Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Deception”

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.

At least 1,207 records · Page 67Linked to original sources
PubMed2002

The prevalence, clinical relevance, and public health significance of subthreshold depressions.

Scientific evidence has accumulated during the last 15 years establishing that SD symptoms have a high prevalence in the general population and in clinically depressed patient cohorts studied cross-sectionally or followed longitudinally. The clinical relevance and public health importance of SD symptoms were confirmed when various investigators, including the authors' group at University of California, San Diego, found that SD symptoms are associated with a significant and pervasive impairment of psychosocial function when compared to no depressive symptoms. There is strong evidence that all levels of depressive symptom severity of unipolar MDD are associated with significant psychosocial impairment, which increases significantly and linearly with each increment in level of symptom severity. It is only when MDD patients are completely symptom free that psychosocial function returns to good or very good levels. The disability associated with depression is state dependent, and disability returns to good or normal levels only when all of the depressed patients' symptoms abate, because disability is present when even a few symptoms (i.e., SD symptoms) are detected. There is strong evidence during the long-term course of illness that major, minor, dysthymic, and subsyndromal symptoms wax and wane within the same patient and that these symptomatic periods are interspersed in the overall course with times when patients are remitted and symptom free. The modal longitudinal symptom status of MDD patients involves primarily subthreshold depressive symptoms, which are much more common than symptoms at the syndromal MDE level. The longitudinal systematic examination of the clinical relevance and high prevalence of SD symptoms helped establish the fact that the long-term symptomatic expression of MDD is dimensional, not categorical, in nature. Abatement of SD symptoms is of fundamental importance in defining full remission or recovery of MDEs. Ongoing residual SD symptoms during the recovery periods after an MDE are associated with psychosocial disability, more rapid MDE relapse, and a more severe chronic future course of illness, all of which indicate that when residual SD symptoms are present the MDE has not fully remitted and the disease is still active. When all depressive symptoms of an MDE abate for a minimum of 8 weeks, then full remission has been achieved. MDE remission defined in this way is associated with significant delay or even prevention of future episode relapse and a less severe, relapsing, and chronic future course. The authors submit that the research reviewed in this article heralds a new paradigm in understanding the progression of clinical depression through various overlapping stages of severity, which begin at the seemingly "subclinical" level of depressive symptoms. This conceptualization in turn dictates a public health approach, which emphasizes that treatment of MDD even at the deceptively mild levels of symptoms should be initiated or maintained.

Depressive Disorder↗
PubMed1991

Ruptured interstitial pregnancy presenting as an intrauterine pregnancy by ultrasound.

Interstitial pregnancy is an uncommon subset of ectopic pregnancy in which the conceptum implants in the intrauterine portion of the fallopian tube. These pregnancies tend to progress further before rupture than do other tubal pregnancies and subsequently have greater propensity for massive intra-abdominal bleeding and maternal demise. Abdominal ultrasound can be deceptive in evaluating interstitial ectopic pregnancies. Transvaginal ultrasonography is more sensitive in the diagnosis of early ectopic pregnancy. Knowledge of the application and limitations of both transabdominal and transvaginal ultrasound will assist the emergency physician in the timely evaluation of this potentially lethal condition.

Abortion, Threatened↗
PubMed1980

Propranolol overdose.

This is a report of a patient who survived a large propranolol overdose, as documented by toxic blood levels. The signs and symptoms were those of profound inotropic and moderate chronotropic cardiotoxicity which failed to respond to parasympatholytics or catecholamines, but subsequently reversed coincident with the administration of glucagon. We report this case because of the sudden development of shock in a patient who looked deceptively well, and because of the improvement apparently brought about by glucagon.

Adult↗
PubMed2000

Future problems requiring scientific consideration.

Water is essential for life, a precept that should control all other considerations. Water and its toxicological safety represent a paradigm for much of what is happening in other areas of society in evolving perceptions of what is 'toxicity', what is 'risk' and what we wish to or are prepared to do about such 'risks' at what cost to ourselves and others. Water is an universal solvent and may contain a wide diversity of substances arising from sources and supply systems and modified by treatment and storage. The problems that are already present, and which are closely linked to others just beginning to be recognisable, arise from the growing sensitivity of analytical techniques showing exposure to novel or ever smaller amounts of known substances in water, how to recognize and evaluate their conventional and possibly new (i.e. previously unrealized) toxic actions, how to measure exposure to water as drunk and as in foods and drinks, in what way can safe exposure levels be set, and is it feasible to people to demonstrate that 'safety' has been achieved? Behind those lie the very real problems of deciding what is 'safety', what level of notional safety do we demand in our assessments, and how do we, the people, come to realise and accept the costs that we shall have to pay in demanding any given level of 'safety'? The latter includes deciding what is an appropriate level of safety for the community as a whole and any specially susceptible groups within it. These questions are deceptively simple to pose and tortuously difficult even to attempt to answer. But they are not all the future problems. Behind them lie the socio-political uncertainties of risk and its place in society-what real or perceived risks do we accept and why, and how in a democratic society are we, the people, to be informed about risks, how should we decide what to accept or reject, and how are we to balance our beliefs and wishes against the costs of prevention or acceptance of diseases that unclean or contaminated water can bring.

Animals↗
PubMed1998

Psychological and physiological parameters of masticatory muscle pain.

The objective of this research was to identify the psychological and physiological variables that differentiate persons reporting masticatory muscle pain (MMP) from normal controls (NC). This study examined the characteristics of 35 MMP patients in comparison to 35 age-, sex-, and weight-matched NCs. All subjects completed a series of standardized questionnaires prior to undergoing a laboratory evaluation consisting of a psychosocial stressor and pressure pain stimulation at multiple body sites. During the evaluation, subjects' emotional and physiological responses (heart rate, blood pressure, respiration, skin temperature, and muscle activity) were monitored. Results indicated that persons with MMP reported greater fatigue, disturbed sleep, depression, anxiety, menstrual symptoms, and less self-deception (P's < 0.05) than matched controls. At rest, MMPs had lower end tidal carbon dioxide levels (P < 0.04) and lower diastolic blood pressures than the NCs (P < 0.02). During laboratory challenge, both groups responded to the standard stressor with significant physiological activity and emotional responding consistent with an acute stress response (P < 0.01), but there were no differences between the MMPs and NCs. Muscle pain patients reported lower pressure pain thresholds than did NCs at the right/left masseter and right temporalis sites (P's < 0.05); there were no differences in pressure pain thresholds between MMPs and NCs for the left temporalis (P < 0.07) and right/left middle finger sites (P's > 0.93). These results are discussed in terms of the psychological and physiological processes that may account for the development of muscle pain in the masticatory system.

Adult↗
PubMed1999

A 15-year experience with varicella infections in a pediatric burn unit.

Because of their well described global immunosuppression, varicella infection may be hazardous in burned children. It is therefore important to prevent cross-infections within pediatric burn units. We describe a 15-year experience with varicella in a pediatric burn unit, focusing on the morbidity associated with the infection and measures that have been effective in the prevention of cross-infection. We found that varicella infection in acutely burned children is associated with pneumonitis, but little wound related morbidity. Despite the deceptively long incubation period, prompt identification and isolation of index cases was associated with an extremely low incidence of cross-infection. Until widespread administration of varicella vaccine confers herd immunity, varicella remains a threat to hospitalized young children, highlighting the importance of a well planned and executed index case isolation strategy.

Boston↗
PubMed2003

Oxygen-hemoglobin affinity at sea level may predict acute illness at altitude: theory and simulation.

Acute mountain sickness carries with it serious health and economic costs. In their pursuit of the mechanisms that produce acute mountain sickness, researchers have overlooked the existence of a possible screening test, a test based on individual variation in cerebral oxygen exchange at sea level. In this paper, I highlight the mathematical link between cerebral oxygen exchange at sea level - this is reflected in the magnitude of the oxygen extraction coefficient - and a change in brain blood flow at altitude; this link has been overlooked. A lower oxygen extraction coefficient at sea level can act - at altitude - to reduce the capacity of the intracranial compartment to accommodate brain swelling, exacerbate increases in cell volume, promote the stimulation of angiogenesis, and further cerebral edema, each of which may contribute to acute mountain sickness. In retrospect, it seems obvious that the initial state of cerebral oxygen exchange will impact the cerebral circulatory response to subsequent hypoxia. This deceptively simple notion offers us an opportunity to identify beforehand those people likely to develop acute mountain sickness when they travel to altitude.

Altitude Sickness↗
PubMed1996

Insomnia.

The series of cases presented here should illustrate that the complaint "I can't sleep" is deceptively simple. The clinician must be prepared to gather information from many disparate aspects of the patient's history and present circumstances. Diagnostic considerations are complicated further by the significant night-to-night variation in the manifestations of the insomnia. Too often, the result of this hidden complexity is a tendency either to prescribe hypnotic drugs as a first intervention or to give signals to patients with insomnia that not much can be done and that difficulty sleeping is simply a fact of life. The sleep log can help to bring order to the jumble of insomniac experiences. It leads both the clinician and patient away from assigning too much weight to a specific instance, instead allowing more general patterns to be discerned. As order is created out of the factors contributing to the insomnia, a treatment plan can be designed that goes beyond mere symptomatic treatment.

Adult↗
PubMed1997

Sudden death due to troponin T mutations.

OBJECTIVES: This study was designed to verify initial observations of the clinical and prognostic features of hypertrophic cardiomyopathy caused by cardiac tropnin T gene mutations. BACKGROUND: The most common cause of sudden cardiac death in the young is hypertrophic cardiomyopathy, which is usually familial. Mutations causing familial hypertrophic cardiomyopathy have been identified in a number of contractile protein genes, raising the possibility of genetic screening for subjects at risk. A previous report suggested that mutations in the cardiac troponin T gene were notable because they were associated with a particularly poor prognosis but only mild hypertrophy. Given the variability of some genotype:phenotype correlations, further analysis of cardiac troponin T mutations has been a priority. METHODS: Deoxyribonucleic acid from subjects with hypertrophic cardiomyopathy was screened for cardiac troponin T mutations using a ribonuclease protection assay. Polymerase chain reaction-based detection of a novel mutation was used to genotype members of two affected pedigrees. Gene carriers were examined by echocardiography and electrocardiology, and a family history was obtained. RESULTS: A novel cardiac troponin T gene mutation, arginine 92 tryptophan, was identified in 19 of 48 members of two affected pedigrees. The clinical phenotype was characterized by minimal hypertrophy (mean [+/-SD] maximal ventricular wall thickness 11.3 +/- 5.4 mm) and low disease penetrance by clinical criteria (40% by echocardiography) but a high incidence of sudden cardiac death (mean age 17 +/- 9 years). CONCLUSIONS: These data support the observation that apparently diverse cardiac troponin T gene mutations produce a consistent disease phenotype. Because this is one of poor prognosis, despite deceptively mild or undetectable hypertrophy, genotyping at this locus may be particularly informative in patient management and counselling.

Biomarkers↗
PubMedDate not supplied

Carotid arteriovenous fistula in the neck as a result of a facial laceration.

Facial lacerations due to penetrating trauma can be deceptive at first glance. The importance of proper wound evaluation and management is illustrated in the case of a patient who sustained a laceration to the face and subsequently developed an arterio-venous fistula in Zone III of the neck. In considering diagnostic studies for evaluation of penetrating wounds to the face, special attention should be placed upon the wounding device, direction, force, and underlying neurovascular structures.

Adult↗
PubMed1998

MRI nerve root enhancement in Krabbe disease.

Krabbe disease is characterized by abnormal breakdown and turnover of myelin, leading to extensive demyelination in both the peripheral and central nervous systems. A 7-month-old infant with early-onset Krabbe disease had deceptively normal head images, but spinal MRI demonstrated abnormal gadolinium enhancement of the lumbosacral sacral nerve roots and cauda equina such as that seen in Guillain-Barré syndrome. Abnormal enhancement in spinal MRI has not been previously described in patients with leukodystrophies.

Cauda Equina↗
PubMed1997

Problems in endocrinologic imaging.

Imaging particularly cross-sectional computer-assisted techniques such as CT and MR imaging, has become so refined and even breathtaking that the display of anatomy is beguiling endocrinologists into an unhealthy reliance on visual data. The demonstration of a focal abnormality in an endocrine gland tells us nothing about its function. Overreliance on such displays of anatomy leads to problems in diagnosis and treatment. This article points out some instances in which imaging is deceptive.

Adrenal Gland Neoplasms↗
PubMed1996

Fine-needle aspiration and the diagnosis of thyroid cancer.

Fine-needle aspiration is a low-cost diagnostic tool, the principal value of which is to determine which patients should undergo surgery. The technique is deceptively simple. Team work and close cooperation among endocrinologists, surgeons, and pathologists are essential for success. Cytologic criteria for diagnosis of the most frequent malignancies found in thyroid aspirates have been provided.

Adenomatous Polyposis Coli↗
PubMed1996

Mixed cryoglobulinemia secondary to hepatitis C virus infection.

Mixed cryoglobulinemia is a systemic vasculitis with clinical manifestations ranging from the characteristic benign-appearing syndrome of palpable purpura, arthrologies, and fatigue to severe vasculitis involving vital organs. A strong association of the disease with hepatitis C virus infection and the demonstration of the specific concentration of the virus in the cryoglobulins have implicated hepatitis C virus in the etiopathogenesis of the disease. The increase in illicit intravenous drug use in the past 30 years seems to have raised the occurrence in the United States of this once uncommon disease and changed the demographics: there seem to be more male intravenous drug users in their forties with the disease than women without risk factors for hepatitis C virus infection in their fifties and sixties. Pathogenesis, therapy, and the hypothesis on the etiologic role of hepatitis C virus are reviewed, and the implications of recent studies and new concepts for treatment of this often benign-appearing but deceptive and potentially life-threatening disease are discussed.

Autoantibodies↗
PubMed2001

Selective impairments of theory of mind in people with schizophrenia.

"Theory of mind" (ToM) means the ability to represent others' intentions, knowledge and beliefs and interpret them. Children with autism typically fail tasks aimed at assessing their understanding of false beliefs. These features of autism are strikingly similar to some negative features of schizophrenia. Mental abilities were studied in 35 schizophrenics (DSM-IV) and 17 normal controls. Subjects heard four ToM stories and simultaneously were shown cartoons depicting the action occurring in the stories. All stories involved false beliefs or deception. As for the current symptomatology, schizophrenics were divided according to Liddle's three-dimensional model (reality distortion, psychomotor poverty, disorganisation). Our results show significant differences between schizophrenics and normal controls in all ToM stories, with schizophrenic people performing worse than controls. In first-order stories (a false belief about the state of the world) significant differences were found among symptom dimensions, with the psychomotor poverty group performing worse than disorganisation subjects and reality distortion ones. As for second-order stories (a false belief about the belief of another character), the psychomotor poverty group performed worse than the other groups only in one of the four ToM stories. More research in separating ToM deficits from attention disturbances is needed.

Adult↗
PubMed2003

Theory of mind and the role of IQ in chronic disorganized schizophrenia.

BACKGROUND: Several studies have suggested a theory of mind (ToM) deficit in schizophrenic disorders. However, the role of interfering variables such as IQ, attention, memory, and severity of the disorder has remained ambiguous. METHODS: A theory of mind picture story comprising a sequencing task, a first and a second order false belief test, and a tactical deception test was given to a group of 23 patients with chronic disorganized schizophrenia and to 12 healthy control persons. In addition, a nonsocial picture story had to be sequenced. Severity of the psychopathology was measured by using the brief psychiatric rating scale (BPRS), IQ was estimated using the 'Mehrfachwahlwortschatztest' (MWT, multiple choice verbal comprehension test). RESULTS: The schizophrenic group was impaired relative to controls on the theory of mind task, but not on the sequencing task of the nonsocial picture story. However, when controlled for IQ, no such difference was found. These findings were neither related to severity, duration, nor age at onset of the disorder. CONCLUSIONS: Theory of mind deficits in schizophrenia may be related to domain general impairments, e.g., intelligence and working memory load, rather than reflecting a 'genuine' compromised mental state attribution similar to autistic spectrum disorders. Schizophrenic patients may, however, rather be impaired in how and when to apply strategic social reasoning. Further studies to investigate the nature of social deficiency in schizophrenia are warranted.

Adult↗
PubMed1997

Caffeine effects on perceptual and motor processes.

The effects of a single dose of caffeine on specific information processing operations were examined by using a visual selective attention task in which subjects were asked to select between a left and right hand response on the basis of two different target letters. The target was presented on a predefined position in the visual field and was either presented alone or with flanker letters, calling for the correct, the incorrect or no specific response. A dose of 3 mg/kg body weight caffeine or lactose, dissolved in a cup of decaffeinated coffee, was administered double blind and deceptively to overnight abstinence coffee drinkers. Behavioural measures were supplemented by psychophysiological measures. The present results replicated the basic findings obtained in this paradigm. The results indicated that the time to localise the target decreased and response preparation started earlier after caffeine than after placebo. These caffeine effects did not interact with the time subjects spent on the task or with the reaction time distribution, which might be due to a high level of practice.

Adolescent↗
PubMed2000

Medical economic considerations of supportive cancer care.

In an era of increasing cost containment in health care, it has become extremely important to allocate resources as efficiently as possible. This implies that formal health economic considerations are taken into account. One of increasing importance is the field of economic appraisal, which allows to quantify the value for money of medical interventions. This research is extremely useful in the field of supportive care of cancer patients. Economic considerations, social, political and ethical issues will also have to be addressed. The sum of these activities will enable us to make better choices in health care and ensure that sufficient resources are allocated to supportive cancer treatment. Cancer patients have physical, social, spiritual and emotional needs. They may suffer from severe physical symptoms, from social isolation, spiritual abandonment, and emotions such as sadness and anxiety, or feelings of deception, helplessness, anger and guilt. In some of them, the disease is rapidly progressing and ultimately they die. Their demanding care evokes intense feelings in health care providers, all the more since these incurable patients represent a challenge, which could be condensed under the heading "the challenge of medical omnipotence". The complexity of the matter, the interdisciplinary approach and the emergence of an increasingly cost conscience health care environment put supportive cancer care in a difficult realm.

Health Care Costs↗