CSF AMP in primary affective disorder: effects of probenecid and tryptophan.
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A case is described of a 47-year-old man who developed a manic psychosis while receiving pargyline treatment for concurrent depression and hypertension. The pharmacologic actions of pargyline are discussed with regard to its partial selectivity for MAO-B and presumed action in dopamine systems, and clinicians are alerted to this uncommon drug reaction.
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AIM: This was to review the literature on Early Childhood Caries (ECC) for the approaches to prevention and restoration of affected primary teeth. METHODS: The methods are reviewed and suggestions made as the approaches necessary for treating very young children. The special problems associated with the need to restore primary incisors in children with very low levels of cooperation are described. The options are outlined and indications for each approach discussed.
Talon cusps are relatively rare dental anomalies that manifest as accessory cusplike structures and project from the cingulum area of the anterior teeth. The condition can occur in both the primary and permanent dentitions. However, the occurrences of anomalous cusps are rather infrequent in the primary dentition. Little has been written about the treatment of talon cusps in the primary dentition compared with their counterparts in the permanent dentition. The purpose of this article was to document the management of a patient with a maxillary primary incisor affected by a talon cusp and the long-term follow up.
Luxation injuries to incisors, including intrusive displacement, occur with a high frequency in the primary dentition. Intrusion injuries are associated with damage to the pulpal and periodontal structures and possible fracture of the alveolar bone. The pulpal tissue of the intruded tooth sustains a severe shock during displacement, which may be reflected later by sequelae ranging from mild discoloration to pulpal necrosis and infection. Disintegration of pulpal tissue may result in periapical tissue inflammation, which in turn may induce developmental disturbances in the germ of the permanent successor tooth. Additionally, severe injury to the periodontal ligament during intrusion may lead to ankylosis of the primary incisor and consequently to delayed or ectopic eruption of its permanent successor. This article will review the possible sequelae affecting primary incisors following their intrusion.
One hundred and fifty four consecutively evaluated new and return psychiatric outpatients were examined by the same interviewer using a detailed, precoded questionnaire based on the diagnostic criteria for psychiatric research proposed by Feighner et al. Affective disorders were present for 75% of the patients and were associated with older age, divorce and a shorter duration of marital status. Race, sex, education and income levels were not related to the presence of affective disorders. Sixty patients with diagnoses of primary affective disorders and 56 patients with diagnoses of secondary affective disorders were identified and studied. Secondary affective disorders were found to be associated with males, younger age (under 34), unmarried marital status, and lower income levels. Primary affective disorders were associated with higher annual incomes (over +4,000) and fewer individuals with a "some high school only" education. Forty one patients with diagnoses of unipolar primary affective disorders were examined. Sex, race, age, marital status and duration of marital status did not vary for the two groups and were not associated with polarity of affective disorders. Lower education and annual income levels both were demonstrated for patients with bipolar primary affective disorders.
Clonidine hydrochloride, administered intravenously (2 micrograms/kg) during the second non-rapid eye movement period, was significantly less suppressant of rapid eye movement sleep in 10 depressed patients with primary major affective illness, according to Research Diagnostic Criteria, than in three groups of matched subjects (10 normal controls, 10 patients with minor depression, and 10 patients with generalized anxiety). These results suggest that depressed patients with major primary affective illness have down-regulated alpha 2-adrenergic receptors. These findings are consistent with the cholinergic-aminergic balance hypothesis of depression and support the aminergic side of the concept. Finally, the rapid eye movement sleep response to clonidine could provide a new biological marker of affective illness.
We used functional magnetic resonance imaging (fMRI) to study neural correlates of a robust somatosensory illusion that can dissociate tactile perception from physical stimulation. Repeated rapid stimulation at the wrist, then near the elbow, can create the illusion of touches at intervening locations along the arm, as if a rabbit hopped along it. We examined brain activity in humans using fMRI, with improved spatial resolution, during this version of the classic cutaneous rabbit illusion. As compared with control stimulation at the same skin sites (but in a different order that did not induce the illusion), illusory sequences activated contralateral primary somatosensory cortex, at a somatotopic location corresponding to the filled-in illusory perception on the forearm. Moreover, the amplitude of this somatosensory activation was comparable to that for veridical stimulation including the intervening position on the arm. The illusion additionally activated areas of premotor and prefrontal cortex. These results provide direct evidence that illusory somatosensory percepts can affect primary somatosensory cortex in a manner that corresponds somatotopically to the illusory percept.
Lithium carbonate has established itself as an effective therapeutic agent in primary affective disorders. As not all the patients with primary affective disorders respond to lithium therapy, it is necessary to identify responders prior to treatment. The important indicators of favourable lithium response include a definitive diagnosis of primary affective disorder, occurrence of less than four episodes of mania and depression within one year, psychotic features during both manic as well as depressive episodes, "grandiose-elated" picture during manic episodes; a family history of bipolar illness and response of affected family members to lithium treatment. While those with more than four episodes are not likely to respond to lithium therapy, those with episodes less frequent than once a year or two may not need prophylactic lithium. Among the depressed, hypersomnic depressed patients respond to lithium combined with a monoamine oxidase inhibitor. In addition to clinical predictors of response to lithium treatment, there are a number of pharmacokinetic, neurophysiological and biochemical indices which have been employed as supplementary predictors of response to lithium therapy.
One hundred and fifty-four consecutively evaluated new and return psychiatric outpatients were examined by the same interviewer using a detailed, precoded questionnaire based on the diagnostic criteria for psychiatric research proposed by Feighner et al. Affective disorders were present for 75% of the patients and were associated with a history of past employment at a declared occupation, inactive occupation status, and recent occupation status change. Sixty patients with diagnoses of primary affective disorders and 56 patients with diagnoses of secondary affective disorders were identified and studied. The primary affective disorder was associated with higher level and longer held occupations with fewer changes of occupation activity status than was the secondary affective disorder. Forty-one patients with diagnoses of unipolar primary affective disorders and 19 patients with diagnoses of bipolar primary affective disorders were examined. The unipolar illness was associated with a shorter duration of occupation type and less permanent unemployment than was the bipolar illness.