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.
Selenium concentration values for human urine samples are presented, and the literature on the chemical species of the element in urine is critically reviewed. Daily excretion levels in healthy persons and in pathological or experimental conditions are compiled. Medical implications and the significance of urinary selenium determination in assessing the selenium status in man are discussed.
Vulvodynia is considered as a "somatoform disorder", i.e. as a somatic complaint not fully explained by a general medical condition. As any other somatoform disorder, it may reveal a depression, associated or not with anxiety. These patients always apply first to general practitioners or gynecologists and not to psychiatrists. It is, therefore, very important that these physicians could perform the diagnosis of depression, when this mood disorder is present, either by themselves or relying on the help of psychiatrists, and implement an appropriate treatment for depression. Vulvodynia is often associated with two pathological conditions: hysterical personality or hypochondriasis. It is fundamental that the doctors recognize these conditions in order to avoid the relational pitfalls, which would hinder the diagnostic and therapeutic approach.
The vertical excursion of the body center of mass (BCOM) was calculated using three different techniques commonly used by motion analysis laboratories. The sacral marker method involved estimating vertical BCOM motion by tracking the position of a reflective marker that was placed on the sacrum of subjects as they walked. The body segmental analysis technique determined the vertical motion of the BCOM from a weighted average of the vertical positions of the centers of mass of individual body segments for each frame of kinematic data acquired during the data trial. Anthropomorphic data from standard tables were used to determine the mass fractions and the locations of the centers of mass of each body segment. The third technique involved calculating BCOM vertical motion through double integration of force platform data. Data was acquired from 10 able-bodied, adult research subjects--5 males and 5 females--walking at speeds of 0.8, 1.2, 1.6, and 2.0 m/s. A repeated measures ANOVA indicated that at the slowest walking speed the vertical excursions calculated by all three techniques were similar, but at faster speeds the sacral marker significantly (p < 0.001) overestimated the vertical excursion of the BCOM compared with the other two methods. The body segmental analysis and force platform techniques were in agreement at all walking speeds. Discrepancies between the sacral marker method and the other two techniques were explained using a simple model; the reciprocal configuration of the legs during double support phase significantly raises the position of the BCOM within the trunk at longer step lengths, corresponding to faster walking speeds. The sacral marker method may provide a reasonable approximation of vertical BCOM motion at slow and freely selected speeds of able-bodied walking. However, the body segmental analysis or force platform techniques will probably yield better estimates at faster walking speeds or in persons with gait pathologies.
PURPOSE: To examine gay youth experiences within the context of normal adolescent development. METHODS: Thematic analyses of interviews with 13 self-identified gay male youth, aged 16-22 years, each reporting minimal sexual identity distress, were completed. Interviews focused on: (a) descriptions of developmental changes perceived to occur for all adolescents, (b) descriptions of the participants' developmental experience, and (c) participants' direct comparisons of their perceptions of gay and nongay developmental experience. Data were analyzed by two investigators who, after initial review of the interview transcripts, developed a unified coding template to permit systematic analysis of the transcripts for recurrent themes. RESULTS: (a) Few (2 of 13) participants reported overall developmental experience markedly different from nongay peers. (b) Peer interaction was seen as the domain most different from that of nongay peers. (c) Open gay self-identification altered, generally positively, all peer interaction. (d) Increased peer interaction enhanced maturity in other domains. (e) Family dynamics were not substantively altered by open gay self-identification. (f) Middle and high school were identified as relatively hostile environments in which to openly identify as gay, affecting the timing and the extent of self-disclosure. (g) Developmental progress showed asynchrony across developmental domains. CONCLUSION: General developmental dysfunction is not inevitable for gay adolescents, nor is identifiable personal or family pathology directly related to sexual identity.
BACKGROUND: Anxiety about illness leading to restriction of activity and physical deconditioning has been hypothesized to contribute to the chronicity of fatigue. Pathological symptom attributions, personality traits, and depression have all been hypothesized to contribute to illness worry. METHODS: We compared 45 chronic fatigue syndrome (CFS) and 40 multiple sclerosis (MS) outpatients using a battery of psychometric instruments comprising the 12-item Illness Worry scale, the Symptom Interpretation Questionnaire (SIQ), the NEO Five-Factor Inventory (NEO-FFI), and a modified version of the SCL-90R Depression scale. RESULTS: There was no difference between the two diagnostic groups on neuroticism, depressive symptoms, as well as the three scales of the SIQ. On the illness worry index, the CFS group had significantly higher scores than the MS group. This difference was due to items tapping vulnerability to illness and the perception that others are not taking their illness seriously. Somatic attributional style, neuroticism, depressive symptoms, and age were all significant predictors of illness worry in both CFS and MS patients. CONCLUSIONS: Somatic attributions, neuroticism, and depression all contribute to illness worry in chronic illness. However, these factors do not account for the higher levels of illness worry in CFS as opposed to MS, which may be due to other specific cognitive and social interactional processes.
BACKGROUND: Radiotherapy and more recently radiosurgery represent important therapeutic methods for the treatment of tumors and arterovenous malformations affecting the central nervous system, even though several significant side-effects have been described (radionecrosis, tumors, etc.). Gliomas induced by radiation therapy are decidedly unusual, and the first descriptions of this association only appeared in the 1960s. METHODS: The pertinent literature was reviewed to yield 116 cases in which a glioma developed after radiotherapy for cranial pathologies (included 10 personal cases treated in our Institution). One of our patients had undergone radiosurgery for a cavernous angioma. RESULTS: Patients who developed a radiation-induced glioma were younger, as a group, than those affected with so-called "spontaneous" gliomas. The tumor originated in the previously irradiated area, after average doses of 32 Gy and an average latency period of 9.6 years in accordance with the findings reported by the authors and in our experience as well. Radiotherapy had most frequently been performed for acute lymphoblastic leukemia. Our Case 10 is the fourth case of intracranial tumor arising after radiosurgery to be described in the literature. CONCLUSIONS: Though rare, gliomas may represent a late complication of radiation treatment. The behavior of the radiation-induced variety of glioma does not seem to differ significantly from that of its "spontaneous" counterpart. Late complications of the radiosurgery are probably underestimated because of the relatively recent introduction of this technique. On the contrary, these should be scrupulously evaluated when deciding whether to employ this method for therapeutic purposes for relatively benign or congenital lesions (which generally affect young patients with a long life expectancy).
Natural thymic peptides have been isolated from calf thymus by mild acid extraction. Pharmaceutical containing natural peptides (Thymalin) was put into practice as immunocorrector. One of the immunomodulatory molecules (L-Glu-L-Trp) has been isolated from Thymalin by reversed-phase high performance liquid chromatography. Pharmaceutical containing this agent (Thymogen) was designed on the base of synthesized dipeptide. A novel immunomodulatory dipeptide was synthesized and termed Vilon. Both natural and synthetic pharmaceuticals activated T-cell differentiation, T-cell recognition of peptide-MHC complexes, induced the changes in intracellular composition of cyclic nucleotides and cytokine [interleukin (IL-2), interferon (IFN)] excretion of blood lymphocytes. Synthetic dipeptides activated neutrophil chemotaxis and phagocytosis. They had no influence on antioxidant response in thymocytes in comparison with natural peptides. Thymalin and Thymogen were used in persons with chronic pathology and immune dysfunction. The results indicate that thymic peptides participate in the regulating mechanisms of inflammatory processes as cytokine antagonists and show the difference between natural and synthetic products. It is important for the drugs designed to prevent immune dysfunction development.
PURPOSE: To analyze the context in which acute colonic pseudo-obstructions occur in a medical practice. METHOD: Retrospective study of patients with an acute colonic pseudo-obstruction hospitalized in an internal medicine department between November 1992 and December 1999. RESULTS: We found 12 patients including eight men (mean age: 80.2 years). All had abdominal pains. Seven patients presented an occlusive syndrome. A septic shock occurred in two subjects. The average diameter of the cecum was 10 cm. Distention involved the whole colon for nine patients, and only the left part for three. Six subjects were affected by a bronchopneumonia, three had a previous history of recent diarrhea, two had colonic diverticulitis, and two others had a diabetic neuropathy. Ogilvie's syndrome revealed hypothyroidism for one patient. Nine patients were taking one or more medications incriminated in the acute colonic pseudo-obstruction: calcium-channel blockers (n = 6), neuroleptics (n = 5), antidepressant agents (n = 4), dopaminergic drugs (n = 2) and opiates (n = 1). Five patients underwent a colonoscopic decompression. Surgical procedures were undertaken for three patients: one underwent a complete colectomy because of numerous perforation. Except for the colectomized patient, the outcome resulted in either recovery (n = 7), partial improvement (n = 3), or recurrence (n = 1). CONCLUSION: In a medical environment, acute colonic pseudo-obstruction is a pathology for elderly persons, namely with a masculine predominance and often associated with iatrogenic factors. The outcome is more often than not favorable, but it may result in invasive acts or significant complications at this age.
Two medical delegations, one from Palestine and one from the United States, were sent to detainment camps in Cyprus in the summer of 1947. The British Mandatory government had set up these camps in the summer of 1946 to stem the flow of Jewish immigrants into Palestine after World War II. The purpose of the medical delegations was to screen the camps' inhabitants and to propose a mental-health program for their life in Palestine. We examine the activities of these two delegations within the context of their scientific interest in the psycho-pathology of displaced persons after World War II and as part of a broader project of mental hygiene. According to the delegations, the detainees would be a potential source of strength for building a new society if they adapted to life in Palestine. However, they would become a burden if they failed to be absorbed. At the same time, the medical delegations also saw the detainee camps as a potential "living laboratory" for scientific exploration. The case of the two medical delegations in Cyprus is also a story about constructing and transgressing medical borders. Apart from the obvious fact that this case study deals with movement of people, refugees as well as health-care workers, it is also about the transmission of knowledge and professions across the ocean.
OBJECTIVE: A pre-/posttherapeutic comparative study was carried out to investigate possible associations of voice symptoms, selected psychological factors and their changing. SAMPLE: A total of 11 patients with spasmodic dysphonia (adductor-type) subjected to botulinum-toxin-therapy. Patients had received treatment without any complications for at least 2 years. During that period of time, they received a minimum of 3 and a maximum of 9 injections (mean: 6). METHODS: Psychosocial data were measured before and after treatment using standardized psychological methods. The time span between measurements ranged from 1;8 to 4;6 years, with an average of 2;1 years. RESULTS: On average, no somatic disorder, no clinically meaningful states of anxiety or pathological manifestations of personality traits could be detected, neither pre- nor posttherapeutically. The average stress load caused by life-changing-events was unobtrusive. Before treatment, 5 of 11 patients had an affective disorder in terms of a depressed mood. This caused a higher than average mean depressivity score for the group as a whole. It was no longer found posttherapeutically. CONCLUSION: The depression is interpreted as a psychic reaction. An association between spasmodic voice symptoms and psychosocial genesis could not be proved.
The diagnostic accuracy of ultrasound in ulnar nerve irritation syndrome was evaluated. 7 patients were examined and compared to a control group of 5 healthy persons. We correlated pathological changes with clinical signs and symptoms, nerve conduction velocity and with the operation report. Ultrasound yielded no false negative or false positive results and is therefore a valuable method for the evaluation of the ulnar nerve irritation syndrome especially in cases of vague localisation of the nerve lesion.
The present paper describes a modified form of profile perimetry. The brightness of a test mark moved at varying speed is increased, and as soon as it is supraliminal the examinee can press a button to reduce the brightness to subliminal again. The accuracy with which the threshold is determined is in the range of a few dB in 1-degree steps in the respective meridian. The reproducibility of the examination makes follow-up possible. A moderate loss of sensitivity can be recognized directly from the record, as can an increased short-term fluctuation of the light difference threshold. Results in subjects with healthy eyes and persons with ocular pathology are described. Possibilities for improvement, in particular to save more time, are discussed.
Community-based treatment is recommended for endemic populations with urinary schistosomiasis; however, the optimal target group for treatment and retreatment interval have not been established. Using ultrasound, this study identified subpopulations whose lesions were most likely to respond to treatment and characterized resurgence of pathology. Ultrasound examination of 1202 infected patients was followed by chemotherapy with praziquantel. A sample of 698 patients was followed for 18 months after treatment. Nearly all types of bladder pathologies resolved after treatment, regardless of patient's age or intensity of initial infection. However, many patients' upper urinary tract pathologies (62.5%) did not resolve. During the 18-month follow-up period, reappearance of severe bladder pathologies was rare, and <10% of persons had resurgence of mild bladder pathologies. For this population, retreatment is not needed annually but might be cost effective if given several years later. Confirmation from other areas is required before general policies can be formed.
Mutations of the N- and K-ras genes occur in approximately 15-30% of acute myeloid leukaemia patients. The role of the oncogenic ras in leukaemogenesis remains unclear. Few studies have revealed that mutations in the ras oncogene family are more probably found in acute myeloid leukaemia patients with previous exposure to toxic agents. A case-case study was conducted in the areas of Florence and Turin, Italy, to investigate whether the presence of N- and K-ras mutations in acute myeloid leukaemia patients was related to a higher frequency of exposure to chemicals. During a 3-year period, 111 acute myeloid leukaemia patients were enrolled. All the patients were interviewed using a semi-structured questionnaire collecting data on residential history, occupation, personal habits and pathological history. The presence of N- and K-ras mutations was analysed by amplification and synthetic oligonucleotide probes and by the so-called polymerase chain reaction amplification for specific alleles technique. A total of 34 (30.6%) patients were found to harbour ras mutations in N-ras and/or K-ras. Fourteen patients (12.6%) had a single ras mutation and 20 patients (18%) had two ras mutations. A positive association between a priori at risk jobs and ras mutations was found, based on nine exposed cases; the odds ratio, adjusted by age, sex and previous X-ray and/or chemotherapy was 2.8 (95% confidence intervals: 0.9-9.0). When considering only subjects with two ras mutations the odds ratio was 4.8 (95% confidence intervals: 1.2-18.8). The odds ratio for a previous X-ray and/or chemotherapy was 16.2 (95% confidence intervals: 1.8-755.9); when only subjects with two ras mutations were considered, the odds ratio was 26.1 (95% confidence intervals: 2.5-1248.9). In conclusion, our data suggest that ras oncogene mutations might identify a group of leukaemia in people with previous X-ray/chemotherapy or with exposure to chemical agents in the work environment.
Using a liberal feminist orientation, the literature on a diverse range of topics concerning the profile of the pathological gambler, from personality traits to psychiatric orientation, as well as consequences of the behavior on individuals was reviewed for its gender-related content. The vast majority of this research has been on male subjects; gender of respondents has not been discussed; gender-related findings have not been reported; mostly male-dominated gambling sites have been investigated. To say that most compulsive gamblers are men and therefore, theorists need to explain them first and only later apply these same explanations to the 'rare' [female] cases is to acquiesce to a patriarchal notion of the world. Action is suggested which would put a halt to this trend and suggestions are made for future research.
Branchial cysts, sinuses and fistulae are reviewed with special reference to their origin, clinical features, pathology and treatment. The material consists of a survey of over 700 recorded cases, a series of 90 cases studied in retrospect with special reference to the pathology, and a personal experience of 42. It is suggested that a proportion of 'branchial cysts' do not arise from the branchial apparatus, but possibly may do so from epithelial inclusions in lymph nodes. It is accepted that branchial sinuses develop from the branchial apparatus, but there is little proof that such an entity as 'branchial fistula' exists.
The neuropathology of Down's syndrome at middle age is compared with that of Alzheimer's disease at that age, through a review of the published literature and from the author's personal observations. The pathological changes of Down's syndrome at middle age, i.e. the form and distribution of senile plaques and neurofibrillary tangles, and the pattern of involvement (atrophy) of neuronal systems are qualitatively the same as those of Alzheimer's disease at that age. Quantitative differences do occur and these may relate to biological or sociological variations inherent to the two parent populations. It is concluded that, in pathological terms, patients with Down's syndrome at middle age do indeed have Alzheimer's disease. Some ways in which a study of patients with Down's syndrome can give insight into the nature and development of the pathological changes of Alzheimer's disease are put forward and discussed.
The authors describe clinical and MRI features of a girl and two boys, aged 9, 17 and 19 years, respectively, with Marinesco-Sjögren syndrome. The clinical findings included the major features of the syndrome, including growth deficiency, ataxia, cataracts, hypogonadism (in two) and seizures (in two). Truncal hypotonia (in three), microcephaly (in two) and leg spasticity (in two) were also present. MRI showed a very small cerebellar vermis in all three patients, various supratentorial abnormalities, an apparently small anterior pituitary gland in two and the absence of a posterior pituitary gland in all three. The MRI features are similar to the few reported pathologic findings for persons with Marinesco-Sjögren syndrome. MRI may be helpful in the early diagnosis of the disorder.