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PubMed1985

The levels of androgen in serum in female acne patients.

Twenty six female acne patients aged between 27 and 42 years were investigated. Blood samples were taken and radioimmunoassayble testosterone, androstenedione and DHEA-S were determined. Seven out of 26 patients (27%) had normal androgen serum levels. In 19 patients one or more androgen serum levels were elevated. DHEA-S (23%) alone and testosterone, androstenedione plus DHEA-S (15%) showed the greatest incidences of elevated levels. Testosterone and androstenedione, respectively, were elevated in 3 patients whereas DHEA-S alone was elevated in 6 patients. 71% with normal androgen serum levels and 72% of patients with elevated androgens presented with premenstrual or menstrual exacerbation of acne. In addition, patients with elevated testosterone, androstenedione or with all measured androgens elevated had menstrual disorders and premenstrual formation of therapy resistant big nodules in the chin area. Present data combine to suggest that the determination of androgens is of importance for the evaluation of acne patients.

Acne Vulgaris↗

PubMedDate not supplied

[Utilization of ambulatory health services by patients with disseminated sclerosis among the population of Lódź].

The reported study included patients with multiple sclerosis with a history of at least 5 years of the disease and aged 46 years or less, living in a big city. On the ground of history data obtained from the patients it was estimated that in the calendar year preceding the study one patient obtained about 11 medical services (in the office of a physician or in the patient's home) and about 10 of these services were given by the doctors of the public health service. The main role in the care of the patients was played by neurologists from the public health service, but the number of house visits provided by physicians of the basic health service was slightly higher than that provided by neurologists. Among the physicians working in medical cooperative or in private practice only the dentists had a more important role in providing of health services to the patients. Thirty percent of patients had no medical visits in outpatient clinics of social health service within a year preceding the study, despite a need for them, and 9% of them had no house visits of physicians. The percent of patients informed about the usefulness of motor rehabilitation treatment was at least half the proportion of patients with walking disturbances. The results indicate inadequate availability of health services for this group of outpatients, similarly as outpatient rehabilitation treatment and treatment in sanatorium, despite the index of employed medical personnel per population which is higher in this city than the average index for the whole country. These results suggest a necessity of undertaking of actions for improving the care of these patients.

Adult↗

PubMedDate not supplied

[Ultraspectrophotometric method of differential determination of DNA and RNA in spermatozoa].

The authors describe a complement of the previously published ultramicrospectro-photometric method for the dosage of nucleic acids. The spermatozoa are scanned by a bundle of U-V. light. It is so possible to obtain the measurement of the U-V. light absorption on a very big number of very small areas. The data are printed very accurately on one histogram. Thereafter spermatozoa are submitted to the action of RNase and DNase and rescanned with U-V. light. The comparison of the histograms allows to estimate the amount of nucleic acids. Further investigations are requested.

DNA↗

PubMed1996

[Debatable issues in the problem of somatoform and related disorders].

The questions of including into ICD-10 and DSM-III-R of extranosological category--somatoform disorders is discussed. Some positive moments were considered, but inexpediency of the limitation of somatoform disorders to psychological disturbances only, doubtfulness of both including psychosomatic diseases in this category and age limitations in beginning and duration of the disease were stressed. The concept of somatopsychic diseases was proposed with three main variations: 1) with relatively independent rise of somatic and psychic disorders, 2) with prevailing etiopathogenic role of psychic factor (psychosomatic disorders, somatized psychic disturbances, somatoform neurotic and psychosomatic disturbances), 3) with prevailing etiopathogenic role of somatic factors (somatogenic psychic disorders). The actual distribution of somatopsychic disturbances are presented on the syndromal, nosologic and personal levels using data of prophylactic medical examination of one big enterprise's employees.

Humans↗

PubMed1987

Identification of psychologic impairment in patients with mild-moderate thermal injury: small burn, big problem.

Sixty-eight patients hospitalized at a tertiary care burn center for more than 1 week, aged 18-32 years, with a mild or moderate burn, adequate social and economic support, and the absence of preexisting psychopathology, substance abuse, or medical illness were studied. From this group 16 patients were identified who had been unable to resume social or occupational functioning even after several months and were impaired by psychologic symptoms related to the burn. Utilizing a psycho-social data base of 250 items, these "Small Burn, Big Problem" (SBBP) patients were compared to those who did not have this problem (control). There were no differences between the two groups with respect to age, sex, race, hospital length of stay, agent of injury, circumstances of the accident, extent of burn, or amount of disfigurement. The SBBP patients did develop significantly more sleep disturbances, which continued into the posthospitalization period. There were significant differences in the use of the defense mechanisms of regression and displacement, the extent of experiencing the injury as a narcisistic injury and in the indication of sexual dysfunction in the SBBP patients as compared to the control group. There were no differences in the amount of psychiatric treatment performed while the patients were in the hospital, although 68% of the SBBP group were referred for psychiatric treatment upon discharge as compared to 14% of the control group. Two case vignettes are presented to demonstrate some of the psychodynamics involved.

Adolescent↗

PubMed1998

Building measurement and data collection into medical practice.

Clinicians can use data to improve daily clinical practice. This paper offers eight principles for using data to support improvement in busy clinical settings: 1) seek usefulness, not perfection, in the measurement; 2) use a balanced set of process, outcome, and cost measures; 3) keep measurement simple (think big, but start small); 4) use qualitative and quantitative data; 5) write down the operational definitions of measures; 6) measure small, representative samples; 7) build measurement into daily work; and 8) develop a measurement team. The following approaches to using data for improvement are recommended. First, begin with curiosity about outcomes or a need to improve results. Second, try to avoid knee-jerk, obstructive criticism of proposed measurements. Instead, propose solutions that are practical, goal-oriented, and good enough to start with. Third, gather baseline data on a small sample and check the findings. Fourth, try to change and improve the delivery process while gathering data. Fifth, plot results over time and analyze them by using a control chart or other graphical method. Sixth, refine your understanding of variation in processes and outcomes by dividing patients into clinically homogeneous subgroups (stratification) and analyzing the results separately for each subgroup. Finally, make further changes while measuring key outcomes over time. Measurement and improvement are intertwined; it is impossible to make improvements without measurement. Measuring and learning from each patient and using the information gleaned to test improvements can become part of daily medical practice in local settings.

Blood Glucose Self-Monitoring↗

PubMed1977

High molecular weight forms of human ACTH are glycoproteins.

The RIA-ACTH in a normal human pituitary, 2 ectopic ACTH-secreting tumors and plasma from a patient with Nelson's syndrome and one with ectopic ACTH syndrome was divided into 3 molecular weight classes after gel exclusion chromatography. The largest component appeared in or near the void volume and was designated "big" RIA-ACTH. The second, designated "intermediate" RIA-ACTH, eluted between the void volume and standard human 1-39 ACTH (mol. wt. 4,541). An immunoreactive material designated "little" ACTH-coeluted with standard human ACTH. A significant fraction (29-61%) of "big" RIA-ACTH from the tumors bound to concanavalin A-agarose and was eluted with 0.2 M alpha-methyl-D-mannopyranoside. An additional 16-22% of "big" RIA-ACTH was more tightly bound to the concanavalin A, but could be purged from the column with 0.1 M acetic acid. A smaller total percent of "big" RIA-ACTH from the pituitary (20%) and plasmas (5-10%) bound to the lectin and was similarly eluted and purged. Relatively little (less than 8%) of "intermediate" RIA-ACTH from all sources bound to concanavalin A, with the exception of that in the pitull sources was essentially excluded (greater than 93%) from the column. These data indicate that a significant fraction of human "big" RIA-ACTH is a glycoprotein and that human "intermediate" RIA-ACTH may be also.

Adenoma, Islet Cell↗

PubMed1992

Manipulation in close relationships: five personality factors in interactional context.

This research had three basic goals: (a) to identify manipulation tactics used in close relationships; (b) to document empirically the degree of generality and specificity of tactical deployment across relationship types (mates, friends, parents); and (c) to identify links between five major personality dimensions and the usage of manipulation tactics. Twelve manipulation tactics were identified through separate factor analyses of two instruments based on different data sources: Charm, Reason, Coercion, Silent Treatment, Debasement, and Regression (replicating Buss et al., 1987), and Responsibility Invocation, Reciprocity, Monetary Reward, Pleasure Induction, Social Comparison, and Hardball (an amalgam of threats, lies, and violence). The Big Five personality factors were assessed through three separate data sources: self-report, spouse report, and two independent interviewers. Personality factors showed coherent links with tactics, including Surgency (Coercion, Responsibility, Invocation), Desurgency (Debasement), Agreeableness (Pleasure Induction), Disagreeableness (Coercion), Conscientiousness (Reason), Emotional Instability (Regression), and Intellect-Openness (Reason). Discussion focuses on the consequences of the five personality factors for social interaction in close relationships.

Adolescent↗

PubMedDate not supplied