Clonidine therapy for comorbid attention deficit hyperactivity disorder and conduct disorder: preliminary findings in a children's inpatient unit

This retrospective study examined the clinical course of 18 prepubertal boys (aged 6 to 12) who had dual diagnoses of attention deficit hyperactivity disorder and conduct disorder and who received clonidine on an inpatient basis after failed trials of conventional drug therapy, consisting predominantly of psychostimulants. The effects of clonidine were assessed during inpatient treatment and after discharge at intervals of 1 to 2 months. Eleven (61%) of the children had marked improvement as measured by clinical impression. Transient sedation lasting 2 to 3 days occurred after initial administration or dosage increase; otherwise, clonidine was well tolerated. Our findings suggest that clonidine may prove to be an alternative treatment of comorbid attention deficit hyperactivity disorder and conduct disorder.     

The primary aortoenteric fistula in The Netherlands--the unpublished cases

OBJECTIVE: Primary aortoenteric fistula is a rare disorder of which only four patients have been reported in the Dutch literature so far. The objective of our study was to obtain more realistic figures on the incidence of this condition, with data on the clinical presentation, diagnostic procedures, treatment and results in a group of patients not previously reported as "case histories". METHODS: A questionnaire was sent to all surgical clinics in The Netherlands. Out of 180 questionnaires, 102 have been returned reporting 27 patients to which data of eight others treated in our own institution were added. RESULTS: In all but one of these 29 patients the fistula was caused by an atherosclerotic aneurysm, the one exception being caused by an ingested cocktail pin. Gastrointestinal haemorrhage was the predominant symptom, being present in 28 of the patients, while the complete triad of haemorrhage, pain and a pulsating mass was found in only eight patients. Twenty-seven patients were treated with an in situ graft of which 14 are doing well at long term follow-up. CONCLUSIONS: Primary aortoenteric fistula is far more common than one would expect from the number of patients reported in literature. A high index of suspicion based on a complete physical examination remains the key to a correct diagnosis. Direct closure of the intestine and in situ grafting of the aorta is the treatment of first choice.     

Pulmonary effects of chronic exposure to airborne cadmium

In haemoglobinometry grave errors are still being made even though an internationally accepted standardized method is available for the determination of the haemoglobin content of blood. Up to the present only haemiglobincyanide reference solutions have been available on a wide scale to check the measuring stage of the standardized haemiglobincyanide method. These reference solutions are shown to remain stable, under proper storage conditions, for more than 10 years. Concentrated haemoglobin solutions have become available recently, offering the possibility to control the dilution and conversion steps of the haemiglobincyanide method. Such a solution is shown to remain stable, under proper storage conditions, for at least a year. Using both haemiglobincyanide reference solutions and concentrated haemoglobin solutions, as well as having the possibility of checking the cyanide content of the reagent used, an acceptable intra-laboratory control program may now be set up.     

Self-esteem in alcoholics and nonalcoholics

Alcoholics scored lower on a test of self-esteem than did nonalcoholics, Alcoholics with lower self-esteem were found to be more willing to seek treatment than those with higher self-esteem.     

Compensating changes in fertility and mortality

This paper illustrates a method of studying changes in vital rate schedules which have no effect on the intrinsic rate of population growth. These changes are described as compensating changes in fertility and mortality. The analysis proceeds from the discrete perspective of Leslie matrices, wherein the central idea is to establish the set of all compensating changes by identifying that class of Leslie matrices which possess the same positive eigenvalue, lambda1. A root-squaring technique is adapted for the purpose of estimating lambda1. Finally, a variety of compensating fertility and mortality changes is illustrated using data from Japan.     

Response properties of single units in an association area of the kitten neocortex

Two percept-genetic methods, the Meta-Contrast Technique (MCT) and the Serial Afterimage Test (AI), were used to study adaptive aspects of perception in a group of 37 subjects suffering from manifest anxiety. The perceptual processes laid bare by these methods reflected not only anxiety but also defensive formations. MCT and AI correlated with each other in these respects and, when combined, correlated with rated symptoms. In accordance with the theory behind percept-genetic methods, anxiety signs appearing late in the test serials were more likely to correspond to manifest symptoms than signs which appeared early. The AI test scores seemed to reflect a difference between anxiety experienced as an inherent quality of life and anxiety as a foreign force struggling for dominance.