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PubMed2002

Nutrition in the elderly.

It is now well accepted that older persons experience a physiologic anorexia, the anorexia of aging, which is caused by alterations in hedonic qualities of food, fundal compliance, and increased leptin levels. Depression is the most common pathologic cause of weight loss in older persons. Older persons fail to recognize thirst and as such have an increased risk of dehydration. Alterations in brain membrane fatty acids can lead to cognitive impairment in older persons.

Journal Article↗
PubMed2006

A retrospective of an unconventionally trained plant pathologist: plant diseases to molecular plant pathology.

Plant pathology evolved from its mycology-oriented origins into a science dealing with biochemical mechanisms of diseases, along with enhanced crop production through disease control. This retrospective describes first my personal experience from my introduction to plant pathology, to the establishment of the concept of accessibility as a model pertaining to genetically defined basic compatibility induced by pathogens. I then refer to the development of molecular plant pathology from physiological and biochemical plant pathology fostered by the growth in recombinant technology in the second half of the past century. This progress was best reflected by the U.S.-Japan Seminar Series held at 4-5-year intervals from 1966 to 2003 and documented by publications in major journals of our discipline. These seminars emphasized that progress in science has always been supported by the invention of novel techniques and that knowledge integrated from modern genomics and subsequent proteomics should contribute to the progress of basic life sciences and, more importantly, to the elaboration of rational measures for disease control.

History, 20th Century↗
PubMed2004

Attachment dimensions as predictors of medical hospitalizations in individuals with DSM IV cluster B personality disorders.

This study investigates predictors of health service utilization in individuals with cluster B personality disorders. We hypothesized an association of severity of psychopathology (that is, global psychosocial functioning and psychiatric comorbidity) and attachment style with the length of medical hospitalizations in this population. Forty-one female subjects were interviewed regarding their diagnoses, level of functioning and service utilization. Attachment style was assessed with a self-report questionnaire. Our findings indicate that degree of psychiatric comorbidity and level of psychosocial functioning do not predict length of hospital stays, whereas preoccupied attachment predicted 23.9% of the variance in the length of hospitalizations. We conclude that the quality of interpersonal relatedness appears to be a better predictor of health service use than severity of pathology in patients with cluster B personality disorders.

Adolescent↗
PubMed1996

[Street pathology].

Diseases of the homeless do not constitute a nosological list. Their nature depends rather on the conditions in which the homeless live, making them susceptible to various classical diseases. Many of these disorders have otherwise become infrequent and of little concern. The "medieval" nature and intrication of these diseases should not prejudice rational diagnosis and treatment, which in the end is rather simple. The homeless live alone. This solitude if often the factor that determines management decisions of the physician.

Diagnosis↗
PubMed1990

The functional dynamics of the narcissistic personality.

The majority of works on Narcissistic Personality Disorder analyze etiological, pathogenetic, structural, and/or clinical-diagnostic aspects of pathological narcissism. This article analyzes the functional dynamics of the narcissistic personality. More precisely, the author discusses the origin of chronically fragile (low) self-esteem of narcissistic personalities, as well as the uniquely narcissistic "way of life," which includes narcissistic mirroring in external objects and narcissistic object choice; the two maneuvers enable narcissistic persons to "confirm" their grandiose self-importance and significance in the external world. Next, stereotyped cycles (zest alternating with disappointment) that reflect narcissistic persons' futile attempts to feed their grandiose expectations, as well as pessimistic mood (characteristic emotional state of decompensated narcissistic persons) are discussed. The clinical features of Narcissistic Personality Disorder are systematized and presented in the framework of the accepted structural concept of this disorder at the end of the article.

Defense Mechanisms↗
PubMed2001

Trends in pathology graduate medical education.

Comprehensive data show trends in graduate medical education in pathology with regard to the numbers of accredited programs, persons certified from those programs, and demographics of the population of first year-trainees in pathology. Experience with US seniors and foreign-trained physicians in the PGY match process for pathology from 1991 through 2000 is presented, along with data on the types of medical schools generating pathology trainees for the PGY-1 year and the top medical schools of origin of US medical graduates who completed the program and became certified in pathology between 1995 and 1999. The impact of reimbursement of the credentialing year is also addressed through data collected from the PRODS Survey 2000, and those results are reviewed. Finally, turnover rates among pathology program directors of combined AP/CP programs and subspecialty programs since 1994 are presented. An analysis of these trends is provided, along with suggestions to improve both the perception of careers in pathology and the actual choice of a career in pathology.

Accreditation↗
PubMed1999

Dimensionality of parkinsonian signs in aging and Alzheimer's disease.

BACKGROUND: Parkinsonian signs are commonly found on the neurologic examination of older persons and are associated with morbidity and mortality. The extent to which parkinsonian signs in aging and Alzheimer's disease cluster in groups typical of Parkinson's disease has not been investigated previously. METHODS: The motor portion of the Unified Parkinson's Disease Rating Scale (UPDRS), or a version with minor modifications, was administered to more than 2,800 persons in three cohorts: (a) 637 older persons with a wide range of neurologic conditions participating in the Chicago Health and Aging Project, a study of common health problems of a random sample of older persons from a geographically defined biracial community population; (b) 638 relatively healthy and highly educated older persons from 25 Catholic religious communities participating in the Religious Orders Study, a longitudinal clinical-pathologic study of aging; and (c) 1,546 older persons undergoing evaluation for possible dementia at the Rush Alzheimer's Disease Center, an urban, tertiary care center that evaluates persons for possible dementia. Separate factor analyses were performed on each data set. Additional analyses examined the factor structure in subsets by gender and race. RESULTS: A similar grouping of items emerged in each cohort and did not differ substantially by gender or race. The factors corresponded closely with the traditional grouping of parkinsonian signs into bradykinesia, gait disturbance, rigidity, and tremor. CONCLUSIONS: The grouping of parkinsonian signs is consistent in diverse samples of older persons and does not vary substantially across gender or race. The results provide an empirical basis for summarizing the principal motoric manifestations of parkinsonism.

Aged↗
PubMed1977

Progress in the treatment of acute gastroduodenal mucosal lesions (AGML).

This article presents an analysis of acute gastroduodenal mucosal lesions (AGML) based on a review of current literature and the personal experience of the authors. The pathology of AGML involes two distinct types of lesions, namely, superficial erosions confined to the acid-secreting gastric mucosa and presenting as erosive hemorrhagic gastritis, and acute ulcers that occur in the alkaline gastric mucosa and duodenum. The etiology of these two lesions is very likely different. Acut gastroduodenal ulcers, best known as stress ulcers, are probably "peptic" lesions, whereas erosive hemorrhagic gastritis appears to be due to pathologic back diffusion of hydrogen ions caused by a breakdown of the gastric mucosal barrier as a result of endogenous factors, such as gastric mucosal ischemia, and sometimes exogenous factors, such as alcohol, urea, and acetylsalicylic acid. Catecholamine hypersecretion resulting from severe stress, such as occurs in hypovolemia, sepsis, and hypercapnea, contributes to ischemia of the gastric mucosa by producing splanchnic vasoconstriction. The key to the diagnosis of AGML is early endoscopy in all cases of upper gastrointestinal bleeding. Therapy for AGML should begin with a trial of medical measures directed at restoring effective perfusion of tissues and removing hydrogen ions from the stomach by gastric washing. Medical therapy is effective in 80% of patients with erosive hemorrhagic gastritis, but surgical treatment is usually required in acute gastroduodenal ulcer. When surgery is necessary for either type of lesion, vagotomy with hemigastrectomy appears to be the most effective operation. The personal experience of the authors has involved 36 patients with AGML who were treated in three periods between 1968 and 1976. The mortality rate of patients with AGML has been reduced from 50% in the first 2 years to zero in the last 2 years by the use of emergency endoscopy for diagnosis, appropriate medical therapy, properly timed and executed surgery, and, most recently, selective angiography.

Acute Disease↗
PubMed2006

Certification from the American Board of Pathology: getting it and keeping it.

In the last 5 years, there have been significant changes in the process of obtaining (and maintaining) certification in anatomic and/or clinical pathology and in pathology subspecialties. These changes include the elimination of the requirement for a "credentialing year" with its attendant "double class" of residents; the implementation of a mandatory maintenance-of-certification program for all persons certified by the American Board of Pathology, Tampa, Fla, on or after January 1, 2006; and the alterations in format and manner of grading for the certifying examinations. This article updates the pathology community regarding these changes and provides references where candidates and diplomates can find the most recent information regarding all aspects of certification and maintenance of certification.

Certification↗
PubMed1993

Object images of eating disorder patients.

The authors investigated images held by eating disorder patients toward selected stimulus words using the semantic differential method. The concept "object image" was introduced here to designate the images which any person has about the mother, the father, etc. A comparison was made between 22 eating disorder patients with concurrent borderline personality disorder, 20 patients without borderline pathology, and 48 controls. The eating disorder patients were found to have a "weaker" image of "motherliness" and "womanliness" compared to the control group. Another characteristic of eating disorder patients was their unfavorable image of children. The authors also studied the images held by fathers and mothers. In the families with borderline patients, the discrepancies between what we term "object images" held by fathers, mothers, and daughters were conspicuous. The importance of a tripartite (daughter-mother-father) relationship in the psychopathology of eating disorder is discussed.

Adolescent↗
PubMed2004

[Personality traits, psychological adjustment, and burnout syndrome in nursing staff].

The nursing staff is prone to develop Burnout because of the work environment and the stressful situations that develop among patients and their families. Burnout syndrome it's a persistent negative mental state, work related and present in non pathologic populations. Burnout has been associated to personality traits but the findings are too heterogeneous and do not allow plausible generalizations. To identify the relation between Burnout, Personality Traits and Psychological Adjustment, questionnaires were applied to 117 subjects, all members of the nursing staff from a University Hospital in Maracaibo, Venezuela. Traits in Burnout subjects were: sensibility to criticism, lack of confidence, poor social capacity and low Psychological Adjustment. The non-Burnout subjects presented traits of optimism, reality in the way they viewed events, proper social abilities and high Psychological Adjustment. Burnout Syndrome is not a personality type and the traits associated with this syndrome seems to be associated with Psychological Adjustment.

Adaptation, Psychological↗
PubMed1997

Anorexia of aging: physiologic and pathologic.

Despite the increase in body fat and obesity that occurs with aging, there is a linear decrease in food intake over the life span. This conundrum is explained by decreased physical activity and altered metabolism with aging. Thus, older persons fail to adequately regulate food intake and develop a physiologic anorexia of aging. This physiologic anorexia depends not only on decreased hedonic qualities of feeding with aging (an area that remains controversial) but also on altered hormonal and neurotransmitter regulation of food intake. Findings in older animals and humans have provided clues to the causes of the anorexia of aging. An increase in circulating concentrations of the satiating hormone, cholecystokinin, occurs with aging in humans. In addition, animal studies suggest a decrease in the opioid (dynorphin) feeding drive and possibly in neuropeptide Y and nitric oxide. The physiologic anorexia of aging puts older persons at high risk for developing protein-energy malnutrition when they develop either psychologic or physical disease processes. Despite its high prevalence, however, protein-energy malnutrition in older persons is rarely recognized and even more rarely treated appropriately. Screening tools for the early detection of protein-energy malnutrition in older persons have been developed. Multiple treatable causes of pathologic anorexia have been identified. There is increasing awareness of the importance of depression as a cause of severe weight loss in older persons. Approaches to the management of anorexia and weight loss in older persons are reviewed. Although many drugs exist that can enhance appetite, none of these are ideal for use in older persons currently.

Aged↗
PubMed1987

Laterality, torque and personality.

Evidence accumulating from a variety of methodological approaches suggests that unusual laterality is often a concomitant feature of emotional pathology. In the present study both torque and a multifaceted measure of laterality were examined with respect to personality variables measured by the 16 PF in a normal population. Interestingly, a pattern of emotionality for subjects with a more confused laterality was revealed in a normal population which is notably similar to reported aberrant personality factors and laterality in more pathological groups. The existence of a cohesive continuum of emotional expression in relation to confused laterality is suggested. In addition, both torque and the multifactored measure of laterality are critiqued as research measures and for their clinical potential.

Adolescent↗
PubMed1992

Patients with antisocial personality disorder. Are they bad or mad?

Antisocial personality disorder is the psychiatric diagnosis most closely linked to explosive and criminal behavior. This diagnosis is easily documented but challenges a clinician's diagnostic skill because of the patient's propensity for masquerade and pathologic lying. The essential feature of antisocial personality disorder is a pattern of irresponsible and antisocial behavior beginning in childhood or early adolescence and continuing into adulthood. The differential diagnosis should include substance abuse, adult antisocial behavior, psychotic and organic illness, and other personality disorders. Suggested medical and psychiatric treatment includes rapidly establishing firm behavior limits and performing a mental status examination to evaluate thought processes and suicidal and homicidal intent.

Antisocial Personality Disorder↗
PubMed2000

Effect of TT virus infection on hepatocellular carcinoma development: results of a Euro-Asian survey.

A small percentage of persons with hepatocellular carcinoma (HCC) lack identifiable causes of liver pathology. The single-stranded DNA virus, TT virus (TTV), has been found in persons with acute and chronic liver injury. Nested polymerase chain reaction was used to search for both TTV and parvoviruses in 293 HCC samples from Asia and Europe. TTV was found in >30% of Chinese and Italian samples but in only 13% of French samples. No clinicopathologic differences were found between TTV-positive and -negative populations. A significant association was found between TTV infection and hepatitis B virus (P<.01) and herpesviruses (P<.02) in HCC patients, suggesting that factors promoting these infections are associated with enhanced TTV positivity. Parvovirus B19 and adeno-associated virus were found in only 7.5% of the tumors. Taken together, these data suggest that TTV infection is unlikely to be associated with the induction or acceleration of the hepatocarcinogenic process in humans.

Adult↗
PubMed2003

[The need for liver transplantation in adult population of the Lviv region].

Hepatic transplantation constitutes a modern standard of a medical care giving to the patients with some diseases of this organ. According to the Lviv regional pathologomorphological bureau data there were choosed and analyzed in detail 144 observations of the persons, died for the 6 years period due to hepatic pathology owing. The annual maximal quantity of retrospectively--possible recipients of liver constitutes 18.3 persons, minimal--14.8 persons. Maximal index of the Lviv region adult population necessity for hepatic transplantation constitutes 8.3 interventions to 1 million of citizens, minimal one--6.7. Regional nosologic structure of the hepatic transplantation necessity corresponds with the world tendencies present.

Adult↗