiatric consultation letter to primary care physicians caring for a sample of patients diagnosed with somatization disorder, a psychiatric condition associated with multiple, unexplained medical complaints, was assessed. To accommodate the small sample size of 73 patients, outcome effects were calculated using panel analysis. Study patients were randomized to a consultation or noconsultation group, and were repeatedly assessed at equal time intervals. Data were analyzed using parsimonious regression models derived from economic theory. During the 1-year follow-up period, a psychiatric consultation letter was associated with a 12% reduction in health care costs ($455 per patient within first year), with no evidence of deterioration in physical, mental, or general health. Less powerful t-test comparisons between treated and control groups lead to different conclusions. Reasons for these differences are discussed.
Adult↗
A team to tackle the issues that count. Problem-solving through quality circles.
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Humans↗
Complications of pregnancy and delivery and psychosis in adult life.
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Female↗
Electrospray ionization mass spectrometry of platinum anticancer agents.
Quantification and identification of platinum drugs and their metabolites in biological samples has always been difficult because these compounds are thermally unstable, non-volatile and insoluble. We have demonstrated that electrospray ionization mass spectrometry can be a valuable technique for direct mass spectral analysis of platinum anticancer agents and for obtaining structural information as a result of fragmentation. Full-scan spectra were obtained with approximately 10 pmol samples. These results show the potential of applying this technique in pharmacokinetic studies of platinum anticancer drugs.
Antineoplastic Agents↗
MRI in schizophrenia: basal ganglia and white matter T1 times.
The T1 relaxation time of the basal ganglia (putamen, globus pallidus and head of caudate) and of the frontoparietal centrum semiovale was compared between 49 schizophrenic patients and 36 healthy controls. Previous reports of increased T1 time in the basal ganglia were not confirmed, and group differences were not detected within the white matter. Within patients T1 values could not be related to tardive dyskinesia or other clinical features. Normal variation seen in basal ganglia T1 times is described for the first time: lowest values occur in the globus pallidus and highest in the caudate, and values within the putamen increase rostrally.
Adult↗
Physiological growth hormone secretion in adult growth hormone deficiency: comparison with normal controls.
A comparison was made between the pulsatile pattern of growth hormone secretion in 14 growth hormone deficient adults (serum growth hormone less than 7 mU/I following insulin-stimulated hypoglycaemia) and 14 age and sex matched controls. The 24-h secretory profile was generated by 2-hourly sampling from 0800 to 2200 h, and 30-min sampling from 2200 to 0600 h. Plasma GH in each sample was measured using a double antibody radioimmunoassay. The profiles were analysed using a computer program (Pulsar). Sleep-electroencephalography was recorded in all subjects. The total amount of GH secreted in a 24-h period (area under the curve over baseline) was significantly less in the growth hormone deficient group (P less than 0.002). The pulse frequency, amplitude, height and percentage GH secreted in peaks were also significantly less in the growth hormone deficient group (P less than 0.002 respectively). We conclude that adults deficient in GH, as defined by conventional pharmacological stimuli, are in addition physiologically deficient of pulsatile GH secretion.
Adult↗
Dysthyroid eye disease masquerading as glaucoma.
Intraocular pressure (IOP) screening by optometrists is increasingly prevalent. Although a raised IOP usually signifies glaucoma there can be other causes, notably dysthyroid eye disease, which those screening should be aware of. The patients in the four cases presented were presumed to have glaucoma on the basis of raised IOPs, and three of them actually received medication. Because their optic nerves and visual fields showed no abnormalities this diagnosis was questioned and the cause shown to be dysthyroid eye disease. Thyroid eye disease causes raised IOP on upgaze due to a thickened inferior rectus identing the globe; however, in the primary position the IOP is normal. A misleading raised IOP can thus be found if tonometry is inadvertently done in upgaze, either because of poor patient positioning or Bell's phenomenon. Although some patients will have a past medical history of thyrotoxicosis, dysthyroid eye disease can occur in the absence of systemic or biochemical abnormalities. The important clinical signs are lid lag, lid retraction, raised IOP on upgaze and proptosis, the first three being the most common. Tonometry should thus always be done in the primary position and if raised IOPs are found without any of the other features of glaucoma, other causes particularly dysthyroid eye disease, should be considered.
Aged↗
Inhibitory mechanisms of attention: locus, stability, and relationship with distractor interference effects.
This paper examines three properties of attentional inhibition mechanisms. First, previous research has suggested that the inhibitory mechanism of selective attention has a central locus between perception and action. We attempt to confirm the locus of this inhibition. Second, the processing of an unattended stimulus has been observed via the effects of the stimulus on a concurrent target (interference), and on a subsequent target (negative priming). The former effect demonstrates that distractors interfere with the processing of the target, and the latter negative priming effect implies that distractors are inhibited during selection. We demonstrate that these two measures of unattended processing can be dissociated. Third, we reveal that inhibition appears to be a stable mechanism of selection, in that effects do not decline after a large number of experimental trials.
Attention↗