Chrysotherapy. A prospective study

A 4-year prospective clinical study of chrysotherapy was designed to reexamine old beliefs and traditions, and to test potentially new approaches to chrysotherapy. The standard weekly dosage of 50 mg was compared to that based on 1 mg/kg body weight; no significant differences were found. The rapidly absorbed aqueous thiomalate was compared to the slowly absorbed oil repository thioglucose; the latter produced significantly less side effects and an appreciably higher percentage of improvement. Almost half (43%) of nonresponders on standard regimen had a satisfactory clinical response at higher dosage levels without increase in toxicity. Some of these findings vary so much with traditional beliefs and practices that the authors urge caution in their interpretation. But generally speaking these problems are technical and do not detract from the conviction that chrysotherapy is valuable and comparatively safe in the management of rheumatoid arthritis and that it deserves more widespread application in clinical practice.     

Self-schemas and risk for depression: A prospective study.

Two longitudinal experiments with 375 undergraduates investigated the role of depressive self-schemas in vulnerability to depression. Ss were divided into 5 groups hypothesized to be at differential risk for depression according to a schema model: depressed schematic, depressed nonschematic, nondepressed schematic, nondepressed nonschematic, and psychopathology control. In Exp I, Ss were followed regularly for 4 mo with self-report and clinical interview measures of depression (e.g., Beck Depression Inventory). There was no evidence of risk for depression associated with schema status apart from initial mood and no interaction of life stress events and schemas. In Exp II, links among self-schemas, information processing, and mood status were investigated. It was shown that depressive self-schemas did not exert an ongoing, active influence on everyday information processing; instead, current mood affected information processing. Remitted depressed Ss resembled nondepressed rather than depressed Ss. Findings support the distinction between concomitant and vulnerability schemas noted by N. Kuiper et al (in press) and help to clarify differences between cognitions that are symptoms of depression and those that may play a causal role under certain conditions. (41 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hardiness and health: A prospective study.

Hypothesized that hardiness—commitment, control, and challenge—functions to decrease the effect of stressful life events to producing illness symptoms. 259 upper- and middle-level male managers (mean age 48 yrs) were administered a battery of tests (including Rotter's Internal–External Locus of Control Scale, the Schedule of Life Events, and the Seriousness of Illness Survey) covering a 5-yr period. Results support the hypothesis by showing main effects on illness for both stressful life events and hardiness and an interaction effect for these independent variables. (37 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pregnancy and multiple sclerosis. A prospective study

OBJECTIVE: To conduct a prospective assessment of pregnancy on women with multiple sclerosis (MS), focusing on pregnancy outcome and relapses during gestation and up to 6 months after delivery. DESIGN: Expected numbers of relapses were based on data for (1) "self-controls": the mothers ("cases") themselves prior to becoming pregnant and (2) "matched controls": female patients with MS "matched" to the mothers for year of birth, age of MS onset, MS type, MS course, and initial MS symptom(s). SETTING: Cases and controls were identified from an ambulatory care MS clinic that serves the province of British Columbia, Canada. PATIENTS OR OTHER PARTICIPANTS: Women with a diagnosis of MS who attended the MS clinic during 1982 through 1986 and subsequently became pregnant during 1982 through 1989 inclusive were included in this study as cases. Matched controls were women with MS who attended the MS clinic during the same period but did not become pregnant. RESULTS: No significant increase in relapse rate was found for cases during the first two trimesters of gestation. The number of relapses was significantly less than expected during the third trimester compared with matched controls (chi 2 = 6.80, df = 1, P < .02), but not compared with self-controls (chi 2 = 3.39, df = 1, P > .05). The observed number of relapses for the 6 months after delivery did not differ significantly from expected (self-controls: chi 2 = 2.84, df = 2, P > .05; matched controls: chi 2 = 1.76, df = 2, P > .05). CONCLUSION: These data suggest that neither pregnancy nor the 6-month period after delivery is a risk factor for relapse in MS. They are consistent with previous observations that, in the long term, pregnancy does not influence subsequent MS disability.     

A prospective study of risk factors for unipolar depression.

The purpose of this study was to identify variables that are antecedents for unipolar depression. Information regarding a number of sociodemographic and psychosocial variables was collected on a community sample of adults (N?=?998), 562 of whom were interviewed and diagnosed according to Schedule for Affective Disorders and Schizophrenia-Research Diagnostic Criteria procedures and received a second assessment on most of the variables. The average time elapsed between Time 1 and Time 2 was 8.3 months. Depressive symptomatology was also assessed with the Center for Epidemiologic Studies Depression Scale CES-D. A number of variables emerged, which predicted both the development of an episode of depression and elevated CES-D scores. These include reporting an elevated level of depressive and other symptoms and having experienced an elevated level of stress. Variables that are predictive of developing an episode of depression include young age, being female, and having had a previous episode of depression. The presence of depressogenic cognitions was uniquely predictive of an elevation of depression symptoms as measured by the CES-D. Virtually no variables demonstrated a significant moderating effect on the stress–depression relation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Chronic hemodialysis treatment of patients older than 74 years. An epidemiological study in 16 renal units in Northern Greece]

In a review of 1057 patients who started receiving chronic haemodialysis treatment during the last decade in 16 renal units of Northern Greece only 25 patients (2.36%) were found to be older than 74 years at start of haemodialysis treatment. The most common cardiovascular problems in these elderly patients were angina pectoris in 9 and difficulties in fistula creation in 10 patients. Arterial hypertension was present in 7 patients. The first year survival rate was 55.5%. Cardiovascular episodes were the commonest cause of death among the 14 patients who died. We conclude that during the last decade in Northern Greece, among patients receiving chronic haemodialysis treatment, only a few started treatment after the age of 74 years and although they had significant cardiac and vascular problems their first year survival rate was acceptable.     

Haematological abnormalities in acute pancreatitis. A prospective study

Twenty-five patients with acute pancreatitis were studied prospectively in the first week of their admission using haematological and coagulation tests. Platelet counts initially fell and later returned to admission levels. Rising levels of plasma fibrinogen were recorded. The kaolin cephalin clotting time was shorter than its control in twenty-one patients. Eighteen patients had elevated fibrinogen degradation products and fourteen had a positive ethanol gelation test. It is suggested that by taking into account the results in series of individual patients a degree of intravascular coagulation may be a common feature of acute pancreatitis. In one patient (presented in detail) strong evidence for disseminated intravascular coagulation was found     

A clinical and epidemiological study of gastro-enteritis

Over a 13-year period, 2,903 Asian, Coloured and White children with gastro-enteritis were admitted to the Wilkins Infectious Diseases Hospital, Salisbury. During a pilot study of 250 patients conducted over the first 2 years, a definite seasonal variation in the occurrence of gastro-enteritis, with a peak incidence in winter, was noticed, and this led to a more detailed study of 2,653 patients over the next 11 years. Bacterial pathogens were recovered from 27% of patients, strains of Shigella accounting for 12% Salmonella for 7% and Escherichia coli for 8%. A severe outbreak of E. coli infection occurred between October 1971 and December 1972, and 4 of a total of 9 deaths occurred during this period, all in children suffering from E. coli 0111/B4 infections. The bacterial recovery rate was highest in the summer (40%) and lowest in the winter (12%). Winter diarrhoea broke out over 3-month periods during each year and accounted for 37% of the cases, but none of the children who contracted it died. The clinical picture of winter diarrhoea differed from the others and the most serious illness was that caused by enteropathogenic strains of E. coli. The over-all mortality in the series was 0,27%.     

Relaxation therapy for tension headache in the elderly: A prospective study.

We evaluated the effects of an 8-week progressive muscle-relaxation therapy regimen on the headache activity of 10 elderly tension-headache subjects. Posttreatment assessment at 3 months revealed significant decreases in overall headache activity (50% or greater) in 7 subjects. Significant clinical or statistical prepost differences, or both, were also found for the number of headache-free days, peak headache activity, and medication index. This is the first prospective study of tension headache in an elderly population, and, unlike previous retrospective studies, it suggests that relaxation therapy may be an effective intervention in the treatment of such headaches. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sudden infant death syndrome. A prospective study

One hundred twenty-five sudden infant death syndrome (SIDS) victims followed up since birth from a large prospective study were compared with matched controls. Some of the future SIDS victims showed evidences of neonatal brain dysfunction including abnormalities in respiration, feeding, temperature regulation, and specific neurologic tests. These abnormalities could not be ralated to events in labor or delivery. A greater proportion of the future victims were mildly underweight for gestational age. The gestations that produced the SIDS victims were characterized by a greater frequency of mothers who smoked cigarettes and had anemia. The demographic profile of SIDS families proved to be indentical to the profile for families with excessive perinatal mortality. Many of the SIDS victims showed a retardation in postnatal growth prior to death.     

Etiology of idiopathic scoliosis. Computational study

A review of the literature on the mechanical aspects of the etiology for idiopathic scoliosis reveals that the buckling hypothesis has been presented as a purely mechanical phenomenon. In an attempt to confirm the buckling hypothesis, a numerical simulation of growth and the resulting buckling phenomena was done by means of finite element analysis. It previously was observed that growth was induced in the T4 to T10 vertebrae. Only the sacrum was assumed to be stationary. From the growth analysis, a deformation process that mitigated thoracic kyphosis was obtained as observed in healthy children during early adolescence. From the buckling analysis, the first to the fourth buckling modes that correspond to the first side bending, first forward bending, first rotation, and second side bending modes were obtained. The shape of the fourth buckling mode (second side bending mode) was in good agreement with the clinical shape. Considering the potential for controlling these modes by posture change, it is concluded that the second bending mode in the coronal plane is one of the most likely etiologic candidates in the mechanics of thoracic idiopathic scoliosis.     

A prospective study of youth gambling behaviors.

Little is known about the course and outcomes of adolescent gambling. This prospective study describes findings from a 3-wave (Time 1 [T1], Time 2 [T2], and Time 3 [T31]) assessment of gambling behaviors among youth (N = 305). Stable rates of any gambling and regular gambling (weekly or daily) were observed across T1, T2, and T3. The rate of at-risk gambling significantly increased at T3 (young adulthood), whereas the rate of problem gambling remained stable over time. Several adolescent risk factors were associated with either T3 at-risk or problem gambling, many of which are risk factors for adolescent substance abuse. Findings suggest that important to the origins of young adult gambling problems are risk factors associated with the problem behavior syndrome of adolescence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Epidemiology of encephalitis in children. A prospective multicentre study

We found 175 cases with acute encephalitis in a population of 791,712 children aged 1 month-15 years during a 2-year surveillance period in 1993-1994. The overall incidence was 10.5/100,000 child-years with the highest figure in children < 1 year of age, 18.4/100,000 child-years. The microbial diagnosis was considered proven or suggested in 110 cases (63%); varicella zoster, respiratory and enteroviruses comprised 61% of these, and adeno, Epstein Barr-, herpes simplex and rota viruses comprised 5% each. A clearcut change seems to have occurred in the aetiology of encephalitis. Mumps, measles, and rubella virus associated encephalitides have been almost eliminated. Varicella zoster, respiratory, and enteroviruses have increased in frequency and occur in younger age groups. New causes were identified, especially Chlamydia pneumoniae and HHV-6. Our data should assist in making a specific diagnosis and defining appropriate antimicrobial therapy. CONCLUSIONS: The spectrum of encephalitis in children has changed due to vaccination programs. The incidence, however, appears to be about the same due to increasing frequency of other associated old and new microbes.     

Risk factors for stress fractures in track and field athletes. A twelve-month prospective study

The aim of this 12-month prospective study was to investigate risk factors for stress fractures in a cohort of 53 female and 58 male track and field athletes, aged 17 to 26 years. Total bone mineral content, regional bone density, and soft tissue composition were measured using dual-energy x-ray absorptiometry and anthropometric techniques. Menstrual characteristics, current dietary intake, and training were assessed using questionnaires. A clinical biomechanical assessment was performed by a physical therapist. The incidence of stress fractures during the study was 21.1% with most injuries located in the tibia. Of the risk factors evaluated, none was able to predict the occurrence of stress fractures in men. However, in female athletes, significant risk factors included lower bone density, a history of menstrual disturbance, less lean mass in the lower limb, a discrepancy in leg length, and a lower fat diet. Multiple logistic regression revealed that age of menarche and calf girth were the best independent predictors of stress fractures in women. This bivariate model correctly assigned 80% of the female athletes into their respective stress fracture or nonstress fracture groups. These results suggest that it may be possible to identify female athletes most at risk for this overuse bone injury.     

Personality and substance use disorders: A prospective study.

The personality systems of Cloninger (as measured by the Tridimensional Personality Questionnaire [TPQ]) and Eysenck (as measured by the Eysenck Personality Questionnaire [EPQ]) both have been linked to substance use and abuse. The current study examined the predictive utility of both systems for substance use disorder (SUD) diagnoses, both cross-sectionally and prospectively. Participants (N?=?489 at baseline) completed the EPQ and TPQ and were assessed via structured diagnostic interview at baseline and 6 years later (N?=?457 at follow-up). Both the EPQ and TPQ scales demonstrated bivariate cross-sectional and prospective associations with SUDs. Within each system, those dimensions marking a broad impulsive sensation-seeking or behavioral disinhibition trait were the best predictors prospectively, although the 2 systems were differentially sensitive to specific diagnoses. These relations remained significant even with autoregressivity, other concurrent SUD diagnoses, and multiple personality dimensions statistically controlled. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stimulation seeking and intelligence: A prospective longitudinal study.

The prediction that high stimulation seeking 3-yr-olds would have higher IQs by 11 yrs old was tested in 1,795 children on whom behavioral measures of stimulation seeking were taken at 3 yrs, together with cognitive ability at 11 yrs. High 3-yr-old stimulation seekers scored 12 points higher on total IQ at age 11 compared with low stimulation seekers and also had superior scholastic and reading ability. Results replicated across independent samples and were found for all gender and ethnic groups. Effect sizes for the relationship between age 3 stimulation seeking and age 11 IQ ranged from 0.52 to 0.87. Findings appear to be the first to show a prospective link between stimulation seeking and intelligence. It is hypothesized that young stimulation seekers create for themselves an enriched environment that stimulates cognitive development. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Group A streptococcal bacteremia. A 10-year prospective study

In this paper we present a prospective evaluation of 100 patients with Group A Streptococcal (GAS) bacteremia evaluated in our hospital over a 10-year period. Sixty-two patients were intravenous drug users (IVDU); all but 1 of these had an obvious cutaneous portal of entry related to the injection of illicit drugs. Twenty-seven patients had infectious metastasis, and the presence of septic pulmonary embolism was associated with suppurative phlebitis. Four of these patients had endocarditis. In the non-IVDU group, 24 patients had an underlying disease, and 12 were immunosuppressed. In 14 cases the infection was of hospital acquisition; in 35% infection was related to medical manipulations. Comparing the IVDU and non-IVDU groups, GAS bacteremia in IVDU patients is associated with a more benign outcome, a longer time of evolution before diagnosis, and a lower frequency of septic shock and mortality than in non-IVDU patients. Although in the univariate analysis GAS bacteremia was associated with several variables, in the multivariate analysis only the presence of shock and nosocomial acquisition of the infection were independently associated with a fatal outcome. Fifty-two patients were infected with human immunodeficiency virus (HIV); 5 of these were in the non-IVDU group. During the last 5 years of study, GAS bacteremia in our hospital was 39 times more frequent in HIV-infected patients than in patients without HIV. Nine patients presented clinical criteria corresponding to Streptococcal toxic shock syndrome (STSS), although its incidence was lower in the IVDU group. In the non-IVDU group, STSS was more frequent in patients with a necrotizing portal of entry, an age between 20 and 40 years, women, and when the origin of the infection was the skin or soft tissue. Six patients with STSS died, and death was associated with the presence of necrotizing lesions and lower counts of white cells, platelets, or hemoglobin.     

Arthroscopic synovectomy of the elbow for rheumatoid arthritis. A prospective study

The short-term assessment of 14 arthroscopic synovectomies of the elbow in 11 patients with rheumatoid arthritis showed that 93% achieved a short-term rating of excellent or good on the Mayo Elbow Performance Score. At the most recent assessment at an average of 42 months, however, only 57% maintained excellent or good results; four had required total elbow replacement. Although rehabilitation is facilitated by an arthroscopic procedure the results deteriorate more rapidly than after open synovectomy. This may be due to the limitations of the arthroscopic technique and is consistent with experience of the similar procedure in the knee. Recognition of the short-term gain and the potential for serious nerve injury should be considered when offering arthroscopic synovectomy.