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Biomedical subjects

L A Wells

Publications and source records attributed to L A Wells.

At least 19 recordsLinked to original sources
PubMed2001

Bulimia nervosa: an update and treatment recommendations.

Bulimia nervosa is a common eating disorder in adolescent women. Biological, psychological, and social factors are implicated in onset and important in treatment. Diagnosis of the syndrome, but not its subtypes, can be made well using the DSM-IV system. Screening tools, laboratory findings, and physical findings can be helpful in making the diagnosis. Comorbid disorders include affective disorders, addictive disorders, anxiety disorders, personality disorders, and anorexia nervosa. The etiology of bulimia nervosa is complex, with biologic, psychological, social, and family factors, which likely differ somewhat from patient to patient. Treatment, accordingly, should be comprehensive, individualized, and multifaceted. Many patients respond well to the use of an antidepressant, and cognitive-behavioral therapy is a useful approach for many patients. Combining these two treatments seems to be a good strategy. Environmental and family issues also need to be addressed. Many patients are treated insufficiently. More research on bulimia nervosa specific to adolescence is needed.

Adolescent↗
PubMed2000

Partial paternal uniparental disomy of chromosome 6 in an infant with neonatal diabetes, macroglossia, and craniofacial abnormalities.

Neonatal diabetes, which can be transient or permanent, is defined as hyperglycemia that presents within the first month of life and requires insulin therapy. Transient neonatal diabetes mellitus has been associated with abnormalities of the paternally inherited copy of chromosome 6, including duplications of a portion of the long arm of chromosome 6 and uniparental disomy, implicating overexpression of an imprinted gene in this disorder. To date, all patients with transient neonatal diabetes mellitus and uniparental disomy have had complete paternal isodisomy. We describe a patient with neonatal diabetes, macroglossia, and craniofacial abnormalities, with partial paternal uniparental disomy of chromosome 6 involving the distal portion of 6q, from 6q24-qter. This observation demonstrates that mitotic recombination of chromosome 6 can also give rise to uniparental disomy and neonatal diabetes, a situation similar to that observed in Beckwith-Wiedemann syndrome, another imprinted disorder. This finding has clinical implications, since somatic mosaicism for uniparental disomy of chromosome 6 should also be considered in patients with transient neonatal diabetes mellitus.

Aneuploidy↗
PubMed2000

Implicit motor sequence learning is represented in response locations.

Previous work (Willingham, 1999) has indicated that implicit motor sequence learning is not primarily perceptual; that is, what is learned is not a sequence of stimuli. Still other work has indicated that implicit motor sequence learning is not specific to particular muscle groups or effectors. In the present work, we tested whether implicit motor sequence learning would be represented as a sequence of response locations. In Experiment 1, learning showed very poor transfer when the response locations were changed, even though the stimulus positions were unchanged. In Experiment 2, participants switched their hand positions at transfer, so that one group of participants pushed the same sequence of keys but used a different sequence of finger movements to do so, whereas another group pushed a different sequence of keys but used the same sequence of finger movements used at training. Knowledge of the sequence was shown at transfer only if the sequence of response locations was maintained, not the sequence of finger movements.

Adult↗
PubMed1996

Functional disorders in children and adolescents: diagnostic considerations.

OBJECTIVE: To describe the advantages of a nosologic approach to "functional" illness and its benefit in planning treatment for such illnesses. DESIGN: A review of common functional syndromes occurring during childhood and adolescence in presented. RESULTS: The functional versus "organic" dualism in pediatrics and family practice is not heuristic. The biopsychosocial model allows a more useful approach to nosology and treatment planning. An approach to such a clinical conceptualization is give. Several case examples are provided. CONCLUSION: Patients with functional syndromes should be assessed with specific diagnostic criteria rather than criteria of exclusion.

Adolescent↗
PubMed1996

Steroid-induced depressive psychosis responsive to electroconvulsive therapy.

We report the case of a 15-year-old girl with acute lymphoblastic leukemia who developed a severe steroid-induced depression, which was rapidly responsive to ECT. This report adds to the growing body of literature supporting ECT as a safe and effective treatment of affective and psychotic disorders in children.

Adolescent↗
PubMed1990

Bulimia nervosa and associated alcohol abuse among secondary school students.

Four adolescent student populations (totalling 686 girls and 705 boys) completed confidential questionnaires (98.6% response rate) concerning bulimia nervosa and alcohol abuse. All of the DSM-III-R criteria for bulimia nervosa were met by 2.0% of the girls and 0.1% of the boys. On the basis of score greater than or equal to 42 on the Adolescent Alcohol Involvement Scale, 12.5% of all girls and 9.2% of all boys were alcohol abusers. Our results suggest a significant association between bulimic behavior and alcohol abuse in this female population. Other factors associated with bulimic behavior included high maternal vocational status, high socioeconomic class (girls only), high weight for age and height, and low personal ideal weight. Other factors associated with alcohol abuse included high maternal vocational status, low paternal vocational status and education, low socioeconomic class (boys only), low grade point average, high age, and high birth order.

Adolescent↗
PubMed1986

Treating bulimia with desipramine. A double-blind, placebo-controlled study.

A controlled study in patients with bulimia demonstrated a significant benefit from desipramine hydrochloride treatment (91% decrease in binge frequency) in contrast to the results from a placebo (19% increase in frequency). When patients originally taking the placebo crossed over to desipramine therapy, their frequency of binges decreased 84%, so that the overall improvement was 87% fewer binges. Global clinical status improved 3.5 scales, Zung depression scores improved 8.0 points, and a bulimia symptom scale improved 14.7 points. Fifteen (68%) of 22 patients attained complete abstinence from binge eating and purging. The presence or absence of previous episodes of anorexia nervosa did not influence the treatment response. One-month follow-up data indicated persistence of the benefit attained.

Adolescent↗
PubMed1986

The dexamethasone suppression test in bulimia before and after successful treatment with desipramine.

Recent reports have suggested that normal-weight bulimic patients without clinical evidence of major depressive disorder will have an abnormal response to dexamethasone. Of 23 normal-weight bulimic patients without clinical evidence of major depressive disorder, 11 had abnormal results on their dexamethasone suppression tests (DSTs). This finding closely matches those of other reports. After successful treatment with desipramine, repeat DSTs showed conversion to normal suppression in 6 of the 7 patients tested. Pretreatment DST results failed to predict the response to medication. The striking similarity of these findings to those reported in patients with major depression suggests that bulimia may be a consequence or an equivalent of major affective disorder.

Adolescent↗
PubMed1981

Human growth hormone in psychiatric disorders.

The authors review some features of the neuroendocrine regulation and neuropharmacologic manipulation of human growth hormone and then discuss some of the data that suggest that this hormone system might be involved in various psychiatric disorders. While emphasis is put on alcoholism and the affective disorders, the effects of stress, psychosocial deprivation and malnutrition are briefly discussed, as well. The possibilities and limitations of the psychoendocrine approach to psychiatric illnesses as exemplified by the growth hormone system are emphasized.

Alcoholism↗
PubMed1981

Family pathology and father-daughter incest: restricted psychopathy.

Father-daughter incest can be found in dysfunctional families of many types. The concept of restricted psychopathy is discussed and examples of this concept in relation ot incest behavior are given. Three cases of father-daughter incest are presented. Ramifications of the concept of restricted psychopathy as it applies to father-daughter incest are discussed.

Adolescent↗