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[Therapeutic effects of taurine in epilepsy: a clinical and polyphysiographic study (author's transl)].

A study was carried out after i.v. administration of 200 mg/Kg of taurine on 37 epileptic patients in whom frequency and duration of seizures was considerable. Twenty-two subjects were given taurine for 15 consecutive days and then, once a week for a period of 6 weeks. In 5 control cases, the daily dosage wascontinued up to the 30th day; in 5 more, up to the 45th day and finally, in 5 up to the 60th day. Out of 37 patients 15 had temporal lobe epilepsy, 10 were cases of Lennox-Gastaut syndrome, 5 had generalised epilepsy, either convulsive or non-convulsive, 4 had H.H.E. syndrome and three brothers had myoclonic familial progressive epilepsy. In each group the results were similar and may be summarised as follows: I) both interictal activity and electroclinical seizures were reduced by about 30% within the first 10 days of administration; II) between the 30th and 45th day the ictal and interictal activity returned to its initial values; III) after this period, on the 60th day, values were similar to the initial ones; IV) as far as interictal activity is concerned, the same effect was found during nocturnal sleep; V) no significant changes were noticed in nocturnal sleep cycles and stages; VI) there was no apparent evidence that any phase of sleep might facilitate any improvement. Improvement was observed in about 50% of the cases (21) both physically and psychologically. The physical improvement was noticed above all in the appearence of the skin while the psychological improvement was mostly related to both attention and memory. Any pathological aspect of personality did not appear to be modified.

Adolescent↗

[Selection criteria used in 1,310 patients in ambulatory major surgery].

From October 1990 through March 1992, 1,310 patients underwent surgery on an out-patient basis. Fifty (3.82%) could not be released on the day of surgery, most often because of surgical complications (17), postoperative pain (11), poor screening (9), and nausea and vomiting (8). Screening for out-patient surgery must not be based solely surgical procedure. Factors of social context, personality and associated pathology must also be weighed.

Adolescent↗

[Mathematical modeling of the dynamics of structural thyroid parameters in thyroid disease with immune disorders].

The material of the study was surgical thyroid biopsies from 126 patients, males and females, aged 14-69 years. 5 groups were studied depending upon the histological picture and the degree of lymphoid infiltration. Thyroids from 10 persons without thyroid pathology who died a violant life served as control. As a result of the factor analysis 5 main factors were distinguished. The first one is lymphoid infiltration, the 2nd and 3rd ones-factors of thyroid epithelium characterizing the structure and the size of thyrocytes, the 4th and the 5th factors characterize the structure of the thyroid as an organ. The analysis confirmed lymphoid infiltration and thyrocyte dimensional parameters are the most important morphological criteria in the diagnosis of thyroid pathology with immune disturbances. Six equations are derived allowing to classify new cases of thyroid pathology.

Adolescent↗

[Comparison of 3 techniques in the serological diagnosis of human hydatidosis].

Three serological techniques for hydatid disease were compared using 60 human serum samples obtained from 29 patients with hydatidosis previously demonstrated by surgery, 15 apparently healthy individuals and 16 persons with different pathologies. The results obtained with these 3 techniques showed some differences that could associate with the anatomical location of the parasite and the biological stage of the hydatid cysts. The global sensitivity of the techniques was 96.6% for ELISA, 86.2% for IHAT and 79.3 for DD5. False positive reactions were observed with IHAT and ELISA in sera from patients with infection by Taenia saginata. ELISA also showed cross reactions in the sera of four patients with intestinal infection by Ascaris lumbricoides. No false positive reactions were observed with DD5 test.

Adolescent↗

[Borderline mental disorders in diabetes mellitus].

124 patients with diabetes mellitus were examined in hospital of endocrine profile. The borderline mental disorders were revealed in 115 cases (92,7%) in the form of neurosis-like disturbances and pathological development of personality. Asthenic, asthenohypochondriac, asthenodepressive, obsessive and hysteroformic syndromes were diagnosed in patients with neurosis-like disorders. The personal disorders included asthenic, hysteric, obsessive, explosive and psychosomatic variations of development of the personality. Besides, poor cooperation of patients with the doctor was observed in the course of "diabetic control".

Adolescent↗

[Psychosomatic motor disorders in the structure of depression in children and adolescents].

106 patients (40 boys and 66 girls) at the age from 3 to 15 years with depression of neurotic level with motor disorders (hyperkinetic, hypokinetic, pseudoepileptic) were examined. The motor disorders were estimated as pseudoneurological ones. The treatment of such patients must be performed with estimation of the typological variations of depression (asthenic type was observed in 31 cases, anxious type--in 37, melancholic type--in 6, combined type--in 32), of the degree of depressions manifestation, of their etiology as well as the pathological "basis" and personal peculiarities of the patients. 81 patients were treated by antidepressants (AD) in combination with tranquilizers and nootropes. AD weren't applied in 25 cases. Of all the patients in which AD were used complete correction of pseudoneurological and depressive disorders was observed in 46 cases (56.8%), considerable improvement--in 26 patients, the improvement--in 9 cases. Meanwhile improvement was observed only in 15 cases and slight improvement in 10 persons in patients who had not received any AD (group differences were significant).

Adolescent↗

[Modified central otoneurological tests supported by computer analysis].

The paper presents the results of the study of gaze-evoked nystagmus, direction-gaze nystagmus and optokinetic nystagmus in 193 subjects, including 85 healthy pilots and 64 persons with vestibular pathology of central origin. For this purpose, a computer program was applied for evoking strictly standardised oculomotor stimuli. Moreover, computer analysis of the responses was introduced. To make the method applicable for otoneurological evaluation of flying personnel members, physiological norms of the parameters of interest for gaze-evoked and optokinetic tests have been presented, based on the study results in different age groups. Regardless the applied procedure, an initial analysis was made in patients with vestibular pathology of central origin. After having compared these results with the results achieved in healthy population, the introduced battery of tests was found to be a reliable method of studies for the purpose of otoneurological diagnostics.

Adult↗

Pathologic gambling.

Pathologic gambling is recognized and clearly defined by the American Psychiatric Association. However, many Americans suffer from an addiction to gambling that is undiagnosed and, therefore, untreated. Pathologic gambling, like any other addiction, can be devastating. Because of the personality characteristic of the pathologic gambler, detecting and diagnosing the problem is difficult. In many cases, the symptoms of gambling addiction, although distinct, are not recognized until a devastating event occurs. The older adult in particular is at great risk for addiction to gambling. Health care providers must be aware of the warning signs and symptoms of addiction to gambling and be ready to provide information that will assist their clients in addressing it. Unfortunately, few programs exist in this country to treat the many people suffering from this addiction. With the current movement to legalize gambling and the increasing popularity of lotteries in many states, the problem of pathologic gambling is sure to escalate.

Aged↗

[Personality and psychological factors in the irritable bowel syndrome].

The study of the psychologic profile of patients with the irritable bowel syndrome (IBS) has shown that psychologic aggression, personality abnormalities, psychiatric diagnostics and pathologic behaviour patterns are more frequently encountered than in normal subjects or those with other disease. Moreover, patients with IBS often relate psychological events experienced in infancy such as a lost child, divorce of parents, or sexual abuse which can affect their future and particularly their manner of seeking medical advice. As it is known that only between 23 and 38 per cent of patients with IBS seek medical advice, it is also important to know whether these psychologic characteristics are true for all subjects with these symptoms or if they are found in a particular subgroup of patients who seek medical advice because, in fact, they are really ill. Multivariate analysis was used to evaluate the medical and psychologic status of 72 patients with IBS, 82 patients with symptoms suggestive of IBS but who did not seek medical advice, and 84 normal subjects. With regard to semeiologic differences according to whether patients sought medical advice or not, there were more subjects in the first group who complained of diarrhea and pain. Moreover, there were more patients with personality abnormalities, pathologic behaviour patterns, and a lower sensitivity to stress in subjects with IBS seeking medical advice than in those with symptoms who did not seek advice (p less than 0.001) or normal subjects (p less than 0.001). There were no significant differences between the subjects with symptoms but who do not seek medical advice and the normal subjects (p = 0.21).(ABSTRACT TRUNCATED AT 250 WORDS)

Colonic Diseases, Functional↗

Pathology of the senescent heart: anatomic observations on 237 autopsy studies of patients 90 to 105 years old.

Persons older than 85 years of age will constitute the fastest growing segment of the US population in the next decade, and despite the recent decline in mortality from heart disease, cardiovascular disease remains the single greatest cause of death in these elderly persons. We studied the pathologic changes in the hearts of 237 patients (93 men and 144 women) who had lived to the age of 90 years or older. The degree and extent of coronary atherosclerosis in these senescent hearts were similar to findings reported in younger patients who died of coronary heart disease, but calcification of the coronary arteries, mitral annulus, and aortic valve was more prevalent, as was cardiac amyloidosis. Multiple cardiac disorders were common in these very elderly hearts, but they seemed to play a lesser role in precipitating heart failure or shortening the life-span of the patients. Important factors in attaining longevity seem to be protection from the development of severe coronary artery disease by an unexplained mechanism and an innate resistance to cardiac dysfunction from a multitude of structural changes that occur with advancing age.

Aged↗

Review of research on pathological gambling.

The literature including a number of review articles was examined for answers to the questions, have distinctive personality test profiles of pathological gamblers been identified, do pathological gamblers have control over their behavior, have studies of alcoholism and addiction increased understanding of compulsive gambling, and has psychotherapy or Gamblers Anonymous been successful for them? Much more information is needed to build on what research on these questions has yielded.

Gambling↗

Nail-Tutor: an image-based personal computer program that teaches the anatomy, patterns of pathology, and disorders of the nails.

Despite the clinical relevance of the nails, the interpretation of the appearance of the nails is often neglected by clinicians and in medical training programs. To help overcome this we developed Nail-Tutor(TM), a personal computer program based on approximately 150 images that systematically teaches the anatomy, patterns of pathology, and diseases of the nails and tests the user's understanding of the material in the program. Nail-Tutor(TM) is intended for medical students, residents, other healthcare trainees, general practitioners, and dermatologists and requires approximately 3 hours to use. The program has a number of advantages over textbook-based instruction and supervised instruction. It does not require an instructor or textbook. In addition it uses animation to show an important anatomic relationship, graphic overlays to unambiguously point out key features of images, it can show key images side by side for comparison, and an examination to evaluate learning objectives. The program can be used as a stand-alone teaching module, a supplement to traditional instruction, a source for continuing education, or as a reference.

Computer-Assisted Instruction↗

Evoked potentials in patients with Huntington's disease and their offspring. I. Somatosensory evoked potentials.

Spinal and cortical somatosensory evoked potentials (SEPs) were recorded in a large sample of patients with Huntington's disease (n = 37) and subjects at risk (first order offspring, n = 43). The SEPs were elicited by stimulation of the median and tibial nerves and recorded at Erb's point, the cervical level (C2) and at the corresponding scalp areas. The most striking finding in patients with Huntington's disease was a drastic diminution of the amplitude of the early cortical components, especially N20/P25 for the median nerve and N33/P40 for the tibial nerve. The latencies (Erb's point, C2, cortical) were only slightly prolonged in comparison to the normal values. Forty-three per cent of the persons at risk exhibited pathological results with a clear reduction in amplitude of the early cortical responses or with a pathological side difference between the amplitudes. Fifty-three per cent of the persons at risk exhibited a normal result. Two persons at risk (= 6%) could not be classified unambiguously. Some patients with benign and symptomatic chorea were investigated. These showed normal results with one exception. The diagnostic and predictive value of the investigation of SEPs in Huntington's disease is discussed.

Adolescent↗

Positive and negative symptoms of schizotypy and the Five-factor model: a domain and facet level analysis.

In this study, we investigated the Five-factor model in the concurrent prediction of positive symptom schizotypy as measured by the Magical Ideation (Eckblad & Chapman, 1983) and Perceptual Aberration (Chapman, Chapman, & Raulin, 1978) scales and negative symptom schizotypy as measured by the Physical Anhedonia (Chapman, Chapman, & Raulin, 1976) and Revised Social Anhedonia (Eckblad, Chapman, Chapman, & Mishlove, 1982; Mishlove & Chapman, 1985) scales. Previous studies suggest that these measures reflect the core symptoms found in schizotypal and schizoid personality disorder (Bailey, West, Widiger, & Freiman, 1993). Negative symptoms were significantly predicted by Neuroticism (+), Extraversion (-), Openness (-), and Agreeableness (-) domains of the Revised NEO Personality Inventory (NEO-PI-R; Costa & McCrae, 1992). Additionally, positive symptoms were significantly predicted by Neuroticism (+), Openness (+), and Agreeableness (-). In addition, we examined the validity of lower order traits in de- scribing these symptoms of character pathology. These findings lend further support for the use of domain and facet scales of the NEO-PI-R in the identification of personality pathology.

Adult↗

Diagnosis of narcissistic self-esteem regulation in patients with factitious illness (Munchausen syndrome).

A quantitative taxonomy for the identification of patients with narcissistic pathology and with borderline personality disorders based on test results is presented. The quantitative identification of these subgroups was produced using a Q-factor analysis. Based on the correlation of the subjects by means of the 241 questions from the narcissistic inventory of Deneke and Müller [27], three subgroups could be defined. Two of these groups exhibited a pathology of the self-system which corresponded to the pathology described by Kernberg [24] for narcissistic and borderline personality disorders. The third group is characterized by reduced observable self-pathology traits from the narcissistic inventory. By means of the reclassification of these three taxonomical groups with the discriminant analysis, two discriminant functions could be calculated, using the weighting of the single test scales for a classification of new patients. These classification functions were used to examine 18 patients suffering from factitious disorders. The evaluation of test profiles with the reduced narcissistic inventory of Deneke and Müller [11] in order to identify the three taxonomical groups showed that 9 patients (50%) had a borderline personality disorder and 6 patients (33%) a narcissistic personality disorder, while 3 patients (17%) could be assigned to the subgroup without self-pathology. In summary, 83% of the examined patients with factitious disorders exhibited a disorder in self-regulation. The previous clinical observations of self-regulation for patients with factitious disorders could thus be confirmed. It becomes clear that different high levels of disorder in self-regulation (position in the sphere of the discriminant function) correspond to varying degrees of prognostic significance.

Adult↗

Infectious diseases in the 21st century.

Infecto-contagious diseases in the twenty-first century with respect to precedent will see themselves deprived of smallpox, dracunculiasis and very probably of paralyzing poliomyelitis. Vaccination-preventable diseases, such as measles, whooping cough, diphtheria, tetanus, rabies, some forms of meningitis, yellow fever and episodes of disseminated tuberculosis will greatly diminish in their rates of morbi-lethality; the elimination of some, and the eradication of measles, are expected. Other diseases such as diarrhea (including cholera), geo-helminthiasis, some severe respiratory tract infections and the majority of vector-transmitted infectious diseases will decrease due to improvements in potable water services, drainage, sanitary food control, living quarters, and individual and community anti-vector action. Leprosy, onchocerciasis and several parasitoses will be controlled by the available antimicrobial drugs. Infectious diseases will continue to be an important health problem due to: Reduction in the immunocompetence resulting from the aging of the population, chemotherapies necessary for neoplasms, and autoimmune pathology and the survival of persons with primary immunodeficiencies; lifestyles prone to infectious pathology, such as mega-city urbanization, children in day care centers, industrialized foods, intravenous drug addiction, sexual liberation, global commerce, and tourism; antibiotic-multiresistant microbial flora; environmental disturbances as a result of global warming, deforestation, the settling of virgin areas, dams, the large-scale use of pesticides, fertilizers and antimicrobials, and natural/social disasters generators of poverty, violence and deprivation will result in emergence or re-emergence of infectious diseases already controlled in the past.

Communicable Disease Control↗

[Noise field screening. Results of a television field study for detection of visual field defects].

White noise field campimetry is able to transform usually negative scotomas immediately into perceivable visual field defects. As this method needs a monitor, the obvious solution was to evaluate the suitability of the noise field stimulus broadcasted to home TV sets. Therefore, in cooperation with the "Süddeutscher Rundfunk" (SDR) as well as several health insurance companies ("AOK Baden-Württemberg" and other "RVO-Kassen"), approximately 300,000 viewers were invited to take this test after receiving brief information and instruction. There were 531 calls for questionnaires to document the subjects' findings and the results of a subsequent ophthalmological examination. In most cases this clarified the perceived noise field defect. Out of 127 evaluable questionnaires, 78 cases did not show any relevant ophthalmological pathology; this held true especially for lesions of the visual pathway. However, in 49 persons the ophthalmologists detected pathological findings; in 20 of these, the scotomas were previously unknown to the physicians. Glaucomatous optic neuropathy and macular degeneration were most frequently diagnosed as causing the white noise field defects. Finally, some preliminary estimates of the costs and benefit of this study are presented.

Adolescent↗

[On some cystographic appearances of prostatic pathology (author's transl)].

The author reports a personal series of 200 cases of prostatic pathology studied by perfusional urography and by radio-urological instrumental methodics. He considers, especially, some radiographic appearances of involvement of the vesical floor, correlating them with clinic and gross pathology. Thus he pointed out that: the marks on the vesical floor with the aspect of "spread wings" is the most frequent radiographic pattern showing the chronic prostatitis; "the endovesical lacuna" is disregarded aspect of medium lobe's hypertrophy, as well as the "raising as tent" of the vesical floor due probably to an hyposphincteric periurethral adenoma. Although the mameloned aspect of vesical floor is typical, only sometimes it is the sign of an early cancer of the superior face of the prostate.

Chronic Disease↗