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PubMedDate not supplied

The delusions of Capgras and intermetamorphosis in a patient with right-hemisphere white-matter pathology.

Previous neuropsychological studies have demonstrated an association between person misidentification and right-hemisphere dysfunction. In the study reported here, we explore the contribution of facial and visual recognition impairments in a patient with right-hemisphere subcortical white-matter pathology in the frontal and parietal lobes and a diagnosis of vascular cognitive impairment. The patient displayed false recognition of unfamiliar faces and deficient retrieval of key biographic detail for famous faces. These results are discussed in the context of the contribution of deficiencies in the visual system and subcortical white-matter lesions to the development of Capgras delusion.

Basal Ganglia↗

PubMed1980

Application of an immunoenzymatic method and an immunoautoradiographic method for a mass survey of nasopharyngeal carcinoma.

The frequency of IgA antibody to virus capsid antigen (VCA) of EB virus was tested by an immunoenzymatic method among adults in a mass serological screening of the general population of 6 communes in South China, as a guide toward early detection of nasopharyngeal carcinoma. Sera from 56 patients already recognized as having nasopharyngeal carcinoma (NPC) also were tested. The screening was conducted with sera from 56,584 persons age 30 years and older in Zangwu County in the Guangsi Zhuang Autonomous Region. IgA antibody to VCA was found in 96% of the NPC patients tested; the geometric mean antibody titer for this group was 1:41. The antibody also was detected in 117 of the persons surveyed in the mass screening, and among these, the geometric mean antibody titer was 1:21. 20 of the antibody-positive persons were diagnosed by clinical and pathological examination as having NPC. 18 of these cases were diagnosed soon after the initial tests in June-September, 1978, and an additional 2 were diagnosed only after follow-up examinations 10 months after the first blood sample was taken. All of the persons who are in the antibody-positive group but exhibit no detectable tumors are to be reexamined periodically.

Adult↗

PubMed1977

[Methodical study of multifactorial prevention of ischemic heart disease].

The purpose of the investigation was to study the possibilities of involving the population at large in mass screening procedures, the possible classification of the population with regard the degree of risk of ischaemic heart disease, and the potentials of its preventive therapy. The examined contingent was classified with due regard to some risk factors (arterialy hypertension, hypercholesterolemia, imparied glucose tolerance) and pathological states. The final grouping of the contingent was as follows: the group of "normal" was comprised by 53.4% of the examined, the "intermediate"-18.6%, the "pathological"-28%. The "intermediate" group comprised 350 persons selected for preventive therapy by a double blind method. Surveillance of 10% of those in the "normal" group and the whole "pathological" group was arranged.

Age Factors↗

PubMed1988

Tympanometry as a screening test for treatable hearing loss in the elderly.

One hundred and fourteen adults with hearing loss, but without otorrhoea, were studied with the aim of establishing whether tympanometry could be used as a screening test to identify potentially treatable aural pathology. Tympanometry was compared with independent otoscopy. No middle ear pathology likely to be of significance in an elderly person was found in ears with a normal tympanogram. All ears with significant pathology gave an abnormal tympanogram, and in addition there was a false positive rate of 6.8%. We suggest that elderly patients with dry ears and a normal tympanogram could be fitted with a hearing aid without specialist otological examination.

Acoustic Impedance Tests↗

PubMedDate not supplied

Cause of death in persons aged between 15 and 50 years in the community of Stockholm. A forensic-pathologic and statistical study.

All deaths occurring in the age group 15-50 years in the community of Stockholm during the period November 1st 1979 to April 30th 1980 have been investigated. There were 272 deaths in total (males 176, females 96). The estimated annual death rate was in total 185/100,000 inhabitants (males 238, females 132). The autopsy rate was 82%. The deaths were divided in five main groups: 32 persons (12%) died from cardiovascular diseases, 60 persons (22%) from other natural diseases, 65 persons (25%) from conditions causally associated with exogenous influence (border line cases) such as abuse of alcohol, medicinal drugs and narcotics at sublethal concentrations. Violent deaths amounted to 108 cases (40%) and finally in 7 cases (3%) no plausible cause of death was proven. In 51 cases (19%) the underlying cause of death was attributed solely to chronic abuse of alcohol. Anamnestic information about abuse was available in 42% of all deaths. Deaths due to arteriosclerotic heart disease comprised a small group and were rare under the age of 45; about half of those were considered sudden and unexpected. The estimated annual rates of deaths due to coronary heart disease were 16.2/100,000 inhabitants for males and 1.4 for females. Difficulties were experienced in defining and delimiting the group of border line deaths due to exogenous influences.

Adolescent↗

PubMedDate not supplied

Exercise options for persons with diabetic complications.

Exercise is a cornerstone in the management of diabetes, yet many persons with diabetes fail to participate in basic physical activity due to secondary diabetic complications. This inactivity can lead to disuse syndrome--a deterioration of functional capacity. Disuse syndrome, coupled with diabetes, can produce significant physiological problems and further disability. This review provides the health educator with information about the pathology and role of exercise for persons with diabetic complications. Examples of exercise to minimize disuse syndrome are given for individuals with peripheral vascular disease, retinopathy, neuropathies, and nephropathy.

Diabetes Complications↗

PubMed2005

[Rational treatment of nasal polyposis].

Despite the therapeutical advances of the last decade, nasal polyposis represents still a problem for rhinology, practitioners. A number of hypotheses have been formulated about its etiopathogenesis, but no one is confirmed, so that nowadays therapy continues to be only symptomatic and does not cure definitively the underlying pathology. Recurrences are frequent and discourage both the practitioner and the patient. Purpose of this paper is to illustrate Authors' therapeutical rationale aimed to reestablish nasal flow, reduce rhinorrhea, improve olfaction, decrease rhinosinusinusal infection rate and maintain as long as possible such a symptomatic improvement. These targets are best achieved by a combination of medical and surgical treatments in order to optimize the results and reduce the side-effects of both the therapeutical options. Moreover the treatment should be tailored on each patient and follow up should be careful and performed at regular interval. Authors reviewed the clinical records of patients who underwent surgery for nasal polyposis between 2002 and 2004 at Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy, with a minimum follow-up of 12 months. All patients underwent the complete set of diagnostic work-up. The choice between surgical or medical options was based on both the kind of the polyposis and the staging of the pathology. The therapy was as more "personalized" as possible, but a homogeneity of treatment was maintained. The results show that a correct "staging" of the patient allows an appropriate therapy and reduces recurrence rate. In conclusion, authors report their experience and propose a scheme of diagnostic work-up in order to define grading/staging of the pathology and establish a "tailored" therapeutic protocol aimed to control a pathology which is rarely definitively treated.

Adolescent↗

PubMedDate not supplied

[Significance of fever following a trip to a tropical region].

Fever occurring during or after a period of time spent in a tropical area is an important element for both patient and the doctor attending him and having to cope with a varied differential diagnosis. First of all, it should be appreciated whether or not the case is an emergency, the admittance in the hospital being compulsory, or the case can be investigated in ambulatory. The differentiation between a "tropical fever" and a common one should be rapidly done, as certain tropical diseases have to be notified and isolation of the patient, identification of the new cases and contacts are recommended. A very carefully anamnesis, in order to define the place, period of time, the purpose of the travel, the specific chemoprophylactic measures, if other travellers have the same complaints should be done and a very good knowledge on the geography of parasitic and infectious diseases is required. Fever can be either acute or chronic. The clinical signs and symptoms accompanying the fever (rash, conjunctival chemosis, haemorrhages, flu like syndrome, jaundice, pulmonary signs, diarrhoea, hepatosplenomegaly, lymphadenopathy), will be considered in a context of a thorough differential diagnosis. The first choice laboratory investigations have to be completed with the specific ones and the quality of the laboratory, mainly in parasitology is essential. The first attitude, when the suspicion of tropical fever occurs, is to perform a systematic evaluation for malaria diagnosis. Travel medicine advice becomes indispensable and, if it is performed by a qualified person, it is very efficient. The recommendations have to take into account the purpose of the travel, the age, immune status and associated pathology of the subject, being adapted and personalized.

Acute Disease↗

PubMed2003

Crisis and connection.

Psychiatric interventions for crisis care lie at the center of the conflict between involuntary commitment and recovery/wellness systems in mental health services. Though crisis can mean completely different things to people who have the experience, the general public has been convinced by the media that people with psychiatric disabilities are to be feared. More and more this has led to social control but is erroneously still called treatment. This does nothing to help the person and in fact further confuses people already trying to make meaning of their experience. This paper offers a fundamental change in understanding and working with people in psychiatric crises. Rather than objectifying and naming the crisis experience in relation to illness, people can begin to explore the subjective experience of the person in crisis while offering their own subjective reality to the relationship. Out of this shared dynamic in which a greater sense of trust is built, the crisis can be an opportunity to create new meaning, and offer people mutually respectful relationships in which extreme emotional distress no longer has to be pathologized. The authors, who have had personal experience with psychiatric crises, have provided this kind of successful crisis counseling and planning and have designed and implemented peer support alternatives to psychiatric hospitalizations that support this model.

Crisis Intervention↗

PubMed1989

Construction of the diagnostic encyclopedia workstation. Computerizing pathology for the pathologist.

The combination of a personal computer and a laser-vision disc player is an adroit tool for storing and retrieving textual information in combination with pictorial information. This paper describes such a system (a "diagnostic encyclopedia workstation"), which provides information to the pathologist engaged in daily diagnostic practice. The system contains a considerable amount of descriptive textual information that might be useful in making diagnoses in histopathology, along with many illustrations; the text is presented in a natural language (English). The descriptive information is divided into 18 categories, including such topics as histology, macroscopy, immunopathology and clinical data; each topic has a separate display in the system. Also present are two types of "decision rules" for making diagnoses (confirmative criteria for a diagnosis under consideration and exclusive criteria for many other diagnoses) and a classifying structure. The present version of this system contains information on about 100 diagnoses in ovarian pathology, illustrated with about 3,000 color slides from about 140 cases. The information and pictures are immediately available. Further characteristics of this system are its flexibility, accessibility and user friendliness; it has been structured so that components of artificial intelligence may be added later.

Artificial Intelligence↗

PubMed1982

The effect of mental retardation and schizophrenia on information processing.

Research Diagnostic Criteria-diagnosed schizophrenic persons with average intelligence and dual diagnosis mentally retarded schizophrenic persons were tested in a forced-choice letter discrimination task in order to examine the relationship between schizophrenia and retardation from the standpoint of information-processing theory. The subjects consisted of eight schizophrenic persons of average or better intelligence, eight mentally retarded schizophrenic persons, and a control group of eight Research Diagnostic Criteria-diagnosed minor depressive individuals who were matched with the nonretarded schizophrenic group for intelligence. The groups did not differ significantly on the minimum exposure duration needed to identify an unmasked target stimulus at criterion levels of accuracy. When masked stimuli were employed, however, the depressive group obtained significantly more correct detections than both schizophrenic groups. More importantly, the performance of the two schizophrenic groups did not differ significantly. Our data indicated that schizophrenic deficits in information processing are independent of intellectual factors. Thus, vulnerability to a masking stimulus in schizophrenic persons can be attributed to the pathology of schizophrenia. This vulnerability indicates that schizophrenic patients are slow information processors.

Adult↗

PubMed1998

Axis II symptomatology, depression, and life stress during the transition from adolescence to adulthood.

This study examined 2 models of the relationship between personality disorder symptomatology and depression, incorporating life stress as an intervening variable. In a community sample of late adolescent women, symptoms of Cluster B disorders predicted interpersonal chronic stress and self-generated episodic stress over 2 years, controlling for initial depression. Cluster A symptoms also predicted subsequent chronic interpersonal stress, over initial depression. Cluster C pathology did not predict subsequent stress. Personality disorder symptomatology was also associated with partner-reported relationship dissatisfaction. Support was found for a mediation model whereby women with higher levels of initial personality disturbance in Clusters A and B generated excessive amounts of episodic stress and interpersonal chronic stress in the next 2 years, which, in turn, increased vulnerability for depressive symptoms. A moderation model, whereby the presence of greater personality disorder symptoms would increase the likelihood of depression in response to stress, was not supported.

Adolescent↗

PubMed2001

Gastro-Oesophageal reflux in the elderly: role of drug therapy in management.

Gastro-oesophageal reflux disease (GORD) is common in the elderly. The presenting symptoms of heartburn and regurgitation, so common in the young, are less frequent in the elderly. Common symptoms of GORD in the elderly are dysphagia, vomiting and respiratory problems. Because of the higher risk of associated pathological oesophageal lesions in the older person presenting with symptoms suggestive of GORD, oesophagogastroduodenoscopy must be performed earlier in their clinical course. There is only a poor correlation between the severity of the symptoms and the severity of the associated oesophagitis. Whereas lifestyle modifications are important in individuals with GORD, the use of proton pump inhibitors is recommended to heal the underlying pathology, to resolve the patient's symptoms, to prevent complications, and to improve the quality of life.

Age Factors↗

PubMed2006

Critical values in anatomic pathology.

Similar to critical values (CVs) in clinical pathology, occasional diagnoses in surgical pathology and cytology could require immediate notification of the physician to rapidly initiate treatment. However, there are no established CV guidelines in anatomic pathology. A retrospective review of surgical pathology reports was recently conducted to study the incidence of CVs in surgical pathology and to survey the perceptions of pathologists and clinicians about CVs in surgical pathology, with a similar analysis of CVs performed in cytology. The results indicated that CVs in surgical pathology and cytology are uncommon but not rare and that there is a wide range of opinion among pathologists and between pathologists and clinicians about the need for an immediate telephone call and about the degree of urgency. It was obvious from the study that there is a lack of consensus in identifying what constitutes surgical pathology and cytology CV cases. Since the Institute of Medicine's report on medical errors, there has been an increasing number of initiatives to improve patient safety. Having guidelines for anatomic pathology CVs could enhance patient safety, in contrast to the current practice in which CV cases are managed based on common sense and on personal experience. Therefore, a discussion involving the pathology community might prove useful in an attempt to establish anatomic pathology CV guidelines that could represent a practice improvement.

Diagnostic Errors↗

PubMed1976

[Treatment of hydatid cysts of the liver perforated into the intrahepatic bile ducts].

After recalling the latest finding on the pathological anatomy, physiopathology, symptomatology, diagnosis and surgical therapy of hepatic echinococcus with intrahepatic bile duct fistulas, the personal series and that of the Palermo Surgical Pathology School is illustrated. These series included 12 patients. The surgery employed is analysed and results obtained reported. It is concluded that modern diagnostic methods, particularly intraoperatory, the new radical surgery techniques, and the improved post-operative assistance offer better chances of success in this condition, reducing both mortality and postoperative complications.

Bile Ducts, Intrahepatic↗

PubMed1981

[Possible correlations between kidney movement and hypertension (author's transl)].

The authors report the first data relating to their research carried out with the intention of showing the possible correlations between pathological kidney movement and so-called essential hypertension. The study of the kidneys has been carried out with 99mTc-DMSA, using multiple projections both in upright and prone positions. Furthermore, the appropriate renogram has been carried out for each patient. In the light of the obtained data the AA. point that in the majority of hypertensive patients personally examined (80.5%) there was a pathological renal movement, most often bilateral (22%) or affecting the right kidney (17.1%), with which variations were often associated, especially in the second stage of the renograph. The authors underline the importance of this type of investigation, which will be further extended by the associated use of 99mTc-Ca-Glucoheptonate.

Humans↗

PubMed1988

A comparison of clinical and pathological features of young- and old-onset Parkinson's disease.

We compared 46 patients having onset of Parkinson's disease before age 45 years with 52 having onset after age 70. Young-onset cases more often presented with muscular stiffness (43%) and old-onset with difficulty walking (33%). One-third of young-onset cases had off-period dystonia, mostly affecting the legs, but no dystonia was recorded in old-onset cases. Presentation with rest tremor occurred in 41% of young-onset and 63% of old-onset. There were no differences in the number of affected relatives, endocrine disease, personality characteristics, dementia, or dyskinesia. A pathological study of 12 young-onset and 22 old-onset cases showed 24% greater nigral cell loss in the young, but no differences in the basic Lewy body pathology. Median disease duration in young cases was 5 years longer in the clinical study and 12 years longer in the pathological study. These studies show that the Parkinson's disease process is similar in young- and old-onset cases.

Adult↗

PubMed2003

[Hyperparathyroidism associated with thyroid disease. Retrospective study of 15 patients treated in 11 years].

The association of hyperparathyroidism with thyroid pathology previous to surgery is not very frequent in our cases, almost a 15%, but it means another difficulty for the diagnostic and treatment. Between 1991 and 2001 we have studied and operated 15 patients with this clinic association. 14 were female and only 1 male with a range age of 59 years old. We studied the type of hyperparathyroidism, personal history, clinic, type of thyroid pathology associated, complementary explorations, type of surgery, anatomopathology evolution, and hospital stay. We have done 12 adenoma resections, 1 subtotal parathyroidectomy, 2 total thyroidectomies and 5 hemithyroidectomies. Only in one patient the anatomopathology was informed as a thyroid carcinoma associated to a parathyroid adenoma, being the other patients benign pathologies. We did literaturer revision on this association. We believe that in all patients with a thyroid pathology we should an associated hyperparathyroidism and vice versa.

Adult↗