The impact of major depression on chronic medical illness

Femoral head necrosis is thought to be the consequence of decreased venous drainage. To confirm this pathogenetic model in lunatomalacia, the intraosseous pressure in 16 necrotic, 16 normal lunates and 16 normal capitates was measured. Intraosseous pressure was recorded in different functional positions: neutral position, extension, flexion, venous stasis, and exsanguinated conditions. Both in extension and in flexion, the intraosseous pressures of all bones exceeded those in neutral position; this corresponded to the increase in pressure during venous stasis. The increase in pressure in normal lunates and capitates could not be explained by mechanical deformation. Lunates showed a much higher increase in pressure than did capitates. Some necrotic lunates showed an intraosseous pressure during extension which exceeded the systolic blood pressure. This implies that mechanical deformation contributed to increased intraosseous pressure in necrotic lunates. The variation of intraosseous pressure suggests a physiological but unstable balance. An increase in pressure reduces the bloodflow and in addition to other promoting influences can lead to pathological conditions. The daily load of the wrist in extension is in accordance with the model of the origin of osteonecrosis on the venous side. The model that lunate necrosis is the consequence of impaired venous outflow can be accepted.     

On the relationship between recall and recognition memory.

The relationship between recall and recognition has been a central topic for the study of memory. A test of alternative views about recall and recognition was arranged by studying amnesic patients. In amnesia, damage has occurred to a brain system important for declarative (conscious) memory, but skill learning, priming, and other forms of nonconscious memory are intact. Recall and recognition were found to be proportionately impaired in amnesic patients, and confidence ratings for the recognition judgments were commensurate with the level of impaired performance. The results are contrary to views that either recognition memory or associated confidence judgments are ordinarily supported significantly by nonconscious memory. The results favor the view that recall and recognition are related functions of declarative memory and equivalently dependent on the brain system damaged in amnesia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On the relation between base-rate and cost-benefit learning in simulated medical diagnosis.

Observers completed a series of simulated medical diagnosis tasks that differed in category discriminability and base-rate/cost– benefit ratio. Point, accuracy, and decision criterion estimates were closer to optimal (a) for category d′?=?2.2 than for category d′?=?1.0 or 3.2, (b) when base-rates as opposed to cost–benefits were manipulated, and (c) when the cost of an incorrect response resulted in no point loss (nonnegative cost) as opposed to a point loss (negative cost). These results support the "flat-maxima" (D. von Winterfeldt & W. Edwards, 1982) and competition between reward and accuracy (COBRA; W. T. Maddox & C. J. Bohil, 1998) hypotheses. A hybrid model that instantiated simultaneously both hypotheses was applied to the data. The model parameters indicated that (a) the reward-maximizing decision criterion quickly approached the optimal criterion, (b) the importance placed on accuracy maximization early in learning was larger when the cost of an incorrect response was negative as opposed to nonnegative, and (c) by the end of training the importance placed on accuracy was equal for negative and nonnegative costs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Successful polymerase chain reaction-based diagnosis of fungal meningitis in a patient with chronic granulomatous disease

The structural and electronic properties of seventeen alkylxanthine derivatives were calculated using the MO program PM3 to elucidate the key features related to their inhibitory activity on phosphodiesterase (PDE) IV isoenzyme. Except for 7-alkylxanthine derivatives, a good correlation could be established between the distance between the tops of the two alkyl groups at the N1 and N3 positions of the xanthine skeleton (molecular length) and the PDE IV inhibitory activity (r=0.973, n=13). The same inhibitory activity could also be significantly correlated with the following electronic parameters of alkylxanthines: HOMO energy (r=0.850), absolute hardness (r=-0.806), and absolute electronegativity (r=-0.825). These results suggest that the electronic properties are partly responsible for PDE IV inhibition as far as the effects of structural properties associated with molecular length are concerned. Alkylxanthines may also act as electron donors in the charge-transfer interaction with the active sites on PDE IV isoenzyme.     

Child and adolescent psychological assessment: Current clinical practices and the impact of managed care.

Which psychological testing measures are clinical child and adolescent psychologists most commonly using? How has managed care influenced the practice of assessment for these professionals? This study provides survey data from 162 child practitioners employed in independent practice and in hospital, outpatient, and school-based settings throughout the United States. The results demonstrate marked consistency with recent surveys of clinicians working with adults, and a list of the 30 most frequently utilized measures is provided. Over 40% of the sample reported significant limitations in psychological testing due to managed-care policies. Strategies for maintaining an assessment practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship of atopic dermatitis to residential environment. A study of the comparison between diagnosis by medical examination and assessment by questionnaire]

Diagnosis of atopic dermatitis (AD) according to criterion of the Japanese Dermatology Society by medical examination and a questionnaire survey concerning the living environment and presence of allergic diseases were performed on 1725 elementary school children living in Hirosaki-city and its suburbs in Aomiri Prefecture. In addition a scratch test for mite antigen was conducted 523 of the children and a patch test on 240. No difference was found between the rate of children diagnosed as having AD during the medical examination which was 12.9%, and the rate of children who responded as presently having AD in the questionnaire which was 12.8%. However the rate of concordance between those diagnosed to have AD by medical examination and the group that responded as having AD in the questionnaire was about 50%. For AD in children diagnosed by medical examination, a residential environment of the houses that there were moldy and leaking appeared to be a risk factor. Risk factors of children with AD from the questionnaire survey appeared to be houses built within 20 years. Clearly there were differences in conclusions regarding risk factor between the medical examination and the questionnaire. In terms of increasing reliability, a medical examination would be preferred. From the results of allergic tests, the children who lived in houses built within 20 years had a high response to the patch test. These results suggest that houses that are moldy and leaking, or built within 20 years may be considered to be risk factors for outbreak of AD.     

Understanding frame-of-reference training: The impact of training on the recall of performance information.

Extends research on the cognitive mechanisms underlying frame-of-reference (FOR) rater training by examining the impact of FOR training on the recall of performance information. It was hypothesized that the shared performance schema fostered by FOR training would serve as the basis for information processing, resulting in better recall for behavioral performance information as well as more accurate ratings of individual ratees. 174 FOR-trained Ss produced more accurate performance ratings, as measured by L. Cronbach's (1955) differential accuracy and differential elevation components, than did 142 control-trained Ss. FOR-trained Ss also recalled more behaviors, representing more performance dimensions, and exhibited less evaluative clustering and a larger relationship between memory and judgment. No differences were found between control and FOR Ss on measures of recognition accuracy. Implications for the evaluative judgment process are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Moyamoya disease. Its clinical picture, diagnosis and new therapies

Moyamoya disease is a chronic cerebral vasculopathy that leads to a slow progressive narrowing and occlusion of the principal arteries responsible for the anterior circulation of the brain. It causes a cerebrovascular insufficiency with the development of multiple anastomoses between internal and external carotid arteries. The diagnosis is based on the peculiar appearance in angiography. Although rare, it is not possible to omit it in the differential diagnosis of ischemic vascular accidents in children. The authors describe a case of a eight year old female caucasian whose diagnosis was suspected by means of the non invasive technique of angiographic magnetic resonance imaging and confirmed by angiography. Based on this case, the main aspects of the disease are described, with particular emphasis on clinical features, diagnosis and treatment.     

Effects of structure and clustering on recall and recognition memory in clinical depression.

Compared retrieval of high, medium, and low structured material, using word lists consisting of uncategorized words and categorized words presented in randomized and clustered order. Clinically depressed Ss were found to be significantly impaired relative to controls only on the medium level of structure and the randomized categories list when measured by free recall. There were no effects of group nor any interactions for recognition memory, although there was a main effect for group on d′ when signal detection analysis was applied. The implications of the findings for models of memory deficits in depression are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Inappropriate helping behavior and its impact on the identified patient.

Presents an integrative approach to understanding and treating inappropriate helping relationships that can be applied both to the professional field (known as "helping syndrome") and to the marital and family environment ("contributors"). Examples illustrate typical colluding behaviors related to alcoholism, depression, and psychosomatic disorders. Psychodynamic perspectives are reviewed to describe the helper's personality and his/her underlying shortcomings. However, perspectives that focus solely on the individual are viewed as limited and incomplete. Systems theory contributes communicational and interpersonal knowledge. A resultant synthesis is proposed as an alternative. Situational, interactional, and intrapersonal influences on helping behavior are integrated within a transtheoretical framework. A questionnaire is included to facilitate exploration on maladaptive helping behavior. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Examining the relationship between free recall and immediate serial recall: The effect of concurrent task performance.

In 3 experiments, participants saw lists of 16 words for free recall with or without a 6-digit immediate serial recall (ISR) task after each word. Free recall was performed under standard visual silent and spoken-aloud conditions (Experiment 1), overt rehearsal conditions (Experiment 2), and fixed rehearsal conditions (Experiment 3). The authors found that in each experiment, there was no effect of ISR on the magnitude of the recency effect, but interleaved ISR disrupted free recall of those words that would otherwise be rehearsed. The authors conclude that ISR and recency cannot both be outputs from a unitary limited-capacity short-term memory store and discuss the possibility that the process of rehearsal may be common to both tasks. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Bender Gestalt: Use of clinical judgment versus recall scores in prediction of Huntington's disease.

Used Bender-Gestalt recall scores and clinical evaluation of Bender protocols to predict organicity in 2 comparisons in a total of 89 Ss: normals vs premorbids for Huntington's disease and normals vs Ss already affected with Huntington's disease (mean ages, 31 yrs for normals and premorbids and 38 yrs for Huntington's Ss). Mean Bender recall scores significantly discriminated between normals and premorbids. Chi-squares reflecting predictive accuracy were significant for both comparisons using the Bender recall score but were nonsignificant for the predictions by clinical evaluations. Hit rates for the recall score prediction, however, were not much better than those for the clinical evaluation method and were too low for diagnostic evaluation of individual cases. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ethnic disparities in patient recall of physician recommendations of diagnostic and treatment procedures for coronary disease

A pilot study was performed to determine the efficacy of 13-cis-retinoic acid (CRA) and alpha-tocopherol (AT) with increasing doses of recombinant human erythropoietin (rHuEPO) in anemic patients with primary myelodysplastic syndrome (MDS), to determine response rate and to determine the dose requirement and long-term effects of rHuEPO therapy on the transition to acute non-lymphocytic anemia and survival of these patients. Twenty-four consecutive MDS patients were entered into the study. Patients were stratified according to their FAB classification at study entry. Therapy consisted of a 6 month trial of CRA (100 mg m(-2) day(-1) and AT (800 mg day(-1)) with rHuEPO (150 units kg(-1) body weight subcutaneously three times a week). The rHuEPO dose was escalated to daily doses at 2 months, and 300 U kg(-1) body weight given three times a week for another 2 months and continuing therapy after 6 months in responsive patients. Response was measured by elimination of transfusions requirement (partial response, PR) and normal hemoglobin level and complete blood counts (complete response, CR). Observed responses for the 23 evaluable patients were 2 CR and 6 PR (34.8%). Odds ratio analysis showed that patients with anemia alone were 14 times more likely to respond than patients with pancytopenia (p = 0.06). In our study, two patients (8%) transformed to acute leukemia in CRA + AT + rHuEPO-treated patients. Median survival of 34 months with a median follow-up of 17 months (range 3-70 months) was observed. The response rates with the addition of rHuEPO to CRA and AT was similar but occurs earlier at 2 months compared to 6-10 months with CRA and AT alone and did not alter survival. There was no increase in the risk for leukemia in the group treated with rHuEPO. Response to either therapy appeared to be limited to patients in the early stages of MDS.     

Mechanical ventilation of the patient with chronic obstructive pulmonary disease

Mechanical ventilation of the patient with COPD is a balance between avoiding overdistension, auto-PEEP, providing adequate gas exchange, and allowing patient-ventilator synchrony. Figure 13 shows an approach that the authors have found helpful to achieve these goals.     

Examining the relationship between free recall and immediate serial recall: The effects of list length and output order.

In 4 experiments, participants were presented with lists of between 1 and 15 words for tests of immediate memory. For all tasks, participants tended to initiate recall with the first word on the list for short lists. As the list length was increased, so there was a decreased tendency to start with the first list item; and, when free to do so, participants showed an increased tendency to start with one of the last 4 list items. In all tasks, the start position strongly influenced the shape of the resultant serial position curves: When recall started at Serial Position 1, elevated recall of early list items was observed; when recall started toward the end of the list, there were extended recency effects. These results occurred under immediate free recall (IFR) and different variants of immediate serial recall (ISR) and reconstruction of order (RoO) tasks. We argue that these findings have implications for the relationship between IFR and ISR and between rehearsal and recall. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of therapist disclosure on patient disclosure.

Conducted a psychotherapy analog study with 90 female undergraduates to examine the effects of therapist disclosure on the S's disclosure to the therapist during a 1st interview. 3 levels of therapist disclosure, no disclosure, demographic disclosure, and personal disclosure, and 2 levels of therapist warmth were manipulated. Ss completed a modified version of the Jourard Self-Disclosure Questionnaire. Ss exposed to a warm therapist offering moderate self-disclosure (demographic disclosure) disclosed more to the therapist than Ss exposed to warm nondisclosing or personally disclosing therapists. No differences were found between nondisclosing and personally disclosing warm therapists. Ss exposed to a cold therapist offered uniformly low levels of disclosure regardless of the level of therapist disclosure. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)