Biomedical subjects
Publications and source records attributed to V Patterson.
This study was undertaken to evaluate factors correlated with crack use by 479 adolescents in 1992 in Dade County, Florida public schools. Based upon self-reports, after application of the Bonferroni correction, only two variables were related to crack use, i.e., having friends who use crack and living alone.
We report an unusual familial myopathy characterized morphologically by the presence of large tubular aggregates in all fibre types. Two patients, a father and daughter, presented with slowly progressive proximal weakness, limitation of eye movement, and Achilles tendon contractures. Serum creatine kinase was 5-10 times normal. Light microscopy revealed type I fibre predominance. Basophilic accumulations, which stained intensely with the NADH-TR reaction, were present in both fibre types. Electron microscopy revealed that these consisted of tightly packed parallel tubular arrays. These varied somewhat in their ultrastructural appearance and were classified accordingly as type I, II, and III tubular structures. The tubular aggregates appear to be derived from the sarcoplasmic reticulum. This report further supports the evidence of a distinct clinico-pathological entity of genetic origin.
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Excessive accumulation of intracellular calcium in Duchenne muscular dystrophy (DMD) may be a necessary step in the process that causes muscle damage in this disease. Because of this possibility, a controlled trial of the calcium channel blocking agent nifedipine was undertaken. One hundred and five patients were randomized and treated in a double-blind manner for 18 months. Muscle strength, contractures, functional ability, cardiopulmonary changes, and laboratory data were monitored. The dose of nifedipine was 0.75-1 mg/kg/day in the first 6 months and 1.5-2 mg/kg/day for the next 12 months. Satisfactory blood levels of nifedipine were attained. The study had a power greater than 0.99 to detect a slowing of the illness to 25% of its original rate of progression. No significant improvement was demonstrated in the treated group. One or more of the frequent mild side effects of flushing, dizziness, and leg edema, often associated with the use of nifedipine in adults, occurred transiently in approximately one-half of the patients in the nifedipine group and in 21% of the placebo group. Four patients died, two on nifedipine and two on placebo. This study demonstrates that nifedipine is safe to administer in children, but that it is without beneficial effect on the course of DMD.
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Psychotherapy supervision has been investigated extensively, but the literature reveals few controlled studies and none that directly assesses the effects of supervision on psychotherapy outcome. In this study, two aspects of psychotherapy supervision--the amount of supervision, and the congruence of theoretical orientation between the supervisor and trainee--were studied in relation to patient change as measured by pretherapy and followup ratings on the Global Assessment Scale (N = 237). Amount of supervision was not found to be related to therapy outcome, but patients showed significantly greater improvement when their trainee-therapists reported theoretical orientations congruent with those of their supervisors.
The authors conducted a systematic psychodynamic investigation directed explicitly toward the bereavement reactions of people who have lost a parent during their adult life. They conducted a single in-depth interview of 14 people with a mean age of 32.4 years who had experienced the death of a parent in the last 3--20 months. The authors present clinical data illustrating several themes, including the importance of the last meeting with the parent, the experience of grief and aggression, coping resources, and growth-oriented aspects of the bereavement process. They also make a number of suggestions regarding clinical practice and further research.
The A-B scale was developed to distinguish therapists with a high rate of therapeutic improvement with schizophrenic patients from those with a low rate. The present study tests the hypothesis, developed by Whitehorn and Betz, expanded by McNair and Lorr, of an interaction between a therapist factor, i.e. the A-B score (identified in this study by the Campbell et al. revision of the Whitehorn and Betz A-B scale), patient diagnosis, and treatment outcome. An automated data system identified all of the adult patients treated by 42 therapists during their training at a psychiatric center containing inpatient and outpatient facilities. The patient group was broken down according to diagnosis and whether or not psychotropic drugs were a major treatment modality. Using a linear logistic regression model, the slope of the line specifying log odds of improvement in relation to therapist A-B was found to be significantly different for schizophrenics and neurotics treated without drugs. (No relationship to A-B was found for drug-treated patients.) For those therapists who had treated both neurotic and schizophrenic patients (N = 19) without drugs, A-B was found to be significantly associated (p = .075) with a measure of dependence between patient type and outcome. These two findings were consistent with the hypothesized relationship between the A-B dimension, patient diagnosis, and case outcome.
How do patients who had brief behavior therapy evaluate change in themselves as compared to those who had brief psychoanalytically oriented psychotherapy a year following termination of their treatment? Restults of the follow-up study reveal that over-all, patients rated themselves at one-year follow-up as improved over their status at three months after therapy but less so than at the time of termination of therapy. The form of therapy did not make a difference in the patients' evaluation of change.
A case is reported in which craniectomy for removal of right frontal meningioma was complicated by porencephaly. A peculiar granulomatous area was found over the brain at reoperation for cranioplasty. Iodine solution was used to paint the reactive material under the scalp flap. Giant swelling of the isilateral eyelids gradually developed, ascribed to interference with lymphatic drainage from the eyelids. There was no communication between eyelids and cerebrospinal fluid spaces. The enlarged eyelids were removed by ophthalmic plastic surgery.
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