[Lymphatic microcirculation in lymph nodes affected by primary and metastatic tumoral proliferations. Histologic, microradiographic and autoradiographic study].
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Adult↗
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[Findings on the psychic personality of subjects affected by primary muscle diseases of childhood and adolescence].
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Adolescent↗
Talon cusp affecting the primary maxillary central incisors in two sets of female twins: report of two cases.
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Child, Preschool↗
Cardiovascular effects of tricyclic antidepressants in childhood asthma: a case series and review.
Children with asthma frequently have significant anxiety and depression that interfere with treatment outcome. Although the use of antidepressants may be helpful, in the one published study of antidepressant use in pediatric asthma, significant side effects necessitated discontinuance; these side effects were increased motor activity, impulsive behavior, insomnia, postural hypotension, premature auricular contractions, diastolic hypertension, and generalized seizure. The objective of this retrospective chart review was to examine whether antidepressants could be tolerated and administered safely to children on asthma medications. Forty pediatric inpatients (mean age 13.3 years, range 7-19) with varying levels of asthma severity (5 mild, 11 moderate, 24 severe) and an average duration of asthma treatment of 10.0 years were administered antidepressants while also taking an average of 5 medications for asthma (range 2-7). Ten of the patients had an additional comorbid medical diagnosis. There were 17 children diagnosed with a primary affective disorder; 7 with a primary anxiety disorder; and 16 with both an affective and anxiety disorder. Thirty-six children ultimately were continued on an antidepressant: 13 on desipramine, 9 on nortriptyline, 6 on imipramine, 4 on fluoxetine, 3 on bupropion, and 1 on sertraline. Significant cardiovascular side effects (tachycardia, hypertension, and postural hypotension) occurred in 4 subjects on tricyclic antidepressants (TCAs) and 1 subject on a non-TCA (fluoxetine); 3 of these subjects were able to continue treatment with an antidepressant. Two subjects were taken off antidepressants because of hypomanic symptoms (increased motor activity, mood lability, impulsive behavior, and insomnia). No medications were discontinued because of electrocardiogram changes, arrhythmias, or seizures. Doses of TCAs were comparable to those in previous studies, but the asthma medications differed. Discussion of current anti-asthmatic medications and potential for interactions with antidepressants is included.
Adolescent↗
[Neurofunctional disturbances as related to cortical ischemia and white matter ischemia].
We evaluated regional cerebral blood flow (rCBF) by means of hydrogen clearance method as well as [14C]-iodoantipyrine autoradiographic method, cortical auditory evoked potentials (AEP), somatosensory evoked potentials (SEP) induced by forelimb (median nerve) stimulation (SEP-F), and SEP induced by hindlimb (tibial nerve) stimulation (SEP-H) in cats after occlusion of the left middle cerebral artery (MCA) under alpha-chloralose anesthesia. According to the degree of ischemia, the experimental animals were divided into two groups. One was the critical ischemia which was defined as permanent total suppression of AEP, and low residual blood flow in the auditory cortex. And the other was the non-critical ischemia which included transient suppression and spontaneous recovery of the cortical sensory evoked potentials, and high residual blood flow (greater than 15 ml/100 g/min). In one cat with transient suppression of three kinds of sensory evoked potentials, the [14C]-iodoantipyrine (IAP) autoradiograph revealed only a limited ischemic area of subcortical white matter. In the critical ischemia group, ischemia of the primary sensory cortex ranged from the mostly affected primary auditory cortex (supplied by the MCA) to the least affected hindlimb projection area within primary somatosensory cortex (supplied by the ACA). The forelimb projection area of the primary somatosensory cortex (supplied by both ACA and MCA) showed a mild or moderate reduction of rCBF after occlusion. The [14C]-IAP autoradiograph showed severe reduction of the white matter including the somatosensory pathway in the wide range. However, rCBF in the thalamus and hindlimb projection area within somatosensory cortex was almost intact in the cat with ischemia.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
'Ilko dacowo:' canine enucleation and dental sequelae in Somali children.
OBJECTIVE: To assess the prevalence of primary canine enucleation and associated dental sequelae in Somali children resident in Sheffield. DESIGN: Cross-sectional survey. SETTING: Somali religious education classes and homework groups, selected primary and secondary schools, and the Charles Clifford Dental Hospital, Sheffield (1998-99). SUBJECTS AND METHODS: The target population were all Somali children aged between 4 and 17 years. Subjects were interviewed to obtain background sociodemographic data and an oral examination was performed. The status of the canine in each quadrant was noted, in addition to the presence of any dental anomalies in adjacent teeth. Features indicative of a history of attempted canine enucleation included: absence of primary canines, localized developmental defects affecting primary or permanent canines and lower lateral permanent incisors, and retention of lower primary lateral incisors with distal eruption of permanent lateral incisors. RESULTS: A total of 260 children were included in the study, comprising 56.5% of the target population. The mean age of the subjects was 9.7 years with an equal male and female distribution. According to the criteria devised, 82 (31.5%) of the subjects were considered to exhibit one or more of the dental features suggestive of a previous history of canine enucleation. There was no significant difference in prevalence according to gender or birthplace (UK, Somalia or another country), but a positive history was greater in subjects whose mother did not speak English. In addition to anomalies involving canines, lower permanent incisors were commonly missing (5.0% of children aged over 9 years). CONCLUSION: The suspected continuation of canine enucleation in UK-born Somali children raises important oral health issues. Culturally sensitive education is indicated to discourage this harmful ritual practice.
Adolescent↗
Effects of raf kinase inhibitor protein expression on suppression of prostate cancer metastasis.
BACKGROUND: Raf kinase inhibitor protein (RKIP), an inhibitor of Raf-mediated activation of mitogen-activated protein/extracellular signal-regulated kinase kinase (MEK), is expressed at lower levels in human C4-2B metastatic prostate cancer cells than in the parental non-metastatic LNCaP prostate cancer cells from which they were derived. We examined whether RKIP functions as a suppressor of metastasis. METHODS: Immunohistochemistry was used to detect RKIP expression in clinical samples of primary prostate cancer and prostate cancer metastases. LNCaP and C4-2B cells were stably transfected with plasmids that constitutively expressed antisense and sense RKIP cDNA, respectively, or with empty vector. Assays of cell proliferation, soft-agar colony formation, and in vitro cell invasion were used to examine the malignant phenotypes of the transfected cells. An orthotopic murine model was used to examine the effect of expressing RKIP in C4-2B cells on the development of spontaneous metastasis. RESULTS: Clinical samples of primary prostate cancer had detectable RKIP expression, whereas clinical samples of prostate cancer metastases did not. There were no differences in the in vitro proliferation rate or colony-forming ability between the control vector-transfected and sense RKIP vector-transfected C4-2B cells or between the control vector-transfected and the antisense RKIP vector-transfected LNCaP cells. Overexpression of RKIP in C4-2B cells was associated with decreased in vitro cell invasion, decreased development of lung metastases in vivo, and decreased vascular invasion in the primary tumor but did not affect primary tumor growth in mice. CONCLUSIONS: RKIP does not influence the tumorigenic properties of human prostate cancer cells. It appears to be a novel and clinically relevant suppressor of metastasis that may function by decreasing vascular invasion.
Aged↗
Connections to primary medical care after psychiatric crisis.
BACKGROUND: Patients presenting with a psychiatric emergency face a unique set of challenges in connecting to primary care. OBJECTIVES: We tested the hypothesis that, in contrast to usual care, case management will result in higher rates of connection to primary care. We examined variables affecting primary care entry, including insurance status, hospital admission, and concurrent linkages to mental health care. RESEARCH DESIGN/METHODS: This article reports on a preliminary outcome of an ongoing randomized controlled trial conducted with 101 patients presenting in an urban psychiatric setting. Patients were randomized to a case management team or to usual care. The need for medical care was assessed by documenting medical comorbidity. RESULTS: Average age of the sample was 37.5; 65% were male, and 78% had low income; 37% were African American and 9% were Hispanic. Within 3 months of study enrollment, 57% of the intervention group was successfully linked to primary care compared with 16% of the usual care group, a difference that was statistically significant (P < .001). Associated positive predictors for linkage to primary care included mental health care visits and success in obtaining health insurance. Inpatient hospital stay at the time of psychiatric crisis was negatively associated with later attendance at primary care. CONCLUSIONS: Case management intervention was effective in establishing linkage to primary care within 3 months. Ongoing work will evaluate primary care retention and physical and mental health outcomes.
Adult↗
[Correlation of physical and mental emotional course in various psychosomatic disease pictures].
The affective process is described as governing at least three different subsystems, expression, cognition and physiology. Different forms of interconnections between them are considered as substantial for two different psychosomatic subgroups. Patients with colitis ulcerosa should have a deficiency of the experienced and expressed affectivity. In contrast patients with functional psychosomatic disturbances should show signs of inhibition with measurable indicators of the repressed affective impulse. 20 male psychosomatic patients suffering from colitis ulcerosa (10) or functional spine disturbances (10) interacted with healthy same sex subjects unknown to them. 20 healthy subjects served as a control group. The affective behavior was analyzed using EMFACS, an emotional facial action cording system, as well as DES, the differential emotion scale. For patients with ulcerative colitis a significant reduction of facial activity is characteristic. Whereas patients with functional spine disturbances are excessive in the same behavior. The observable reduction is however centered around affective arousal indicators not the primary affects per se. The observable differences between expressed affectivity and the experience did not reach significance mainly, because the great variability of the patients with functional spine disturbances. Clinical impressions are confirmed however not with exactly the phenomena the clinicians thought.
Adult↗
Abnormal beta-endorphin and beta-lipotropin responses to TRH and LRH administration in primary and secondary affective disorders.
Anomalous anterior pituitary hormone responses to acute administration of TRH and LRH have previously been observed in patients with primary affective disorders (PAD), with TRH eliciting GH, FSH and LH rises, and LRH eliciting GH and Prl rises. We examined whether the same unusual responses were present also for beta-endorphin (beta-EP) and beta-lipotropin (beta-LPH) in 15 PAD patients, in 9 patients with secondary affective disorders (SAD), and in 7 controls. TRH (500 micrograms iv) elicited rises of beta-EP plasma levels in 5 PAD and 2 SAD patients, and of beta-LPH in 4 PAD and 3 SAD patients. LRH (150 micrograms iv) elicited rises of plasma beta-EP levels in 2 PAD and 2 SAD patients, and of beta-LPH in 5 PAD and 2 SAD patients. No rises of beta-EP and beta-LPH plasma levels were observed in PAD patients after saline administration, nor in the controls after TRH, LRH or saline administration.
Adult↗
Assortative mating and affective disorders.
Seventy-two spouses of subjects with recurrent primary affective disorders (PAD), were investigated for the presence of psychiatric disorders in their lives and in those of their first degree relatives, and compared with 71 spouses of non-psychiatrically ill control subjects. No difference was found in the risk for PAD; on the other hand spouses of affective patients manifested a greater occurrence of psychiatric disorders belonging to the affective spectrum, as did their respective first-degree relatives.
Affective Disorders, Psychotic↗
Liveliness.
OBJECTIVE: The objective of this study is to explore the significance of the experience of liveliness in psychotherapeutic interactions and its relevance to the practice of psychotherapy. METHOD: Stern's notion of 'vitality affects' and Emde's concept of a 'primary affective core' are employed in developing a concept of liveliness, or an enlivening-deadening axis of experience. A critique of Freud's 'principles of mental functioning' is made in the light of this concept. Clinical examples are provided as illustrations of the relevance of considering the 'sense of liveliness', and its sustainability, in psychotherapy. RESULTS AND CONCLUSIONS: A sense of liveliness relates closely to activity within a system of interpersonal resonance with non-linear characteristics. The experience of, and responses to, vitality affects may be an important basis of a sense of liveliness. Sudden shifts towards experiences of deadness are a matter for concern in psychotherapy. This sphere of experience, although occurring largely outside verbal awareness, may constitute a distinct type of mental process. Three types of mental activity or process are postulated: (i) emergent, pre-representational activity characterised by the sense of liveliness; (ii) Play-related thought or activity typically experienced as enlivening; and (iii) work-related or adaptational thought or activity.
Affect↗
Effect of an acid mine drainage effluent on phytoplankton biomass and primary production at Britannia Beach, Howe Sound, British Columbia.
We investigated the effect of acid mine drainage (AMD) from an abandoned copper mine at Britannia Beach (Howe Sound, BC, Canada) on primary productivity and chlorophyll a levels in the receiving waters of Howe Sound before, during, and after freshet from the Squamish River. Elevated concentrations of copper (integrated average through the water column >0.050 mgl(-1)) in nearshore waters indicated that under some conditions a small gyre near the mouth of Britannia Creek may have retained the AMD from Britannia Creek and from a 30-m deep water outfall close to shore. Regression and correlation analyses indicated that copper negatively affected primary productivity during April (pre-freshet) and November (post-freshet). Negative effects of copper on primary productivity were not supported statistically for July (freshet), possibly because of additional effects such as turbidity from the Squamish River. Depth-integrated average and surface chlorophyll a were correlated to copper concentrations in April. During this short study we demonstrated that copper concentrations from the AMD discharge can negatively affect both primary productivity and the standing stock of primary producers in Howe Sound.
Biomass↗
Plasma lithium levels and therapeutic outcome in the prophylaxis of affective disorders: a retrospective study.
Patients receiving prophylactic lithium therapy for primary affective disorder during a four year period were studied for recurrence of affective illness. Patients who had affective episodes during this period did not differ from those who remained well in age, sex or diagnosis. Those with a favourable outcome had spent significantly less time at serum lithium levels above 0.9 mmol/litre than those who had a recurrence of affective episodes.
Adult↗
Heritable factors in the severity of affective illness.
A review of clinical experience with 163 patients with primary affective disorder indicates that patients with a history characterized by recurrent depression interspersed with periods of hypomania (bipolar II) may have clinical courses that are distinguishable from bipolar I (depression with histories of mania) or unipolar patients. A prior history of suicide attempt and suicide after discharge from the research unit were most frequent among bipolar II patients. The family histories of bipolar I and bipolar II patients revealed similarly increased morbid risks for bipolar illness, whereas no bipolar illness was found in the first-degree relatives of unipolar patients. The suggestion that patients classified as bipolar II be separately considered in future studies of affective disorder is discussed.
Adult↗
A follow-up and family study of schizophrenia.
The Washington University Psychiatry Clinic, St Louis, study began with the systematic clinical evaluation of a cross section of 500 of the clinic's patients. This was followed by a "blind" follow-up of the index subjects and a blind study of first-degree relatives. This report deals with the diagnosis of schizophrenia at index, at follow-up, and among the first-degree relatives. The results indicate that the criteria used for the diagnosis of schizophrenia select patients who show a high degree of diagnostic consistency over many years, although not all patients who meet these criteria after follow-up receive the diagnosis of schizophrenia initially. Most important, the diagnostic criteria select cases associated with a strong familial increase in the risk of schizophrenia (nearly fivefold). The follow-up results indicate also that Feighner-positive schizophrenics often experience intercurrent depressions, but that the presence of such depressions does not affect the familial incidence of either schizophrenia or primary affective disorders.
Depressive Disorder↗
The occurrence of secondary affective disorder in an in-patient population with severe and recurrent affective disorder.
One hundred and eighty nine consecutive in-patients with treatment-resistant affective disorder were administered the Renard Diagnostic Interview to determine whether the 45 with secondary affective disorder (SAD) differed from the 144 with primary affective disorder (PAD). The SAD group, including 15 subjects with bipolar disorder, had an earlier mean age of onset of depression and contained more unmarried individuals. The total secondary group could not usefully be differentiated by assessment of clinical symptoms or discriminating analysis of social and clinical variables. While the present study of a severely depressed population does not lend itself to generalisability, this combined sample does have characteristics of patients used in biological investigations. No significant inter-group discrimination was found to support a previous assumption that identification of a prior psychiatric disorder provides the most suitable mechanism for selecting a population for research in affective disorders.
Adult↗
Pediatrician participation in Medicaid--findings of a five-year-follow-up study in California and elsewhere.
Medi-Cal-California's Medicaid program-underwent significant changes during the period 1978 through 1983. Most notable were the imposition of new copayments, reductions in physician reimbursement and selective contracting for hospital services. The state-funded medically indigent program was transferred to the counties and the state began to experiment with bulk purchasing of drugs and supplies, a lock-in for overutilizers and primary care case management. How have these changes affected primary care providers' participation in Medi-Cal? Surveys of California pediatricians in 1978 and 1983 suggest that while most continue to participate, the level of limited participation in Medi-Cal increased from 23% to 51%. Most pediatricians express discontent with the level of Medicaid payments and there is a growing sentiment that Medicaid regulations interfere with the provision of high quality medical care. Future Medi-Cal policy developments, such as contracting for physician services, should be structured in ways that maximize participation of primary care providers in the program.
Attitude of Health Personnel↗