SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
This paper describes an organic model used successfully to demonstrate flexible sigmoidoscopy to family medicine residents. Its advantages include low cost, portability, disposability, and ease with which it induces laughter while its drawbacks are unique and well worth tolerating.
The authors examined 100 children aged 3 to 14 years with paroxysmal disturbances during sleep, which were the first manifestations of epilepsy. On the basis of a long-term follow up these disturbances were differentiated clinically from similar disorders of non-epileptic nature. The most typical epileptic disturbances occurring during sleep (psychomotor paroxysms, crying, laughter, night fears, nightmarish dreams, psychosensory disorders) had some characteristics in common, namely changes in consciousness, appearance almost at the same time, stereotyry of the manifestations, attendant autonomic disorders, nocturnal enuresis followed by the development of the typical epileptic forms of attacks. The treatment of paroxysmal disturbances was conducted with regard to their clinical structure and the localization of the epileptic focus.
In order to determine whether the vagal mechanism is predominant in the physiopathology of asthma, we investigated in the first part of this work. If the new vagolithic, ipratropium can improved the respiratory parameters of asthmatic patients. If the effect is complete or admits yet the supplementary effect of a betadrenergic, Fenoterol. 46 asthmatic patients were registered in some spirographic parameters, e.g. FEV1 (Forced Expiratory Volume in 1 sec.), MMFR25-75 (Maximum Mid-expiratory Flow Rate between the 25 per cent and the 75 per cent of the forced vital capacity) and FEF 200-1200 (Forced Expiratory Flow between 200 ml. and 1200 ml. of the forced vital capacity). The same registers were made 30 minutes after aerolization with 0.05 mg of Ipratropium (two shots) and 10 minutes after 60 micrograms of Fenoterol (three shots). It was found that 78.5 per cent of the patients improved one of the parameters with Ipratropium more than 20 per cent. But 58 per cent of the patients showed an additional improvement with the betadrenergic in one or more of the parameters. This shows that in many cases the physiopathology of asthma is mixed, vagal and betareceptor dependent, in which the medication with Ipratropium plus Fenoterol will obtain better results. Only in some patients the bronchial spasm is vagolithic dependent exclusively, while few others responded to betadrenergic and only 9 per cent of patients did not respond to either one. In the second part of this work we tried to verify if by anamnestic inquiry and additional use of Ipratropium and Fenoterol it is possible to recognize one group of patients with asthma produced by nonimmunologic irritant factors acting on the large airways from another group with asthma due to inhalants allergens and spasm of the small bronchi. The same 46 patients were divided in two groups: Patients who recognize that asthmatic accesses begin after exercise, laughter cold weather, cigarette smoker exposure sprays, synthetics and insecticides. This is the predominantly irritative nonimmunologic group. Patients who recognize that coughing or wheezing begins after contact either with pollen, dust or danders. This is the predominantly allergic group. We proved that patients A improve more with Ipratropium and the opposite is true with patients B. The results with the two drugs are roughly parallel to the anamnestic records.(ABSTRACT TRUNCATED AT 400 WORDS)
George Cotzias was a person of towering dimensions, with a great brain, a great sense of humor, a great loyalty and a great pride. A giant of 6'2", he made an immediate impact on all who met him, for his physical and intellectual force were wedded to courage, vision, and an extraordinary capacity to share and to motivate others. He was at one and the same time vigorous and opinionated , gentle, kind and sensitive. Courage and challenge were part of Cotzias ' makeup. He shared dreams, ambitions and built towers in the sky with his friends and colleagues. The vitality and love, the enthusiasm and praise, the roar of indignation and the boom of laughter: he was a Zorba of science, with warm friends all around the earth, doctors and scientists, barbers and taxi drivers, poets and musicians, children and all the women in the world.
Pauses, laughter, interruptions, and questions were postulated to be inversely related to marital conflict stress, which was measured by voice analysis of spouses using the Psychological Stress Evaluator. Conflict between spouses was stimulated by the Inventory of Marital Conflicts. Sixty-eight middle-class couples volunteered to participate. Because communication variables were positively related to stress, the hypotheses were not supported. It is postulated that stress as measured in this study was a function of problem-solving activity rather than marital conflict. Significant correlations between communication variables indicate that this pattern of communication may be valuable as an assessment index of family system health.
Drug therapy in Parkinson's disease can be performed by anticholinergic substances, adamantines or dopamines. Combinations are often useful. There are some new substances, such as bromocriptine. The paper gives a therapeutic scheme, after having shown the way to diagnosis. The non-drug or "additional" therapy is very important in Parkinson's disease: The patient's family must know the main symptom of slowing down for most reactions like laughter or eating for instance! Physiotherapy is important in the hospital, but also at home. In respect to the incidence rate all collegians should know the principles of treatment.
The clinical, electro-encephalographic and neuroradiological findings in 2 boys with gelastic epilepsy are described. Both patients had hypothalamic masses thought to be hamartomas, and 1 had precocious puberty. These 2 cases are compared with a previously published case of gelastic epilepsy with a left temporal focus. It was not possible to differentiate the hypothalamic lesions from the left temporal lesion on clinical grounds. The laughter in the hypothalamic group did not lack affect, as described by some other authors. Interictal EEGs in the patients with hypothalamic lesions showed generalized wave-spike activity, whereas localized abnormality was present in the patient with a left temporal EEG focus. Ictal recordings were the same in both groups. The combination of gelastic epilepsy and precocious puberty is rare. Only 10 cases have been reported in the literature, our patient being the 11th.
The Angelman syndrome is a neurological disorder characterized by constant features: severe mental retardation, easily provoked laughter, ataxia, absent speech, seizures. Most cases are sporadic but familial cases have been reported. About 60 to 70% of cases are due to an interstitial deletion on the maternally inherited chromosome 15 in the region q11-q13. Rare cases result from paternal disomy. In 30% of patients, neither maternal by inherited deletion, nor paternal disomy, can be found. In this category of patients recurrence risk for sibs is high and molecular mechanisms are not completely known. They appear to be more complex than previously suggested. It is clear that this syndrome is a genetically heterogeneous group. The main example of genomic imprinting in human pathology, Angelman syndrome is now a model in research for understanding molecular mechanisms underlying imprinting.
1. There is always some degree of stress in the OR. The trick is to play up the eustress (positive, motivating energy) and alleviate the distress (negative/draining energy). Eustress is characterized by smiles, chatter, purposeful movement, and an OR that hums with efficiency. Distress can be assessed by unhappy faces, loud grumbling, dragging feet, and an OR that grinds to a halt. 2. Humor relaxes people and situations. It allows creative juices to flow and enhances what people take away from meetings by facilitating the creative process. The staff members feel good about themselves and what they are doing, and they become more productive. 3. The OR can be both a wonderful (eustress) and a horrible (distress) place in which to work. We need to savor the wonderful--and season the horrible with humor to make it palatable. As directors use humor to reduce staff stress levels, they should remember to bring laughter and humor into their own lives as well.
BACKGROUND: Angelman (happy puppet) syndrome is a neuro-developmental condition characterized by an ataxic gait with puppet-like limb movements, paroxysmal bouts of laughter and severe mental retardation. Although considered a rare condition, over 140 cases have been documented since its designation in 1965. To date, only one study has been published investigating the ocular defects of Angelman syndrome. METHODS: In this paper we report the cognitive, motor, systemic, and oculo-visual findings of a 3 year old child with Angelman syndrome. RESULTS: The oculo-visual findings include choroidal hypopigmentation, iris hypopigmentation, strabismus, and hyperopia. CONCLUSIONS: As in many neuro-developmental conditions, early diagnosis is crucial. The ocular findings of fundal/iris hypopigmentation and strabismus with minimal refractive error in conjunction with the cognitive, behavioral, and motoric characteristics the patient exhibits may be the first clues for the diagnosis of Angelman Syndrome in a developmentally delayed child. The initiation of individualized optometric diagnosis and treatment is important for all children with developmental disabilities. The eye care professional should work in concert with speech, occupational, and physical therapists, neurologists, and special educators in the multi-disciplinary treatment and habilitation of all children with disabilities including those with Angelman Syndrome.
AS is characterized by severe mental retardation, seizures, ataxic gait and easily evoked laughter. About 70 approximately 80% of AS patients have a chromosomal/molecular deletion at 15 q11-q13, occurring exclusively in the maternally-derived chromosome 15. There have been 4 AS patients whose chromosomes 15 are paternal uniparental disomy. This biased parent-of-origin suggests that genomic imprinting may play a role in the occurrence of the syndrome. GABRB3 is located at 15 q11-q13. GABAA is a main inhibitory neurotransmitter in the central nervous system (CNS) and functions through its receptor. The beta 3 subunit, one of the components of the receptor, is present in the telephalonal cortex, hippocampus, thalamus and cerebellum, and a peak GABRB3 expression is observed during embryogenesis. This indicates that GABRB3 plays a role in CNS development, suppression of seizures and behavioral control. Since GABRB3 is encompassed within the smallest deletion among AS patients, it becomes a candidate responsible for the central nerve disturbances in AS. This smallest deletion was found in 3 AS sibs, their phenotypically normal mother and maternal grandfather in a family, suggesting that the paternally-derived deletion has no phenotypical effect in the offspring but the maternally-derived one. However, recent studies demonstrated that the mouse Gabrb3 is not involved in imprinting. The confirmation of GABRB3 to be the AS gene needs to provide direct evidence of its imprinting. Our preliminary study showed that GABRB3 was not expressed in hydatidiform mole that is composed only of the paternal genome, while it was expressed fully in normal villous tissue, suggesting that GABRB3 is paternally imprinted.(ABSTRACT TRUNCATED AT 250 WORDS)
The Angelman syndrome or "happy puppet" syndrome is a disorder of severe mental retardation, seizure, paroxysms of laughter, absent speech, jerky movements and ataxic gait. We present two sibs, man and woman, with this disorder, fact that support the possible autosomal recessive inheritance as a cause of this pathology, which hereditary mechanism is still a controversial point. Besides, we can observe different expression, being the woman more severely affected than the man. To our knowledge, this is the first mexican family reported with this syndrome, and with a ten years follow up. Chromosomal studies, with high resolution technique, were normal, we did not find the 15 chromosomic deletion referred as a possible cause in some cases, that is why it is undeniable that genetic heterogeneity exists in this syndrome.
This article describes the use of humor as a nursing intervention and asks if nurses can justify the integration of the use of humor into the repertoire of nursing interventions. Several uses for humor are illustrated, and humor is differentiated from laughter. The article quotes many nurse leaders' opinions about humor and identifies do's and do not's of appropriate humor; it discusses six research studies in which health care professionals used humor as a treatment protocol. The studies were in the areas of preoperative teaching, clinical evaluation, strategies to prevent hopelessness in adolescents with oncologic illness, and group cohesiveness. Results of these six studies give some evidence, although not robust, that humor is an effective intervention. Methods of determining and implementing humor as an appropriate nursing intervention are included.
The diagnosis of Angelman syndrome has seldom been made in infancy because the typical craniofacial dysmorphism and the typical outbursts of unprovoked laughter are not fully developed before the second and third year of life. Other features such as mental retardation or absence of language, though invariably present, are less obvious in the first year of life. We describe three children in whom consecutive electroencephalographic (EEG) studies show very large amplitude slow activity at 2-3/s, often rhythmic, usually occurring in prolonged runs and often more prominent posteriorly, sometimes with spikes or sharp-wave activity, and invariably associated with a diffuse rhythmic activity at 4-6/ s of 200 microvolts. The changes were present as early as six months of life. They preceded development of seizure and occurred much earlier than the craniofacial dysmorphology. It is concluded that methodical use of EEG in the elucidation of children with developmental disorder and knowledge of the characteristic EEG picture may help to identify patients with Angelman syndrome at an early age and before the clinical features become obvious.
Humour is an integral part of everyday life and therefore a component of the care and treatment of elderly patients in the modern health care. This article deals with the role of humour in aged nursing from the perspective of the nursing home residents. It also describes some preliminary results of our study on the meaning of humour to professional nurses. The chief motivation for the study is to provide a deeper understanding of humour as a part of aged nursing and as a 'phenomenon', which should also help us in the continuing challenge to improve the quality of nursing care. In this study the qualitative approach was used because the focus of interest was on an issue that has received only little attention in earlier research. The research material consists of data from patients and nurses. The data were collected via interviews and essay-type responses. The data obtained were analysed using the qualitative method of content analysis. In the light of our findings here, humour can be described as a joie de vivre which manifests itself in human interaction in the form of fun, jocularity and laughter. The assumption is supported by earlier research results which indicated that humour is an individual and personal matter and, in aged nursing care it is also very much a context-bound phenomenon. Humour makes it easier for some of the elderly patients to experience a positive, human relationship with the nurse. According to the results it seems to us that research should be continued and intensified into the role and use of humour in elderly people's everyday life and particularly in gerontological nursing care.
A sense of humor and an ability to laugh can be therapeutic for both patient and caregiver. It reduces stress, enhances hope, relieves tension, and stimulates the immune system. Review of scientific evidence of laughter's benefits as well as practical suggestions and resources to develop a humor program are presented.
OBJECTIVE: To review studies that have examined an association between wellness programs and improvements in quality of life and to assess the strength of the scientific evidence. DATA SOURCES: A MEDLINE search was constructed with the following medical subject headings: "psychoneuroimmunology," "chronic disease" and "health promotion," "chronic disease" and "health behaviour," "relaxation techniques," "music therapy," "laughter," "anger," "mediation" and "behavioural medicine." Searches using the text words "wellness" and "wellness program" were also carried out. References from the primary articles identified in the search and contemporary writing on wellness were also considered. STUDY SELECTION: Selection was limited to randomized controlled trials or prospective studies published in English that involved human subjects and that took place between 1980 and 1996. All studies with an intervention aimed at promoting wellness and measuring outcomes were included, except studies of patients with cancer and HIV and studies of health promotion programs in the workplace. Of the 1082 references initially identified, 11 met the criteria for inclusion in the critical appraisal. DATA EXTRACTION: The following information was extracted from the 11 studies: characteristics of the study population, number of participants (and number followed to completion), length of follow-up, type of intervention, outcome measures and results. All 11 studies were assessed for the quality of their evidence. DATA SYNTHESIS: All studies reported some positive outcomes following the intervention in question, although many had limitations precluding applicability of the results to a wider population. CONCLUSIONS: Despite the suggested benefit associated with wellness programs, the evidence was inconclusive. Whether the composition of the target group or the type of intervention has a role in determining outcomes is unknown. Although trends suggest that wellness programs may be cost-effective, further research is needed for confirmation.
Coughing was detected by measuring body-surface acceleration. Twenty-seven patients with a chief complaint of coughing were studied. The sensor used is an apparatus for sound communication in aircraft, in which cranial vibrations that occur as the pilot speaks are converted into acceleration waves. An acceleration sensor was fixed to the body of each subject. The acceleration of the chest wall was recorded as a voltage change. Subjects rested in bed to exclude acceleration due to body movement. Acceleration waves of large amplitude were recognized during coughing. Conversation or laughter only caused very weak acceleration waves. Sound has often been used as an indicator of coughing, because coughing was thought to be one kind of human vocalization. However, distinguishing speaking from coughing was difficult, and complicated analysis was necessary. We regarded coughing as a movement causing acceleration of the body surface, and measured it without using sound. We plan to collect data on acceleration of the body surface in 3 dimensions simultaneously. After a continuous long-term recorder of coughing is developed the effects of antitussive drugs can be assessed.