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PubMed2000

Psychogenic factors in the aetiology of stomatopyrosis.

This research has been conducted on the basis of the association between a psychogenic factor and stomatopyrosis as its consequence. Stomatopyrosis is characterized as a burning sensation or as pain in the mouth cavity with clinically normal oral mucosa. It typically occurs with elderly female population, aged on average 67. Burning mouth as a symptom occurs primarily on the lips, although it may be located on some other sites on the oral mucosa. There are various etiological factors influencing the emergence of stomatopyrosis. They are divided into local factors, related to candidiasis, dysfunction, problems caused by dentures; systemic factors, with hormonal or immunological disturbance, medicines, etc; and, finally, psychogenic factors, characterised by various psychological states and conditions like depression, anxiety, adaptability and emotional stability. The objective of this research was to prove that psychogenic factors cause the burning mouth syndrome sensation. Methods which helped us to establish the link between psychogenic factors and the emerging of stomatopyrosis were general history of the respondents, clinical history, which included both objective and subjective assessment, and psychological rating scales and tests. The results have shown that sex of the respondents does not make any difference. Diagnosis of the oral disease shows that burning is the symptom as well as in the diagnosis of the disease, that localisation of the symptom is primarily on lips, followed by tongue, cheeks, and palate. The description of the symptoms shows that respondents with stomatopyrosis complain of burning and dryness in the mouth cavity. As far as the intensity of the symptom is concerned, the results have shown that the symptom is in most cases unbearable. The frequency of the occurrence of the symptoms said to be continuous. The typical time when the symptom occurs is daytime, followed, by night and evening, day and night. Tension dentures and hot food intensify the symptom. Subjective change in taste is present in the high percentage. Visual analogue scale shows a high degree subjective assessment of the symptoms in the mouth cavity. Thermoestesiometry has established that there are no pathological changes on the oral mucosa. Psychological rating scales and tests have established the presence of psychical changes in a high percentage. What we took into account were the most frequent changes: depression, anxiety, adaptability and emotional stability. We also established a systematic and a psychiatric diagnosis that was necessary for making the right choices when treating people with stomatopyrosis. Stomatopyrosis is the state whose factor, apart from local and systematic factors, may be psychogenic factor. We think that stymatopyrosis may be psychosomatic state that can be cured or treated by appropriate treatment, which includes psychiatric treatment as well.

Aged↗
PubMed1998

Near normalization of final height with adapted doses of growth hormone in Turner's syndrome.

An adapted GH dose regimen was evaluated in 14 untreated patients with Turner's syndrome. The initial GH dose (0.7 U/kg.BW) was increased by 0.7 U/kg.BW, up to a maximum of 2.1 U/kg.BW, when growth velocity (GV) declined to less than 200% of the pretreatment level. These patients were compared to a group of 17 patients with similar initial characteristics, who received a fixed dose of 0.9 U/kg.BW GH. Tolerance to both GH regimens was excellent. The adapted GH doses only partially prevented the waning effect observed with conventional doses of GH, and the initial goal of doubling GV was only achieved in 42% of the 112 patient-semesters. Doubling the GH dose from 0.7 to 1.4 U/kg.BW increased the GV by 1.6 +/- 1.8 cm/yr (P < 0.006); increasing the GH dose from 1.4 to 2.1 U/kg.BW increased GV by 0.8 +/- 1.3 cm/yr (P = NS). The overall height gain during the 4-yr trial was 25.6 +/- 3.9 cm in the adapted dose group and 21.8 +/- 3.9 cm in the conventional group (P < 0.02). Final height (FH) results were obtained in 12 of 14 patients in the adapted dose group and all 17 patients in the conventional group and compared to the predicted FH using Lyon's method. The estimated height benefit was 10.6 +/- 3.8 cm in the adapted dose group compared to 5.2 +/- 3.7 cm in the conventional group (P < 0.01). Eighty-three percent of the patients in the adapted dose group had an FH superior or equal to -2 SD score for the general population compared to 29% in the conventional group. In conclusion, a marked increment in the GH dose in girls with Turner's syndrome associated with a relatively late age at introduction of estrogen therapy brought 83% of the patients into the lower range of the normal height distribution of the general population.

Adolescent↗
PubMed1993

Poliomyelitis and the post-polio syndrome: exercise capacities and adaptation--current research, future directions, and widespread applicability.

Poliomyelitis is an acute viral disease that attacks the brain and the ventral horn of the spinal cord. Damage to the lower motor neurons usually results in atrophy and weakness of muscle groups, perhaps paralysis and possibly deformity. A second type, bulbar poliomyelitis, infects the medulla oblongata and may result in dysfunction of the swallowing mechanism along with respiratory and circulatory distress. Minor forms of poliomyelitis result in fever, sore throat, headache, and upper body stiffness, but leave no significant atrophy or paralysis. The purpose of this paper is to review post-polio syndrome (PPS) as well as the effect of exercise on the symptoms and morphologic adaptations to PPS and where future research efforts should be directed. The most common features of PPS for over 350,000 afflicted survivors include general fatigue, weakness, and joint/muscle pain. The primary reasons for these symptoms include 1) destruction of the anterior horn cells by the polio virus, leaving fewer motor neurons to induce muscle contraction; 2) unaffected motor unit enlargement by reinnervation through terminal sprouting; and 3) defective transmission at the neuromuscular junction secondary to failure of terminal axonal sprout. Acute responses to resistive exercise suggest significant muscle strength decrements in the knee extensors compared with similar aged people without polio. However, limited training investigation indicates significant strength increases for the knee extensors following at least 6 wk of training. Acute aerobic responses also differ significantly from those observed in aged-matched control subjects. Chronic aerobic responses to limited training studies suggest significant elevations in maximal oxygen uptake.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Physiological↗
PubMed2000

The DSM-IV nosology of chronic pain: a comparison of pain disorder and multiple somatization syndrome.

This study evaluates the classification of pain from the perspective of the DSM-IV system. Of 60 in-patients with long-standing and disabling pain syndromes, 29 with pain disorder (PD) and 31 with pain as part of a multiple somatization syndrome (MSS) were compared before and after a structured cognitive-behavioral treatment. It was hypothesized that MSS patients show more psychological distress, are more severely disabled, and respond less to the treatment. Both groups were similar with respect to sociodemographic status, history of pain symptomatology and comorbidity with DSM-IV mental disorders. The results show that MSS patients had higher levels of affective and sensoric pain sensations as well as more pain-related disabilities. They were also less successful during treatment to reduce their pain-related depression and anxiety. Psychosocial functioning was improved only by PD patients, but remained almost unchanged in the MSS group. However, there were no group differences concerning general depression and hypochondriasis, dysfunctional attitudes towards body and health, and use of pain coping strategies. It is concluded that the DSM-IV distinction between 'pure' pain disorder and syndromes involving pain plus multiple somatoform symptoms cannot generally be confirmed, but further studies of validation are needed.

Adaptation, Psychological↗
PubMedDate not supplied

[Adolescents and AIDS: knowledge, attitudes, behaviors, perceptions and consequences for prevention].

The vital issues at stake in the credibility and effectiveness of AIDS prevention programs for young people have led to the emergence of a trend in research focused on the study of adolescents' understanding of AIDS, their attitudes and behaviour towards it, and their beliefs about it. This research can be classified under the three main ways of approaching the problem: 1) results of inquiries about knowledge, attitudes and behaviour; 2) research centred on beliefs and their consequences on a social and individual level; 3) reports and analysis of prevention programs. The results obtained by the different authors bring to light certain characteristics among the adolescent population, notably, their understanding of the disease, their attitudes towards people who are HIV positive, their sexual behaviour, their beliefs about AIDS, and the general direction of the prevention programs which are best adapted to this particular population.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Optic atrophy in Wolfram syndrome.

The clinical and electrophysiologic findings in 11 cases of Wolfram syndrome are presented. These findings suggest that optic atrophy in Wolfram syndrome is not secondary to retinal pathology, but probably represents part of a generalized degeneration of neural structures. The relationship of diabetes mellitus to this process of neural degeneration remains unclear.

Adolescent↗
PubMed1996

Hypothermic general cold adaptation induced by local cold acclimation.

To study relationships between local cold adaptation of the lower limbs and general cold adaptation, eight subjects were submitted both to a cold foot test (CFT, 5 degrees C water immersion, 5 min) and to a whole-body standard cold air test (SCAT, 1 degree C, 2 h, nude at rest) before and after a local cold acclimation (LCA) of the lower limbs effected by repeated cold water immersions. The LCA induced a local cold adaptation confirmed by higher skin temperatures of the lower limbs during CFT and a hypothermic insulative general cold adaptation (decreased rectal temperature and mean skin temperature P < 0.05) without a change either in metabolic heat production or in lower limb skin temperatures during SCAT after LCA. It was concluded that local cold adaptation was related to the habituation process confirmed by decreased plasma concentrations of noradrenaline (NA) during LCA (P < 0.05). However, the hypothermic insulative general cold adaptation was unrelated either to local cold adaptation or to the habituation process, because an increased NA during SCAT after LCA (P < 0.05) was observed but was rather related to a "T3 polar syndrome" occurring during LCA.

Acclimatization↗
PubMed2006

[Congenital cataract: general review].

Cataract is a loss of lens transparency because of a protein alteration. Etiopathogenesis is poorly understood but new mutations of different developmental genes involved are found in 25% of cases. Frequency of onset, particularly when different ocular development anomalies occur, is related to the lens induction phenomena on the eye's anterior segment structure during embryologic development. Genetic transmission is often found on the dominant autosomal mode. Diagnosis is based on a complete and detailed examination of the eye, often with general anaesthesia. This condition predisposes children to later, sometimes serious amblyopia. Different clinical aspects can be observed: from cataract with ocular and/or systemic anomalies to polymalformative syndrome, skeletal, dermatological, neurological, metabolic, and genetic or chromosomal diseases. A general systematic pediatric examination is necessary. Congenital cataract requires first and foremost early diagnosis and a search for all etiologies. Surgical treatment is adapted case by case but it has progressed with the quality of today's intraocular lenses even if systematic implantation continues to be debated. Life-long monitoring is absolutely necessary.

Cataract↗
PubMed1989

Ecobehavioral characteristics of a pediatric burn injury unit.

Behavioral observations were conducted on 40 children admitted consecutively to an inpatient pediatric burn care unit (PBCU) over a 6-month period. Children's responses to the PBCU environment as well as adult responses to patients were assessed. Data indicated that children most frequently (a) were oriented and alert, (b) emitted vocalizations or verbalizations, (c) were environmentally engaged, (d) and demonstrated positive or neutral affective responding. Adult-child interactions occurred during the majority of observations. Age was found to be significantly related to the type of distress response exhibited. Positive responses indicative of patient well-being were found to be associated with environmental engagement and the presence of other patients. In general, little evidence emerged to support the notion of a PBCU response pattern which resembles that observed in pediatric intensive care units (i.e., ICU syndrome). The use of observational methods for studying the behavioral adaptation of children in medical settings and the implications of the data for the design of interventions on PBCUs are discussed.

Adaptation, Psychological↗
PubMed1997

[Individual differences in susceptibility to motion sickness].

Several different theories exist about the origin of kinetosis and the space adaptation syndrome, with individual sensitivities differing significantly. One explanation involves the hypothesis of a different otolith mass between the right and left statolith organ and especially a difference in the utricles. A difference in mass results in a different sensitivity to acceleration. For this reason we measured interindividual variances in saccular and utricular otolith mass. Since the anatomy of the vestibular organ in vertebrates is based as similar principles, we selected fish (salmon and trout) as our study model to facilitation preparations. The maximum difference in mass in the saccule was 17% and was generally smaller in the utricle, although in individual cases was much higher. We assume that a misbalanced sensitivity of the statolith organs occurs but is totally compensated for by the vestibular system as long as physiological motion patterns take place. Decompensation leads to kinetosis under non-physiological motion patterns. When the vestibular system is better balanced and has an equally distributed otolith mass to both sides, the possibility for developing kinetosis or space adaptation syndrome is much less likely.

Animals↗
PubMed2003

Evidence for axonal pathology and adaptive cortical reorganization in patients at presentation with clinically isolated syndromes suggestive of multiple sclerosis.

Previous work has suggested that functional reorganization of cortical areas might have a role in limiting the clinical impact of axonal pathology in patients with established multiple sclerosis (MS). Since there is evidence for irreversible tissue damage even in patients with early MS, we assessed, using functional MRI (fMRI) and a general search method, the brain pattern of movement-associated cortical activations in patients at presentation with clinically isolated syndromes (CIS) suggestive of MS. To elucidate the role of cortical reorganization in these patients, we also investigated the extent to which the fMRI changes correlated with the extent of overall axonal injury of the brain. From 16 right-handed patients at presentation with CIS and 15 right-handed, age- and sex-matched healthy volunteers, we obtained: (1). fMRI (repetitive flexion-extension of the last four fingers of the right hand), (2). conventional MRI scans, and (3). a new, unlocalized proton MR spectroscopy ((1)HMRS) sequence to measure the concentration of N-acetylaspartate of the whole brain (WBNAA). Compared to controls, patients with CIS had more significant activations of the contralateral primary somatomotor cortex (SMC), secondary somatosensory cortex, and inferior frontal gyrus. They also had significant decreased WBNAA concentration. Relative activation of the contralateral primary SMC was strongly correlated with WBNAA levels (r = -0.78, P < 0.001). This study shows that axonal pathology and functional cortical changes over a rather distributed sensorimotor network occur in patients at presentation with CIS suggestive of MS and that these two aspects of the disease are strictly correlated. This suggests that the increased functional recruitment of the cortex in these patients might have an adaptive role in limiting the clinical impact of irreversible tissue damage.

Adaptation, Physiological↗
PubMed1997

Stability and change in psychosocial resources during caregiving and bereavement in partners of men with AIDS.

This study examines the effects of caregiving and bereavement on psychosocial resources in HIV+ and HIV- caregivers of men with AIDS. We explored three hypotheses regarding these effects: the "wear and tear" hypothesis, which asserts that the chronic stress of caregiving and bereavement diminishes resources; the "enhancement" hypothesis, which asserts that caregiver resources may increase in response to increased demands; and the "personality" hypothesis, which asserts that psychosocial resources reflect stable personality characteristics. We addressed four questions: (a) What are the effects of caregiving on resources? (b) How do these resources vary by the imminence of the partner's death? (c) What is the effect of the partner's death on these resources? and (d) How does the caregivers' HIV serostatus influence the effects of caregiving and bereavement on resources? Support for the personality hypothesis predominated, with some support for the wear and tear hypothesis, depending on the resource in question. In general, HIV seropositivity did not put people at additional risk for resource depletion.

Acquired Immunodeficiency Syndrome↗
PubMed1997

The evolution of adjustment issues in HIV/AIDS.

The issues of emotional adjustment to AIDS have been inextricably linked to medical advances in fundamental knowledge about the human immunodeficiency virus and its potential therapies. In 1987 patients were struggling with the advantages and disadvantages "to do or not to do AZT (zidovudine)," whereas the choices imposed by combination therapies and the protease inhibitors in 1997 are fundamentally different and are occurring in an evolving context created by a number of striking medical advances, expanding populations, the availability of environmental support, and changing public sentiments. As the psychiatric treatment of HIV-positive individuals shifts increasingly from "AIDS specialists" to the wider therapeutic community, it is important that the therapist who has had relatively little experience with this population not assume that contemporary issues and concerns of the seropositive patient, or the patient with AIDS, are essentially those discussed widely in the earlier years of the epidemic. Patients living with this virus for a number of years have traveled a long and arduous journey and will experience more empathy from a therapist who has some knowledge of that path. Awareness of the evolution of emotional adjustment, counseling, and ethical issues of AIDS should amplify the general fund of knowledge required for good clinical management of the person living with AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1993

An empirical evaluation of multidimensional clinical outcome in chronic low back pain patients.

Individuals with persisting pain often present a constellation of symptoms that includes pain, health-related impairment and dysphoric mood. It is now widely accepted that comprehensive assessment must address each of these dimensions. Despite recognition of the value of multidimensional assessment, no empirical efforts have validated the construct of a multidimensional clinical outcome presentation based on the dimensions of pain, impairment and dysphoric mood. We employed cluster analytic procedures on standard measures of pain, impairment and depression in chronic low back pain (CLBP) patients (n = 96) attending a general orthopedic clinic in order to empirically characterize multidimensional clinical outcomes. Results indicated that 3 groups could be identified reliably: (1) 'Chronic Pain Syndrome' (n = 25; high levels of pain, impairment and depression), (2) 'Positive Adaptation to Pain' (n = 24; high levels of pain with low levels of impairment and depression) and (3) 'Good Pain Control' (n = 47; low levels of pain, impairment and depression). The reliability of this cluster solution was supported by several tests of internal consistency. Discriminability of the clusters was examined across both the outcome measures themselves and several additional independent variables. The cluster solution was then cross-validated in an independent sample of pain clinic CLBP patients (n = 180) to test its generalizability. Finally the stability of the cluster dimensions over time was tested by re-assessing 36 CLBP patients 6 months after they initially were characterized into 1 of the 3 outcome groups on the same measures. MANOVA results indicated that the outcome groups were differentiated statistically across assessments. The multiple outcome measures did not change significantly across time, nor did the outcome groups change differentially across time on these measures. We conclude that the outcome dimensions of pain, impairment and depression are relatively stable phenomena that differentially describe CLBP patients.

Adult↗
PubMed1989

Efficacy and tolerability of a new antipsychotic compound (savoxepine): results of a pilot-study.

Savoxepine is a new tetracyclic compound displaying potent neurolepticlike effects in pharmacological studies. Of particular interest is its preferential binding to dopamine-2 receptors in the hippocampus, which leads to the hypothesis that savoxepine may exert antipsychotic effects at doses not inducing extrapyramidal side-effects. In an open pilot-study 18 patients suffering from acute schizophrenic psychoses or paranoid syndromes were treated with savoxepine in an individually adapted dose range from 0.50 to 10 mg per day. A good antipsychotic efficacy could be demonstrated in 10 of 16 patients. Savoxepine was found to be generally well tolerated. Contrary to expectations, mild or moderate extrapyramidal side-effects, especially of the parkinsonian type, were registered. Future research has to test the suggested advantage of savoxepine in comparison with other neuroleptic drugs.

Adult↗
PubMed2005

Anoxic brain injury following near-drowning in children. Rehabilitation outcome: three case reports.

PRIMARY OBJECTIVE: To describe the outcome of near-drowning and rehabilitation contexts for recovery. METHODS AND PROCEDURES: Standardized measures were used to emphasize the functional impact of deficits over the first year post-injury in three children <2 years. Multimodal contexts for meaningful interplay were early adapted to the three cases. MAIN OUTCOMES AND RESULTS: The clinical pathways of recovery are identified. Initially all three cases manifested a generalized dystonia. Case 1 exhibited a good outcome with transient dyskinetic-dystonic syndrome; subsequently Bálint's syndrome emerged. In this case, the rehabilitation approach was organized on the pickup of direct perception of task-specific affordances. Cases 2 and 3 had poor outcomes presenting the worsening of torsion dystonia (status dystonicus) that hindered rehabilitation intervention. CONCLUSIONS: The dynamic reaggregation of spatial organization through meaningful interaction in specific ecological contexts is the principal goal of rehabilitation intervention. Status dystonicus represents the worst feature for recovery.

Brain Injuries↗
PubMed1990

[Clinico-epidemiological characteristics of mentally ill patients identified in the therapy department].

A clinico-epidemiological study was made of the incidence of mental diseases among the adult community visiting the therapeutic department of a city polyclinic. Mental patients registered at the PND (41.9 per 1000 population) underwent examinations. A large group of patients, mainly with borderline mental diseases, was additionally revealed (134.4 per 1000 population). Therefore, the total incidence of mental diseases among the adult community amounted to 176.3 per 1000 population. Both groups are compared in terms of the clinical syndromes, sex, age, and the level of social adaptation.

Adult↗
PubMed2002

Multiple organ dysfunction syndrome (MODS) in the obstetric population.

Multiple organ dysfunction syndrome (MODS) has the potential to negatively affect obstetric outcomes of critically ill maternity patients. This pathophysiologic condition may often be indistinguishable from that which occurs during normal pregnancy. The normal adaptations of pregnancy, in their exaggerated form, may cause functional change to become dysfunctional in the maternal patient. Although pregnancy is considered a state of health, MODS is a grave condition with terminal outcomes. Regional perfusion deficits in oxygen and global defects of volume are two potential pathologic sequelae. Many general medical and obstetric causes may be identified. An exaggerated systemic inflammatory response syndrome (SIRS) precedes this patterned process of death. This article will apply current theories, assessment, and treatment practices of MODS to the obstetrical populace.

Disseminated Intravascular Coagulation↗