A data-based reply to Hare-Mustin on family therapy perils.

Refutes R. Hare-Mustin's (see record 1981-26292-001) contention that family therapy may not be in the best interests of individual family members by presenting a brief review of the empirical evidence. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Suicide" gene for the control of graft-versus-host disease

OBJECTIVES: To determine the 10-year outcome of patients presenting with rest pain. METHODS: One hundred and three consecutive patients presenting with ischaemic rest pain in 1987 were followed up after 10 years. Hospital notes, death certificates and telephone interviews with patients were used to determine outcome. RESULTS: Follow-up data is available for 97 (94%) patients. Thirteen patients are alive (13.7%) after 10 years, 12 presented with rest pain alone and one had ulceration. Three of these had amputation. The commonest cause of death was myocardial infarction (n = 21, 25%). In those who had died, the median age of onset of symptoms was 72 years (49-93) for rest pain, 74 years (56-87) for ulceration and 71.5 years (45-85) for gangrene. Their survival after admission was a mean of 39 months with rest pain, 33 months with ulceration and 42 months with gangrene. The overall 5-year survival was 31% and the 10-year survival 13%. CONCLUSION: Patients presenting with ischaemic rest pain have a poor prognosis. The presence or absence of ulceration or gangrene does not influence the outcome. Most patients die from smoking-related diseases.     

The anthropometric laboratory of Ireland.

Extends the analysis of F. Galton's (1885, 1892) anthropometric data presented by R. C. Johnson et al (see record 1986-11384-001) by presenting historical information about the anthropometric laboratory of Ireland. (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The need to test hypotheses about paranoid schizophrenia: Reply to Clementz and Sweeney.

Responds to the criticism of B. A. Clementz and J. A. Sweeney (see record 1989-32933-001) on the article by the present authors (see record 1988-23546-001) presenting the hypothesis that paranoid schizophrenia is not a true schizophrenia but one of several responses to an underlying depressive mode. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

What Mahoney "knows."

Criticizes M. J. Mahoney (see record 1990-03226-001) for presenting facts about and arguments against behavior analysis (BAN) as though they were context free. This is ironic in light of his own wrongly placed criticism of BAN for being objectivist in epistemology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluation of the erythrocyte sedimentation rate in children presenting with limp, fever, or abdominal pain

An erythrocyte sedimentation rate (ESR) is commonly ordered as part of the evaluation of patients with nonspecific but potentially serious symptoms. To investigate the performance of ESR in this setting, we used a computerized database and medical chart review to identify children (n=299) with ESR done for a previously undiagnosed condition. Medical records were reviewed to determine symptoms at presentation, referral status, and subsequent diagnoses, which were classified as serious (n=93) or benign (n=206). We found that serious underlying disease was about 7 times as likely in patients with ESR>50 mm/hr (57/102) than in patients with ESR<20 mm/hr (7/89). Although the prevalence of serious disease was higher among referral patients, the likelihood ratios were similar for referral and primary-care patients. An erythrocyte sedimentation rate greater than 50 mm/hr was most informative in patients presenting with limp (likelihood ratio [LR] =8.2) and abdominal pain (LR=6.0) and least informative in patients presenting with fever (LR=2.5). On the other hand, an ESR<20 mm/hr is reassuring in patients presenting with fever (LR=0) or limp (LR=0.3), but not in patients presenting with abdominal pain (LR=0.8). An ESR between 20 and 50 mm/hr (23% of the patients) provided little information (LR 1.2-1.5) in each of the three groups. These results suggest that the ESR often provides useful information about the likelihood of serious illness among children presenting with worrisome but nonspecific symptoms, in particular in patients presenting with limp.     

Undetected cardiogenic shock in patients with congestive heart failure presenting to the emergency department

The purpose of this study was to examine the use of lactic acid levels and continuous central venous oxygen saturation (central venous oximetry) to stratify and treat patients with acutely decompensated end-stage chronic congestive heart failure (CHF) presenting to the emergency department. This prospective, convenience, non-outcome study was performed at an urban tertiary care hospital. Patients with end-stage CHF with an ejection fraction <30% presenting in decompensated CHF were eligible for the study. Patients were assessed using the Killip classification and New York Heart Association criteria. After lactic acid levels were obtained, patients were managed according to a standardized protocol guided by central venous oximetry. The patients were divided into high lactic acid (n = 22), low lactic acid (n = 5), and control groups (stable patients presenting to a cardiology clinic, n = 17) for comparison. There was no statistical difference in vital signs, or Killip and New York Heart Association criteria among the 3 groups. Central venous oxygen saturation was significantly lower in the high lactic acid group (32 +/- 12%) than in the normal lactic acid (51 +/- 13%) and control groups (60 +/- 6%) (p < 0.001). After treatment there was a significant decrease in lactic acid (-3.65 +/- 3.65 mM/L) and an increase in central venous oxygen saturation (32 +/- 13%) in the high lactic acid group compared with the normal lactic acid group (p < 0.001). A significant subset of patients with decompensated end-stage CHF present to the emergency department in occult shock and are clinically indistinguishable from patients with mildly decompensated CHF and stable CHF. Once identified, these patients require aggressive alternative management and disposition. Further study is necessary to identify whether this intervention impacts morbidity, mortality, and health care resource consumption.     

Birth order effects: A reply to Schooler.

Replies to C. Schooler's (see record 1973-00727-001) criticisms regarding birth order studies by presenting evidence to support Breland's contention that birth order effects on verbal achievement do exist, and that these are not caused by either population biases or socioeconomic status differences. (22 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Quantitative flow cytometry can predict childhood acute lymphoblastic leukaemia presenting with aplasia

Acute lymphoblastic leukaemia (ALL) presenting as a transient pancytopenia is known to occur in children and less commonly in adults. The period of pancytopenia usually resolves after about 5-38 weeks, to be followed by overt ALL. The pathogenesis is not known and there are no specific cytogenetic abnormalities. Diagnosis is often difficult during the period of bone marrow hypoplasia. Quantitative flow cytometry can help to establish early diagnosis, and can be used on more patients presenting in a similar way.     

Image displacement and the movement aftereffect: Comment on Wallach.

Comments on H. Wallach's (see record 1986-08161-001) analysis of visual motion perception derived from primary or learned stimulation by presenting experimental findings from a variety of studies that contradict the conception of image displacement as primary and by suggesting that perception of object movement can be derived from configurational changes alone. (13 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The "frisson" benefits of managed care.

Comments on the article by Anonymous (see record 1995-33982-001) which, in presenting the hidden benefits of managed care, offers a spoof on the managed care debate. The current author applauds the article for its comic relief and its way of turning the qualities of managed care that are generally considered intrusive into positive attributes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prisoner of managed care?

Comments on the article by Anonymous (see record 1995-33982-001) which, in presenting the hidden benefits of managed care, offers a spoof on the managed care debate. The current author likens the article's conceptualization of managed care to his own experiences as a prisoner of war in World War II. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Experimental effects and person effects in delay of gratification.

Elaborates on findings included in W. Mischel's (see record 1985-06679-001) article regarding the effect of personality factors and experimental manipulations on delayed gratification by presenting a meta-analysis of experimental studies related to delay of gratification and by suggesting that broad range effect sizes are larger and more important than they are generally considered to be. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A second look at the personality/disease specificity hypothesis: A response to Friedman and Booth-Kewley.

While presenting persuasive evidence of the functional integrity of an interactive mind/body system, H. S. Friedman and S. Booth-Kewley's (see record 1987-31704-001) meta-analysis of the personality/disease relationship does injury to the specificity hypothesis, which contends that there may be emotion-specific/disease-specific linkages in the etiology and progress of certain stress-responsive syndromes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Genomic variation of human papillomavirus type 16 and risk for high grade cervical intraepithelial neoplasia

BACKGROUND: Epidemiologic studies have demonstrated strong and consistent associations between the detection of human papillomavirus (HPV) type 16 DNA and the risk of cervical intraepithelial neoplasia (CIN) and cervical cancer. However, HPV16 is also the most common type of HPV in the normal population, and only a minority of women with HPV16 infection develop cervical cancer. Studies of genomic heterogeneity in HPV16 have demonstrated the presence of multiple variant forms in all human populations examined to date. It is conceivable that the natural variants of HPV16 in a given population may not have the same biologic behavior. PURPOSE: This study was designed to determine the association between natural variants of HPV16 and the risk of biopsy-confirmed CIN 2 or 3, the most important precancerous lesions of the uterine cervix. METHODS: Prospective studies were conducted among 1) women attending a university and 2) women presenting to a sexually transmitted disease clinic. Subjects were eligible for inclusion in this investigation if the initial cytologic findings did not reveal CIN 2-3 and HPV16 DNA was detected by means of a polymerase chain reaction (PCR)-based method in one or more cervical or vulvovaginal samples. Eligible subjects were followed every 4 months with cervical Pap smears and colposcopic examinations. Women were referred for biopsy if cytology or colposcopy suggested CIN 2-3. Two groups of HPV16 variants, prototype-like and nonprototype-like, were determined by means of single-strand conformation polymorphism (SSCP) analysis of PCR products from the noncoding region of the viral genome. Representative SSCP patterns from HPV16 variants were further characterized by direct DNA sequencing of the PCR products. Relative risks (RRs) and 95% confidence intervals (CIs) were calculated by Cox regression analysis. RESULTS: Prototype-like variants accounted for 79% of the HPV16 detected in university students and 86% of the virus detected in patients presenting to the sexually transmitted disease clinic. CIN 2-3 was confirmed by biopsy in nine of 57 HPV16-positive women attending the university and in 10 of 66 HPV16-positive women presenting to the sexually transmitted disease clinic. Among university students, those with HPV16 nonprototype-like variants were 6.5 (95% CI = 1.6-27.2) times more likely to develop CIN 2-3 than those with prototype-like variants. A similar association was observed among women presenting to the sexually transmitted disease clinic (RR = 4.5; 95% CI = 0.9-23.8). CONCLUSIONS: This study suggests that the risk of developing CIN 2-3 is not the same with all variants of HPV16 and that nonprototype-like variants confer a greater risk compared with prototype-like variants. The important genomic differences underlying this increased risk of CIN 2-3 remain to be determined.     

The treatment of patients with chronic cerebral circulatory failure by using laser puncture and the microclimate of the biotron

A mode is proposed of treatment of chronic cerebrovascular disorders, such as initial manifestations of cerebral blood supply insufficiency (IMBSI) and dyscirculatory encephalopathy (DE) stage I-II in hypertensive disease, involving the use of laser puncture and microclimate of biotron. All patients (n = 162) were exposed to laser puncture (10-12 procedures). Laser puncture treatments were devised according to classical approaches of reflexotherapy, using determinants of electropuncture diagnostic method by Riodoraku. The treatments were carried out with the aid of infrared portable laser "Biomed-001". IMBSI patients presenting with vegetovascular dystonia and about 70% of IMBSI patients presenting with hypertensive disease derived benefit from a course of laser puncture, as evidenced by REG, EEG, acupuncture diagnosis, iridodiagnosis according. In DE stage I-II patients and about 30% IMBSI patients presenting with hypertensive disease good therapeutic effect occurred after treatment in a ward with a stable microclimate of biotron. The proposed method can be used for treating chronic cerebrovascular disorders and administering stroke prophylaxis.     

PD98059 is an equipotent antagonist of the aryl hydrocarbon receptor and inhibitor of mitogen-activated protein kinase kinase

Striatal dopamine transporter function and dopamine D2 receptor status were evaluated in 15 patients with early untreated Parkinson's disease using single photon emission tomography (SPECT) with 123I-Iodo-2beta-carboxymethoxy-3beta-(4-idiophenyl)tropane (beta-CIT) and 123I-Iodobenzamide (IBZM) as pre- and postsynaptic ligands. Symptoms were unilateral in five patients and bilateral but asymmetric in 10 patients. Patients with bilateral symptoms had significantly lower 18-hour striatal/cerebellar beta-CIT binding ratios (3.59 +/- 0.79) than hemiparkinsonian patients (5.76 +/- 1.48, p < 0.05) reflecting more advanced disease in this subgroup. Patients with bilateral parkinsonism were also found to have a significant side-to-side difference in striatal beta-CIT binding with more marked reduction contralateral to the presenting limb (18-hour striatal/cerebellar ratio: 4.13 +/- 0.78 [ipsilateral] versus 3.59 +/- 0.79 [contralateral], p < 0.05). Dopamine D2 receptor binding as measured by IBZM was significantly elevated contralateral to the affected side in hemiparkinsonian patients (striatal/cerebellar ratio: 2.42 +/- 0.90 [contralateral] versus 2.19 +/- 0.80 [ipsilateral], p < 0.05). This asymmetric upregulation was absent in the patients with bilateral parkinsonism (striatal/cerebellar ratio: 1.85 +/- 0.43 [contralateral to more severely affected side] versus 1.83 +/- 0.34 [ipsilateral], p > 0.05). Our data suggest that postsynaptic dopamine receptor upregulation contralateral to the presenting side occurs in untreated unilateral PD and disappears in untreated bilateral (asymmetric) PD despite a greater loss of dopamine transporter function. Combined beta-CIT and IBZM SPECT studies may be helpful to monitor the progression of nigrostriatal dysfunction in early PD.     

Comment on ethical issues in Malamuth, Heim and Feshbach's "Sexual responsiveness of college students to rape depictions: Inhibitory and disinhibitory effects."

The concern of N. M. Malamuth et al (see record 1981-09143-001) about presenting "totally false" rape depictions to students is reviewed in terms of (a) possible effects of exposure and debriefing, which were not evaluated; (b) responsibilities in interpretation when data differ from expectations and for males and females; and (c) communications to the public. Classroom testing on rape depictions is questioned. (7 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Comprehensive casebook of cognitive therapy.

Reviews the book, Comprehensive casebook of cognitive therapy edited by Arthur Freeman and Frank W. Dattilio (see record 1993-97032-000). This volume details somewhat over 30 individual cases to illustrate how cognitive strategies can be applied to a wide range of presenting problems. The Casebook takes seriously its intent to be "comprehensive," offering case examples of several mental disorders. Each case begins with a briefing on the patient's background and presenting problems, but, according to the reviewer, editors Freeman and Dattilio have ably succeeded in keeping their authors focused primarily on the sequence of interventions that enables their patients to move from distress to more positive functioning. The reviewer believes that this tightly managed casebook will be helpful to both students in courses on cognitive therapy as well as the experienced therapist by clarifying the potential traps and the potential treasures inherent in cognitive approaches to treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The clinical and radiological features of cholecystocolic fistulae

The clinical and radiological features of seven patients presenting with cholecystocolic fistulae are reviewed. The majority of the patients were elderly (age range 43-85 years, mean 70.7 years) and there was a female preponderance (6:1). The condition usually has a benign clinical course. Diarrhoea was the most common presenting symptom and the typical clinical features of gallbladder disease were absent. Cholangitis occurred in only one patient. The time between onset of symptoms and diagnosis varied from 1 week to 2 years (mean 22 weeks). In only one patient was the diagnosis of biliary-intestinal fistula suspected on the basis of the plain abdominal radiograph (Case 5). A diagnosis of cholecystocolic fistula was established by barium enema (5 cases), endoscopic retrograde cholangiopancreatography (ERCP) (1 case) and diagnostic laparotomy (1 case). The only cause identified in this series was acute or chronic cholecystitis.