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PubMedDate not supplied

Personality disorder in obsessive compulsive disorder: a controlled study.

In order to assess Axis II pathology in Obsessive Compulsive Disorder patients as compared to other anxiety disorder patients, the Personality Disorder Examination was administered to 258 anxiety disorder patients. In contrast to a number of recent reports, a low rate of personality disorder diagnoses were found in the OCD sample as well as the anxiety disorder control subjects. The findings of the current investigation are discussed in terms of state-trait confounding.

Agoraphobia↗
PubMed1992

Mycosis fungoides--type cutaneous T-cell lymphoma arising before 30 years of age. Immunophenotypic, immunogenotypic and clinicopathologic analysis of nine cases.

BACKGROUND: Cutaneous T-cell lymphomas (CTCLs) rarely arise before 30 years of age; therefore the characteristics of these lymphomas are largely unknown. OBJECTIVE: Our purpose was to assess the clinical and pathologic aspects of CTCL in young persons. METHODS: We identified nine patients who had epidermotropic CTCL by 30 years of age and analyzed their lymphoma phenotypes and genotypes. RESULTS: The diagnosis of CTCL was made an average of 6 years after the reported onset of the lesion. Histologic examination revealed the mycosis fungoides (MF) form of CTCL, and none of the patients underwent conversion to nonepidermotropic or large-cell variants of CTCL. The immunophenotypes were typical of MF-type CTCL; seven of eight lymphomas tested were predominantly CD4+ although in only three were abnormal CD4/CD8 ratios present. All four cases tested were CD7- (Leu-9-), and seven of eight specimens tested exhibited deficient Leu-8 expression. The loss of one or more pan-T-cell markers was found in four of eight patients tested. Clonal beta-chain T-cell receptor gene rearrangements occurred in skin samples from four of eight tested cases. CONCLUSION: A persistent eruption, even in youths and young adults, should be thoroughly evaluated for possible CTCL.

Age Factors↗
PubMed2005

Wound care issues in the patient with cancer.

As cancer continues to represent a major health problem in the United States and in other developed countries, MCWs will continue to represent a complex problem for patients and health care professionals alike. Goals of care may range from healing to palliation, depending on the underlying pathology and patient preferences regarding their personal goals of wound or disease management. Palliative wound care should focus on patient comfort and quality of life as the goals, instead of wound. As evidence related to wound healing, products, and technology continues to increase,nurses can be at the forefront of putting into practice the science of wound healing for the benefit of patients.

Extravasation of Diagnostic and Therapeutic Materi↗
PubMedDate not supplied

[Severe traumatic coma from diffuse brain lesions (neuropathological aspects) (author's transl)].

From a review of recent literature, and pathological study of more than 100 personal cases, the authors describe the most interesting of these "diffuse" lesions; they only recall the most common types of lesions (contusions, vascular lesions, edema and its consequences - especially on brain stem); but a more detailed description is given of less known lesions of corpus callosum, brain stem and white matter, which have a more complex pathogeny (direct physical injury, anoxia-ischaemia, edema), and which they consider to be factors which worsen or protract the coma. "Biochemical" lesions (basic myelinic protein, liberated "false" neurotransmitters) are also discussed.

Brain↗
PubMed2001

The context of delusional experiences in the daily life of patients with schizophrenia.

BACKGROUND: Global characteristics and psychosocial risk factors related to delusions have been identified. The present study extends these findings to the level of everyday functioning, identifying characteristics of delusional moments (DMs) and contextual risk and protective factors for delusional exacerbations in daily life. METHODS: Data were collected using the Experience Sampling Method (ESM), a time-sampling technique. Forty-eight chronic patients diagnosed with schizophrenia rated the intensity of pathological symptoms and mood states and described their thoughts and the environmental context during consecutive moments in daily life. Delusions were defined on the basis of self-rated suspicion, preoccupation, feeling controlled, and coded thought pathology. Daily context included current activity, persons present and location. Characteristics of DMs and non-delusional moments (nDMs) were compared, and a multilevel logistic regression model was used to identify contexts that might trigger or prevent DMs. RESULTS: On average, patients experienced delusions less than one-third of the time. DMs were characterized by higher negative affect and lower positive affect. The presence of family or acquaintances decreased the risk of subsequently experiencing a DM, whereas withdrawal from activities increased this risk. CONCLUSIONS: Data support the validity of ESM for investigating delusions in schizophrenia. Daily life contexts appear to alter the probability that delusions will occur. Knowledge about such contexts may therefore be useful in helping patients develop better coping strategies and in creating therapeutic interventions that can lessen emotional distress.

Adult↗
PubMed2000

Incidence and epidemiology of heart failure.

Epidemiologic data from the Framingham Study provide insights into the population burden of heart failure (CHF), its prognosis and modifiable risk factors that promote it. In the general population CHF is chiefly the end stage of hypertensive, coronary and valvular cardiovascular disease. It is a major and growing problem in most affluent countries because of aging populations of increased size, and the prolongation of the lives of cardiac patients by modern therapy. Once clinically manifest, CHF, despite recent innovations in therapy, carries an unacceptably high mortality rate. In the Framingham Study, median survival is only 1.7 y for men and 3.2 y for women, with only 25% of men and 38% of women surviving 5 y. This is a mortality rate 4-8 times that of the general population of the same age. This poor outlook is observed for all etiologies of CHF and sudden death is a prominent feature of the mortality. Based on population attributable risks, hypertension has the greatest impact, accounting for 39% of CHF events in men and 59% in women. Despite its much lower prevalence in the population (3-10%) myocardial infarction also has a high attributable risk in men (34%) and women (13%). Valvular heart disease only accounted for 7-8% of CHF. Hypertension increased the age and risk factor adjusted hazard of CHF 2-fold in men and 3-fold in women, with a greater impact of the systolic than diastolic blood pressure. Diabetes increased CHF risk 2-8 fold with risk ratios twice as large in women as men. About 19% of CHF cases have diabetes. It accounted for 6-12% of the CHF in the Framingham Study cohort. Dyslipidemia characterized by a high total/HDL cholesterol ratio, but not the total cholesterol alone was a risk factor for CHF. An enlarged heart on X-Ray, ECG-LVH, a reduced vital capacity and rapid heart rate usually signified deteriorating cardiac function. CHF risk associated with ECG-LVH was independent of X-Ray cardiomegaly but risk was further augmented when both coexist. Echocardiographic left ventricular hypertrophy signifies a high risk of CHF proportional to the degree of increase in left ventricular mass without a critical value that delineates compensatory from pathological hypertrophy. Risk of CHF in persons predisposed by hypertension, diabetes or cardiac conditions varies over a 10-fold range depending on the aforementioned modifiable risk factors and indicators of deteriorating left ventricular function. Using multivariate risk formulations it is possible to identify 20% of the population from which 70% of the CHF will evolve. Those in the upper quintile of multivariate risk are good candidates for echocardiographic testing to delineate those needing aggressive preventive measures to delay the onset of CHF. Therapy of CHF must begin with treatment of presymptomatic left ventricular dysfunction to reverse the dysfunctional maladaptive changes.

Age Distribution↗
PubMed2003

Categorical versus dimensional models of mental disorder: the taxometric evidence.

OBJECTIVE: To review studies of the categorical versus dimensional status of mental disorders that employ taxometric methodology. METHOD: A comprehensive qualitative review of all published taxometric studies of psychopathology. RESULTS: Categorical and dimensional models each receive well-replicated support for some groups of mental disorders. Studies favour categorical models for melancholia, eating disorders, pathological dissociation, and schizotypal and antisocial personality disorders. Dimensional models tend to be favoured for the broad neurotic spectrum--general depression, generalized anxiety, posttraumatic stress disorder--and for borderline personality disorder. CONCLUSIONS: Taxometric research clarifies the latent structure of psychopathology in ways that have implications for the classification, assessment, explanation and conceptualization of mental disorder.

Humans↗
PubMed1980

Giant lymph node hyperplasia associated with thrombotic thrombocytopenic purpura.

Giant lymph node hyperplasia has been assoociated with a number of disorders, particularly hematologic abnormalities. The association of giant lymph node hyperplasia with thrombotic thrombocytopenic purpura has not been previously reported. This report documents the simultaneous occurrence of these two entities in one person and discusses their clinical and pathologic features.

Adult↗
PubMed1996

Upper gastrointestinal motility disorders and respiratory symptoms.

The association between upper gastrointestinal (GI) motility disorders and respiratory problems is reviewed. Upper GI motility disorders, such as gastroesophageal reflux disease, gastroparesis, and achalasia, have been associated with respiratory problems, including aspiration, airway obstruction, asthma, bronchospasm, chronic cough, and laryngitis. These associations, which had been based solely on clinical observation, have recently been supported by physiologic studies and treatment trials. The association of reflux disease with asthma has the most support. Up to 80% of persons with asthma have evidence of pathologic gastroesophageal reflux, and in several studies antireflux therapy with prokinetic agents, antisecretory drugs, or fundoplication surgery has been found to reduce asthma symptoms and the need for medication in some patients. Reflux has also been associated with chronic cough and laryngitis, and antireflux therapy can reduce respiratory symptoms. Gastroesophageal reflux, gastroparesis, and achalasia are all associated with aspiration. In addition, in rare instances, the megaesophagus associated with achalasia can produce mechanical airway obstruction. Effective therapy for these GI motility disorders can eliminate complicating respiratory problems.

Adult↗
PubMed1990

Geriatric sleep apnea syndrome: a preliminary description.

We compared 8 patients diagnosed with geriatric sleep apnea syndrome (GSAS) with 12 healthy older controls (GCON) matched on age, sex, weight, education, and socioeconomic standing. GSAS was diagnosed if patients had an apnea + hypopnea index (AHI) greater than or equal to 10 and an impairment involving at least two of the following: hypertension, cardiac arrhythmias, or daytime hypersomnolence. In addition to significant differences on selection variables (e.g., AHI, frequency of hypertension, Multiple Sleep Latency Test), GSAS patients had significantly more sleep disturbance, were sleepier on subjective measures, were more depressed, and had lower scores on tests of nonverbal problem solving and nonverbal memory. Thus, GSAS resembles SAS described in middle-aged populations. More research is needed to determine the most efficient diagnostic parameters for identifying pathological levels of SDB in older persons.

Aged↗
PubMed1994

Intracranial chondromyxoid fibroma extending into the jugular foramen.

A case is reported of an intracranial chondromyxoid fibroma (CMF) in a 67 year old man. The tumor originated in the petrous part of the temporal bone and extended into the jugular foramen. Microscopically, the tumor showed a lobular appearance, and was composed of spindle or stellate cells in an abundant myxoid, chondroid stroma. Immunohistochemically, S-100 protein was positive in the tumor cells and myxoid stroma. Intracranial CMF, especially in an elderly person, is exceedingly rare. Clinical and pathological findings are presented with reference to the previously reported articles.

Aged↗
PubMed1990

Oral findings in elderly nursing home residents in selected countries. 2. Soft tissue lesions and denture wearing habits.

This paper demonstrated that 38% of the 610 examinees at seven institutions in four countries have soft tissue lesions. Seventy to eighty percent of the detected lesions were of the erythematous type. This incidence was found at institutions with and without attending dentists, in denture and non-denture users, in dependent and independent patients. Tissue lesions in denture wearers were four times as many as in non-denture wearers. The percentage of inflammatory lesions in both denture and non-denture wearers was considerably higher at institutions with no attending dental personnel when compared with those with dental care facilities. Where patients depended on the staff and/or their relatives for their personal hygiene, a sharp increase in pathological findings was seen when compared to independent dwellers. The nursing staff and the relatives know very little about the oral problems of the elderly residents. There was no uniform policy about telling patients when to wear their removable dentures and patients did not always follow instructions when they were given. Many patients sleep with their upper denture while the lower one is removed for the night. Patients sometimes sleep in the dentures and sometimes remove one or both dentures for varying periods of time. The high percentage of soft tissue lesions and erratic denture wearing habits point to neglect and insufficient oral care toward the geriatric population studied.

Aged↗
PubMed1987

Pathogenesis and transmission of AIDS.

AIDS is a slow virus disease caused by a lentivirus. The silent incubation period following infection usually lasts many years, during which the infected person is potentially infectious to others. Pathological changes accumulate imperceptibly. When major symptomatic disease develops it is eventually fatal. The epidemic spread of the virus is new in Africa, as well as in North America and Europe. Twenty-five per cent of people infected with the virus die within seven years of infection. The ultimate mortality 20 years after infection cannot yet be known, but it may turn out to be close to 100 per cent. It is already apparent that AIDS is the most lethal epidemic viral disease of humans known to medical science. Flaws in the generally accepted hypothesis that AIDS is a sexually transmitted infection are exposed. It has been, characteristically, a blood-borne infection in the early years of the epidemic. However, the AIDS virus is exceptionally unstable genetically and it is probable that means of transmission more efficient than through blood have already developed.

Acquired Immunodeficiency Syndrome↗
PubMed1975

Studies on an immunologic method for the diagnosis of varicose veins.

A glycoprotein fraction was isolated from varicose veins by a successive extraction procedure. Antibodies to this fraction were shown to exist in the serum of persons suffering from varicose veins. The pathology of this illness is discussed in relation to the autoimmune reaction, and the basis for a method for the early diagnosis of varicose veins is proposed.

Adult↗
PubMed1980

[New physiological aspects of the human urinary bladder (author's transl)].

With respect to the new electrophysiological, morphological, histochemical, pharmacological and urodynamical investigations of the function of the urinary bladder, the common aspect of the existence of a smooth sphincter on one hand and a striated sphincter on the other hand, an alternate function of the parasympathetic and sympathetic nervous system in filling of the bladder and in micturition can no more be accepted. A new own concept of the mechanism, which is in action at the bladder neck closure, is demonstrated. This concept goes out from the existence of two systems of smooth musculature in the outlet of the bladder. The first one with mainly longitudinally laying strips is standing under parasympathetic control. Its activation in the beginning of voiding opens the bladder neck. The second one consists of more circulary strips. Its activation is alpha-adrenergic. The contraction of this part of the musculature causes the closure of the bladder neck. Certainly the striated musculature does not play an important role of the continence in normal persons resting conditions. However, in some pathological conditions, it must be taken into consideration. It must be noted, too, that the striated urethral musculature and the pelvic floor do not act synchronous.

Humans↗