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Biomedical subjects

A Compton

Publications and source records attributed to A Compton.

At least 19 recordsLinked to original sources
PubMed1992

Positive impact of home hemodialysis.

The intended patient outcomes have been achieved. Home hemodialysis has improved the quality of life for this entire family. Continuous support is necessary to help this family maintain an acceptable lifestyle. This remains a primary goal of care. The nephrology nurse proved to be the key to this successful home hemodialysis experience. Appropriate training coupled with frequent communication and encouragement resulted in a positive patient and family outcome.

Child↗
PubMed1992

The psychoanalytic view of phobias. Part I: Freud's theories of phobias and anxiety.

This paper initiates a series of communications on psychoanalytic and current psychiatric approaches to the understanding and treatment of phobic syndromes with a review and discussion of Freud's evolving ideas on phobias and anxiety. A list of issues that any theory of phobic syndromes must address is compiled on the basis of Freud's work.

Anxiety Disorders↗
PubMed1992

The psychoanalytic view of phobias. Part II: Infantile phobias.

The psychoanalytic literature on infantile phobias, despite disclaimers by several of its prominent authors, seems to demonstrate a growth in knowledge of these conditions and an increasing respect for methodology. It is also noteworthy in its close adherence to the presentation of clinical material. Looking at phobia from this developmental viewpoint has caused us to modify our definition of phobia, adding independence from immediate, fear-provoking stimuli and requiring an inference on the part of the observer because of some integral mental process which is nontransparent. These additions are further specifications of the meaning of the term in general; they are not intended to be limited to infantile phobias. Phobic syndromes can certainly arise well before age four, well before there is any evidence of a child's having entered the oedipal phase of development. Nevertheless, because of the early genital phase, castration reactions, albeit with a somewhat different meaning, usually appear to be involved in the symptom formation. There is also a suggestion that all infantile phobias may begin to arise at this period of development. The symptom pictures in the cases of the children reported in the psychoanalytic literature are very similar. We seem to have described a disorder which, we can hypothesize, has its beginnings in the early genital phase, may emerge as a psychopathological condition at that time, or may reach proportions sufficient to interfere with function or development only several years later. The disorder appears to make use of inherited reflex-like patterns of response to certain stimuli as dangers. On the basis of the reported psychoanalytic experience, we cannot really generalize much about psychogenetics or psychodynamics. Psychoanalysts have applied their ideas about neurotic symptom formation in general to these cases. Just why the illnesses assume these particular forms in these particular children is unclear. The only steps toward specification have been hypotheses introduced by Anna Freud and Owen Renik. Anna Freud hypothesized that a major condensation occurs to focus infantile anxieties on a single symbol, thus causing sharply focused, rather than generalized, anxiety. Renik related self-object differentiation and cognitive development to such "symbolization" in infancy, explaining phobic object formation in terms of primary and secondary process representations and their interaction. Although we have descriptively defined a syndrome "phobia," it is not yet clear whether the disorders of infancy and childhood which fit that definition have significant similarities--descriptively or psychodynamically--with conditions which develop later in life and also appear to fit the descriptive parameters.(ABSTRACT TRUNCATED AT 400 WORDS)

Age Factors↗
PubMed1990

Psychoanalytic process.

Differing concepts of psychoanalytic process and views of its "locale" are related to how essential the interactivity of the analyst is judged to be. Scientific scrutiny of clinical psychoanalysis requires that the interactive nature of the process be recognized. In this endeavor the concept of "process model" is helpful, as is the view of psychoanalysis as a form of treatment in which therapeutic process and therapeutic agent are distinguished.

Freudian Theory↗
PubMed1990

Metabolic control of von Gierke disease (glycogen storage disease type Ia) in pregnancy: maintenance of euglycemia with cornstarch.

In patients with glycogen storage disease type Ia, glucose-6-phosphatase deficiency reduces the liver's ability to generate free glucose from glycogen. Without a continuous, exogenous source of glucose, severe hypoglycemia and subsequent metabolic perturbations occur. Our observations of a patient with glycogen storage disease type Ia, who also had a clomiphene-induced triplet gestation, suggest that cornstarch, which can be catabolized by debranching enzymes, may be used to maintain a constant state of maternal and fetal euglycemia and correct many metabolic abnormalities. Our data suggest that patients with glycogen storage disease type Ia can be safely managed in pregnancy under a tightly monitored and regulated protocol of raw cornstarch feedings.

Adult↗
PubMed1989

Histologic examination of the placenta in the growth-retarded fetus.

This investigation was undertaken to determine whether histologic examination of the placenta contributed to a better understanding of the cause of intrauterine fetal growth retardation. Placentas were examined of 151 liveborn infants whose birthweights were in the lower 10th percentile for gestational age. One or more histologic aberrations were found in 139 (92%) cases, in contrast to one or more antenatal risk factors (primarily hypertension) in 77 (51%) cases or a gross placental abnormality (primarily abruption) in 46 (30%) cases. Compared with placentas belonging to appropriately sized fetuses, histologic signs of uteroplacental vascular insufficiency, chronic inflammation, and hemorrhagic endovasculitis were significantly more common in the study group. The primary histologic condition was supportive of prior clinical impressions in 61 (40%) cases, contradictory in 23 (15%) cases, or solely contributory to explaining the growth retardation in 55 (36%) cases. Placental histologic examination may clarify a cause for delayed fetal growth, especially after a normotensive pregnancy.

Female↗
PubMed1989

The volunteer in bereavement work: tracking the grief process.

A Hospice volunteer looks at common obstacles and challenges in the grief process for persons who have experienced the death of a loved one. Opportunities to give emotional support and appropriate information are offered to facilitate the volunteer's efforts in tracking the bereaved along the continuum of grief.

Bereavement↗
PubMed1989

Oral phenobarbital given antenatally to reduce neonatal intraventricular hemorrhage. A comparison between maternal and umbilical cord serum levels at delivery.

This investigation was undertaken to compare maternal and neonatal cord serum levels of phenobarbital given orally to mothers anticipated to deliver very low birthweight infants at risk for neonatal intraventricular hemorrhage (IVH). Fifty women anticipated to deliver between 26 and 34 weeks' gestation agreed to receive a daily oral dose of 90 mg of phenobarbital. The umbilical cord to maternal phenobarbital concentration ratio at birth was 1.05 and remained constant after the first day of maternal therapy. Cord phenobarbital concentrations increased rapidly during the first 3 days until reaching a steady state by the end of the first week of therapy. In contrast to recent promising reports using large doses of phenobarbital given parenterally shortly before delivery, lower doses of oral phenobarbital did not reach cord levels reported to be protective against IVH or therapeutic as an anticonvulsant.

Administration, Oral↗
PubMed1988

Antenatal phenobarbital and bilirubin metabolism in the very low birth weight infant.

Prior studies in term infants have suggested that in utero phenobarbital exposure may accelerate bilirubin metabolism by stimulating hepatocyte glucuronyl transferase activity. This report reviews our experience with maternal phenobarbital therapy and fetal bilirubin conjugation in the very premature fetus. Mothers with arrested premature labor between 26 and 33 weeks' gestation were randomly assigned to receive oral phenobarbital (90 mg daily) or not. Infants in the two groups were similar in race, birth weight, and gestational age. Conjugated bilirubin levels at birth were significantly higher for infants receiving several days of phenobarbital in utero than no therapy (0.31 +/- 0.03 vs 0.16 +/- 0.01 mg dl, p less than 0.01). A smaller portion of infants exposed to phenobarbital in utero required phototherapy (10/23, 43% vs 24/29, 83%, p less than 0.01), which was also more likely to be delayed beyond 48 hours after delivery. Antenatal phenobarbital enhances bilirubin conjugation before delivery of a very low birth weight infant.

Bilirubin↗
PubMed1987

Reversing severe hypoglycemia during pregnancy with glucagon therapy.

Glucagon therapy has been used to reverse severe hypoglycemia-induced unconsciousness, but no known study exists which reports its use during pregnancy. Pregnant diabetic women were eligible if they had either a prior hypoglycemic episode requiring intravenous glucose administration or had repeated capillary blood glucose determinations less than 40 mg/dl without any warning adrenergic symptoms. Of 51 insulin-dependent diabetic women, 16 were candidates for glucagon use during a recent 3 1/2-year period. Seven of these 16 persons required an injection on 12 occasions, and an immediate reversal of unconsciousness was encountered in 11 circumstances. No apparent short- or long-term maternal adverse effects were present. We conclude that glucagon therapy is needed infrequently for diabetic women during pregnancy but is helpful in reversing acute episodes of severe hypoglycemia.

Adult↗
PubMed1987

Objects and attitudes.

The concept of an attitudinal object has long been present in psychoanalysis but almost entirely neglected. This omission is integral in the confusion and controversy about the object concept in general. It has left a theoretical gap which the so-called object relations theories have attempted to fill. This paper offers some preliminary suggestions for a psychoanalytic understanding of attitudes as a first level of inference in the study of relationships and their psychological basis.

Attitude↗
PubMed1986

Freud: objects and structure.

This paper, part of a series exploring the development of Freud's object concept, deals with the concepts of objects and psychic structure in the period from 1915 to 1938. In connection with the increased prominence of object loss and hostility in his clinical material, the role of objects in the building of psychic structure via identification assumed increased importance from 1917 on. After introduction of the ego-id-superego model, Freud asserted for the first time that object choice does take place as early as the oedipal period, and interpolated the phallic-oedipal phase into his sequence of developmental phases. The prominence of structure formation through identification continued, but no new object concepts are discerned.

Drive↗
PubMed1986

Urologic evaluation of urinary tract infection in pregnancy.

Thirty-three antepartum patients with urinary tract infections underwent urologic evaluation as soon as the infection had been successfully treated. The evaluation included history of voiding habits, cystometry, urethral calibration and cystourethroscopy. A second phase of the urologic evaluation included an excretory urogram and repeat cystometry 10-12 weeks postpartum. Sixty percent had a history of infrequent voiding, and 90% of them had a bladder capacity greater than 450 mL. Forty-one percent of the patients had a normal bladder capacity (less than 450 mL), and 85% of this group did not have any history of infrequent voiding. The radiographic evaluation postpartum in 18 of 33 patients revealed major abnormalities in 50%. These abnormalities were seen as often and were as significant in women with asymptomatic bacteriuria as in those who presented with acute pyelonephritis. The results suggest that the large bladder seen in pregnant women may be secondary to the chronic, unphysiologic habit of infrequent voiding. Furthermore, this study reinforced the fact that most pregnant women with urinary tract infection have preexisting chronic bladder or renal abnormalities that predispose them to infection. Those at risk should be identified early through a careful history and urinalysis to determine which ones need urinary prophylaxis during pregnancy. Postpartum urologic investigation should be carried out to identify any structural or functional problems; understanding them is helpful in present and future management.

Adolescent↗
PubMed1985

The development of the drive object concept in Freud's work: 1905-1915.

In 1905 Freud established the idea of an object of an instinctual drive as the basic object concept of psychoanalysis. He also introduced the derivative concepts of object directedness, object choice, and object finding. While taking these steps he simultaneously deemphasized the importance of drive objects in sexual life, contradicted himself on whether drives are autoerotic or object-directed in infancy, and made incompatible statements about whether or not object choice occurs before puberty. Freud's clinical work, reflected especially in the major case reports and a series of papers on fantasy, led to an apparent recognition of complexity in the mental life of children far greater than had been described earlier. The increased attention to and appreciation of mental content in childhood especially augmented Freud's understanding of the role of drive objects, object directedness, and object choice in infancy. This, in turn, led him to postulate a sequence of organizations of sexual life, named according to the zonal drive source plus the mode of object directedness, a process of theory development that continued through 1924. Object choice and, to a lesser extent, object directedness are concepts derived from and dependent upon the concept of drive object. Both require, however, explanatory constructs besides drive constructs. In 1915 Freud defined the term "object" in the context of stating his drive theory. Freud used the term object with several new modifying words during this decade. No new object concept was introduced, however, in this work, although some steps in that direction appeared to be in progress.

Child↗