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At least 1,549 records · Page 86Linked to original sources
PubMedDate not supplied

[Neuropsychological disorders in Parkinson's disease: evaluating them and their impact on the caregiver].

INTRODUCTION: There are no specific scales for evaluating the broad profile of potentially relevant neuropsychological disorders associated to Parkinson's disease. Moreover, the information about their impact on the quality of life of caregivers (QLC) is scarce. OBJECTIVES: This study outlines a model of a practical questionnaire developed to evaluate the neuropsychological disorders in Parkinson's disease and how to apply it to determine the effect they have on the QLC. PATIENTS AND METHODS: A study was performed in two phases: 1. The application of a list of items from several scales used for neuropsychological disorders; 2. After selecting and reducing the number of items by means of psychometric methods, they were applied to a sample of patients. At the same time, using the data obtained from the above mentioned procedure, the impact of the neuropsychological disorders on the QLC was evaluated with the Glozman scale. RESULT: In Parkinson's disease some neuropsychological disorders are relatively frequent, unlike those observed in a control group (either because of their frequency or their intensity) and are significantly associated to other aspects of the disease. There was an overall deterioration of the QLC and this worsened significantly as PD progressed and the disability of the patient increased. With respect to the neuropsychological disorders, verbal communication (rS = -0.59), cognitive behavioural mental status (rS = -0.54) and depression (rS = -0.41) (p < 0.001) were the domains significantly linked to deterioration of the QLC. CONCLUSIONS: The QLC of patients with Parkinson's disease is decreased and is correlated with the extent of the patient's motor disorders, functional status and neuropsychological disorders.

Aged↗
PubMed2001

Cognitive deficits due to asymmetrical bilateral thalamic lesions.

The cognitive deficits are described in a 20-year-old right-handed man with asymmetrical bilateral thalamic lesions and a lesion resulting in the 'locked-in' syndrome. Memory and intellectual assessment, modified due to the physical and communication difficulties, suggested that the patient had little impairment of verbal intelligence and performed normally on memory test involving immediate recall of new material. There was, however, considerable impairment of organization, planning and in the recall of visual and especially verbal memory, over longer periods. Remote memory was relatively intact, except for chronological errors in time-tagged material, and he was disoriented for year, month and day.

Adult↗
PubMed2006

Functional independence among young adults with spina bifida, in relation to hydrocephalus and level of lesion.

Knowledge about the level of functional independence that can be expected in adulthood might support decisions on the treatment of newborn infants with spina bifida. This study determined functional independence among young adults with spina bifida and its relationships with pathological characteristics known from birth (hydrocephalus and level of lesion). Data were collected from medical records and by physical examination. Functional independence was assessed on six domains (self-care, sphincter control, transfers, locomotion, communication, and social cognition) using the Functional Independence Measure (FIM). Participants were 165 patients with spina bifida (69 males, 96 females; age range 16 to 25y, mean 20y 9mo [SD 2.9]; 117 with hydrocephalus). Patients without hydrocephalus were independent for all FIM domains except sphincter control, as were patients with hydrocephalus with a lesion level below L2. Most patients with hydrocephalus and a lesion at L2 or above were dependent as regards sphincter control (98%), locomotion (79%), and self-care (54%), and quite a few needed support in transfers (38%), social cognition (29%), and communication (15%).

Activities of Daily Living↗
PubMed1985

Psychiatric disorders in geriatric medical/surgical patients. Part II: Review of clinical experience in consultation.

Of a consecutive series of 1,000 psychiatric consultation requests, 195 were for patients 60 years of age or older. The most frequent psychiatric diagnoses assigned by the consultant were organic psychiatric and depressive spectrum disorders. This communication reviews frequently encountered syndromes and the other major clinical issues relevant to geriatric psychiatry and provides illustrative cases. The mental status examination is a sensitive diagnostic tool that can improve the clinician's diagnostic skills. We conclude that screening the elderly medically ill patient for these psychiatric disorders will improve patient care and significantly diminish morbidity.

Age Factors↗
PubMed1985

Reducing behavior problems through functional communication training.

It is generally agreed that serious misbehavior in children should be replaced with socially appropriate behaviors, but few guidelines exist with respect to choosing replacement behaviors. We address this issue in two experiments. In Experiment 1, we developed an assessment method for identifying situations in which behavior problems, including aggression, tantrums, and self-injury, were most likely to occur. Results demonstrated that both low level of adult attention and high level of task difficulty were discriminative for misbehavior. In Experiment 2, the assessment data were used to select replacements for misbehavior. Specifically, children were taught to solicit attention or assistance or both verbally from adults. This treatment, which involved the differential reinforcement of functional communication, produced replicable suppression of behavior problems across four developmentally disabled children. The results were consistent with an hypothesis stating that some child behavior problems may be viewed as a nonverbal means of communication. According to this hypothesis, behavior problems and verbal communicative acts, though differing in form, may be equivalent in function. Therefore, strengthening the latter should weaken the former.

Adolescent↗
PubMedDate not supplied

Communicating risk in prenatal genetic testing.

Prenatal testing for Down syndrome and neural tube defects has become routine, and testing for other genetic conditions is becoming commonplace. Counseling about these tests involves a discussion of risk information, so pregnant women and their partners can use the information effectively when they make choices about testing. Discussing risk can be challenging, as many individuals, particularly those of lower literacy, have a poor understanding of the numerical concept of risk. Furthermore, whether risk is comprehended accurately or not, it is interpreted by patients in light of their existing knowledge and past experiences. Strategies available to optimize understanding of risk include communication of risk figures as frequencies rather than as probabilities or percentages and explicit discussion of a woman's preconceptions about her risk and about the condition being tested for.

Chromosome Disorders↗
PubMed1977

Family sequelae after a child's death due to cancer.

In a small study assessing the psychologic sequelae on disadvantaged families after a child's death from cancer, a high incidence of psychologic problems was found. The implication is that the coping mechanisms failed partially as a result of inadequate anticipatory griefing.

Adaptation, Psychological↗
PubMed1998

Central auditory processing in a patient with bilateral temporal lobe tumors: case report.

The purpose of this article is to report the audiologic and central auditory processing abilities of a 34-year-old male with a right temporal lobe tumor and a history of bilateral tumors of the temporal lobes. The patient was evaluated presurgical re-exploration and again at 2.5 months and 4 months postoperatively. Test results demonstrated little change in peripheral hearing abilities; however, marked fluctuations were recorded on several tests administered postoperatively. Overall, this patient demonstrated a wide range of performance on tests of central auditory function, notably scores that decreased postoperatively and returned to better than baseline on the SCAN-A and repeated abnormal scores on the Pitch Pattern Sequence Test and the Symbol Digit Modality Test. Auditory Fusion Test-Revised results were initially normal, were markedly abnormal immediately postoperative, and returned to normal during the second postoperative visit. Our purpose in conducting this case study was to demonstrate, with central auditory processing test findings as well as magnetic resonance images, functional disorders of communication in a pre- and postoperative patient with a temporal lobe tumor.

Adult↗
PubMed2003

[Comparative evaluation of speech disorders and verbal and non verbal communication within two groups of patients: patients with facial paralysis (FP) and those who had undergone hypoglosso-facial anastomosis (HFA)].

INTRODUCTION: Speech disorders were often allotted to hypoglossal-facial anastomosis (HFA) without being clearly shown. We have compared patients with a peripheral facial paralysis at those with HFA. AIMS OF THE STUDY: Retrospective study comparing verbal communication (articulation) and non-verbal within two groups of patients: patients with patient FP versus with HFA. PATIENTS AND METHODS: 10 patients with idiopathic FP versus 7 patients with HFA took part in this study. The series of tests includes an evaluation of the motor possibilities, bilabial pressure measurement (for the patients with FP), speech capacities and finally an evaluation of the verbal and non-verbal communication from a scale of satisfaction. RESULTS: The results highlight: the presence of real speech disorders (permanent) among patients with FP and their absence among patients having profited from HFA; a real satisfaction of the HFA versus FP on the quality of life compared to daily tasks, more specifically concerning verbal and food skills. CONCLUSION: The HFA is not responsible for speech disorders, and makes undeniable improvements confirmed subsequently by the patients.

Anastomosis, Surgical↗
PubMedDate not supplied

[Care of a patient with leptospirosis icterohemorrhagica].

Leptospirosis is an acute generalized infectious disease caused by a spirochete of the genus Leptospira. Humans become infected by direct contact with the animal reservoir or indirectly through standing water or contaminated wet areas; once the leptospira has entered the body through the mucosa or eroded skin, it is spread by blood circulation. It can cause hepatic, renal and muscular disorders, as well as meningeal inflammation. We report the case of a patient admitted to the ICU for an infectious process produced by leptospira. Complications are described and identified as nursing problems and/or diagnoses. Following the NANDA nomenclature, the diagnoses were: Tissue-perfusion disturbance. Deterioration of gas exchange. Deterioration of verbal communication. Nutritional disorder. These categories enabled specific nursing interventions to be planned for the patient's care. The patient died of multiple organ failure in spite of conventional care and treatment.

Acute Disease↗
PubMed1993

Some reflections on humour in psychoanalysis.

This article proposes that for humour to be effective as a therapeutic intervention in psychoanalytic treatment, it must approximate an affect releasing and growth promoting interpretation. The presence and psychological significance of surprise, which is common to both wit and 'good' interpretations, is taken as the point of departure and the importance of the psychoanalyst's spontaneity is discussed in relation to this. The author explains his opposition to the use of humour as a contrived communication: as a parameter aimed at reviving a dying analysis or as an attempt to resolve an impasse. In particular the dangers of countertransference acting out the provision of transference gratifications are explored. Equal emphasis is placed on recommending that the analysis of a patient's humorous responses should not be neglected and how an analyst without humour may negatively affect the treatment process. The paper includes clinical vignettes which illustrate the constructive and creative use of humour in the analytic situation.

Borderline Personality Disorder↗
PubMed1995

Linguistic reference performance in parents of schizophrenic patients.

Clinicians have often reported observing subtle signs of thought disorder or communication difficulties in parents of schizophrenic patients. Ascertaining empirically whether these impressions are valid and, if so, clarifying the nature of such disturbances is important for at least two reasons. First, it could assist in elucidating the etiologies of the illness. If distinguishing parental characteristics could be clearly defined, then further research could be undertaken to determine to what extent they represent genetic vulnerability markers, pathogenic environmental influences, or behavioral responses to having a disordered offspring. Secondly, it could facilitate our understanding of the cognitive processes involved in schizophrenia or in the constitutional vulnerability to schizophrenia.

Adult↗
PubMed2005

Understanding of an aggregate probability statement by patients who are offered participation in Phase I clinical trials.

BACKGROUND: There is concern that patients with poor numeracy may have difficulty understanding the information necessary to make informed treatment decisions. The authors sought to characterize a special form of numeracy among patients with advanced cancer who were offered participation in Phase I oncology clinical trials. METHODS: Surveys were administered to 328 cancer patients who were considering Phase I trials. Their frequency-type numeracy was assessed using a multiple-choice question involving a hypothetical scenario in which a physician stated that an experimental treatment would control cancer in "40% of cases like yours." In univariate and multivariable analyses, patient characteristics that were associated with better numeracy were identified. RESULTS: The correct frequency-type interpretation was selected by 72% of respondents. Fourteen percent of respondents incorrectly selected a belief-type answer, "The doctor is 40% confident that the treatment will control my cancer." In a multivariable model, patients who answered incorrectly tended to have less formal education and less experience with experimental therapies. CONCLUSIONS: Because the misunderstandings some patients demonstrated may influence their treatment decision making adversely, it is critical to identify such patients and to give them special consideration when communicating information about potential risks and benefits of treatment.

Adult↗
PubMed1994

Building structure for the borderline construct.

This article overviews the development of the borderline personality disorder construct. In the past 25 years, the borderline personality diagnosis has grown remarkably in clinical usage even as its construct has undergone dramatic shifts in the process. It originated as a type of intrapsychic personality organization that reflected psychoanalytic observations and the hope for long-term curative therapies. It was transformed by descriptive observations into a syndrome whose boundaries with first schizophrenia and then affective disorders became the subject of intense study. More recently, it is recognized as a specific type of personality disorder that communicates substantial information about pathogenesis and that helps guide clinical planning and prognostication. The context dependency of the borderline patient's presentation explains why the diagnosis can often elude recognition.

Borderline Personality Disorder↗
PubMed1980

Experimentally produced child uncontrollability: effects on the potency of adult communication patterns.

This study was concerned with the effects of child controllability on adult assertiveness, as moderated by adult control perceptions. 4 boys (aged 7--9), trained to be responsive or unresponsive, interacted in adult-child dyads on a toy construction task with 32 women. As predicted, adult locus of control moderated the effects of child behavior. Child unresponsiveness produced an effect on adult behavior only among adults with low control perceptions ("externals"). With unresponsive children, external adults had relatively less assertive voice intonation during their statements of verbal approval and disapproval than during neutral statements (typically consisting of task directions). This pattern replicated previous observation of the communication of mothers with their own unresponsive children. For all other adult-child groupings, voice assertion was higher during affective messages than during neutral messages.

Adult↗