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Biomedical subjects

H Stewart

Publications and source records attributed to H Stewart.

13 recordsLinked to original sources
PubMed1989

Technique at the basic fault/regression.

This paper is concerned with problems of technique in patients who regress in analysis to a benign or malignant state of regression as conceptualized by Balint in his book, The Basic Fault. The clinical examples of technique in regression given in that book only illustrate states of benign regression and not those of the malignant variety. These examples are examined critically, particularly those advocating the allowance by the analyst of the patient holding his finger or hand, and clinical reasons are advanced to show the disadvantage of this technique in that it can be anti-therapeutic. Aspects of the technique of treating cases of malignant regression are presented and discussed, particularly in terms of the vital importance of maintaining the analytic setting, necessitating the confrontation of the patient in maintaining the analytic boundaries and limits. The need to interpret the intensity and malignancy of the patient's destructive envious attacks on the analyst's capabilities and capacities is essential, as is the need for the analyst not to confuse his healthy aggressive firmness with his sadistic cruelty.

Humans↗
PubMed1988

Overnight clonidine suppression test in the diagnosis and exclusion of pheochromocytoma.

In a prospective study designed to differentiate pheochromocytoma from other forms of hypertension, urinary catecholamines were measured after sleep and clonidine administration in 12 patients with pheochromocytoma, 19 hypertensive patients in whom pheochromocytoma was suspected but later excluded, and 31 hypertensive patients in whom pheochromocytoma was never suspected. The test correctly identified all 12 patients in whom pheochromocytoma was present. Four of these had equivocal plasma levels of both norepinephrine and epinephrine, suggesting that overnight clonidine suppression may be of particular value when tumor secretion is intermittent or low. When pheochromocytoma was not present, urinary norepinephrine and epinephrine levels were suppressed below 60 and 20 nmol/mmol creatinine, respectively, after sleep and clonidine, the two in combination giving better suppression than sleep alone. Since urinary catecholamines can be determined relatively easily by high-pressure liquid chromatography with electrochemical detection, this test may be more widely applicable than suppression tests based on plasma measurements.

Adrenal Gland Neoplasms↗
PubMed1987

Overview of randomized trials of postoperative adjuvant radiotherapy in breast cancer.

An overview of the mortality results of the mature trials in which radiotherapy was a randomized option after simple or radical mastectomy is presented. The principal aim of the overview was to study long-term survival, and recent trials, often including chemotherapy options, have not been included. A total of 7941 patients were entered into these trials and 4148 deaths occurred. No differences were found in survival in the first 10 years of follow-up, in trials employing either radical mastectomy or simple mastectomy. Follow-up information after 10 years came mostly from trials employing radical mastectomy with or without irradiation, and in these trials a significant excess of deaths was observed among patients given radiotherapy (P less than 0.001, all trials; P = 0.002, radical mastectomy trials only). Further data collection will be necessary to determine which causes of death are elevated.

Breast Neoplasms↗
PubMed1987

Overview of randomized trials comparing radical mastectomy without radiotherapy against simple mastectomy with radiotherapy in breast cancer.

An overview of mortality in the mature randomized trials comparing radical mastectomy without radiotherapy against simple mastectomy with radiotherapy has been conducted. These trials mark a transitional period between radical mastectomy and simple mastectomy as the generally preferred surgical treatment and as such are not strictly trials assessing the value of postoperative adjuvant radiotherapy. All known mature trials have been included and these four trials have entered a total of 3236 patients, in whom 1678 deaths have been recorded. Overall, no significant difference in survival was seen, but there was a nonsignificant trend for patients given radiotherapy to do worse after 15 years of follow-up.

Breast Neoplasms↗
PubMed1987

Varieties of transference interpretations: an object-relations view.

The author describes six types of transference interpretations that are looked for from the object-relations viewpoint. In addition, he describes a type of transference interpretation that is better not made, and emphasizes the transference value of silence on the part of the analyst at certain crucial moments in the analysis.

Dreams↗
PubMed1985

Changes of inner space.

This paper describes the relationship between the experiential aspects of the concept of inner space and of emptiness. This is based on the change of inner experience of a borderline patient during analysis from one of empty space to one of real space. The analysis is described and the relationship of inner space to schizoid and depressive emptiness elaborated, together with the emergence of a healthy inner space (positive emptiness). The components of the capacity to experience inner space from infancy onwards are enumerated and discussed.

Adult↗
PubMed1977

Effect of cholestyramine on the symptoms of reflux gastritis. A randomized, double blind, crossover study.

Bile acids have been proposed to be important in the pathophysiology of the syndrome of "bile reflux gastritis" after surgery. To examine the role of cholestyramine, an ion exchange resin that binds bile acids, on symptoms of this syndrome, we did a randomized, double-blind crossover study on 16 patients. No differences in frequency of abdominal pain, nausea, vomiting, or bitter taste were observed among cholestyramine (4 g, three times daily for 3 weeks), placebo, and routine (dietary restriction and ad libitum antacid) treatment periods. We conclude that this regimen of cholestyramine was ineffective in symptomatic treatment of bile reflux gastritis.

Adult↗