Two family outbreaks of Chlamydia pneumoniae infection

During autumn 1992, we observed two unrelated family outbreaks of Chlamydia pneumoniae infection. Family A consisted of grandmother (aged 77 yrs), father (aged 41 yrs), mother (aged 38 yrs), daughter (aged 10 yrs), and two sons (aged 6 yrs and 3 months, respectively). The grandmother and daughter suffered from pneumonia, father from pharyngitis and bronchitis and the older son from mild bronchitis. No symptoms were recorded in the mother and younger son. Symptomatic subjects showed a fourfold increase in immunoglobulin G (IgG) titre for Chlamydia pneumoniae, determined by a microimmunofluorescence test with specific antigen (TW-183). Other serological studies against Mycoplasma pneumonia, Legionella pneumophila, influenza virus type A and B, adenovirus and respiratory syncytial virus (RSV) were negative. Sputum culture gave a positive result for Haemophilus influenzae, colony forming units (cfu) = 10(4).ml-1 in the grandmother. No serum positivity was recorded in the mother and younger son, who remained asymptomatic. All symptomatic patients were successfully treated with macrolides. Family B consisted of mother (aged 63 yrs) and daughter (aged 36 yrs). Both suffered from Chlamydia pneumoniae pneumonia. Diagnosis was made by means of serological microimmunofluorescence test, and direct identification using an indirect immunofluorescence test on pharyngeal swab. Sputum culture and other serological tests remained negative. Both patients were successfully treated with macrolides. These observations emphasize the relevance of Chlamydia pneumoniae in family cluster respiratory infections.     

Effect of beclomethasone dipropionate on bone mineral content assessed by X-ray densitometry in asthmatic children: a longitudinal evaluation

There is little information on bone turnover in asthmatic children taking long-term treatment with inhaled steroids (ICS). The aim of this longitudinal study was to determine the effects of inhaled beclomethasone dipropionate (BDP) on bone mineral density (BMD), in asthmatic children treated over a period of six months. BMD and growth were studied in two age- and sex-matched groups of asthmatic children. These comprised: 14 asthmatic children (Group 1) who had taken BDP in a dosage of 300-400 micrograms daily through a 145 ml spacer device for at least 6 months (mean age 9.1 yrs); and a control group of 16 age- and sex-matched asthmatic patients (Group 2) not treated with ICS (mean age 9.5 yrs). Mean duration of asthma was 5.7 yrs in Group 1 and 5.5 yrs in Group 2. Vertebral BMD (L2-L4) was measured by dual energy X-ray absorptiometry (DEXA) at the beginning (baseline) of the study and 6 months later. There were no significant differences in the baseline bone mass (mean +/- SEM) between the two groups (0.63 +/- 0.03 and 0.64 +/- 0.02 g.cm-2 in Group 1 and 2, respectively). During the observation period, bone density increased, by 4% (95% confidence interval (95% CI) 2-6) in the control group and by 2.3% (95% CI 0.4-4.2) in the group under BDP treatment, showing no significant influence of the treatment. No difference was found in height velocity evaluated before starting BDP and after 6 months of therapy.(ABSTRACT TRUNCATED AT 250 WORDS)     

Bilateral frontal lobe disease and selective delayed response deficits in humans.

Compared the performance of 6 male patients (aged 24–65 yrs) with frontal lobe disease; 17 amnesic male patients (12 with etiology of alcoholic Korsakoff's disease [mean age 53.6 yrs] and 5 with surgically treated ruptured anterior communicating artery aneurysm [mean age 45.6 yrs]), and 12 male alcoholic controls (mean age 39.7 yrs) with no memory impairment on delayed alternation (DA) and delayed response (DR) tasks, known to be sensitive to frontal lobe damage in nonhuman primates. Ss (except the Korsakoff and alcoholic Ss) completed the Wechsler Memory Scale, and all Ss completed the Wechsler Adult Intelligence Scale (WAIS) and the Wisconsin Card Sorting Test. Results show that bilateral frontal lobe damage was associated with impairment on both tasks. There was no relation between performances on DA and DR and performance on the Wechsler Memory Scale, strengthening the suggestion that the former tasks are not sensitive to anterograde amnesia in humans. (41 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Children's belief in photographic fidelity.

Photographs give the impression that they capture reality more truly than other pictorial forms such as drawings and paintings. This study, conducted with 100 operational children ( 5 yrs 10 mo to 7 yrs 3 mo old) and 100 pre-operational children (5 yrs 10 mo to 7 yrs 2 mo old), was concerned with the child's belief as to whether a series of photographs and a parallel series of drawings that depicted illogical or logical outcomes to a conservation of liquid procedure more truly represented reality than directly perceived logical and illogical referent events. Results show the significant influence of the representational medium on fidelity judgments. Six-year-olds treated photographs as having greater fidelity to the reality they depicted than drawings had, but both forms of representation were in general less compelling than real materials themselves. (12 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological adjustment to survival from Hodgkin's disease.

Compared the psychological adjustment of 60 male Hodgkin's disease survivors, aged 20–47 yrs, with an age-matched sample of 20 physically healthy men. Assessment included objective self-report, projective testing, observer rating, and interview. Measures included the Global Assessment Scale, Rosenberg Self-Esteem Scale, and Thematic Apperception Test (TAT). All Ss had received no treatment and had shown no evidence of disease for the previous 6–240 mo (median 2 yrs). On most measures, no differences were found between cancer survivors and healthy controls. However, the hypothesis of greater psychosocial dysfunction in the cancer sample overall was partially confirmed by significantly lowered intimacy motivation, increased avoidant thinking about illness, prolonged difficulty in returning to premorbid work status, and illness-related concerns. Conversely, patients were significantly more appreciative of life than nonpatients. Within the patient group, late stage (aggressively treated) Ss were at highest risk for psychological distress and psychosocial disruption during the 1st 2 yrs off treatment. (52 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preference for and comfort with male versus female counselors among sexually abused girls in individual treatment.

20 sexually abused girls (aged 7–15 yrs) received 6 sessions of psychoeducationally based individual counseling from either male (n?=?10) or female (n?=?10) counselors. Clients' pretreatment and posttreatment preference for sex of their counselor and the girls' anticipated comfort with male vs female counselors were analyzed, as was clients' posttreatment actual comfort with their counselors. Analyses of covariance (ANCOVAs), with pretreatment data as the covariate, revealed that participants treated by male counselors expressed significantly greater preference for and anticipated comfort with male counselors following completion of the treatment program than did their counterparts who were treated by female counselors. Girls treated by male counselors were not significantly more or less comfortable with their assigned counselor following completion of treatment than were those treated by female counselors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Children's evaluations of fathers' socialization behavior.

30 boys and 30 girls in each of 4 age groups (5 yrs 3 mo to 7 yrs 6 mo, 8 yrs 5 mo to 10 yrs 3 mo, 11 yrs 4 mo to 13 yrs 5 mo, and 15 yrs 8 mo to 18 yrs 9 mo) were asked to evaluate fathers' discipline techniques over a range of situations in which a culprit was described as having transgressed. The techniques consisted of induction, physical punishment, love withdrawal, and permissiveness. Evaluations were determined more by the nature of the child making the evaluation than by the type of situation. Whereas the youngest age group indicated no clear pattern of preferences for one technique over another, the 3 older age groups generally evaluated both induction and physical punishment more favorably than the other 2 techniques. In no age group was induction evaluated more highly than physical punishment for all situations. Boys generally evaluated fathers more favorably than did girls, particularly in their use of physical punishment in situations of simple disobedience and physical harm to self. For the youngest boys, self-reports of empathy were correlated with positive ratings of fathers' induction on the combined situations. The differential socialization behavior of fathers is discussed in terms of bidirectional processes. (19 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Development of role-taking skills in young children.

A role-taking hierarchy was developed based on analysis of the H. Borke (see record 1972-00686-001), the N. Burns and L. Cavey (1957), and the M. J. Chandler and S. Greenspan (see record 1973-02093-001) role-taking tasks, and on 2 new tasks constructed by the authors, all of which deal with the same affective content. Tasks were presented to 7 girls and 7 boys in each of 3 age groups (3 yrs 0 mo to 3 yrs 11 mo, 4 yrs 0 mo to 4 yrs 11 mo, and 5 yrs 0 mo to 5 yrs 11 mo). Data were analyzed by a scalogram and a cluster analysis. The hypothesis that these tasks would form a hierarchy such that the skills needed for the early tasks are logically prerequisite to those needed for the later tasks was supported. A fundamental structural difference--sequential vs simultaneous decentering--was identified. The multidimensional nature of role-taking tasks is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Construct validity of the Child Behavior Checklist: Effects of item overlap on second-order factor structure.

The broadband factor structure of the Child Behavior Checklist (CBCL) was examined for the narrowband scales as measured in practice (i.e., with items scored on more than 1 narrowband scale). On the basis of parallel and minimum average partial criteria, a 1-factor solution was indicated for boys age 4–5 yrs, girls age 4–5 yrs, and girls age 12–16 yrs and a 2-factor solution for boys age 6–11 yrs, girls age 6–11 yrs, and boys age 12–16 yrs. The implications of item overlap for research and professional practices associated with the CBCL and related materials are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effectiveness of single therapists versus cotherapy teams in sex therapy.

Assigned 65 sexually dysfunctional couples to treatment by a single male therapist, a single female therapist, or a dual-sex cotherapy team. The male Ss in age ranged from 21 to 69 yrs; female Ss were aged 20 to 65 yrs. Mean duration of the Ss' relationships was 12.7 yrs. Treated dysfunctions included male erectile failure and premature ejaculation and female primary and secondary orgasmic dysfunction. Assessments of marital and sexual satisfaction and functioning were made at initial intake, at the start of therapy, immediately following therapy, and at a 3-mo follow-up. The assessment battery included the Sexual Interaction Inventory, a marriage inventory, patient global ratings, and measures of symptom remission. Repeated measures ANOVA and post hoc comparisons failed to reveal any differences in effectiveness of single therapists vs cotherapy teams. Furthermore, in cases treated by single therapists, a matching of sex of therapist with sex of the dysfunctional member of the couple did not lead to better outcome than for nonmatched cases. Overall, sex therapy was generally effective, although greater gains were shown in Ss' global ratings of satisfaction and in the psychometric measures of adjustment than in actual symptom remission. (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nature des stratégies d'adaptation au sein des relations conjugales: présentation d'une version abrégée du Ways of Coping Questionnaire.

Studied the dimensions of a brief French version of the WCQ (S. Folkman and R. S. Lazarus, 1988) in a sample of 506 married and cohabiting couples. Human Ss: 506 normal male Canadian adults (mean age 37 yrs). 506 normal female Canadian adults (mean age 36 yrs). Each S completed the WCQ, and data were treated with factorial analyses to identify strong and stable dimensions of marital coping. (English abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Determinants of survival in pulmonary Langerhans' cell granulomatosis (histiocytosis X). Groupe d'Etude en Pathologie Interstitielle de la Société de Pathologie Thoracique du Nord

The course of pulmonary Langerhans' cell granulomatosis (pulmonary LCG) is variable, difficult to predict and ranges from spontaneous remission to progressive respiratory insufficiency and death. To identify the determinants of survival, we performed a survival analysis on 45 patients with pulmonary LCG. The patients were aged 28 +/- 10 yrs (mean +/- SD) (range 12-62 yrs), 32 males and 13 females, almost exclusively current smokers (96%), and 78% presented symptoms at the time of diagnosis. Diagnosis was made by lung biopsy in 25 patients (56%) and by bronchoalveolar lavage (BAL) analysis in 20 patients (44%). The patients were followed for a median period of 6 yrs (range 1-29 yrs) after the diagnosis. During the period of observation, 33 (73%) patients survived (median follow-up period = 5.8 yrs; range, 1-29 yrs) and 12 (27%) died or underwent lung transplantation (median follow-up period = 8.4 yrs; range 1.4 - 16.1 yrs). The median survival was approximately 13 years. A univariate analysis demonstrated that diminished survival was significantly associated with: an older age at diagnosis (p = 0.0001); a lower forced expiratory volume in one second/forced vital capacity (FEV1/FVC) ratio at diagnosis (p = 0.005); a higher residual volume/total lung volume (RV/TLC) ratio at diagnosis (p = 0.02); and steroid therapy during follow-up (p = 0.03). Additional predictive information on mortality was: age > 26 yrs (sensitivity 83%, specificity 64%); FEV1/FVC ratio < 0.66 (sensitivity 75%, specificity 86%); and a RV/TLC ratio > 0.33 (sensitivity 75%, specificity 63%). In multivariate Cox analysis, the combination of factors which gave the best prognostic value was FEV1/FVC ratio and age (p < 0.01). The present findings suggest that adverse prognosis factors at diagnosis in pulmonary Langerhans' cell granulomatosis include older age, lower FEV1/FVC ratio and higher RV/TLC ratio, with additional predictive information on mortality if aged > 26 yrs, FEV1/FVC ratio < 0.66, and RV/TLC ratio > 0.33.     

Effects of behavioral marital therapy on couples' communication and problem-solving skills.

Videotaped 55 couples' (mean age 33.5 yrs) interacting and coded discussions of problem areas. 29 couples were being treated with behavioral marital therapy, 14 couples were in a waiting-control group, and 12 were nondistressed couples. Analysis showed that treated couples had significantly more positive and less negative behaviors than the control couples. The interaction patterns of treated Ss resembled the pattern exhibited by the nondistressed couples. However, it was also found that treated Ss appeared to react to aversive stimuli from their spouses. It is suggested that behavioral observation is valuable in improving therapeutic interventions on an empirical basis. (43 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical study of testicular cancer

Since April 1986, a prospective clinical trial for testicular cancer has been underway by our Nara Uro-Oncology Research Group. One hundred and forty-eight cases of germ cell tumor were entered into this study between April, 1986 and August, 1995. They included 99 cases (66.9%) of seminoma and 49 cases (33.1%) of non-seminomatous germ cell tumor (NSGCT). The mean age of seminoma cases (39.7 yrs) was higher than that (30.2 yrs) of NSGCT cases. One hundred and twenty-three cases were treated according to our protocol. In the treatment group, one patient with stage I seminoma died of other diseases and one patient each with stage II and stage III seminoma died of cancer. Three patients with stage III NSGCT died of cancer. The 5-year survival rate was 100% for stage I seminoma, and stage I and stage II NSGCT, 75.0% for stage II seminoma, 0% for stage III seminoma and 66.7% for stage III NSGCT. These findings suggest that new treatment modalities should be introduced into our protocol in the future.     

Children's concepts of volume and flotation.

Conducted a pilot study in which children (aged 7–9 yrs and 11–13 yrs) were asked to judge which 1 out of 3 wooden blocks would float (or sink), given weight and volume information for each block relative to a block that was known to float (or sink). Analysis of explanations indicated that judgments may have been based on the size–weight illusion. An experiment exploring the basis of flotation judgments was conducted with 14 children aged 7 yrs 1 mo to 9 yrs 6 mo and 16 children aged 11 yrs 4 mo to 14 yrs 11 mo that involved a test for judgment of volume based on information integration theory. Results show that Ss aged 7–24 yrs accurately judged volume by integrating 3 dimensions—width, depth, and height—according to the multiplicative rule. A rule assessment of their flotation judgments showed no age differences in initial rule, with weight rules being most popular. However, after feedback there were marked age effects; the 7–9 yr olds abandoned their initial rule without finding an alternative, and the 11–24 yr olds were generally able to find the correct flotation rule. It is concluded that children aged 7–24 yrs can judge volume but 7–9 yr olds have difficulty with the concept of flotation, possibly because it requires mental comparison of 2 ratios, a task known to be difficult for 7–9 yr olds. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gender dysphoria, gender reorientation, and the clinical management of transsexualism.

Conducted 2 studies of gender dysphoria and postoperative adjustment by transsexuals. Study 1 examined the relation of gender reorientation (approximation of the status of the opposite biological sex) to psychological adjustment in gender dysphorics. Three S groups (75 heterosexual males, mean age 36.7 yrs; 85 homosexual males, mean age 29.8 yrs; and 103 biological females, mean age 27.4 yrs) were studied in multiple regression analyses, with psychological symptoms as criteria and measures of 3 roughly sequential components of gender reorientation (role changes, document changes, and physical changes), age, and education as predictors. Psychological complaints correlated negatively with the earliest phase of reorientation for females and with the later phases for males. Age and education bore little relation to current symptoms. Results suggest that psychological improvement accompanies gender reorientation in both male and female gender dysphorics; the greatest degree of improvement is seen earlier in the process for females. Ss in Study 2 were postoperative transsexuals (32 homosexual males, mean age 33.2 yrs; 9 heterosexual males, mean age 47.7 yrs; and 38 biological females, mean age 32.6 yrs) at least 1 yr after surgery. Follow-up rate was 77.5% for all Ss meeting the 1-yr criterion. Satisfaction with surgery was high, and psychosocial adjustment was acceptable for the majority. Results of both studies support the rationale for clinical intervention in aid of gender reorientation in selected cases. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sex similarities in verbal and performance IQ deficits following unilateral cerebral lesions.

Investigated whether men and women produce similar Verbal IQ and Performance IQ patterns following unilateral cerebral lesions. Ss included 24 women (mean age 43.96 yrs) and 24 men (mean age 45.08 yrs) with independent neurological evidence of neoplastic or vascular lesions of the right cerebral hemisphere, 24 women (mean age 47.88 yrs) and 24 men (mean age 47.50 yrs) with such lesion evidence of the left cerebral hemisphere, and 14 female (mean age 46.43 yrs) and 14 male (mean age 45.50 yrs) controls. Each group was equated for education, lesion site, severity, chronicity, and etiology. Ss were administered the Wechsler-Bellevue Intelligence Scale, and differences in Verbal and Performance IQ values were compared. Contrary to reports in the literature, no consistent evidence of Sex?×?Lesioned Hemisphere interactions was found. Differences in the lateralization effects between men and women were not reflected in direction or pattern but only in magnitude, arguing against a theory of differential cognitive lateralization according to sex. (15 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment of nightmares via relaxation and desensitization: A controlled evaluation.

32 self-referred nightmare sufferers (mean age 36 yrs) were randomly assigned to relaxation training, systematic desensitization, or a waiting-list control. Ss on the average had been having 9 nightmares/mo and reported mean problem duration of 12 yrs prior to treatment. After the intervention phase, both treated groups showed significant decreases in nightmare frequency relative to controls. After subsequent treatment, the waiting-list group showed similarly decreased frequency but remained unimproved on nightmare intensity relative to prior treated groups. Hierarchical desensitization did not increase efficacy at 15 wks beyond benefits associated with relaxation alone. At 25 wks, however, desensitized Ss showed significantly greater reduction in nightmare intensity. Overall, at least 80% reduction in nightmares was reported by 20 Ss, of whom 12 reported total elimination of symptoms at 25-wk follow-up. Some Ss experienced fewer but more intense nightmares, others maintained frequency of previously disturbing dreams but were no longer awakened or distressed by them, and 2 reported substantial worsening of symptoms. Unfavorable outcome was associated with personality disorder profiles on the MMPI. Findings are discussed in relation to a conceptualization of nightmares as a symptom of a more generalized arousal disorder. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Age at first onset for nonbipolar depression.

Examined the onset age distribution for first episodes of unipolar depression for men and women using 2,046 Ss (aged 18–88 yrs) selected for a diagnostic interview on the basis of elevated scores on the Center for Epidemiological Studies Depression Scale. Of those Ss interviewed, 1,012 were diagnosed as having suffered from a previous episode of depression. The Life Table method (S. Anderson et al [1980]; J. D. Kalbfeisch and R. L. Prentice [1980]) was used to describe the risks associated with different ages for developing an initial episode of depression. The results indicate that the hazard rates are very low through age 14 yrs, increase during adolescence (15–29 yrs) and young adulthood (20–24 yrs), peak between 45 and 55 yrs, and then decrease with increasing age, becoming zero at 80 yrs or older. The hazard rates for men and women differed, with women between the ages of 9 and 69 yrs having higher hazard rates than men between the same ages. The average age at onset for first episodes of depression for men and women did not differ. (53 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)