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Biomedical subjects

W V McCall

Publications and source records attributed to W V McCall.

71 records · Page 4Linked to original sources
PubMed1992

Subjective total insomnia: an example of sleep state misperception.

Sleep state misperception (SSM) is the diagnostic term proposed in the International Classification of Sleep Disorders to describe those insomniacs who mislabel their sleep as wakefulness. Although sleep misperception has long been recognized among insomnia patients, it is debatable whether this clinical finding warrants a distinctive diagnosis or simply represents an extreme variation of other, more common forms of insomnia. We present two cases to explore the clinical meaningfulness of SSM. It is concluded that SSM represents a distinctive, albeit rare, sleep disorder. However, refinements in existing diagnostic criteria may be needed to improve the meaningfulness of the SSM diagnosis.

Adult↗
PubMed1992

Periodic limb movement variability in older DIMS patients across consecutive nights of home monitoring.

Older difficulty initiating and/or maintaining sleep (DIMS) patients who met criteria for periodic limb movement disorder (PLMD) were monitored for three consecutive nights in their homes using ambulatory polysomnography (PSG). Correlational analyses of the group data suggested little night-to-night variability in either movement indices or movement-related arousal indices for this sample. However, within-subjects comparisons suggested considerable variability in these indices and other sleep measures across nights. Nevertheless, for most subjects, the variability noted for these indices appeared to have little effect on PLMD severity classification or clinical treatment decisions derived from blind examinations of PSGs. Further, the initial PSG study generally led to a representative severity classification and clinical decision. Additional research is needed to determine the generalizability of these results to younger subjects, patients with complaints of excessive somnolence and other methods of home PSG monitoring.

Age Factors↗
PubMed1991

Neurological findings in insomniacs with periodic limb movements.

This study investigates the relationship between abnormal neurologic findings and periodic limb movements (PLMs). Neurologic abnormalities were found to be statistically related to the occurrence of PLMs on polysomnographic study. The neurologic abnormalities may represent a risk factor for PLMs independent of age.

Adolescent↗
PubMed1991

Sleep variability across consecutive nights of home monitoring in older mixed DIMS patients.

Twenty patients with difficulties initiating and maintaining sleep (DIMS) were monitored in their homes for three consecutive nights using ambulatory polysomnography (PSG). Following each night of monitoring, patients provided subjective ratings of sleep disturbance and tolerance of the PSG equipment. Friedman analyses of variance performed on the objective and subjective parameters showed that the sample, as a whole, evidenced no systematic first night effects (FNE) in response to monitoring. Inspection of the data from each individual subject, nevertheless, showed that half of the sample did experience multiple FNE. Further, several scales from the Minnesota Multiphasic Personality Inventory discriminated those patients who showed multiple FNE from those who did not. However, far more striking was the finding that clinically and statistically significant intrasubject variability across nights was observed for each sleep parameter measured. Given this finding, a single ambulatory PSG study may not fully convey the nature of the sleep disturbance experienced by the DIMS patient even when FNE are absent. We thus, recommend multiple ambulatory sleep studies for those clinical and research situations in which it is necessary to document patients' night-to-night sleep variability. In contrast, when the goal of the PSG study is that of determining a sleep diagnosis, a single ambulatory study, in combination with other clinical data, may be sufficient.

Aged↗
PubMed1990

Daytime functioning and nighttime sleep before, during, and after a 146-hour tennis match.

Two adult males (ages 31 and 35 years) were studied while they participated in a week-long marathon tennis match under conditions of extreme sleep restriction (4-5 h reductions per night). Polysomnographic monitoring was conducted on the two nights prior to the marathon, continuously throughout the match, and on two recovery nights. In addition, measures of daytime sleepiness, mood state, and cognitive performance were obtained during the course of the study. Despite undergoing marked sleep restriction, both players continued to obtain their usual (baseline) amounts of slow wave sleep throughout the marathon. Both players showed a gradually increasing tendency toward daytime dozing across the first few days of the marathon. This tendency decreased on the fifth day but increased again on the sixth day of the match. Also, both players showed a pre- to postmatch decline on some cognitive measures. However, the players differed markedly in their ratings of sleepiness, mood ratings, recovery sleep patterns, and endurance with respect to the demands of the match. Results appear to be consistent with previous laboratory studies in documenting the primacy of the "slow wave sleep drive." Given the marked differences observed between the players, research designed to identify factors that predict response to sleep loss seems to be warranted.

Adult↗
PubMed1989

Abnormalities in the response of plasma arginine vasopressin during hypertonic saline infusion in patients with eating disorders.

We examined the response of plasma arginine vasopressin (pAVP) to intravenous 5% hypertonic saline in patients with anorexia nervosa (AN) and bulimia nervosa (BN). Patients did not differ from controls in their subjective response for the onset of thirst; however, only 5 patients (3 AN and 2 BN) showed pAVP levels that were within the normal range (0.5-11.0 pg/ml) for this test. With the exception of two eating disorder (ED) patients, all others showed some nonlinear irregularities in the pattern of their secretion of pAVP in response to the hypertonic saline infusion. Seven of the ED patients showed an irregular abnormally high pAVP secretion, and three patients showed abnormally low pAVP responses. Both of these pAVP secretion abnormalities occurred in underweight and weight-recovered AN patients, as well as in BN patients. The cause and pathophysiological consequences of these abnormalities remain unresolved.

Adolescent↗
PubMed1989

Physical treatments in psychiatry: current and historical use in the southern United States.

Several surveys during the 1970s showed a decline in the use of electroconvulsive therapy (ECT). Psychosurgery, insulin coma, and continuous sleep treatment are widely assumed to be in total disuse. This is the first comprehensive survey on the use of physical treatments in psychiatry in the southern United States. Seventy-five percent of 315 surveys sent to psychiatric medical directors and chief residents were returned. ECT was used in 89% of training hospitals, 57% of Veterans Administration hospitals, and 44% of private hospitals, but only 19% of state hospitals within the last year. None of the 19 state hospitals begun since 1970 had started ECT services. Moreover, state hospitals abandoned ECT at a higher rate than private hospitals. The lack of this service in the public sector is a result of sociolegal pressure rather than lack of confidence or enthusiasm for ECT. The other physical treatments were reported to be in almost total disuse.

Convulsive Therapy↗
PubMed1989

Two methods of scoring sleep with the Oxford Medilog 9000: comparison to conventional paper scoring.

This study evaluated two methods of scoring taped polysomnographic data directly on the Medilog 9000 scanner: (a) screen-by-screen scoring, and (b) rapid screen scoring. Sixteen overnight polysomnograms recorded on Medilog 9000 recorders were scored using the above two methods and were also printed on paper for conventional paper scoring. Interscorer agreement was 87.8% for paper scoring, 85.5% for screen-by-screen scoring, and 84.2% for rapid screen scoring. Comparison of screen-by-screen scoring with paper scoring revealed small absolute deviations and correlations of r greater than 0.90 for all sleep parameters, with the exception of brief (less than 2 min) awakenings (r = 0.69). Rapid screen scoring resulted in slightly lower correlations and greater deviations from paper scoring on several sleep parameters, but appeared acceptable for most clinical purposes and greatly reduced the required scoring time. Although some statistically significant differences between scoring methods were observed, the size of effect was small and of doubtful clinical importance. These findings suggest that polysomnographic data recorded on Medilog 9000 recorders can be reliably and accurately scored on the Medilog scanner, obviating the laborious task of printing the taped data on paper.

Adolescent↗
PubMed1988

Clomiphene blocks the effect of intravenous estradiol on the firing rate of rat nigral dopamine neurons.

Intravenous 17-beta-estradiol (BETA) has a potent, stereo-specific, and rapid effect on dopamine (DA) neuron firing rate in the substantia nigra compacta (SNC). Our data demonstrate that immediate intravenous pretreatment with the anti-estrogen clomiphene (CLOM) blocks the action of subsequent intravenous BETA administration. Our results provide further physiologic evidence for membrane-bound estradiol (E2) receptors within the rat brain.

Animals↗
PubMedDate not supplied

Social support increases in the year after inpatient treatment of depression.

High levels of social support are reported to protect against major depressive episode (MDE), but little is known about how social support changes during MDE. In this study, we measured total social support and four subtypes of social support in 75 psychiatric inpatients at the time of admission and one year later. The four subtypes of social support were tangible support, affectionate support, positive social interaction, and emotional/informational support. The majority of the sample were women (81%) with a mean age of 53.7+/-14.9 years. The severity of depressive symptoms improved over the year and was accompanied by a significant increase in two types of social support -- positive social interaction, and emotional/informational support. There was no significant change in tangible support or affectionate support. Linear regression showed that changes in all four subtypes were correlated with changes in depressive severity after adjustment for age, gender, and baseline clinical characteristics. While Instrumental Activities of Daily Living (IADL) scores also improved throughout the period of observation, and while the change in IADL scores were significantly associated with changes in social support, change in IADL scores were no longer significantly associated with change in social support after adjustment for change in depression severity. These results suggest that supportive relationships improve after psychiatric hospitalization for MDE, and these changes are best explained by reduction in depression severity.

Activities of Daily Living↗