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Biomedical subjects

D Pathak

Publications and source records attributed to D Pathak.

At least 37 records · Page 2Linked to original sources
PubMed1993

Comparison of primary and secondary panic disorder: a preliminary report.

We examined the onsets of comorbid psychiatric disorders in patients with panic disorder (PD) (N = 54). In 42 patients (77.8%), PD was preceded by another psychiatric condition (secondary PD group), while in 12 patients (22.2%), PD occurred first or was the only diagnosed mental disorder (primary PD group). Patients with primary and secondary PD did not differ with respect to demographic variables, mean ages of onset of PD, mean duration of PD, number of patients with a personality disorder, and number of patients with different DSM-III-R subtypes of PD. Except for the anger and sleep scales of the Hopkins Symptom Checklist 90, patients with primary PD had significantly less self-rated psychopathology; they also displayed less extensive phobic avoidance, and had a lower rate of current psychiatric comorbidity. These findings are discussed in light of the value of the concepts of comorbidity and primary/secondary dichotomy.

Adult↗
PubMed1993

Comorbidity in panic disorder: II. Chronology of appearance and pathogenic comorbidity.

Ages of onset and the sequence of appearance of panic disorder (PD) and comorbid conditions were determined in a sample of 54 patients with the principal DSM-III-R diagnosis of PD. The onset of PD was earlier in patients with moderate to severe agoraphobia (AG) than in panic patients without AG. Patients with alcohol abuse and drug abuse before the onset of PD also had a tendency to develop PD earlier, which suggests that these conditions might have specifically predisposed to PD. All comorbid disorders, except for major depression, were more likely to precede the onset of PD so that, more often than not, PD appeared as a chronologically secondary condition. However, it was found that only for primary substance abuse such a temporal relationship might denote etiologic relatedness to PD, because of the reduced temporal distance between the onset of primary substance abuse and secondary PD.

Agoraphobia↗
PubMed1993

Alterations in cardiac myosin isozymes associated with aging and chronic hypertension: their modulation with nifedipine.

OBJECTIVE: Pressure induced left ventricular hypertrophy is associated with alterations in distribution of cardiac myosin isozymes. This study evaluated the influence of aging, superimposed chronic hypertension on aging, and treatment with nifedipine on cardiac myosin isozyme proportions. METHODS: Myosin isozyme (V1, V2, and V3) proportions were investigated by pyrophosphate gel electrophoresis, and left ventricular to body weight ratio was studied in two subgroups each of hypertensive and normotensive rats, with and without nifedipine treatment. Nifedipine treatment was started at 48 weeks and concluded at 60 weeks. RESULTS: For all four groups, the V1 level was the lowest (range 15%-24%), V3 was the highest (47%-60%), and V2 was intermediate (25%-29%). The left ventricular weight to body weight ratio was 25% higher (p < 0.001) in the untreated old hypertensive v old rats, but V1 level was of the same magnitude in both these groups. The left ventricular weight to body weight ratio was 18% lower (p < 0.001) in the old hypertensive treated v untreated rats. The V1 level was higher in both treated groups; old normotensive as well as old hypertensive rats. The changes in V1 were not statistically correlated with arterial pressure and left ventricular to body weight ratio. CONCLUSIONS: The profound decrease in V1 myosin isozyme proportion acquired with aging is not accentuated by superimposed chronic hypertension. The aging process, and not the left ventricular hypertrophy by itself, seems to be the principal determinant of the myosin isozyme shift. The myosin isozyme shift that occurs with aging is not fixed, and can be partially reversed or prevented by nifedipine.

Aging↗
PubMed1993

Accelerated glycolysis in early hypertensive left ventricular hypertrophy.

Changes in energy metabolism have been demonstrated in established left ventricular hypertrophy (LVH). It is not known if cardiac energy metabolism is shifted toward anaerobic pathways during the early stage of hypertensive LVH. Accordingly, glycogen, pyruvate, and lactate levels from left ventricular homogenate were measured in 8-week-old spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto rats (WKY). Systolic arterial pressure and left ventricular weight were determined to establish hypertensive state and LVH, respectively. The glycogen and pyruvate levels in SHR versus WKY were lower by 19 (p < 0.05) and 12% (NS), respectively. The lactate level in the SHR was 14% higher (p < 0.05) than in WKY. The lactate/pyruvate ratio in the SHR was higher than in the WKY, but did not reach statistical significance. These data suggest that the anaerobic metabolism is induced early in the development of hypertension, before the development of substantial LVH.

Animals↗
PubMed1992

Dyspnea, anxiety, and depression in chronic respiratory impairment.

In order to examine the relationship of dyspnea to anxiety and depression, the authors rated dyspnea using several methods in 50 patients with chronic respiratory impairment. Anxiety and depression were measured by the Symptom Checklist-90 and the Symptom Questionnaire. Results varied with the method of assessing dyspnea. Physician-rated dyspnea was significantly associated with patients' self-ratings of breathlessness as well as with pulmonary function tests, but not with any of the self-rating scales of emotions. Self-rated breathlessness was significantly associated with self-rated depression. In multiple regression analyses, depression was predictive of breathlessness. When the sample was limited to patients with chronic obstructive pulmonary disease, the results remained the same. The patients were significantly more depressed and anxious than matched family practice patients. In the study of the complex relationship of dyspnea to physical and emotional factors, it is desirable to use more than one measure of dyspnea because the results depend in part on the method of assessment.

Adult↗
PubMed1992

Panic disorder and hypochondriacal fears and beliefs.

The purpose of this study was to examine correlates of hypochondriacal fears and beliefs in patients with panic disorder (PD) (n = 54). They were evaluated using the structured diagnostic interviews for axis I and axis II disorders (SCID-UP-R and SCID-II). They were administered the Illness Attitudes Scales (IAS) as a measure of hypochondriacal fears and beliefs, the Hopkins Symptom Checklist 90 (HSCL), and the Fear Questionnaire (FQ). One half of the patients rated themselves as having substantial hypochondriacal fears and beliefs. The sample was divided into groups of patients seeking predominantly treatment or relief from symptoms (treatment-oriented), and those who were searching for a cause of their illness (explanation-seeking): the latter had significantly more hypochondriacal concerns. Avoidant, histrionic, and borderline personalities were more common in the hypochondriacal group. The results of several analyses suggest that patients with PD who are also agoraphobic, fear physical disease more and have more false beliefs of having a disease than PD patients without agoraphobia.

Adolescent↗
PubMed1992

Patterns of comorbidity in panic disorder and agoraphobia.

Diagnoses of comorbid disorders were determined in a sample of 54 patients with panic disorder as defined in DSM-III-R. The sample was divided into the following three groups: (1) uncomplicated panic disorder (PDU); (2) panic disorder with mild agoraphobia (PDM); and (3) panic disorder with moderate to severe agoraphobia (PDA). In comparison with patients with PDU, patients with PDA had higher comorbidity rates in general, received multiple comorbid diagnoses more frequently, had a higher prevalence of major depression, dysthymia, social phobia, generalized anxiety disorder, and obsessive-compulsive disorder, and scored higher on most measures of self-rated psychopathology. These findings support the notion that PDA may be a disorder essentially different from PDU.

Adult↗
PubMed1992

Self-rated inhibited anger, somatization and depression.

In order to examine the relationship of self-rated inhibited anger to somatization, the authors administered several self-rating scales, including the SCL-90 and a Likert scale pertaining to inhibited anger, to psychiatric patients and family practice patients of both sexes. In a linear stepwise regression, depression predicted inhibited anger in all four groups. Previous studies have reported an association of inhibited anger and somatization; the present study suggests that depression is the link between the two in the majority of patients. The relationship of inhibited anger to depression may have implications for psychotherapy.

Adolescent↗
PubMed1992

Changes in chronic nightmares after one session of desensitization or rehearsal instructions.

OBJECTIVE: The purpose of this study was to examine the effects of one session of instructions on the frequency of chronic nightmares and on self-rated distress. METHOD: Twenty-eight volunteers with chronic nightmares (mean duration = 19 years) were treated with either one session of desensitization with instructions on how to practice this treatment or with one session of instructions to change the nightmare and how to rehearse the new version. The authors administered four scales of the SCL-90 and the corresponding scales of the Symptom Questionnaire. RESULTS: At 7-month follow-up of 23 patients, there was a significant reduction in the frequency of nightmares and significant decreases in self-rated depression, anxiety, and hostility. There were no significant differences between the effects of the two types of treatment. In four patients, whose mean duration of nightmares was 23 years, the nightmares ceased. CONCLUSIONS: The results of this preliminary study suggests that the instructions given to the patients reduced the frequency of their chronic nightmares and decreased their self-rated distress.

Adult↗
PubMed1992

Hypochondriacal fears and beliefs, anxiety, and somatisation.

Four self-rating scales of hypochondriasis and the Symptom Checklist-90 were administered to 100 general practice (GP) patients and matched non-psychotic psychiatric out-patients. In a stepwise linear regression, self-rated somatic symptoms and anxiety predicted hypochondriacal fears and beliefs; self-rated depression did not appear as a predictor. There were differences between males and females and between psychiatric patients and GP patients in the associations of these constructs. These results varied in part with the scale of hypochondriasis used. Various scales of hypochondriasis appear to measure different features of the hypochondriasis syndrome. Fear of disease (disease phobia) was associated with anxiety, whereas a false belief of having a disease (disease conviction) was associated more with somatic symptoms.

Adolescent↗
PubMed1992

The beneficial effects of one treatment session and recording of nightmares on chronic nightmare sufferers.

Twenty subjects with chronic nightmares for 17.2 years mean duration were randomly divided into two groups: Rehearsal and Recording. At inception, subjects in both groups were instructed to write down their nightmares for one month. The Recording group received no other intervention. Rehearsal subjects received a single treatment group session teaching an imagery rehearsal technique to reduce nightmare frequency. At inception and three months follow-up, both groups were compared for nightmare frequency and for self-rated distress with scales (Symptom Checklist and Symptom Questionnaire) measuring anxiety, depression, hostility, somatization and total distress. Nightmare frequency decreased significantly in both groups: Rehearsal group-7.2 per month to 2.0 per month (72% reduction) (p < 0.006); Recording group-9.4 per month to 5.0 per month (47% reduction) (p < 0.02). There were no statistically significant differences in the nightmare frequency reductions between groups. All anxiety, depression, somatization, hostility and total distress scores decreased substantially in the Rehearsal group. Most changes were significant. Changes in the Recording group were inconsistent and not significant. Two brief case histories are presented.

Adult↗
PubMed1991

Thiol protease-like active site found in the enzyme dienelactone hydrolase: localization using biochemical, genetic, and structural tools.

The active site of dienelactone hydrolase (DLH), a microbial enzyme of the beta-ketoadipate pathway, has been conclusively located using a combination of crystallographic, biochemical, and genetic techniques. DLH hydrolyzes a dienelactone to maleylacetate and has esterase activity on p-nitrophenyl acetate and trans-cinnamoyl imidazole. The identification of Cys-123 as containing the essential thiol confirms the localization of the active site as suggested by the crystal structure of DLH, and disproves an earlier hypothesis regarding its location. Two mutant proteins have been engineered in which Cys-123 has been converted to a serine (C123S DLH) and an alanine (C123A DLH), respectively. C123S DLH (Km = 9900 +/- 2300 microM; Vmax = 4.4 +/- 0.8 mumol/min-mg) displays burst kinetics with p-nitrophenyl acetate and is 10% as active as DLH (Km = 170 +/- 7 microM; Vmax = 21.1 +/- 0.4 mumol/min-mg). C123A DLH is inactive. The structures of DLH, C123S DLH, and C123A DLH have been refined at 1.8, 2.2, and 2.0 A, respectively. Comparison of the structures of these proteins demonstrates that the only differences between them are centered at residue 123. The structures of the active sites of DLH, papain, and subtilisin are similar and are suggestive of the three enzymes having evolved convergently to similar active sites with similar enzymic mechanisms.

Base Sequence↗
PubMed1990

Refined structure of dienelactone hydrolase at 1.8 A.

The structure of dienelactone hydrolase (DLH) from Pseudomonus sp. B13, after stereochemically restrained least-squares refinement at 1.8 A resolution, is described. The final molecular model of DLH has a conventional R value of 0.150 and includes all but the carboxyl-terminal three residues that are crystallographically disordered. The positions of 279 water molecules are included in the final model. The root-mean-square deviation from ideal bond distances for the model is 0.014 A and the error in atomic co-ordinates is estimated to be 0.15 A. DLH is a monomeric enzyme containing 236 amino acid residues and is a member of the beta-ketoadipate pathway found in bacteria and fungi. DLH is an alpha/beta protein containing seven helices and eight strands of beta-pleated sheet. A single 4-turn 3(10)-helix is seen. The active-site Cys123 residues at the N-terminal end of an alpha-helix that is peculiar in its consisting entirely of hydrophobic residues (except for a C-terminal lysine). The beta-sheet is composed of parallel strands except for strand 2, which gives rise to a short antiparallel region at the N-terminal end of the central beta-sheet. The active-site cysteine residue is part of a triad of residues consisting of Cys123, His202 and Asp171, and is reminiscent of the serine/cysteine proteases. As in papain and actinidin, the active thiol is partially oxidized during X-ray data collection. The positions of both the reduced and the oxidized sulphur are described. The active site geometry suggests that a change in the conformation of the native thiol occurs upon diffusion of substrate into the active site cleft of DLH. This enables nucleophilic attack by the gamma-sulphur to occur on the cyclic ester substrate through a ring-opening reaction.

Amino Acid Sequence↗
PubMed1989

Anxiety and depression in patients with the abdominal pelvic pain syndrome.

The authors matched gynecologic patients with the abdominal pelvic pain syndrome (N = 41) with other gynecologic patients. They administered to both groups self-rating scales of anxiety, depression, anger-hostility, and somatization of the Hopkins Symptom Checklist and of the Symptom Questionnaire, a questionnaire about disruptions in early home life, and a questionnaire of recent stressful events. Patients with pain rated themselves on the average significantly more anxious, depressed, and hostile, and had more somatic symptoms than other patients; 56% of the patients with pain rated themselves within the normal ranges on all scales. There were no significant differences between the two groups in reports of disruptions of early home life and recent losses. The findings are consistent with the view that patients with the abdominal pelvic pain syndrome are psychologically a heterogeneous group; in many patients, depression and anxiety may be consequences of persistent pain.

Abdomen↗
PubMed1989

New Mexico safety restraint law: changing patterns of motor vehicle injury, severity, and cost.

The impact of the New Mexico safety belt law on patterns of injury, severity, and cost was evaluated (using an emergency department data base). Data collected from November 1985 through February 1986 compared the 2 months before the January 1986 law with 2 months after. Before the law, 22.2% of the 379 injuries included abrasions, contusions, and lacerations to face, neck, and head. Following the law, this category constituted only 13.8% of 356 injuries, representing a reduction of 38% (P less than .05). Cost and injury severity scores (ISS) for 436 injured patients covered by the law were not significantly different between the pre- and post-seatbelt law periods. However, significant cost and severity differences were observed after the law between belted and nonbelted occupants: +2,569 compared with +662; ISS of 3.6 compared with 2.0 (P less than .05). Methodologic problems of an emergency department-based study and the need for E coding (external causes of injury) are discussed.

Accidents, Traffic↗
PubMed1989

Serum potassium concentrations following succinylcholine in patients undergoing beta-adrenoceptor blocking therapy.

Efflux of serum potassium following succinylcholine was compared in surgical patients undergoing low-dose, long-term beta 1-adrenoceptor or beta 1,2-adrenoceptor blocking therapy and in those receiving neither of these therapies. There were no significant differences in serum potassium concentration prior to, and over a study period of, 2 hours following succinylcholine administration among the three groups of patients.

Administration, Oral↗
PubMed1989

Anxiety, depression, and somatization in DSM-III hypochondriasis.

To assess the severity of distress and of somatization in hypochondriasis, the authors administered several validated self-rating scales of depression, anxiety, somatic symptoms, and anger/hostility to 21 psychiatric outpatients with the DSM-III diagnosis of hypochondriasis and to matched groups of other nonpsychotic psychiatric patients, family practice patients, and employees. Anxiety and somatic symptoms were highest in hypochondriacal patients; depression and anger/hostility did not differ from those of other psychiatric patients but were higher than in the other groups. The findings do not support the theory that hypochondriasis is a defense against anxiety or that it is a masked depression or depressive equivalent. The findings are consistent with the view that the interaction of severe anxiety and severe somatic symptoms is a common feature of the psychopathology of hypochondriasis.

Adult↗