Unusual dermatoglyphic findings associated with rubella embryopathy.
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Clinical Trials as Topic↗
Biomedical subjects
R G Harper
Publications and source records attributed to R G Harper.
Age, affective distress, and illness detection in patients evaluated for gastrointestinal complaints.
A study of 260 patients was conducted in 1990 using a questionnaire that was designed to measure and assess their recall of symptom patterns, symptom distress levels, symptom interpretation, and physician-recommended treatment plans. The questionnaire was mailed 6-18 months after they had undergone a gastrointestinal workup for unexplained chest or abdominal pain. The authors found comparably high rates of both younger patients (age < 65) and older patients (age > or = 65) reporting symptom patterns sufficient to meet DSM-III criteria for panic, generalized anxiety, and depressive disorders. For younger but not older patients, the number of symptom complaints was related to their recall of a stress-related diagnosis made by the physician, which was less frequent for older patients. The older patients less often identified their symptoms as tension-related. Further research is needed concerning symptom reporting, illness attribution, and physician recognition of emotional etiology among elderly and younger patients with somatizing disorders.
Adolescent↗
Relationship of psychiatric morbidity and psychosocial factors in organ transplant candidates.
The purpose of this study was to explicate the statistical relationship between psychiatric diagnosis and psychosocial adjustment and health status in organ transplant candidates. Interview and psychometric data were obtained from 311 heart, kidney, lung, and liver transplant candidates. Over 60% of the cases met criteria for DSM-III-R Axis I diagnoses, nearly 32% for Axis II disorders. Axis II disorders were significantly associated with medical compliance problems, whereas Axis I disorders were predominantly associated with poorer psychosocial adjustment and health status. Nearly one-quarter of the patients had comorbid Axis I and Axis II disorders, and evidenced poorest premorbid coping and degree of marital harmony, defining a subgroup at special risk for problematic outcome. The incidence of psychiatric disorders and their association with lack of psychosocial resources and poor physical health supports the use of systematic, multidisciplinary assessment of transplant candidates.
Adaptation, Psychological↗
Group B coxsackievirus infections in infants younger than three months of age: a serious childhood illness.
From 1970 to 1979 the viral laboratory at the Nassau County Medical Center (NCMC) tested 602 culture specimens that were positive for group B coxsackievirus. Eighty-one of the specimens were from hospitalized infants younger than three months of age with nonfatal infection. The case histories of 77 of these infants, whose medical records were available for study, are reviewed here. Aseptic meningitis was the clinical syndrome seen most frequently (48 of 77 patients). Protein levels in cerebrospinal fluid (CSF) did not rise above 170 mg/dl, and in only three infants did the glucose concentration in CSF fall below 30 mg/dl. Infants were febrile for an average of 3.1 days, and no infant had fever of longer than six days' duration. During 1970-1981, eight newborns whose culture specimens were examined at NCMC died of overwhelming group B coxsackievirus disease. The clinical histories of these eight patients and 33 other fatal cases reported in the literature are reviewed. Three patterns of death were observed. Rapid death occurred in 12 patients aged 2-17 days. In 11 patients a diphasic illness led to death at age 8-24 days. In 18 patients a progressive illness was described. Myocarditis was present in all infants. Pulmonary hemorrhage and liver necrosis occurred in 30 and 18 patients, respectively. Jaundice was more frequently observed in fatal cases. Bleeding diatheses were also reported and probably reflect hepatic necrosis. Twenty-four mothers had evidence of a viral-like infection occurring between 10 days antepartum and five days postpartum. Group B coxsackievirus infection must be considered a serious disease of the newborn, which in our community occurred in 77 of 153,250 live births and accounted for six deaths between 1970 and 1979.
Coxsackievirus Infections↗
Self-report evaluation of health behavior, stress vulnerability, and medical outcome of heart transplant recipients.
OBJECTIVE: The purpose of this study was to explore the value of patient self-report assessment in heart transplant candidacy evaluation, utilizing the Millon Behavioral Health Inventory (MBHI). Patient's MBHI measures were related to important pretransplant patient characteristics and posttransplant measures of health behavior, medical morbidity, and mortality. METHOD: Ninety heart patients with end-stage cardiac disease completed the MBHI during pretransplant candidacy evaluations, and also were interviewed concerning their coping effectiveness, support resources, and compliance history. Postransplant follow-up of 61 living and 29 deceased patients included measures of survival time, postsurgical medical care, rejection and infection episodes, and nurse ratings of medication compliance and problematic interpersonal health behaviors. RESULTS: The MBHI coping scales were found to significantly discriminate good and poor pretransplant compliance, and interview judgments of good and poor coping and support resources, with modest accuracy. The MBHI also was superior to these interview judgments in predicting posttransplant survival time and medical care used. Certain scales were also positively associated with physical parameters of pretransplant and posttransplant status. CONCLUSIONS: Patient self-report with the MBHI can contribute to identification of patients at risk for a problematic outcome with transplant, by providing information pertinent to clinical decision making and outcome management analysis with this special population of cardiac patients.
Adult↗
De Lange syndrome. Clinical, dermatoglyphic and chromosomal findings in nine cases.
Nine cases of the de Lange syndrome are reviewed. Our findings show that the facial characteristics in the present series and in previously reported cases are remarkably similar. Dermatoglyphically, we have documented an increased incidence of tibial loops on the hallucal area and increased incidence of single flexion creases of the digits from this study series. Our study also supports the previous authors who have recorded an increased incidence in radial loops on the second and third digits and increased incidence of simian lines. We have not been able to document a consistent chromosomal defect.
Child, Preschool↗