PubMed Health⌕ Search

Biomedical subjects

B P Radanov

Publications and source records attributed to B P Radanov.

At least 19 recordsLinked to original sources
PubMed2004

Quality of life and coping behaviour in Type 1 diabetes mellitus: relationship with metabolic control.

Uncovering factors possibly leading to insufficient metabolic control in Type 1 diabetes, both on the part of the patient or the treating physician, is of considerable relevance. The present long-term study investigated the relevance of patient-related vs education-related factors for the success in achieving acceptable glycaemic control. Adolescents or young adults with Type 1 diabetes mellitus (n= 26, mean age= 22+/-2 yr, diabetes duration= 11+/-5 yr) were followed during 36+/-5 months. All patients were treated by the same diabetologist. At the beginning of the study coping behaviour, quality of life and evaluation of emotional status were assessed. Changes in HbA1c were used as a parameter of glycaemic control. At follow-up there was a significant decrease in HbA1c of 0.4% (p<0.01). However, this was not in statistically significant correlation with age, gender, aspects of quality of life or coping behaviour. Therefore, glycaemic control and/or improvement of glycaemic control in adolescents or young adults with Type 1 diabetes mellitus seems to be primarily related to other factors, eg continuous education provided in a stable setting.

Adaptation, Psychological↗
PubMed2001

Symptomatic approach to posttraumatic headache and its possible implications for treatment.

We investigated 112 patients [mean age 39.5 +/- 10.5 years, 59% women (n=66)] with chronic posttraumatic headache following cranio-cervical acceleration/deceleration trauma after an average time interval of 2.5 +/- 1.9 years from trauma. Headache following minor head injury or whiplash is one of the most prominent problems in neurotraumatology. Previous research is inconclusive regarding the symptomatic approach of this type of headache. Details of the phenomenology of posttraumatic headache in the previous literature are inconclusive. This may lead to inappropriate treatment strategies, because recent advances in therapy of different headache types may be neglected. Patients were investigated at the outpatient service of the Department of Psychiatry. Headache was analyzed according to its principal location, laterality, projection, quality, precipitation or aggravation and possible additional symptoms. For this analysis, headache was diagnosed according to the classification of the International Headache Society. The results showed that 42 patients (37%) had tension-type headache, 30 (27%) were identified as suffering from migraine, whereas 20 patients (18%) had cervicogenic headache. An additional 18% of patients suffered from headache that did not fulfill criteria of a particular category. In 104 patients (93%), neck pain was associated in time with headache. Each of the diagnosed headache types in this study may require specific treatment strategies based upon empirical studies of non-traumatic headache types. For these reasons a detailed analysis of headache following cranio-cervical acceleration/deceleration trauma is necessary.

Adult↗
PubMed2001

Central hypersensitivity in chronic pain after whiplash injury.

OBJECTIVE: The mechanisms underlying chronic pain after whiplash injury are usually unclear. Injuries may cause sensitization of spinal cord neurons in animals (central hypersensitivity), which results in increased responsiveness to peripheral stimuli. In humans, the responsiveness of the central nervous system to peripheral stimulation may be explored by applying sensory tests to healthy tissues. The hypotheses of this study were: (1) chronic whiplash pain is associated with central hypersensitivity; (2) central hypersensitivity is maintained by nociception arising from the painful or tender muscles in the neck. DESIGN: Comparison of patients with healthy controls. SETTING: Pain clinic and laboratory for pain research, university hospital. PATIENTS: Fourteen patients with chronic neck pain after whiplash injury (car accident) and 14 healthy volunteers. OUTCOME MEASURES: Pain thresholds to: single electrical stimulus (intramuscular), repeated electrical stimulation (intramuscular and transcutaneous), and heat (transcutaneous). Each threshold was measured at neck and lower limb, before and after local anesthesia of the painful and tender muscles of the neck. RESULTS: The whiplash group had significantly lower pain thresholds for all tests. except heat, at both neck and lower limb. Local anesthesia of the painful and tender points affected neither intensity of neck pain nor pain thresholds. CONCLUSIONS: The authors found a hypersensitivity to peripheral stimulation in whiplash patients. Hypersensitivity was observed after cutaneous and muscular stimulation, at both neck and lower limb. Because hypersensitivity was observed in healthy tissues, it resulted from alterations in the central processing of sensory stimuli (central hypersensitivity). Central hypersensitivity was not dependent on a nociceptive input arising from the painful and tender muscles.

Adult↗
PubMed2000

[Prevalence of sleep disorders in an employed Swiss population: results of a questionnaire survey].

BACKGROUND: The aim of the study was to demonstrate the variety of sleep disorders occurring in a working population in Switzerland and to estimate the prevalence of the main sleep disorders in this Swiss cohort. We also intended to demonstrate that with just a few systematic questions a straightforward diagnostic workup is possible in general practice. METHODS: A questionnaire was sent to all 1473 clerks of the Berne main post office. The questions allowed a choice between "yes" or "no", or often (= +3), occasionally (= +2), rarely (= +) and never (= 0). Daytime sleepiness was assessed by the Epworth Sleepiness Scale. RESULTS: 668 questionnaires (45%) were available for analysis. Daytime sleepiness, assessed by an Epworth score > or = 10, was found in 13% of the respondents. Short sleep (< 7 h sleep) was reported in 47%, and long sleep (> 9 h sleep) in 5% of this population. Specific questions clearly suggested obstructive sleep apnoea in 6%, restless-legs syndrome in 4%, disorders of initiating and maintaining sleep in 19% and narcolepsy in 0.5% of respondents. CONCLUSION: Chronic sleep insufficiency and sleep complaints appear to be frequent in this relatively young Swiss working population. The questionnaire-based estimated prevalence of the main sleep disorders is comparable to previously published international data.

Adult↗
PubMed2000

[Whiplash injury of the cervical spine--initial evaluation and treatment of late sequelae].

Principal requirement for adequate management of whiplash patients is considerable familiarity with symptoms of whiplash injury and knowledge of risk factors contributing to delayed recovery. In addition, evidence based knowledge of treatment strategies may help promoting an integrative initial assessment leading to therapy which likely may prevent chronicity.

Cervical Vertebrae↗
PubMed2000

Saccadic eye movement disturbances in whiplash patients with persistent complaints.

In order to analyse the possible basis of subjective complaints following whiplash injury, horizontal eye movements were examined in subjects with persistent complaints ('symptomatic group') and subjects who had completely recovered ('recovered group'). The results for the symptomatic and recovered groups were compared with those for age-matched, healthy volunteers (control group). A battery of different saccade paradigms was employed: two were reflexive saccade tasks including a gap and an overlap task, and two were intentional saccade tasks consisting of an antisaccade and a memory-guided saccade task. In addition, the symptomatic and recovered groups also underwent psychiatric evaluation in a structured clinical interview, and all groups were assessed for emotional functioning using the Beck Depression Inventory (BDI). The recovered group did not differ significantly from the control group in saccade performance and emotional functioning. The symptomatic group showed dissociation of their performances of reflexive and intentional saccade tasks: performance in reflexive saccade tasks was normal, but in intentional saccade tasks the symptomatic group showed significantly impaired inhibition of unwanted reflexive saccades, impaired saccade triggering (i.e. increased latency) and a higher percentage error in amplitude in memory-guided saccades. Based on clinical interviews, no signs of major depression or dysthymia were found in any of the groups. Compared with the other two groups, the symptomatic group had significantly higher overall BDI scores, but these resulted from BDI dimensions that were non-specific to depression, viz. 'physiological manifestations' (e.g. fatigue, sleep disturbance) or 'performance difficulty' (e.g. work inhibition). In summary, in the symptomatic group the pattern of eye movement disturbances together with normal performance in reflexive saccade tasks and impaired performance in the intentional saccade tasks, especially impaired inhibitory function, suggests dysfunction of prefrontal and frontal cortical structures.

Adult↗
PubMed1999

[Controversy regarding the sequelae of minor craniocervical trauma with special reference to neurobiological aspects of cognitive disorders].

This paper focuses primarily on the biomechanical factors which may lead to a substantial brain-tissue lesion following cranio-cervical trauma. Emphasis is placed on pathoanatomical findings and clinical parameters in the assessment of trauma-severity. Results from previous research are highlighted to demonstrate close interrelationship between the severity of a trauma and neurological, psychological, neuropsychological sequelae or lesions visible by neuroimaging. Knowledge of this interrelationship clearly indicates the necessity of proper initial assessment to allow reliable prognosis of outcome and establishment of treatment strategies.

Biomechanical Phenomena↗
PubMed1999

Relation between neuropsychological and neuroimaging findings in patients with late whiplash syndrome.

OBJECTIVES: The interpretation of long term cognitive impairment after whiplash injury is still a problem for many physicians. On the grounds of nuclear medicine findings previous research speculated that brain damage is responsible for cognitive problems of patients with whiplash. To test this hypothesis the relation between neuroimaging and neuropsychological findings was analysed. METHODS: Twenty one patients (11 women, 10 men, mean age 42.2 (SD 8.6) years) with the late whiplash syndrome (average interval of trauma 26.1 (SD 20.7) months) referred for diagnostic action to the Department of Neurology were investigated. Assessment included computer assisted assessment of working memory and divided attention, neuroimaging (by the means of [99mTc]-HMPAO-SPECT, [15O]-H2O-PET and [18F]-FDG-PET), testing of emotional functioning (depression and anxiety ratings), and pain intensity at the time of testing. RESULTS: On average, scoring on tests of cognitive functioning was very low. However, no significant correlations were found between regional perfusion or metabolism in any brain area and the scores of divided attention or working memory. By contrast, significant relations were found between indices of impaired emotional functioning (state anxiety) and divided attention. In addition, low scoring in divided attention was significantly correlated with pain intensity at the time of testing. CONCLUSIONS: The present data do not provide evidence of a significant relation between detectable morphological or functional brain damage and impaired cognitive performance in the late whiplash syndrome. Results indicate triggering of emotional and cognitive symptoms on the basis of initial injury of the cervical spine.

Adult↗
PubMed1998

[Neuropsychiatric aspects of expert evaluation reports after whiplash injury of the cervical spine].

Considerable familiarity with the symptoms of whiplash injury and a knowledge of the risk factors contributing to delayed recovery are requirements for the professionals who write expert reports. In addition, good skills in evaluating the factors influencing pain and illness behavior are necessary, as is the assessment of cognitive performance. Knowing these factors allows as integrative assessment of whiplash patients and is preferably performed by psychiatrists or physicians trained in psychosomatic medicine.

Expert Testimony↗
PubMed1998

Developmental background and outcome in patients with nonepileptic versus epileptic seizures: a controlled study.

PURPOSE: This study was designed to evaluate the relevance of developmental emotional stress factors, which are considered to influence emotional functioning, as contributing factors in the development of psychogenic symptoms. METHODS: Ten patients with nonepileptic seizures (non-ESs) (frequently referred to as psychogenic seizures), in whom diagnosis had been confirmed by a placebo-infusion test (PT), and 10 control patients with complex partial seizures (ESs) were evaluated with regard to developmental background by using structured in-depth interviews performed by a single interviewer blinded to the diagnosis. In addition, outcome assessment in the non-ES group after PT was done. RESULTS: There were no significant differences between groups in developmental psychosocial stress or in any single developmental stress factor. Six months after PT, the outcome was favorable in patients with non-ES: six were seizure free, and two had a considerable reduction in frequency of seizures. CONCLUSIONS: Our research indicates the following: (a) a high incidence of developmental stress factors and functional disturbances may be found in patients with non-ESs and ESs; (b) assessment of developmental emotional stress and functional disturbances as a basis for validating the diagnosis of non-ES should be treated with caution; (c) use of PT followed by supportive information about the nonepileptic origin of the attacks may have a positive therapeutic effect or help to introduce psychotherapeutic treatment.

Adult↗
PubMed1998

PET with 18fluorodeoxyglucose and hexamethylpropylene amine oxime SPECT in late whiplash syndrome.

BACKGROUND: Many patients have cognitive abnormalities and psychological problems after whiplash injury to the cervical spine. To our knowledge, neuroradiologic imaging has not depicted brain damage that explains the symptoms. Parietotemporo-occipital perfusion deficits on hexamethylpropylene amine oxime (HMPAO) SPECT studies have been described among patients who have sustained whiplash injury. METHODS: We examined 13 patients with typical late whiplash syndrome (study group) using HMPAO SPECT, 18fluorodeoxyglucose (FDG) PET, and MRI of the brain and compared the findings with those for 16 control subjects who underwent FDG PET. RESULTS: In the study group, statistical parametric mapping revealed significantly decreased FDG uptake in the frontopolar and lateral temporal cortex and in the putamen. The frontopolar hypometabolism correlated significantly with scores of the Beck Depression Inventory. However, in individual cases, reliability in the depiction of hypometabolic areas was relatively low. No alterations were found in the parietotemporo-occipital area. In these areas, decreased uptake of HMPAO and FDG correlated with cortical mass. CONCLUSION: FDG PET did not allow reliable diagnosis of metabolic disturbances for individual patients. Therefore, we do not recommend FDG PET or HMPAO SPECT as a diagnostic tool in routine examinations of patients with late whiplash syndrome.

Adult↗
PubMed1998

[Correlation between dental status and dental anxiety].

The relationship between dental status and dental anxiety was analysed in 165 patients. To assess the dental status, D3.4 MFS-index and Bleeding-on-Probing-Index (BOP) were applied. Dental anxiety was assessed using dental anxiety rating, whereas aspects of state and trait anxiety were analysed by the State-Trait-Anxiety Inventory. The hypothesis was: higher levels of dental anxiety lead to avoiding check-ups and necessary treatment, the consequence of which is a deterioration of the dental status. No significant correlation was found between dental anxiety and dental status. A significant difference was found when comparing patients with high or low dental anxiety in respect of the D3.4 MFS-index, whereas a different trend was found on comparing these groups for BOP-index. In addition, a significant correlation was found between dental anxiety and trait anxiety. These results suggest that dental anxiety is a rather non-specific phenomenon, since it is an aspect of proneness to anxiety. In addition, in patients who display considerably high dental anxiety, this may lead to anxiety denial and abnormal behaviour (e.g. avoidance of dental hygiene or care) thus contributing to further deterioration of oral health.

Adult↗
PubMed1997

Outcome of survivors of accidental deep hypothermia and circulatory arrest treated with extracorporeal blood warming.

BACKGROUND: Cardiopulmonary bypass has been used to rewarm victims of accidental deep hypothermia. Unlike other rewarming techniques, it restores organ perfusion immediately in patients with inadequate circulation. This study evaluated the long-term outcome of survivors of accidental deep hypothermia with circulatory arrest who had been rewarmed with cardiopulmonary bypass. METHODS: Deep hypothermia (core temperature, <28 degrees C) with circulatory arrest was found in 46 of 234 patients with accidental hypothermia. In 32 of the 46 patients, rewarming with cardiopulmonary bypass was attempted, resulting in 15 long-term survivors. In most of these patients, deep hypothermia developed after mountaineering accidents or suicide at tempts. After an average (+/-SD) of 6.7+/-4.0 years of follow-up, we obtained the patients' medical histories and performed neurologic and neuropsychological examinations, neurovascular ultrasound studies, electroencephalography, and magnetic resonance imaging of the brain. RESULTS: The average age of the patients was 25.2+/-9.9 years; seven were female and eight were male. The mean interval from discovery of the patient to rewarming with cardiopulmonary bypass was 141+/-50 minutes (range, 30 to 240). At follow-up there were no hypothermia-related sequelae that impaired quality of life. Neurologic and neuropsychological deficits observed in the early period after rewarming had fully or almost completely disappeared. One patent had cerebellar atrophy on magnetic resonance imaging with mild clinical signs, a condition that may have been caused by hypothermia. Other clinical abnormalities were either preexisting or due to injuries not related to hypothermia CONCLUSIONS: This clinical experience demonstrates that young, otherwise healthy people can survive accidental deep hypothermia with no or minimal cerebral impairment, even with prolonged circulatory arrest. Cardiopulmonary bypass appears to be an efficacious rewarming technique.

Accidents↗
PubMed1997

Determination of future health status expectation in rheumatoid arthritis.

While examining the relationship between, neuroticism, somatic factors and future health status expectation in rheumatoid arthritis (RA) patients, the present study found a considerable level of pessimism in patients, which may be related to perceived limitation of the quality of life. However, psychosocial disposition (i.e., neuroticism) did not prove to be a crucial factor by which RA patients assessed their future health status expectation. These results may be important in future treatment procedures.

Aged↗
PubMed1997

Dental anxiety and illness behaviour.

BACKGROUND: To analyse the relationship between dental anxiety and illness behaviour. METHODS: Dental anxiety was assessed in 165 patients from private practice using the Dental Anxiety Scale (DAS), aspects of illness behaviour were evaluated by the Illness Attitude Scale (IAS), and aspects of general anxiety were analysed by the State Trait Anxiety Inventory (STAI). Dental status was documented using the DMFS index and Bleeding-on-Probing index (BOP). RESULTS: Multiple regression analysis (explained proportion of variance = 32%) showed that dental anxiety was significantly correlated with female gender (t = 3.109, p < 0.002) and IAS health habits (t = -2.210, p < 0.03). In addition, a correlation trend was found between dental anxiety and BOP index (t = -1.789, p < 0.08). CONCLUSION: Dental anxiety appears to be a gender-specific phenomenon. Results indicate a tendency towards abnormal illness behaviour (i.e. denial of dental anxiety) in a considerable proportion of subjects and as a consequence display of poor health habits (i.e. counterphobic behaviour). The latter may lead to an increased tendency to develop gingivitis as indicated by the correlation trend between dental anxiety and BOP index.

Adult↗
PubMed1997

Relationship between self-rated functional status and psychosocial stress in patients suffering from rheumatoid arthritis.

BACKGROUND: To assess relationship between psychosocial factors and self-rated functioning in rheumatoid arthritis (RA). METHODS: In 66 RA patients (mean age +/- SD = 50.8 +/- 12.6 years, women 49 (74%), illness duration mean +/- SD = 13.4 +/- 10.5 years) aspects of developmental psychosocial stress thought to influence human behavior were assessed in an in depth interview using structured biographical history. Furthermore evaluation included Trait anxiety, global functional status according to the ACR criteria, radiological staging of illness and patients' self-ratings of functioning obtained by the Health Assessment Questionnaire (HAQ). Bivariate correlations were performed using psychosocial and somatic factors and self-rated functional status. RESULTS: Scores of developmental psychosocial stress significantly correlated with interviewers scoring of nurture (r = -0.722, p < 0.001) indicating good internal consistency of interview data. Significant correlations were found between patients' scoring of functional status (HAQ) and (i) ACR criteria (r = 0.490, p < 0.0001) and (ii) score of Trait anxiety (r = 0.367, p < 0.003). There was no significant correlation between developmental psychosocial stress and HAQ score. CONCLUSION: Developmental psychosocial stress does not significantly contribute as to how RA patients perceive their functional ability. In a proportion of RA patients self-rated functional status may depend on the patients disposition (e.g. neuroticism) probably promoting impaired illness behavior (e.g. regressive tendencies) which should be considered in assessing treatment procedures.

Anxiety↗