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At least 325 records · Page 18Linked to original sources

PubMed1990

[Neonatal screening and follow-up of congenital hip luxation using echography. Review of the literature and personal contribution on 1421 newborns].

US screening for hip dysplasia was performed on 1421 full-term newborns. The study was aimed at: 1) evaluating US feasibility in an unselected maternity ward population; 2) determining the frequency of the different types of hips, and correlating ours with literature data; 3) evaluating the efficacy of both an early prevention and treatment. All US examinations were performed within the first week of life and the 2842 hips classified according to Graf. At birth, normal hips (Ia, Ib) were 2064 (72.6%) (group I); physiologically immature hips (IIa) were 721 (25.4%) (group II); pathological hips (group III) were: 43 (1.5%) IIc, 8 (0.3%) IId, 6 (0.2%) III. Hips in group B were checked at 3 months: 502 were normal, 51 were type IIb, and 1 was type IId: the latter 52 hips were treated and normalized in the following months. Hips in group C (types IIc, IId, and III = 57 hips) were treated and checked every seventh week until normalization. Our experience confirms US value in the evaluation of hip dysplasia in the newborn. In our opinion, the use of this method should be encouraged, although US screening of all newborns remains controversial on a cost-benefit ratio. Multicentric studies will better define US sensitivity, specificity and reliability. The correlation of our results with literature data was difficult, because study populations are not always homogeneous. As for therapy, we found the plastic splint very effective and easy to use. In 2 cases, Milgram devices were used for a few months.

Female↗

PubMed1978

Maladaptive cognitive structures in depression.

According to the cognitive view, the individual's negative and distorted thinking is the basic psychological problem in the depressive syndrome. The distorted cognitions are supported by maladaptive cognitive schemata, which involve immature "either-or" rules of conduct or inflexible and unattainable self-expectations. These schemata are probably acquired early in development and, if uncritically carried into adulthood, serve to predispose the individual to depression. Since these schemata are long-term identifiable psychological patterns that influence attitude and behavioral responses, they may constitute a cognitive dimension of the depression-prone individual's personality. The authors discuss the treatment implications of the cognitive approach to depression.

Attitude↗

PubMed2005

[Surgical treatment of late tractional retinal detachment appearing on the basis of retinopathy of prematurity].

Retinopathy of prematurity (ROP) is a proliferative retinopathy affecting predominantly immature children and children with low birth weight under 2500 g in 5-6%. During 11 years we operated on 15 eyes of 15 patients aged 5-31 years, because of late tractional retinal detachment (TRD) appearing on the basis of ROP. The average follow-up period was 37.2 months; the minimal follow-up period was 1 year. In all patients, the personal medical history revealed the pre-term birth at the gestation age of 28-34 weeks. The birth weight was in the range 850-1600 grams. According to the extend of vitreoretinal traction and type of retinal defect we indicated: a) primary cryosurgical procedure (CP) with episcleral silicone implants. The operation was indicated in 6 eyes: cerclage, segmental perilimbal plombage in the temporal half and puncture of the subretinal fluid; b) pars plana vitrectomy (PPV). In total in 9 eyes the PPV was indicated, in 5 eyes it was supplemented with relaxing retinotomy, and in 7 eyes with silicone oil (SO) implantation. Three eyes were re-operated by means of PPV with SO implantation. The final anatomical success of the surgical treatment of the prognostic unfavorable TRD, including re-operations was achieved in 12 eyes (80%), which we consider as a good one. The visual acuity improved or remained the same also in 12 eyes (80%) and visual acuity 6/60 and better (20/200 or 0.1) in 8 out of 15 eyes (53%).

Adolescent↗

PubMed1997

Psychological defense styles in late adolescence and young adulthood: a follow-up study.

OBJECTIVE: The aims of this follow-up study were to examine in both sexes (1) the stability of defense styles from late adolescence to early adulthood and (2) the ability of adolescent defense styles to predict later psychiatric symptoms. METHOD: Defense styles were examined using the Defense Style Questionnaire. Five hundred sixteen high school students (337 females and 179 males) completed the questionnaire at 15 through 19 years of age, and again 5 years later. In the follow-up examination the General Health Questionnaire was used to assess psychiatric disturbance. RESULTS: Neurotic and immature defense style scores decreased significantly in both sexes, whereas mature defense style scores did not change significantly. Females had significantly higher neurotic defense style scores than males in both late adolescence and young adulthood. Psychiatric disturbance at follow-up was associated positively with baseline immature defense style scores in both sexes, and negatively with baseline mature defense style scores in females. CONCLUSIONS: Development of defenses was apparent as a decrease in neurotic and immature defense style scores. In both sexes, immaturity of defenses in late adolescence predicted psychiatric symptoms in young adulthood.

Adolescent↗

PubMed1983

Methadone maintenance treatment: the other side of the coin.

The psychopharmacological rationale and clinical effectiveness of the methadone maintenance treatment program was subjected to critical theoretical and methodological analysis. It was concluded (1) that the MMTP constitutes and perpetuates an immature coping mechanism; i.e., "subliminal euphoria"--pervasive pharmacological shielding of addicts from the inevitable discomforts attending adaptation to the real world; (2) that it does not satisfy so-called tissue craving for florid euphoria because most "stabilized" clients actively seek and obtain same from heroin, methadone itself, and/or other potentially euphorogenic drugs; (3) that the source of this craving resides in the addict's personality rather than in his tissues; (4) that official evaluation studies of the MMTP grossly exaggerate its clinical effectiveness; and (5) that the MMTP has inadvertently created incomparably more primary methadone addicts than it has cured heroin addicts.

Drug Tolerance↗

PubMed1989

So-called intracranial germ cell tumours: personal experiences and a theory of their pathogenesis.

We investigated 110 cases of intracranial germ cell tumours (up to the end of 1986), 56% of which showed monotypic histological patterns and 44% were shown to be mixed tumours. All these cases underwent surgery followed by radiation and/or chemotherapy. All cases of choriocarcinoma and embryonal carcinoma died within 2 yr: cases of endodermal sinus tumour also showed poor results (4 yr survival rate was 12.5%). Mature teratoma had a 5 yr survival rate (5YSR) and a 10 yr survival rate (10YSR) of 78.3% each: immature teratoma showed a 5YSR of 44.9%. Two-cell pattern tumours (PTC) showed a 5YSR of 85.8% and a 10YSR of 82.4%. They (PTC) can be divided into two groups (i) germinoma and (ii) pinealoma of pineal parenchyma origin (pineocytoma with lymphocytic infiltration) on the basis of the difference in the tumour cell-stroma relationship and also placental alkaline phosphatase stain. In the pineal region, 70% of PTC belonged to the category of pinealoma and in the suprasellar region, 92% of PTC were germinoma. Germinoma showed a 5YSR of 91.4% and a 10YSR of 91.4%, whereas those of the pinealoma were 78.2% and 68.4% respectively. This suggests that the biological characteristics of germinoma and pinealoma may be different. All these results may bring into question the validity of the germ cell theory, since germinoma, which should be the most undifferentiated according to the theory, was the most benign and choriocarcinoma and endodermal sinus tumour, which should be the most differentiated, were the most malignant in the follow-up study.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1991

The relationship of interparental conflict and global marital adjustment to aggression, anxiety, and immaturity in aggressive and nonclinic children.

Although there is agreement that marital problems are associated either directly or indirectly with particular child behavior problems, there is disagreement about the types of marital conflict associated with these problems and the differential effects on boys and girls in clinic and nonclinic samples. We examined the relationships among mothers' ratings of marital adjustment, parenting disagreements, and three child problem factors (aggression, anxiety, and immaturity) after the child's age and family socioeconomic status were controlled. These relationships were compared with samples of boys and girls (3 to 8 years of age) from clinic and nonclinic populations, revealing that parenting disagreement predicted aggression in all groups and that both marital adjustment and parenting disagreement predicted anxiety in boys. Neither marital variable predicted immaturity. Possible reasons for the results (including methodological limitations of the present data) are discussed.

Aggression↗

PubMedDate not supplied

Oral function in the physically handicapped with or without severe mental retardation.

Neuromotor handicaps and mental retardation have been associated with various types of dental malocclusions and oral dysfunction. In this study the specific role of mental status on oral functions was examined. For this, oral function capacity was compared between two groups of physically handicapped children and young adults, one with a physical handicap alone, the other with mental retardation. The latter were found not only to be significantly more motor-impaired in general, but also were found to have significantly more deficient oral functions (speech, swallowing and chewing). Mentally retarded also showed significantly more frequent involvement with regard to some other characteristics of oral function and oral conditions, such as lip seal, tongue posture and drooling. As oral dysfunction may cause dental malocclusion, it seems likely that the deviating or immature oral functions in the mentally retarded group may explain earlier observations of a higher prevalence and often more severe malocclusion in these individuals, compared to those who are handicapped.

Adolescent↗

PubMed1988

Niridazole metabolism by rat embryos in vitro.

We report the results of studies on the reductive activation of the schistosomicidal agent, niridazole (NDZ). Intact rat embryos in vitro reduced this compound, generating a stable metabolite in the presence of 5% O2. By contrast, embryo and yolk sac homogenates or liver microsomes appeared to require anaerobiasis. Malformation incidence--specifically, axial asymmetry--showed a strong correlation with nitroreductase activity rates when the latter were modulated by oxygen tension. Data presented here suggest that when embryos are exposed to NDZ under conditions of low oxygen in vitro, redox cycling ensues with molecular oxygen serving to oxidize early reduction products. This process continues, regenerating the parent compound until oxygen is depleted locally. The basis of this localized depletion is unknown, but inability of the immature supply system to replete oxygen or demand by precociously aerobic tissues may be involved. Once local anaerobiasis is attained, further reduction could generate toxic metabolites capable of covalently binding cellular macromolecules. Localized hypoxia represents another potential mechanism of dysmorphogenesis.

Abnormalities, Drug-Induced↗

PubMed1987

Psychiatric interviews and psychological tests as predictors of medical students' success.

Psychiatric interviews carried out during the first year of four medical school classes of the University of Chicago School of Medicine (now Pritzker School of Medicine) during 1946 through 1949 were found to be statistically significant in predicting the students' graduation. However, the number of "false negatives" was high; that is, a large number of students predicted not to graduate did graduate. Psychological tests--consisting of personality, interest, and intelligence tests--were not statistically significant in predicting graduation. Neither the interviews nor the tests correctly predicted the students' mental or physical health or their occupational or marital adjustment as of 1982, as measured by replies to a questionnaire from more than 90 percent of the students in the original study who could be located. There is some subjective evidence that moderate degrees of anxiety, immaturity, and compulsivity are not associated with failure to complete medical school but that passivity, withdrawal, and weak motivation are. Although psychiatric interviewing of applicants is not now feasible because of legal restrictions, some of the findings of the study reported here may be useful for admission interviewers and as a basis for further research.

Achievement↗

PubMed1978

Squamous cell dysplasia and carcinoma in situ of the cervix and vagina after prenatal exposure to diethylstilbestrol.

Squamous cell abnormalities of the vagina and cervix were evaluated in 1424 women exposed to diethylstilbestrol (DES) in utero. The prevalence of dysplasia was 2.1% and the incidence 0.85/100 person-years of followup. The dysplastic epithelial changes were almost always mild in women with no prior history of dysplasia and was slightly more frequent in the cervix than the vagina. Severe dysplasia and carcinoma in situ (CIS) were encountered only in those subjects specifically referred because of those abnormalities. The most common problem in the diagnosis of these squamous cell changes was the misinterpretation of mature and immature metaplastic cells for dysplastic squamous cells. Discordance between biopsy and cytology was common-place in the detection and followup of dysplasia, especially when it was mild. There were no instances in the study where cytology and biopsy samples from the vagina were both abnormal concurrently. Colposcopically directed biopsies did not increase the frequency of confirmation of cytologic findings. These data suggest that both cytology and biopsy of abnormal segments of the vagina and cervix remain an integral part of the examination of the DES-exposed female during long-term follow-up studies.

Adolescent↗

PubMed1976

Natural history of male psychological health. V. The relation of choice of ego mechanisms of defense to adult adjustment.

Ninety-five men, selected in college on the basis of health have been prospectively followed up for 30 years. Their adaptive styles have been isolated, labeled by the ego mechanisms of defense that their behavior reflects, and studied by semiquantitative techniques. A hierarchy of ego mechanisms was devised that ordered defenses along a continuum that reflected the following two dimensions: (1) immaturity-maturity and (2) psychopathology-mental health. The most important finding was that despite blind assessment, a scale reflecting the maturity of a subject's defenses correlated with scales measuring his objective psychopathology (r = -.35) and his objective adaptation to the external environment (r = .65). Highly significant shifts in defensive style occurred as individuals matured. In order to conceptualize the continuum that underlies mental health, identification of a person's dominant defensive styles may be superior to our current scheme of static unitary diagnoses.

Adaptation, Psychological↗

PubMed2002

The contact system.

OBJECTIVES: To review the literature for conditions, diseases, and disorders that affect activity of the contact factors, and further to review the literature for evidence that less than normal activity of any of the contact factors may be associated with thrombophilia. DATA SOURCES: MEDLINE search for English-language articles published from 1988 to 2001 and pertinent references contained therein, as well as search of references in recent relevant articles and reviews. STUDY SELECTION: Relevant clinical and laboratory information was extracted from selected articles. Meta-analysis was not feasible because of heterogeneity of reports. DATA EXTRACTION AND SYNTHESIS: Evidence for association of altered levels of the contact factors and thrombophilia was sought. A wide variety of disorders is associated with decreased activity of the contact factors; chief among these disorders are liver disease, hepatic immaturity of newborns, the antiphospholipid syndrome, and, for factor XII, being of Asian descent. These disorders are more common than homozygous deficiency. The few series and case reports of thrombophilic events in patients homozygous for deficiency of contact factors are not persuasive enough to support causality. The apparent association between levels consistent with heterozygosity (40%-60% of normal) of any of the contact factors (but especially factor XII) in persons with antiphospholipid antibodies appears to be due to falsely decreased in vitro activity levels of these factors, which are normal on antigenic testing. The apparent association with thrombosis is better explained by the antiphospholipid syndrome than by the modest reduction of the levels of contact factors. CONCLUSIONS: Presently, it is not recommended to measure activity of contact factors during routine evaluation of patients who have suffered venous or arterial thromboembolism or acute coronary syndromes.

Blood Coagulation↗

PubMed1989

[Causes of interruption of dental studies and subsequent change in careers].

During recent years an increasing number of dental students at the University of Oslo used prolonged student time and graduated with mediocre results, or interrupted studies without graduation Jacobsen, Acta Odontol Scand 45:399-408, 1987). The present investigation aimed at clarifying the reasons for interrupted studies and at getting information about subsequent career. Semistructured questionnaires on curricular and socioeconomic causes for drop-out and on subsequent career were mailed to 98 persons who had quit dental studies during a 10-year period. Free comments on circumstances relevant to their drop-out were encouraged. The following findings are based on 68 replies (69 per cent): Sixty-three students (93 per cent) quit dental school for different curricular reasons, a majority of which was "more interest in other subjects". Contributory factors of socioeconomic nature, mostly future unemployment concern, were often mentioned. Forty-five (66 per cent) later graduated with university degrees in medicine, economics, veterinary medicine, science, technology, law etc, and the remainder, except two persons, finished up to 4 years of studies at regional colleges or similar institutions. Free comments focused on curricular, pedagogical, and social shortcomings at the dental faculty. The findings indicated that a large majority of the students who dropped out did so for lack of stimulation by the dental curriculum and not for lack of academic potential. Only a few students quit because, in their own description, they were immature for university studies at the time, or because they had "academic" difficulties with the early science/biology courses or with the preclinical technique courses.

Adult↗

PubMed2000

Erythromycin for feeding intolerance in preterm infants.

BACKGROUND: Functional immaturity of gastointestinal motility predisposes preterm infants to feeding intolerance. Motilin, a gastrointestinal peptide, stimulates propagative contractile activity during phase III of the migratory motor complex in the interdigestive state. Erythromycin (EM) is a motilin agonist with prokinetic effect at low doses (1-3mg/kg). OBJECTIVES: To evaluate the effectiveness of EM in promoting gastrointestinal motility in preterm infants with feeding intolerance and assess clinically significant adverse effects associated with its use. SEARCH STRATEGY: Systematic literature search in accordance with the Cochrane Neonatal Collaborative Review Group search strategy. Randomized and quasi-randomized controlled trials of EM use, at any dose, in preterm infants to promote gastrointestinal motility were identified by searching MEDLINE, EMBASE, CINAHL, the Cochrane Library, reference lists of published studies, personal files, and abstracts published in Pediatric Research. SELECTION CRITERIA: Randomized controlled trials of oral or intravenous EM use at dose range of 3 to 12 mg/kg/day in preterm infants less than or equal to 36 weeks gestational age with feeding tolerance were included in this review. DATA COLLECTION AND ANALYSIS: Data regarding the primary clinical outcome of days to achieve full enteral feeding were compared among studies. Data on secondary outcomes including adverse effects associated with the use of EM (diarrhea, nosocomial infections, cardiac arrhythmias, or theophylline toxicity), duration of parenteral nutrition, weight gain, incidence of necrotizing enterocolitis (NEC), hypertrophic pyloric stenosis, and length of hospital stay were assessed. MAIN RESULTS: Two randomized controlled studies of EM use in preterm infants for improving gastrointestinal motility were identified. Since both studies involved preterm infants treated with EM at dose >12mg/kg/day at commencement of feeding, they did not meet inclusion criteria defined a priori for this review. There was no statistically significant difference in the incidence of NEC (RR 0.59, 95%CI 0.11, 3.01; RD -0.021, 95%CI -0. 087, 0.045). No statistically significant difference was noted in days to achieve full enteral feeds, length of hospital stay, and adverse events between groups. REVIEWER'S CONCLUSIONS: EM at antimicrobial doses may not be effective in preterm infants with feeding intolerance. Further studies are needed to determine whether EM in lower doses is effective as a prokinetic agent in such infants.

Anti-Bacterial Agents↗

PubMed2000

The chick embryo chorioallantoic membrane as a model for in vivo research on anti-angiogenesis.

Anti-angiogenesis, i.e. inhibition of blood vessel growth, is being investigated as a way to prevent the growth of tumors and other angiogenesis-dependent diseases. Pharmacological inhibition interferes with the angiogenic cascade or the immature neovasculature with synthetic or semi-synthetic substances, endogenous inhibitors or biological antagonists. The chick embryo chorioallantoic membrane (CAM) is an extraembryonic membrane commonly used in vivo to study both new vessel formation and its inhibition in response to tissues, cells, or soluble factors. Angiogenesis or anti-angiogenesis is evaluated quantitatively or semiquantitatively. The fields of application of CAM in the study of anti-angiogenesis, including our personal experience, are illustrated in this paper.

Allantoin↗

PubMed1991

Asymmetric development of mitochondrial activity in rat embryos as a determinant of the defect patterns induced by exposure to hypoxia, hyperoxia, and redox cyclers in vitro.

Previous study has shown that midorganogenesis-stage rat embryos exposed to strong redox cyclers under moderate hypoxia in vitro develop severe necrotic defects on the right side. Similar effects can be produced by exposure to severe hypoxia alone. Studies presented here indicate that exposure to severe but survivable hyperoxia induces comparable necrotic degeneration on the left sides of all embryos. We hypothesize that the basis of these axially asymmetric defects is relatively precocious mitochondrial maturity on the left side of the embryo. In order to investigate this hypothesis, we compared mitochondrial oxygen utilization (NADH oxidase activities) on either side of rat embryos between days 11 and 14 of gestation. Activities were consistently higher on the left side during this period and significantly higher on day 11. We also found that the asymmetric embryotoxicity induced by niridazole, a strong redox cycler, could be attenuated by prior culture under hyperoxic conditions. We propose that mitochondrial immaturity on the right results in inadequate energy generation under hypoxic conditions, either directly or as a result of redox cycling. On the other hand, necrosis associated with hyperoxic conditions results from "leakage" of superoxide from functionally mature mitochondria on the left side.

Abnormalities, Drug-Induced↗

PubMedDate not supplied

Lessons learned in public health emergency management: personal reflections.

Multiple environmental, ecological, and socio-political forces are converging to increase the occurrence of both natural and technological disasters. Ten forces are of most concern in this regard. These are: 1) global warming, with its consequent weather extremes and climate changes; 2) continued rapid human population growth and concomitant increased urbanization; 3) decreased bio-diversity and consequent ecological fragility; 4) deforestation and loss of natural habitat for animal species, with resultant greater overlap of human and animal habitats, human exposure to animal pathogens, and other ecological perturbations; 5) increased technological development throughout the world (especially in developing countries with their typically immature safety programs); 6) globalization and increased population mobility; 7) sub-national religious and ethnic conflicts, and their potential for conflict escalation and large scale displacement of populations; 8) the collapse of several major countries and consequent unraveling of national identity and social order; 9) the rise of terrorism; and 10) dramatic advances in the science and technology of computing, communications, biotechnology, and genomics. This paper describes 10 lessons learned relative to the public health aspects of emergency management, especially as they pertain to disasters. 1) Planning pays; 2) A bad situation can be made worse by inappropriate responses; 3) Most life saving interventions will occur before the disaster happens and immediately afterwards by local action; 4) Public health emergency management is not a democratic process; 5) Psychological impacts are usually greater than anticipated; 6) Communications and information management are vital, but often are the weak link in the response chain; 7) Collaboration and partnerships are essential; 8) Unsolicited volunteers and aid are inevitable and must be planned for and managed; 9) Never assume anything, and always expect the unexpected; and 10) Post-event evaluation is important, and must be coordinated. The paramount lesson learned from past emergencies is that the untoward impact of these events can be anticipated and significantly ameliorated by appropriate planning and preparation. On the other hand, preparation for emergency events has deteriorated because of health-care financial constraints, and resources to support planning and needed infrastructure have diminished. Given these realities, the major unresolved challenge is how to ensure that planning for the common good is supported and, in fact, gets done.

Communication↗