[Behavior of urinary elimination of ICSH in subjects with disorders of spermatogenesis].
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Adult↗
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Results for “Elimination Disorders”
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Length of lithium treatment needed to eliminate the high mortality of affective disorders.
Recent studies have indicated that long-term lithium treatment reduces the expected suicidal activity and overall mortality of patients with affective disorders. Based on the data from the lithium clinics in Berlin and Hamilton (n = 512), a minimum length of two years of continued lithium treatment is needed to reduce the high mortality resulting from affective disorders.
Confidence Intervals↗
Idiopathic physical symptoms: a common manifestation of psychiatric disorders in primary care.
Worldwide, patients with common mental disorders, such as depression and anxiety, have a tendency to present first to primary care exhibiting idiopathic physical symptoms. Typically, these symptoms consist of pain and other physical complaints that remain medically unexplained. While in the past, traditional psychopathology emphasized the relevance of somatic presentations for disorders, such as depression, in the last few decades, the "somatic component" has been neglected in the assessment and treatment of psychiatric patients. Medical specialties have come up with a variety of "fashionable" labels to characterize these patients and the new psychiatric nomenclatures, such as the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, attempt to classify these patients into a separate "somatoform disorders" category. These efforts fall short, and revisionists are asking altogether for the elimination of "somatoform disorders" from future nomenclatures. This review emphasizes the importance of idiopathic physical symptoms to the clinical phenomenology of many psychiatric disorders, offers suggestions to the diagnostic conundrum, and provides some hints for the proper assessment and management of patients with these common syndromes.
Comorbidity↗
Systemic immunoglobulin light-chain amyloidosis.
Amyloidosis is a rare disease in which amyloid fibrils compromise organ function and lead to death. Systemic immunoglobulin light-chain amyloidosis, usually caused by free light chains (FLCs) made by clonal plasma cells, is the most frequent type. Hereditary and senile systemic amyloidosis are less frequent types. Rarely, a patient with a tissue diagnosis of amyloidosis might have a monoclonal gammopathy and a hereditary protein. In systemic immunoglobulin light-chain amyloidosis, circulating clonal light chains can be measured with the FLC assay and provide a target for therapy aimed at eliminating the underlying plasma cell disorder while supporting the patient. Elimination of the pathologic FLC can lead to resorption of amyloid deposits and improvement in organ function. Monthly oral melphalan and dexamethasone for 1 year is effective therapy for patients not eligible for autologous stem cell transplantation (SCT) but carries a risk of myelodysplasia. For patients with limited organ involvement, SCT is an effective approach and, when followed after SCT by adjuvant thalidomide and dexamethasone for persistent plasma cell disease, achieves a high 1-year hematologic response rate. Complete hematologic responses can be durable beyond a decade and are usually associated with organ recovery. New agents, such as bortezomib and lenalidomide, have shown promising activity, and novel monoclonal antibody approaches are also under active investigation.
Amyloidosis↗
Pathogenesis, microbiological and clinical aspects of oral candidiasis (candidosis).
The clinical significance of the oral candidiasis (either as independent disorder, or as a part of another disease) is increasing with time. The diagnosis and local treatment of the oral candidiasis may not be satisfactory, this disorder cannot be eliminated without the correct diagnosis and management of the underlying disease. At the same time, some disorders, such as Candida induced leukoplakia, may significantly enhance tumor development. Fungal infection of the mouth is often the initial sign of several immunodeficiency diseases. It is, therefore, very important to clarify the background of a fungal infection, since this may be critical regarding the prognosis.
Antifungal Agents↗
Treatment of previously undiagnosed psychiatric disorders in persons with developmental disabilities decreased or eliminated self-injurious behavior.
BACKGROUND: Self-injurious behavior (SIB) is one of the most common challenging behaviors in persons with autistic disorder or severe/profound mental retardation. Many psychotropic drugs have been evaluated for their effectiveness in SIB. Results have varied, and no one psychotropic drug has been indicated for SIB. In this prospective, open clinical study, psychotropic drugs were used to treat the previously undiagnosed psychiatric disorder in persons exhibiting SIB. METHOD: Data were collected from 26 individuals with mental retardation (14 males, 12 females), 7 to 45 years of age (mean = 30.3 years), who exhibited SIB. Psychiatric diagnosis was made according to DSM-III-R and DSM-IV criteria. The Behavior Problem Inventory, Yudofsky's Overt Aggression Scale, repeated direct observation, and information on use of protective devices and Likert scales from log books were used to evaluate degree of SIB. Most of the patients were treated with different psychotropic drugs and behavior modification before they were evaluated for this study, but only 7 of them carried a psychiatric diagnosis. Data were collected between 1987 and 1997. RESULTS: Depressive disorders, impulse-control disorder, and anxiety disorder were the most common final diagnoses. Neuroleptics were discontinued in 5 patients and tapered by 50% to 75% in 14 patients. Antidepressants were added in 12 patients. Treatment of psychiatric disorders produced significant (p < .001) decrease in the severity of SIB in the 26 patients, and SIB was eliminated in 12 patients. The severity of SIB decreased to mild from a moderate, severe, or extreme degree in 11 patients and from an extreme to a severe degree in 3 patients. CONCLUSION: The most effective treatment for SIB that is resistant to environment changes and behavior modification in persons with developmental disabilities is the treatment of their psychiatric disorders with the appropriate psychotropics.
Adolescent↗
An unusual case of pica.
This paper presents the case of a 29 year old woman who compulsively ate rocks and pebbles, a habit developed in childhood. Extensive psychometric testing did not demonstrate phobias, obsessions, tendency to increased anxiety, depression or anorexic or bulimic disorder. The development of pica is partially explained by a childhood eating disorder, obsessive personality traits, cultural factors and specific (personality induced) stresses. Stress-reducing measures were successful in eliminating the eating disorder.
Adult↗
Effect of DSM-III personality disorders on outcome of tricyclic antidepressant-treated nonpsychotic outpatients with major or minor depressive disorder.
This is the first outcome report of the effect of a personality disorder on nonhospitalized major depressive patients that used a standardized DSM-III measure and did not prescreen to eliminate certain personality disorders. Six-month outcome was compared for nonpsychotic patients with major depression and a DSM-III personality disorder (n = 26) and those who did not have a personality disorder (n = 11). Patients without a personality disorder had significantly better outcome as measured by the Global Assessment Scale and employment status. There was also a trend for less physician utilization in this group.
Adjustment Disorders↗
Generalized anxiety disorder in patients with major depression: is DSM-IV's hierarchy correct?
OBJECTIVE: DSM-III imposed a hierarchical relationship in the diagnosis of anxiety disorders in depressed patients, stipulating that anxiety disorders could not be diagnosed if their occurrence was limited to the course of a mood disorder. In the subsequent versions of the DSM this hierarchy was eliminated for all anxiety disorders except generalized anxiety disorder. The authors examined the validity of this remaining hierarchical relationship between mood and anxiety disorders. METHOD: Psychiatric outpatients with major depressive disorder (N=332) were evaluated with a semistructured diagnostic interview and completed paper-and-pencil questionnaires on presentation for treatment. To study the validity of the DSM-IV hierarchical relationship between generalized anxiety disorder and mood disorders, the authors made a diagnosis of modified generalized anxiety disorder for patients with major depressive disorder who met all the criteria for generalized anxiety disorder except for the exclusion criterion. The analyses compared the characteristics of three nonoverlapping groups of patients with DSM-IV major depressive disorder: 1) those with coexisting DSM-IV generalized anxiety disorder, 2) those with coexisting modified generalized anxiety disorder, and 3) those with neither DSM-IV nor modified generalized anxiety disorder. RESULTS: Compared to the depressed patients without generalized anxiety disorder, the depressed patients with DSM-IV and modified generalized anxiety disorder had higher levels of suicidal ideation; poorer social functioning; a greater frequency of other anxiety disorders, eating disorders, and somatoform disorders; higher scores on most subscales of a multidimensional self-report measure of DSM-IV axis I disorders; a greater level of pathological worry; and a higher morbid risk for generalized anxiety disorder in first-degree family members. The two generalized anxiety disorder groups did not differ from each other. CONCLUSIONS: The findings question the validity of the DSM-IV hierarchical relationship between major depressive disorder and generalized anxiety disorder and suggest that the exclusion criterion should be eliminated.
Adolescent↗
[Prolonged regional intra-arterial therapy in multimodal treatment of patients with severe skeletal trauma].
A total of 108 victims with open fractures of long tubular bones of different localization are examined. Regional intraarterial therapy was added to their treatment protocols. Stable functional disorders in local hemodynamics in these patients impede the repair processes and can lead to development of infectious complications. Regional intraarterial therapy allows early elimination of hemodynamic disorders, selective antibiotic therapy, and improves the adaptation potential of the immune system.
Analgesics↗
Macromastia as an etiologic factor in bulimia nervosa: 10-year follow up after treatment with reduction mammaplasty.
Patients with psychologic diagnosis such as eating disorders have been automatically disqualified as candidates for plastic surgery. We have previously reported on a cohort of women with bulimia nervosa who presented with symptomatic macromastia. All patients reported that dysfunctional eating habits where in part the result of breast enlargement. Five patients underwent reduction mammaplasty and postoperatively reported relief of physical symptoms and improvement in psychologic well-being. Symptoms of eating disorders were completely eliminated or greatly reduced. The aim of the current study is to evaluate the degree of long-term postoperative satisfaction and recovery from eating disorders. Patients participating in the original study were contacted for long-term follow-up telephone survey. Data regarding current physical symptoms, body dissatisfaction, and eating attitudes measured by the Eating Attitude Test-26 (EAT-26) questionnaire was obtained. A statistical analysis was performed. Data was obtained from 4 patients. All patients maintained consistent recovery from their eating disorder. A statistically significant improvement in eating attitudes was found when comparing pre- and postoperative data obtained from the EAT-26. Comparing body dissatisfaction, pain, and physical symptoms, we found an overall consistent improvement in subjective scoring. Macromastia can produce a distortion of body image and become a secondary cause of eating disorders. Surgical correction of macromastia can correct physical symptoms, improve body image, and lead to permanent amelioration of associated eating disorders. This could, in part, represent a surgical treatment of a psychologic abnormality. Consequently, the presence of an eating disorder should not automatically exclude a woman from surgical consideration.
Body Image↗
Reduction mammaplasty in patients with bulimia nervosa.
Women with eating disorders have been disqualified as candidates for plastic surgery. We present a group of 6 young women with bulimia nervosa who presented with clinically symptomatic evidence of macromastia. All patients reported that dysfunctional eating habits, at least in part, where due to breast enlargement. Five patients underwent bilateral reduction mammaplasty. Patients were interviewed postoperatively and reported relief of physical symptoms and improvement in psychological well-being. Symptoms of eating disorders were completely eliminated or greatly reduced. This series has supported the contention that macromastia can produce a distortion of body image and become a secondary cause of eating disorders. Surgical correction of large breasts has improved body image, leads to the amelioration of associated eating disorders, and may in part represent a surgical treatment for a psychological abnormality. The presence of an eating disorder should not, therefore, automatically exclude a patient from surgical consideration. Routine preoperative evaluation of young women seeking plastic surgery should include a set of standard questions regarding eating behaviors.
Adolescent↗
Urate nephrolithiasis in ranch mink.
Urate nephrolithiasis with epistaxis and bleeding around foot pads was diagnosed in ranch mink. Investigation of affected, unaffected-related, and unaffected-unrelated mink did not disclose the cause of these problems but did eliminate inherited bleeding disorders as a cause of the bleeding. All affected mink were males, had been sired by related sires, and were affected in the 1st year of life. Elimination of affected mink and their parents from the breeding stock eliminated the condition from the herd. The findings were consistent with an inherited defect in uric acid metabolism or excretion.
Animals↗
[Extra-articular rearrangement of temporomandibular joint internal derangement and associated neuromuscular disorders].
This report introduces a new method for treatment of TMJ internal derangements and associated neuromuscular disorders. This operation consists of two main surgical procedures: (1) To detach the muscular attachments of masseter, temporal, and internal pterygoid muscle from the mandible and to detach the external pterygoid muscle from the external pterygoic plate for eliminating the neuromuscular disorders. (2) To reposition the condylar head from the glenoid fossa after making a vertical osteotomy on the posterior portion of the ramus for eliminating the internal derangements of the joint. Therefore, the causes of considerable embarrassment of TMJDS could be eliminated and the iatrogenic trauma to the joint could be avoided. Since 1987-1990, 15 cases have been successfully performed.
Adolescent↗
Communication and health--health as an ecosystem.
The importance of communication in public health is described with reference to recent experiences in Australia where good progress has been made with certain major public health problems. There has been a 30% fall in road accident deaths and a 40% fall in deaths from coronary heart disease, and a smoke free environment has been established in public places and in the work place. These successes depended on effective communication based on appropriate data. Evaluation data have also been used to keep the public informed and to reinforce the message. The cooperation of the media has been most important in stimulating a new awareness of health and the opportunities for self help and community initiatives. In central Australia, new initiatives involving the Central Australian Aboriginal Congress have led to an improvement in the health of Aborigines, the training of Aborigines as health workers and the development of a Centre for Appropriate Technology at the Alice Springs College of Technical and Further Education. At the international level, Australia sponsored a World Health Assembly resolution in 1986 calling for the elimination of iodine deficiency disorders. With the support of the Australian International Development Assistance Bureau and the United Nations Children's Fund (UNICEF), an international expert group of scientists and public health professionals, the International Council for Control of Iodine Deficiency Disorders (ICCIDD), based in Adelaide, has been able to work with the World Health Organization (WHO) and UNICEF in the development of an international public health programme aimed at eliminating iodine deficiency disorders by the year 2000. The ICCIDD is a new model for communication and action in international health which is now being advocated for other areas.
Breath Tests↗
Iodised salt is safe.
Iodine deficiency disorders are prevalent in all the States and Union Territories in India. Under the National Iodine Deficiency Disorders control programme, the Government of India has adopted a strategy to iodisation of all edible salt in the country which is a long term and sustainable preventive solution to eliminate iodine deficiency disorders. The benefits to be derived from universal salt iodisation are more to the population. Iodised salt is safe and does not cause any side effect.
Adolescent↗
Outcome for patients with bulimia and breast hypertrophy after reduction mammaplasty.
OBJECTIVES: To determine the outcome of patients with bulimia nervosa and symptomatic breast hypertrophy (macromastia) who had reduction mammaplasty and to identify factors that were associated with positive outcomes. DESIGN: Case series with semistructured, retrospective, personal interviews performed an average of 4 years after the procedure. SETTING: University hospital-based adolescent eating disorder program. PATIENTS: Five adolescent and young adult females who had been treated for bulimia nervosa and underwent reduction mammaplasty. OUTCOME MEASURES: Presurgical and postsurgical report of physical symptoms, body image and weight control habits, ability to exercise, psychosocial functioning and self-esteem. RESULTS: All patients experienced improvement in physical symptoms (pain and inframammary dermatitis), in their posture, and in their ability to find clothes that fit properly, to exercise, and to avoid embarrassment in social situations. Preoperative eating disorder habits were a dysfunctional attempt to achieve more "normal" body proportions; postoperatively, symptoms of an eating disorder were completely eliminated or greatly reduced. Factors related to favorable outcome included professional validation of patient's symptoms, realistic patient expectations from the surgical procedure, supportive family dynamics, and ongoing treatment for the eating disorder. CONCLUSION: This series of patients with bulimia nervosa and macromastia experienced significant improvement in symptoms related to their eating disorder and their breast hypertrophy following reduction mammaplasty.
Adolescent↗
Female urethral syndrome. A female prostatitis?
The cause of the female urethral syndrome has previously been obscure, as it has been associated by definition with a lack of objective findings but a plethora of subjective complaints of retropubic pressure, dyspareunia, urinary frequency, and dysuria. There is now strong evidence that the microscopic paraurethral glands connected to the distal third of the urethra in the prevaginal space are homologous to the prostate. They stain histologically for prostate-specific antigen and, like the prostate, are subject to both infection and cancer. The most important aspect of recognizing this microscopic "female prostate" as an anatomic feature is that its infections may completely explain many cases of the urethral syndrome. Further, the diagnosis is not elusive if trained clinicians palpate for localized and objective paraurethral tenderness through the anterior vagina wall to one or both sides of the urethra. Treatment parallel to that for male prostatitis is usually rewarded by the elimination of symptoms and the objective finding of the loss of tenderness of the paraurethral glands. As with prostatitis, the localized problem often recurs. It is time to alert primary care physicians to this disorder and to eliminate the widespread practice of treating affected women with either invasive urethral dilation or tranquilizers.
Cystitis↗