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Biomedical subjects

S Hack

Publications and source records attributed to S Hack.

16 recordsLinked to original sources
PubMed2001

Pediatric psychotropic medication compliance: a literature review and research-based suggestions for improving treatment compliance.

Without good compliance the best psychiatric treatment is ineffective. This article reviews what is known or can be inferred about compliance with psychiatric medications in the pediatric population. The review includes discussions of assessment techniques, risk and protective factors, the relevant research literature, and research-based practical techniques to improve compliance. A Medline search surveying the years from 1966 to August 2000 yielded only seven peer-reviewed papers reporting on compliance with pediatric psychopharmacology. All seven studies looked at stimulant compliance among children with attention deficit hyperactivity disorder. Reported levels of compliance range from 56% to 75%. These rates, although low, are likely to be overestimates of actual compliance. We review two related areas of research for which there are small but significant bodies of knowledge: pharmacological compliance studies among adult psychiatric populations and pediatric medical populations. This literature supports the idea that medication compliance is a significant obstacle to the effective treatment of patients. Because compliance rates are lower for children as compared to adults and psychiatric patients as compared to medical patients, we suspect that children with psychiatric illness may be at great risk for poor medication compliance. Fortunately, the research literature demonstrates several simple techniques that clinicians can use to improve medication compliance among their patients. The treatment alliance; education; and medication duration, dosing, palatability, and cost can all be tailored to improve medication compliance.

Adult↗
PubMed2000

Fast temporal interactions in human auditory cortex.

The temporal resolution of the human primary auditory cortex (AC) was studied using middle-latency evoked fields. Paired sounds with either the same or different spectral characteristics were presented with gaps between the sounds of 1, 4, 8 and 14 ms. Spatio-temporal modelling showed (1) that the response to the second sound was recognizable with gaps of 1 ms and rapidly increased in amplitude with increasing gap durations, (2) an enhanced N40m amplitude at gaps > 4 ms, (3) delayed N19m-P30m latencies when the stimuli were different. The median psychoacoustical thresholds were 1.6 ms for the same stimuli and 2.5 ms for different stimuli, confirming the electrophysiological evidence for rapid pattern-specific temporal processing in human primary auditory cortex.

Acoustic Stimulation↗
PubMed1998

Historical clues to the diagnosis of the dysfunctional child and other psychiatric disorders in children.

This article focuses on selected historical clues that can help the busy pediatrician identify children who are at risk for or already suffering from psychosocial dysfunction. Certain historical elements have been chosen because they reveal either common areas of childhood dysfunction or potentially dire outcomes. The major function realms of a child's life are covered, such as family, school, peer relationships, activities, and emotions, as well as related topics such as injury, poverty, substance abuse, and risk-taking behavior. Questions designed to elicit the relevant historical clues are suggested. Used as a set, these questions are intended to bring to light sufficient psychosocial history for pediatricians to identify most dysfunctional children.

Child↗
PubMed1998

Early identification of emotional and behavioral problems in a primary care setting.

Adolescence is a time when many psychiatric disorders first manifest themselves. The challenge to pediatricians is to recognize early signs of behavioral problems in their adolescent patients. This review suggests several practical approaches to the detection, assessment, and treatment of emotional problems in adolescents within the time limits of a typical pediatric exam. The approaches presented range from general health supervision of all adolescents to more intensive evaluation of at-risk adolescents.

Adolescent↗
PubMed1997

Anorexia nervosa in a 7-year-old girl.

We report on a 7-year-old girl with anorexia nervosa and consider factors contributing to this early emergency. Cognitive differences in younger children can alter their understanding of this illness, so we chronicled this girl's treatment because it diverged from practices used with older patients. Accordingly, effective interventions in very young anorexics might require modifications of treatments used in postpubertal populations.

Age of Onset↗
PubMed1993

Antibodies to human papillomavirus and to other genital infectious agents and invasive cervical cancer risk.

Human papillomaviruses (HPVs) play an important part in the development of cervical cancer, but the role of other infectious agents, such as herpes simplex virus (HSV), is not clear. We assayed serum samples collected from 219 women with cervical cancer and from 387 controls for antibody to infectious agents. HPV 16-E7 and/or HPV 18-E7 antibodies were significantly related to cervical cancer risk (RR 1.9, 95% CI 1.2-3.2). Antibodies to HSV types 1 and 2, Chlamydia trachomatis, and to multiple infectious agents were associated with cervical cancer when seroprevalence rates in all cases and controls were compared, but when HPV-seropositive cases and controls were compared these associations were weaker and non-significant. This finding suggests that past infections with sexually transmitted infections other than HPV may be surrogate markers of exposure to HPV, and of no separate aetiological significance.

Adult↗
PubMed1993

Resting energy expenditure. Evolution during antibiotic treatment for pulmonary exacerbation in cystic fibrosis.

STUDY OBJECTIVES: To compare the changes in resting energy expenditure (REE) to concomitant changes in clinical status and pulmonary function in cystic fibrosis (CF) patients during treatment for acute pulmonary exacerbation. To determine if weight loss during exacerbation in CF is related to decreased calorie intake or increased energy needs. DESIGN: Measurements of REE, pulmonary function tests, oxygen saturation, respiratory rate, maximal inspiratory pressure (MIP), white blood cell count, chest x-ray films and attribution of clinical score (ACS) on admission, mid-hospitalization, and discharge. Anthropometric measurements on admission, assessment of dietary intake and nitrogen balance upon admission and prior to discharge. SUBJECTS: Thirteen CF patients admitted for treatment of acute pulmonary exacerbation with a mean age of 11.0 +/- 7.9 (SD) years. RESULTS: From admission to discharge, REE decreased from 44.5 +/- 9.0 to 33.8 +/- 8.5 kilocalorie (kcal)/kg/d (p < 0.003). Similarly, the ACS improved from 7.5 +/- 2.0 to 4.0 +/- 2.2 (p < 0.0001); the absolute neutrophil count decreased from 10,685 +/- 6,226/microliters to 6,363 +/- 168/microliters (p < 0.005); respiratory rate decreased from 32.6 +/- 6.2 to 25.0 +/- 3.7 breaths per minute (p < 0.01); and MIP increased from 77.5 +/- 20.0 to 90.0 +/- 20.4 cm H2O (p < 0.01). In parallel, less significant improvements occurred in pulmonary function tests, oxygen saturation and chest x-ray film scores. Calorie intake was 1,893 +/- 635 and 2,054 +/- 707 kcal/d on admission and discharge, respectively (p = NS); during hospitalization, weight increased from 23.6 +/- 10.1 to 25.7 +/- 10.1 kg (p < 0.005). While carbohydrate and fat content of the diet remained essentially unchanged, a significant increase in protein intake (3.15 +/- 0.92 to 3.5 +/- 0.81 g/kg/d [p < 0.05]) and in nitrogen balance (1.8 +/- 2.5 to 5.6 +/- 2.9 g of nitrogen per day [p < 0.05]) were observed. CONCLUSIONS: In acute CF, pulmonary exacerbation, changes in REE parallel those of clinical improvements and are more sensitive than pulmonary function tests and chest x-ray films as an objective clinical correlate. Increased metabolic requirements but not decreased dietary intake are the cause of weight loss in CF patients.

Acute Disease↗
PubMed1991

Effect of cigarettes on memory search and subjective ratings.

The effects of smoking a nicotine versus a nonnicotine cigarette on performance on Sternberg's memory search task and subjective ratings were examined. Testing sessions were undertaken both before and after a period of 24 hours' abstinence in occasional and regular smokers. Memory search rate was significantly faster after the nicotine cigarette than the nonnicotine cigarette. No significant difference in search rate was found between the results from occasional and regular smokers, and between the effect of a cigarette before and after the period of abstinence. The regular smokers inhaled more smoke from the nicotine and nonnicotine cigarettes than did the occasional smokers, but the amount of smoke inhaled from the test cigarettes did not change significantly from pre- to postabstinence. The nicotine cigarette produced stronger dizziness, tremor and palpitations than the nonnicotine cigarette, the more so after abstinence than before in the regular smokers. The results indicate that smoking a cigarette can produce subjective effects and performance improvements in regular and occasional smokers during the course of normal smoking, and that some subjective effects can be greater after abstinence.

Adult↗
PubMed1986

Observations of vitamin A toxicity in three patients with renal failure receiving parenteral alimentation.

Elevated serum retinol concentrations have been previously reported in patients with renal failure, although overt clinical toxicity has been described only rarely. We present three patients with renal failure receiving total parenteral nutrition (TPN) who developed biochemical and clinical findings of hypervitaminosis A. Improvement followed deletion of vitamin A from the TPN. These cases demonstrate that patients with renal failure may be at risk for symptomatic vitamin A toxicity if given TPN with standard retinol supplementation. Such patients should be carefully observed clinically and biochemically if supplementation is given.

Adolescent↗
PubMedDate not supplied

Vitamin E measurement in patients receiving intravenous lipid emulsions.

Two methods for the determination of plasma vitamin E--high-pressure liquid chromatography and spectrophotofluorometry--were compared on samples from four groups of pediatric patients: children and infants receiving lipid emulsion as part of their parenteral nutrition regimen, neonates receiving parenteral nutrition who were not receiving lipid emulsion at the time of blood sampling, and short admission surgery control subjects. In control subjects and patients not receiving lipid emulsions, both methods yielded similar results for vitamin E as alpha-tocopherol. In contrast, in patients receiving lipid emulsion, the fluorometric method yielded values ranging from 200% to 300% greater than did high-pressure liquid chromatography. The source of the discrepancy is most probably the presence of naturally occurring non-alpha-tocopherol isomers in the lipid products, which add to the fluorescent measurement but are resolved by high-pressure liquid chromatography. This study confirms clinically that fluorescent measurement of vitamin E is no longer the method of choice for monitoring tocopherol status in intensive care nurseries.

Child↗