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Biomedical subjects

L M Arnold

Publications and source records attributed to L M Arnold.

At least 19 recordsLinked to original sources
PubMed1999

An open clinical trial of fluvoxamine treatment of psychogenic excoriation.

The purpose of this study was to examine the safety and efficacy of fluvoxamine in the treatment of psychogenic (neurotic) skin excoriation. Fourteen subjects with psychogenic excoriation were given fluvoxamine in a 12-week, open-label trial after completion of the Structured Clinical Interview for DSM-IV. All subjects met DSM-IV criteria for at least one comorbid psychiatric disorder, with mood disorder the most common. Most subjects' excoriation had features of an impulse control disorder. Both completers (N = 7) and the entire group had significant improvement on the modified Yale-Brown Obsessive Compulsive Scale but no improvement on the Hamilton Rating Scale for Depression. In the self-report data, the seven completers had significant reduction in behaviors involving the skin (e.g., scratching, picking, gouging, or squeezing) and in global assessment of symptoms. Endpoint analysis of all 14 subjects' self-report data demonstrated significant improvement in the presence of skin sensations, skin appearance and lesions, behaviors involving the skin, control over skin behavior, and global assessment. The results of this preliminary open trial suggest that fluvoxamine may be effective in reducing psychogenic excoriation, and this effect seems to be independent of mood. Controlled studies are needed to confirm these findings.

Adult↗
PubMed1998

Characteristics of 34 adults with psychogenic excoriation.

BACKGROUND: Psychogenic excoriation, characterized by excessive scratching or picking of the skin, is not yet recognized as a symptom of a distinct DSM-IV disorder. The purpose of this study was to provide data regarding the demographics, phenomenology, course of illness, associated psychiatric comorbidity, and family history of subjects with psychogenic excoriation. METHOD: Thirty-four consecutive subjects were recruited from an outpatient dermatology practice and by advertisement. Subjects completed the Structured Clinical Interview for DSM-IV augmented with impulse control disorder modules, the Yale-Brown Obsessive Compulsive Scale, and a semistructured interview for family history, demographic data, and clinical features. RESULTS: Most subjects were women who described a mean age at onset of 38 years and a chronic course. Subjects excoriated multiple sites, most frequently the face. The behavior caused substantial distress and dysfunction. All 34 subjects met criteria for at least 1 comorbid psychiatric disorder, with a mood disorder the most common. Family histories were notable for depressive disorders and psychoactive substance use disorders. Most subjects experienced both mounting tension before excoriation and relief after excoriation as in impulse control disorders. A minority of subjects excoriated skin as part of obsessive-compulsive disorder. Body dysmorphic disorder with preoccupation about the skin's appearance precipitated excoriation in about a third of subjects. CONCLUSION: Psychogenic excoriation is chronic, involves multiple sites, and is associated with a high rate of psychiatric comorbidity. The behavior associated with the excoriation is heterogeneous and spans a compulsive-impulsive spectrum. Most subjects in this sample described features of an impulse control disorder.

Adult↗
PubMed1993

Estimated prevalences of panic disorder and depression among consecutive patients seen in an emergency department with acute chest pain.

OBJECTIVE: 1) To determine whether the frequencies of panic disorder (PD) and depression (DEP) in an emergency department (ED) population were comparable to those in other primary care groups; 2) to evaluate whether patients without the clinical diagnosis of acute cardiac ischemia (ACI) had higher frequencies of these disorders; and 3) to identify characteristic clinical findings in patients with PD or DEP. SETTING: An urban teaching hospital ED. PATIENTS: Three hundred thirty-four patients with acute chest pain were evaluated prospectively over an eight-week period. The cohort participating (69%-229/334) completed psychiatric screening measures, including the Panic Disorder Self-Rating Scale, the Beck Depression Inventory, and the Zung Self-Rating Anxiety Scale. MEASUREMENTS AND MAIN RESULTS: A symptom profile consistent with PD was identified in 17.5% of the patients (40/229), DEP in 23.1% (53/229), and either disorder in 35% (80/229). The prevalences of PD were similar in those with and without ACI (19.4% vs 16.6%, respectively, p > 0.05). The likelihoods of one or more ED visits for chest pain in the previous year were significantly greater in those with PD (57.5% vs 36%, p < 0.05) and DEP (54% vs 35%, p < 0.05) than in those without these psychiatric disorders. CONCLUSION: This study suggests that approximately one in three patients presenting to the ED with acute pain has symptoms consistent with a psychiatric disorder. These disorders occur frequently in both those with and those without acute cardiac ischemia, and clinical variables may help identify these frequent ED utilizers.

Acute Disease↗
PubMed1993

Effect of isoenergetic intake of three or nine meals on plasma lipoproteins and glucose metabolism.

To investigate the effects of meal frequency on plasma lipid and carbohydrate metabolism, 19 healthy normocholesterolemic free-living men and women consumed their usual diet as three or nine meals per day in random order for 2 wk each. There was no significant difference in macronutrient intake. Compared with the three-meal/d diet, nine meals per day reduced fasting plasma total, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) cholesterol by 6.5% (P < 0.005), 8.1% (P < 0.005), and 4.1% (P < 0.05), respectively. Body weight, fasting triglycerides, apolipoproteins A-I and B, and the LDL-HDL cholesterol ratios were not different for the two diets, as were 24-h urinary C peptide-creatinine ratios and insulin-glucose response to a glucose load. The insulin-glucose curve measured over 3 h in the evening after the evening meal was flatter for the nine meals, but the areas under the curves were not significantly different. Increasing meal frequency while maintaining a constant nutrient intake produces a small but significant decrease in LDL cholesterol in normolipidemic free-living subjects.

Adult↗
PubMed1991

QSARs for monosubstituted anilines eliciting the polar narcosis mechanism of action.

The relative toxicities (log IGC50(-1] of a fairly heterogeneous series of 66 anilines that were monosubstituted in the 2-, 3-, and 4-positions have been evaluated in the 48 h static Tetrahymena population growth impairment system. Quantitative structure-activity relationships (QSARs) were examined using the 1-octanol/water partition coefficient (log KOW) and the summation of the Hammett sigma electronic substituent constant (sigma sigma) as orthogonal independent predictors. Four chemicals, 4-decylaniline, 4-dodecylaniline, 4-tritylaniline and 4-aminophenethyl alcohol, did not elicit the measured response at saturation. Five chemicals, 2-aminophenol, 2-phenylenediamine, 4-aminophenol, 4-phenylenediamine and 4-nitroaniline, had an altered HPLC spectrum with time. As previously reported, the parent compound, aniline, as well as the 4-position halogen derivatives have been shown to be aberrantly more toxic than expected. None of these chemicals were included in QSAR development which employed linear regression analysis. Log IGC50(-1) = 0.599(log KOW) - 0.905 (n = 52, r2 = 0.885, s = 0.265, f = 383.65, Pr greater than f = 0.0001) was found to be a good predictor of relative toxicity of these monosubstituted anilines. The addition of sigma sigma as a second predictor did not improve the predictability of this QSAR. Abiotic loss over the duration of the assay varied markedly with derivative; however, chemical persistence was not considered to be a factor with this model. The above equation was strikingly similar to log IGC50(-1) = 0.595(log KOW) - 0.996 (n = 67, r2 = 0.866, s = 0.254, f = 421.64, Pr greater than f = 0.0001), a previously developed QSAR from data on a heterogeneous set of monosubstituted phenols. The data for these two equations were combined and subsequent regression analysis resulted in log IGC50(-1) = 0.588(log KOW) - 0.939 (n = 119, r2 = 0.873, s = 0.261, f = 806.49, Pr greater than f = 0.0001). The authors feel that this represents the log KOW-dependent QSAR in the Tetrahymena population growth assay for the polar narcosis mechanism of toxic action.

Aniline Compounds↗
PubMed1991

Axis I disorders in ER patients with atypical chest pain.

To examine the contribution of psychopathology to emergency room (ER) visits for atypical chest pain, we administered two screening measures and the Structured Clinical Interview for DSM III-R (SCID) to thirty-five subjects within seventy-two hours of their ER visit. Follow-up SCID interviews were completed in thirty subjects at five to twelve months. Sixty percent of the sample had an initial Axis I diagnosis, predominately affective (34%) and anxiety (46%) disorders. Forty percent had multiple diagnoses initially. The most common diagnoses were panic disorder (31%) and major depression (23%). At follow-up 47 percent had Axis I diagnoses, 30 percent had multiple diagnoses, with only slightly decreases rates for panic disorder (27%) and major depression (17%). Many subjects had lost, gained, or switched diagnoses by follow-up, in spite of one consistent rater and a few subjects seeking treatment. ER physicians often do not recognize these psychiatric disorders in chest pain patients. The high risk of suicide in panic disorder and depression, and the high cost of disability in recurrent chest pain make it essential that ER physicians include these disorders in the differential of atypical chest pain.

Adult↗
PubMed1990

Relationships of quantitative structure-activity for normal aliphatic alcohols.

The relative toxicity of 14 normal aliphatic alcohols has been determined as 48-hr 50% population growth inhibition (log BR, biological response) of Tetrahymena pyriformis. A linear relationship was observed between log BR and the 1-octanol/water partition coefficient (log Kow). Comparison of log BR with 96-hr 50% mortality data for Pimephales promelas revealed excellent agreement between the two test systems. A relatively constant steady-state biophase toxicant concentration is calculated for each alcohol. Calculated chemical activity increased with an increase in hydrocarbon chain length. In addition, there was good agreement between chemical activity and the activity coefficient for narcosis.

Alcohols↗
PubMed1986

Docents' and students' perceptions of the ideal and actual role of the docent.

In the study reported here, the authors investigated the perceptions of medical students and faculty mentors, called docents, regarding the docents' role. A total of 197 students and 22 docents responded to a questionnaire asking them to rate 32 docent activities on a 4-point scale where 1 = seldom done and 4 = very often done. They were requested to rate these activities on the basis of how often they would be carried out by a docent ideally and on the basis of how often in their experience they were actually carried out. Mean ratings of ideal and actual practice were calculated for each activity as perceived by the docents and by the students. Rank-order correlations were computed to compare the docents' and students' perceptions. Although both the docents and the students consistently felt that more time should be devoted to each activity than actually was, the rank-order correlation between the docents' rating of the ideal and actual practice was .87, and between the students' ratings of ideal and actual it was .93. Both the docents and the students perceived the docents as actually carrying out their essential role-modeling, teaching, and patient-care functions.

Clinical Clerkship↗
PubMed1982

Nuclear scanning in necrotizing progressive "malignant" external otitis.

The usefulness of radionuclear scanning in the treatment of 18 patients with necrotizing progressive "malignant" external otitis is discussed. A Tc 99-m bone scan, a valuable test since results are positive in early cases of osteomyelitis of the temporal bone and base of skull, showed increased uptake in all 18 patients. In 6 patients, Ga-67 citrate scans were obtained at the start of therapy and at 5-6 week intervals thereafter. The serial gallium scans were useful in evaluating the effectiveness of therapy since the uptake decrease with control of infection.

Aged↗
PubMed1982

Predictors of performance of minority students in the first two years of a BA/MD program.

This study examines cognitive and noncognitive selection variables as predictors of multiple criteria of performance for minority and nonminority students entering the University of Missouri-Kansas City School of Medicine between 1972 and 1977. Data analysis aims at identifying characteristics associated with success in the crucial first two years of the combined BA/MD program. Pearson product moment correlations and multiple regression equations have been determined for all selection variables and three criteria measures. A number of nontraditional variables are significantly predictive of minority student performance. The cognitive variables of aptitude test and high school science/mathematics preparation are significant predictors of all three performance measures in both racial groups. The data support the position that separate equations are not necessary to predict performance of minority and nonminority students, but that admission committees, when selecting minority students, should recognize both personal attributes and academic preparation as indicators of potential success or failure.

Adult↗
PubMed1980

Primary chordoma of the maxillary sinus.

A case of primary chordoma of the maxillary sinus is presented. The embryology of the notochord is reviewed and it is suggested that the frequently used adjective "ectopic" is a misnomer. The literature of primary paranasal sinus chordomas is reviewed and the clinicopathological features described. It is emphasized that these lesions can mimic other benign and malignant processes both clinically, radiographically and histologically. The treatment and prognosis is more favorable than the more common craniocervical chordoma.

Adult↗
PubMedDate not supplied

Schwannomas of the larynx: review and computed tomographic scan analysis.

Neurogenic tumors consist of schwannomas, neurofibromas, and neurosarcomas that arise from the Schwann cell of a peripheral nerve. Their occurrence in the larynx is rare, with only 115 cases having been reported. Three new cases are presented, the literature is reviewed, and the first computed tomographic (CT) scan of a benign schwannoma of the larynx is demonstrated. The diagnosis and treatment of these tumors and the CT scan analysis are discussed.

Adult↗
PubMedDate not supplied

Psychopathology and trauma in epileptic and psychogenic seizure patients.

Forty-one patients admitted to an inpatient epilepsy unit for intractable seizures were evaluated for the presence of Axis I and Axis II diagnoses and for a history of trauma by use of a structured clinical interview. Both the interviewer and the patient were blind to the seizure diagnosis. Following video and electroencephalographic evaluation, 27 patients were diagnosed with epileptic seizures, and 14 had psychogenic seizures. The history of Axis I and Axis II disorders did not distinguish the two groups of patients. A history of trauma was significantly more likely in the patients with psychogenic seizures. The experience of trauma appears to be an important factor in the development of psychogenic seizures. Sexual trauma alone, however, was not significantly associated with psychogenic seizures.

Adolescent↗