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PubMed1978

An application of a multitrait-multimethod test to validity data of a social learning treatment for aggressive children.

Campbell and Fiske's (1959) multitrait-multimethod matrix was applied to data from two independent social learning measures designed to evaluate procedures used to aid aggressive children. Six parallel or like-named variables--noncomplying, crying, whining, negativism, destructiveness, and yelling--from both a home observation assessment system and a parent telephone data system were used. The data from 47 cases indicated that the categories of whining, crying, and destructiveness demonstrated significant convergent validity, but only whining demonstrated discriminant validity. The situation-specific versus cross-situational consistency aspects of the behaviors studied, and the implications for future research, were discussed.

Adolescent↗
PubMed1986

Cellular localization of the Ro/SS-A antigen.

The cellular localization of the Ro/SS-A antigen was defined using indirect immunofluorescence and eight monospecific anti- Ro/SS-A antisera which were identified by immunoblotting. Several mammalian tissues were used as substrates. The Ro/SS-A antigen was located mainly in the nucleus of dog liver and Hep-2-cells, and anti-Ro sera had produced a speckled staining pattern. Cytoplasmic fluorescence appeared only in one serum. IgG was the predominant immunoglobulin with anti-Ro/SS-A activity; five sera had complement fixing activity. The sera absorption studies with partially purified Ro/SS-A antigen and the negativation of the ANA tests had confirmed the specificity of our findings.

Absorption↗
PubMed1980

[Individual achievement capability and performance demand at work].

Fitness and job requirement must have a positive correlation to avoid an overstress with its negativ consequence for physical health. Very often jobs with high physical stress restult in partial stress. Jobs like controller reduce the physical capacity, if no preventive training is done. This paper gives a way to improve or conservate at least, physical fitness by short daily training--following the physical laws of training--for the purpose to balance physical and performance demand. Thereby the degree of fatigue by work can be reduced.

Achievement↗
PubMed2001

The many varieties of catatonia.

About 10% of patients with severe acute psychiatric illness exhibit a cluster of motor signs (mutism, negativism, rigidity, posturing, stereotypy, staring, etc.) that are identified as the syndrome of catatonia. Catatonia responds to sedative anticonvulsant treatment (barbiturates, benzodiazepines) and to electroconvulsive therapy. These treatments raise seizure thresholds. The commonality in response indicates that catatonia, malignant catatonia, neuroleptic malignant syndrome, toxic serotonin syndrome, delirious mania, catatonic excitement, benign stupor, and oneirophrenia are best evaluated as diverse manifestations of one syndrome for clinical and neuroscience research purposes.

Acute Disease↗
PubMed1996

[Perioperative myocardial infarction and cardiac complications after noncardiac surgery in patients with prior myocardial infarction. I. Clinical data and diagnosis, incidence].

UNLABELLED: Patients with a prior myocardial infarction (MI) have a high risk of perioperative reinfarction compared with the normal population (5%-8% vs. 0.1%-0.7%) [10]. According to Rao [13], a reduction of this risk is possible when patients are monitored invasively and all haemodynamic parameters are kept within the physiological range. In most institutions it is not feasible to treat patients as Rao recommended: this would overstrain both hospital structure and financial resources. We studied the incidence of perioperative MI and other cardiac events in patients with prior MI. During the study period the anaesthesia and intensive care methods of our institution were neither changed nor influenced. In addition to this clinical evaluation, we performed perioperative Holter electrocardiographic monitoring and measured serum levels of the recently introduced marker troponin T (parts II and III). METHODS: Institutional informed consent was obtained. The study was planned prospectively. All patients with prior MI (156) and/or coronary artery bypass grafting (CABG) (4) who were scheduled for elective noncardiac surgery between April 1992 and March 1993 were included. The following information was acquired and tabulated: age, sex, body weight, preoperative risk factors, ASA classification, preoperative blood pressure, pulse rate, and ECG (interpreted by an independent cardiologist), serum electrolytes, haemoglobin, creatine kinase (CK), CKMB faction, creatinine. Preoperative regular medications, type of anaesthesia, type, site, and duration of surgery, and intraoperative haemodynamic changes were documented. The patients were divided into four groups depending on the time interval between MI and surgery (group I: 0-3 months, group II: 3-6 months, group III: > 6 months, group IV silent MI and prior CABG without infarction). We then studied the number of patients who developed a perioperative MI or died of cardiac causes within 7 postoperative days (n = 160). Because of early discharge of 21 patients, we could study the occurrence of cardiac events within 7 postoperative days in 139 patients only. Definitions of perioperative MI included [3]: changes of ST pattern (horizontal ST depression > 0.1 mV or elevation > 0.2 mV) during 30 s and longer; new T-negativation or Q-wave; pathological CKMB fraction (> or = 6% of total CK); and angina pectoris; two of these criteria were required to be positive (WHO). Definitions of cardiac events included: ischaemia: any reversible horizontal depression of the ST segment of more than 0.1 mV or any ST segment rise of more than 0.2 mV. Patients with bundle branch block (BBB) were excluded; angina pectoris: any chest pain that disappered after application of nitroglycerine; arrhythmia: any change from preoperative rhythm or appearence of ventricular premature beats; and left ventricular failure: clinical and radiological signs of ventricular failure. Statistical evaluation of the demographic data was performed by the Kruskall-Wallis test; categoric variables were examined using the chi 2 test and Fisher's exact test. P values of less than 0.05 were considered significant. RESULTS: Six of the 160 patients with prior MI developed a perioperative MI (3.8%); 2 of them (33%) died of cardiac causes (3rd and 6th postoperative day). All of these patients were in groups III or IV (interval > 6 months). Forty-two patients had one or more other cardiac events; arrhythmias (22) and ischaemia (14) were most common. Intraoperative hypotension was associated with postoperative MI (5 of 58 vs. 1 of 102). Preoperative congestive heart failure (4 of 18 vs. 3 of 121) and major surgery (7 of 68 vs. 0 of 71) led more often to postoperative left ventricular failure. Patients who received beta-blocking agents preoperatively had significantly fewer ischaemic cardiac events (0 of 28 vs. 14 of 90, 21 patients excluded with BBB) but differed in mean age (67 vs. 71 years). The use of beta-blocking agents was not associated with a reducti

Adrenergic beta-Antagonists↗
PubMed2006

Neospora caninum immunoblotting improves serodiagnosis of bovine neosporosis.

Neospora caninum ranges among the major causes of infectious abortion in cattle worldwide. The present study was designed to improve the serodiagnostic tools by complementing a conventional ELISA with a highly sensitive and species-specific N. caninum immunoblot. To evaluate this test combination, sera from several groups of cows were tested. The first group, consisting of experimentally infected calves, showed that immunoblot antibody reactivities were detectable 1 to 3 days earlier than those found in ELISA. The first immunodominant bands that appeared were a 29-kDa (NcSAG1) and a 36-kDa (NcSRS2) antigen. Other groups, based upon naturally infected cattle, were used to compare the diagnostic sensitivity of ELISA and immunoblotting. Overall, N. caninum immunoblotting exhibited a higher sensitivity (98%) than ELISA (87%). Conversely, immunoblotting also confirm in two other cases, true transient negativation in some animals. In general, banding patterns and band staining intensity correlated to the semiquantitative ELISA findings. On the other hand, the banding pattern could not be used to discriminate between sera from animals with a recent abortion and those of cows with latent N. caninum infection. We also addressed putative cross-reactions due to infection with Toxoplasma gondii. Sera from animals with a serologically proven T. gondii infection were either clearly negative by Neospora immunoblotting or they yielded a specific immunoblot antibody profile indicating a double infection with N. caninum. Sera from animals with positive findings in both Toxoplasma and Neospora ELISA thus provided dichotomic results in the immunoblot by allowing to confirm or to rule out the specificity of the antibody reaction in Neospora ELISA. Altogether, our findings demonstrate that N. caninum immunoblotting is a very sensitive and specific complementary tool to improve the serology for N. caninum infections in cattle.

Abortion, Veterinary↗
PubMed1999

Follow-up of hepatitis C virus RNA in peripheral blood mononuclear cells during interferon therapy.

Mononuclear cells can be infected in vitro by hepatitis C virus and the viral RNA can be detected in mononuclear cells of chronically infected patients. It was suggested that the virus could persist in the mononuclear cells of some patients treated by interferon. The aim of this study was to follow the presence of viral RNA in the plasma and peripheral blood mononuclear cells of 16 chronically infected patients treated by alpha 2b interferon for 1 year. The RNA was detected by reverse transcription followed by nested PCR and quantified using the branched DNA method at regular intervals for at least one year. Before PCR, the mononuclear cells were treated by RNase and trypsin in order to eliminate the viral particles that could be stuck at the cell surface. Six patients were non responders and had persistent plasmatic viral RNA during the treatment. Two patients were good responders and had persistently negative PCR in both plasma and mononuclear cells. Eight patients had initial negativation of plasmatic hepatitis C virus RNA but showed a relapse characterized by positive plasmatic PCR. Positive PCR in mononuclear cells despite negativity of plasmatic PCR was noted 18 times in 8 patients. Persistently positive PCR in mononuclear cells in absence of detectable viraemia was followed by a virological relapse in 5 of these patients. This study confirms that hepatitis C virus RNA can be detected in mononuclear cells despite negative plasmatic PCR in patients treated by interferon. Moreover, the persistence of viral RNA in peripheral mononuclear cells could be a predictive factor of treatment failure. Our data also suggest that detection of viral RNA in mononuclear cells is probably not only due to passive virus adsorption from plasma.

Adult↗
PubMed2002

Bacteriological conversion in twenty urinary tuberculosis patients treated with ofloxacin, rifampin and isoniazid: a 10-year follow-up study.

Twenty patients with urinary tuberculosis were treated with ofloxacin (200 mg/day, 6 months), rifampin (600 mg/day, 3 months) and isoniazid (300 mg/day, 3 months) between 1989 and 1990. All patients were new cases, diagnosed by observation and/or isolation of Mycobacterium tuberculosis in one of the three morning urine samples. Bacteriological culture conversion (negativization) was assessed as a clinical guide of efficacy, comparing it, as the only parameter, against a control group (150 patients) with urinary tuberculosis who received conventional therapy. Bacteriological follow-up studies were performed in both groups monthly for 6 months, then again 6 months later and then every year for 10 years after completion of treatment. In the 20 patients, the initial culture was positive with over 100 colonies per culture (>50%); the smear was positive in 45% of the patients (most were 2+). All strains were susceptible to rifampin, isoniazid and ofloxacin. Two patients discontinued treatment. Beginning with the first month of treatment, the bacteriological conversion was 100%, 89.5% and 100% in the remaining controls. In the control group, which received conventional treatment, the conversion was: 90%, 87%, 93% and 100% in the remaining controls. Treatment with ofloxacin resulted in a bacteriological conversion similar to that following conventional treatment ( p>0.05, Fisher's exact test). After 10 years of patient follow-up, we conclude that ofloxacin, in combination with rifampin and isoniazid (both for 3 months only is effective against M. tuberculosis, providing satisfactory bacteriological and clinical efficacy.

Adult↗
PubMed1984

Evaluation of a computerized drug review system: impact, attitudes, and interactions.

A study was carried out across 11 psychiatric and mental retardation, and developmental disabilities facilities to investigate the impact of a computerized drug prescription monitoring system on clinicians' prescribing behavior, knowledge of pharmacotherapy, attitudes toward computers, and the relationships between their attitudes and changes in their prescribing practices. The results document that surveillance systems can improve prescribing practices. The tangible feedback provided by the exception report, although in the form of a surveillance mechanism, also increased user acceptance to computer technology. However, the findings also suggest that user acceptance is not necessarily required to see positive effects, which in environments where clinical and fiscal accountability are paramount, may override some clinicians' concerns. Attention to human factors components may help to alleviate some negativism.

Attitude↗
PubMed1994

A long-term follow-up study of asymptomatic hepatitis B surface antigen-positive carriers in Montreal.

BACKGROUND/AIMS: Prospective studies from the Far East and Alaska have shown an increased mortality from cirrhosis and/or hepatocellular carcinoma in asymptomatic hepatitis B virus (HBV) carriers. The magnitude of this risk in apparently healthy North American carriers remains undefined. METHODS: The outcomes of 317 asymptomatic hepatitis B surface antigen-positive carriers from the Montreal area were examined after 16 years of follow-up. A majority of carriers were of French Canadian origin, were positive for antibody to hepatitis B e antigen, and had normal serum transaminase levels; institutionalization in orphanages as infants or children was the most important epidemiological risk factor, suggesting horizontal transmission of HBV during childhood. RESULTS: At follow-up, mean age was 46 +/- 8 years; 3 carriers had died of HBV-related cirrhosis, 1 of alcoholic cirrhosis, and 9 of causes unrelated to liver disease. No carrier died of hepatocellular carcinoma; had the risk of hepatocellular carcinoma been similar to that reported from the Far East and Alaska, 17 cases of hepatocellular carcinoma-related deaths would have been expected. During follow-up, the annual negativation rate for hepatitis B surface antigen was 0.7%. CONCLUSIONS: In asymptomatic HBV carriers from Montreal, a majority are "healthy" carriers and remain asymptomatic after 16 years of follow-up and the risk of death from HBV-related cirrhosis and/or hepatocellular carcinoma is low.

Adult↗
PubMed1988

Somatization, paranoia, and language.

Somatization and paranoia are circumscribed distortions of reality that are impervious to the normative process of consensual validation. These distortions are often postulated as a means of bolstering lowered self-esteem. We used computerized content analysis of the free speech of patients with these disorders in order to identify and compare dimensions of self-concept reflected in their lexical choices. Interestingly, patients with these disorders differed in the themes prominent in their speech. The higher frequency categories used by the somatization disorder group conveyed an overwhelming sense of negativism, distress, and a preoccupation with an uncertain self-identity. In contrast, the categories used by the paranoid patients portrayed an artificially positive, grandiose self-image and a defensive abstractness. Our exploratory analysis suggests that circumscribed distortions of reality in somatization and paranoid disorders are not associated with the same common defensive style attempting to bolster self-esteem.

Adult↗
PubMed1988

The preschool child: developmental themes and clinical issues.

The preschool years are a remarkable period of dramatic growth in the areas of physical, affective, and cognitive development. Physical development is characterized by a slow but steady rate of somatic growth and the mastery of motor skills that facilitate the child's achievement of autonomy and independence. Major themes in affective development include the achievement of autonomy and independence from family, a lessening of attachment to parents and the alleviation of separation anxiety, and the acquisition of impulse control and socialization skills. Cognitive development during the so-called preoperational period is best characterized by the mastery of language. The remarkable developmental gains achieved during this dynamic period culminate in a child who can function independently and competently and begin the major occupation of childhood--attending school. Health maintenance issues during the preschool years directly reflect the child's developmental stage. For example, nutritional issues reflect not only physical growth and motor skills, but also negativism and the child's struggle to achieve autonomy. Similarly, safety and injury prevention related to the "motor-minded" behavior so characteristic of children at this age, as well as the illogical, egocentric thought that predominates during this period of cognitive development. Examples of other stage-related issues addressed during health maintenance visits include discipline and behavior problems, sleep problems and night awakening, and toilet training. The unique aspects of development during the preschool years also have implications for other components of child health maintenance, including developmental screening, procedures and immunizations, and physical assessment. A number of clinical issues are of special significance during the preschool years. For example, the most common causes of children's short stature, constitutional delay in growth and familial short stature, may result in major parental concerns at this time. Recurrent otitis media is an important problem during this period of language acquisition. Among preschool children with urinary tract infections, the risk of an underlying structural anomaly of the urinary tract and the danger of irreversible renal damage is greater than for older children.(ABSTRACT TRUNCATED AT 400 WORDS)

Age Factors↗
PubMed1987

Seven deadly sins of childhood: advising parents about difficult developmental phases.

Seven of the more difficult developmental phases for any parent to deal with are colic, awakening at night, separation anxiety, normal exploratory behavior, normal negativism, normal poor appetite, and toilet training resistance. For the child living in a high-risk family, these innocent acts can trigger dangerous or even deadly abuse. The two behaviors most commonly associated with fatal abuse are colic and toilet training. When we recognize a child who is going through a provocative phase, we should be prepared to advise the parents on some practical alternatives to a physical response. Such advice is welcomed by most types of families. Any treatment plan for an abusive family that fails to include this type of problem solving may be inadequate.

Anxiety, Separation↗
PubMed1993

ECT in the treatment of the catatonic syndrome.

OBJECTIVE: To determine the efficacy of ECT in the treatment of the catatonic syndrome and to identify predictors of good response. METHOD: 28 cases of catatonia in 22 patients admitted to a psychiatry or medical psychiatry inpatient unit between January 1989 and June 1992 were retrospectively evaluated. Cases were included if they met criteria for catatonia as described by Kahlbaum, i.e., 4 or more signs including immobility, mutism, withdrawal, staring, rigidity, posturing/gimacing, negativism, waxy flexibility, echo phenomena, stereotypy, and verbigeration. Primary diagnoses were: Major Depressive Disorder (8), Bipolar Affective Disorder (5), schizophrenia (5), schizoaffective disorder (2) and organic mental disorder (2). Mean age was 54.5 years; sex ratio was 15 females to 7 males. Patients received a mean of 12.0 treatments with mean seizure duration 50.9 s (by EEG) per treatment. RESULTS: By Kahlbaum criteria, resolution of the catatonic syndrome occurred in 26 out of 28 cases (93%). The mean number of signs present per patient prior to ECT was 5.6 versus 0.93 following ECT (p = 0.00001). Overall, ECT brought about resolution of 83.5% of all symptoms with 98% resolution of primary symptoms and 74% resolution of secondary symptoms. CONCLUSIONS: ECT is an effective treatment of the catatonic syndrome. ECT is effective in the resolution of both cardinal (primary) and secondary signs of catatonia. In this study, there is not a statistically significant difference in the effectiveness of the resolution of catatonic symptoms in persons with affective disorder versus schizophrenia.

Adult↗
PubMed1984

Informed consent as a source of bias in clinical research.

Clinical observation suggested that schizophrenic patients more often refused to participate in experiments. In two studies psychiatric patient volunteers and nonvolunteers were compared on discharge diagnoses (psychiatric and medical), medication given, demographic measures, and hospitalization characteristics. In each study, patients with paranoid schizophrenia were more likely to refuse participation. Also, in each study, volunteers received more benzodiazepines and more nonpsychiatric medication. The latter difference could not be explained on the bases of rated severity of or probability of drug use in diagnosed medical illnesses, or number of medical illnesses. Characteristics of schizophrenic patients such as suspiciousness, negativism, and ambivalence were suggested as possible sources of their refusal to participate. Nonvolunteers were suggested to be less agreeable and compliant in general, and perhaps less likable, possibly explaining their receiving fewer benzodiazepines and nonpsychiatric medications. Attempts to characterize and correct the volunteer bias should be made, including offering tangible reward.

Benzodiazepines↗
PubMed1989

Interferon antibodies in patients with chronic HBV infection treated with recombinant interferon.

In different trials, a total of 46 adults and 12 children suffering from chronic hepatitis B virus (HBV) and who were HBV-DNA- and HBeAg-positive were treated with recombinant interferon-alpha (rIFN alpha)-2A. The interferon was administered intramuscularly in different doses ranging from 1.5 MU to 20 MU/m2 of body surface, two or three times weekly during 4-6 months. Specific detection of anti-IFN antibodies by enzymoimmunoassay (EIA), radioimmunoassay (RIA) and biological assays during treatment and follow-up periods were performed. None of the children developed anti-IFN antibodies. During therapy, 12 adult patients (26%) were found to have anti-IFN antibodies. A total of five patients became HBV-DNA-negative during therapy, but in three cases a reactivation of viral replication occurred subsequently. In these three patients, the appearance of anti-IFN antibodies occurred prior to or at the same time as HBV-DNA loss. The other seven patients did not respond to therapy. In conclusion, the development of anti-IFN antibodies during rIFN alpha treatment of chronic hepatitis B may modify the response to therapy, especially if they appear before HBV-DNA negativization.

Adolescent↗
PubMed1989

Is psychotherapy mandatory during the acute refeeding period in the treatment of anorexia nervosa?

Forty-five adolescent and preadolescent patients (42 females, three males) with anorexia nervosa (AN) were treated in a pediatric day care unit of a large urban hospital by a multidisciplinary team. In our treatment model, the pediatrician has the responsibility for the initial evaluation and physical rehabilitation while the pediatric psychiatrist does the initial evaluation of the patient and family and is available for intervention in an emergency. Parents are actively involved in the treatment program. Family psychotherapy is recommended for each patient and his or her family. Among 45 patients, 24 did not enter psychotherapy during the first 2 months of the refeeding period, while the remaining 21 patients started psychotherapy (family and/or individual) during this period. Weight gain was higher in the group without formal psychotherapy during the initial period of refeeding (7.3 +/- 3.1 kg versus 5 +/- 2.5 kg; p less than 0.01). It is suggested that the initiation of structured psychotherapy is not mandatory and does not contribute to treatment effectiveness in the acute phase when emaciation and negativism may hinder the psychotherapeutic process. We believe a multidisciplinary team, together with the parents, is the treatment of choice during the acute phase of AN.

Adolescent↗
PubMed1991

Changes: the Delphi technique adapted for classroom evaluation of clinical placements.

Too frequently during the post-allocation evaluation of clinical areas, some student psychiatric nurses displayed varying degrees of negativism towards or lack of involvement with the clinical area. The design of a classroom exercise 'Changes' was an attempt to overcome these undesirable features. The exercise was an adaptation of the Delphi technique and involved the student nurses in identifying changes that they would wish to make if returning to the clinical areas. Some simple manipulation of the ideas generated allowed a group consensus to be achieved. On closer inspection an additional interesting aspect of the suggestions was the large proportion of desirable changes that could be achieved with no financial implications. Alternatively changes in attitudes or work practices were implicated. Having achieved the original intention and moreover, generated suggestions for potential improvements it was decided to retain and repeat the exercise with future groups of student nurses. A similar pattern was obtained. Finally, the results were presented to representatives of the clinical areas and the technique along with facilitation time, offered to and accepted by ward managers as a means of quickly identifying ward team priorities, and generating ideas for improving their areas.

Attitude of Health Personnel↗