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PubMed2006

Psychiatry and psychology in medieval Persia.

OBJECTIVE: The history of psychological sciences and especially the ways in which related disorders were treated in medieval Persia are not well known in the West. The main objective of this article is to review the clinical approaches to psychological disorders used by practitioners in medieval Persia. DATA SOURCES: Several documents still exist from which the clinical data on different psychological syndromes in medieval Persia can be ascertained. Data for this review were identified by searches of MEDLINE, Current Contents, the Internet, references from relevant articles and books, the Astan-e-Ghods Razavi Library, the Tehran University Library, the Mashhad University Library, and the files of the authors. Search terms included psychiatry, psychology, Persian, medieval, Avicenna, and pharmacotherapy. DISCUSSION: The medieval practitioners defined various signs and symptoms, apparent causes, and hygienic and dietary rules for prevention of these disorders. Medieval Persian medical writings encouraged the treatment of psychological disorders by tackling the conditions that cause or contribute to the disorder and through the use of electrical-shock therapy, phlebotomy, psychotherapy, music and color therapy, and especially prescription of long lists of medicaments. CONCLUSION: Some of the approaches of doctors in medieval Persia are accepted today, although most remain largely unexamined. With further research, more of these treatments may be shown to be of use to modern medicine.

History, Medieval↗
PubMed1984

Eye color as a predictor of outcomes in behavior therapy.

Eye color research has centered primarily on the dimension of self-paced vs. reactive performance. Self-paced activities are those in which the individual may initiate the activity when he/she chooses while the stimulus situation remains relatively constant. Reactive activities must be initiated at the precise time dictated by a rapidly changing stimulus situation. The present study examined the relationship between outcomes of behaviorally oriented treatment for children (N = 366) and eye color. The findings were consistent with theoretical expectations: Dark-eyed children and teenagers responded better to reactive treatment programs than their light-eyed counterparts, while the reverse was true for self-paced treatment programs. Implications for research and practice were discussed.

Adolescent↗
PubMed1997

Color vision tests for early detection of antiepileptic drug toxicity.

A previous suggestion that antiepileptic drugs may induce color vision deficiencies prompted us to examine whether color vision deficiencies may occur at lower drug serum concentrations than those associated with symptoms of neurotoxicity. Eighty patients presenting with epilepsy received monotherapies of valproic acid, phenytoin, or carbamazepine; 18 patients did not receive antiepileptic drug therapy. Color vision was tested by the Farnsworth-Munsell 100-hue test, spectral sensitivity, and the newly developed tritan screening plates. Patients treated with phenytoin or carbamazepine developed blue-yellow color vision deficiencies. In contrast, patients exposed to valproic acid or receiving no drug treatment showed normal color vision. There was a significant correlation (p < 0.0001) between signs of neurotoxicity induced by phenytoin or carbamazepine and blue-yellow color vision deficiencies. In contrast, we found no correlation between these signs of neurotoxicity and the drug serum concentrations (p = 0.0637). Color vision testing in epileptic patients treated with phenytoin or carbamazepine appears to be a sensitive method for early detection and monitoring of clinical neurotoxicity.

Adolescent↗
PubMed2003

An open trial of calcium dobesilate in patients with venous ulcers and stasis dermatitis.

BACKGROUND: Venous leg ulcers and associated stasis dermatitis are a major cause of morbidity, economic loss, and decreased quality of life in afflicted patients. Hence, there has been a renewal of interest in the medical management of varicose veins and ulcers. Calcium dobesilate, a capillotropic agent, has been found to be beneficial in the treatment of varicose veins. METHODS: This is an open pilot study of 25 patients (15 with venous ulcers with/without stasis dermatitis, 10 with stasis dermatitis only) who were given calcium dobesilate, 500 mg twice daily, for 8 weeks. The clinical parameters were graded (0-4; 0, absent; 1, mild; 2, moderate; 3, severe; 4, very severe) both before and after therapy, and included pain, itching, tiredness, heaviness, paresthesia, cramps, and leg swelling. Evaluation also included subjective changes in tenderness, oozing, and pigmentation, and measurement of the circumference of the leg for swelling and malleolar edema (measured in millimeters). The venous ulcer sizes were also recorded both before and after therapy. Color Doppler studies were performed to confirm the diagnosis of varicose veins, determine the competence of the valves, and to rule out deep vein thrombosis. Serum biochemistry, hemogram, and urinalysis were performed both before and after treatment. The results were analyzed statistically using the Wilcoxon rank sum test and Student's t-test. RESULTS: A statistically significant improvement was observed post-therapeutically in the clinical parameters of pain, itching, tiredness, heaviness, and leg swelling. There was also a significant decrease in ulcer size. The serum biochemistry, hemogram, and urinalysis remained unaffected. Color Doppler studies before treatment revealed venous valvular incompetence in 20 patients. They were repeated in only 10 patients after treatment, four of whom showed improved valvular competence. Recurrence of venous ulcers was seen in five of 12 patients who were followed up after therapy. No significant side-effects were noted. CONCLUSIONS: Calcium dobesilate is an effective adjuvant therapy, with an absence of significant side-effects, in patients with venous ulcers and stasis dermatitis. More double-blind trials are required in the future to substantiate and evaluate the role of the drug in these two indications.

Adult↗
PubMed1996

Ultrasound-guided compression repair for treatment of femoral artery pseudoaneurysm: acute and follow-up results.

Femoral artery pseudoaneurysm is a significant problem in patients undergoing arterial diagnostic or therapeutic catheterization. The aim of this investigation was to report the incidence of pseudoaneurysm after arterial catheterization and the success rate of ultra-sound-guided compression repair. During a 3-year period (11/91-11/94) 9,051 patients underwent 7,312 cardiac catheterizations and 1,739 peripheral percutaneous transluminal coronary angioplasty procedures. Patients suspect of pseudoaneurysm were referred for a color Doppler ultrasound examination. All patients with pseudoaneurysm were considered for ultrasound-guided compression repair. Pseudoaneurysm occurred more frequently after interventional procedures with new devices (valvuloplasty 2.3%, stent 3.2%) than after conventional catheterization diagnostic cardiac catheterization 0.2%, electrophysiology 1.3%, percutaneous transluminal coronary angioplasty 0.2%). The incidence of pseudoaneurysm after peripheral percutaneous coronary transluminal angioplasty, including intra-arterial lysis and stent, was 1%. Ultrasound-guided compression repair was successfully performed in 37 of 41 cases with pseudoaneurysm (90%). Ultrasound-guided compression repair was successfully performed in 30 of 31 patients (97%) without anticoagulation and in 7 of 10 patients (70%) receiving anticoagulants (P < 0.05). There was no correlation between mean diameter of the pseudoaneurysm, age of the lesion, or antiplatelet therapy. Color Doppler ultrasound re-examination at up to 3 months indicated successful treatment in all patients. The use of complex interventional catheterization procedures leads to an increased frequency of pseudoaneurysms compared with conventional angiography and percutaneous transluminal coronary angioplasty. Ultrasound-guided compression repair is a non-invasive, efficient, safe and cost-effective therapy for post-catheterization pseudoaneurysm.

Adult↗
PubMed1995

[Congenital arterio-venous malformations: an unusual cause of heart failure at birth and during the first months of life].

BACKGROUND: Congenital arteriovenous malformations represent a rare cause of heart failure in neonates. MATERIALS: Four neonates with arteriovenous malformations (cerebral in one, hepatic in two and pulmonary in one) are reported. RESULTS: In the first three cases Color Doppler echography was able to image the arteriovenous malformations, to identify the afferent and efferent vessels and to quantify the arteriovenous shunt. In the neonate with pulmonary malformation, a cardiac cause of heart failure was excluded by echocardiography, and the diagnosis was stated by selective angiography. The neonate with cerebral great arteriovenous malformation died at 4th day of life. The two neonates with hepatic malformations improved both with medical therapy; in the last neonate, with multiple arteriovenous pulmonary fistulae, selective embolization was performed, but the child died a few months later. CONCLUSION: Congenital arteriovenous malformations are rare, and an early diagnosis is the base for a correct therapy; Color Doppler echography represents the gold standard for cerebral and hepatic malformations, while selective angiography should be reserved to patients who might profit of embolization or surgical resection.

Arteriovenous Malformations↗
PubMed1991

Doppler ultrasonography of malignant melanomas of the uvea.

Doppler shifts were detected using duplex and color Doppler scanning in 41 of 42 patients with malignant melanomas of the uvea. Mean maximum tumor systolic velocity was 18.8 +/- 7.6 cm/s. Time-averaged maximum velocity in the tumor vessels was 12.3 +/- 5.3 cm/s. Maximum tumor velocity increased in four of eight tumors and was unchanged or had diminished in the other four 2 to 3 days after ruthenium plaque irradiation. Doppler shifts were undetectable in three tumors, markedly reduced in three tumors, and unchanged in one tumor 1 to 4 months after treatment. We detected minimal non-pulse-synchronized Doppler shifts in one of three tumors, and no shifts in the remaining two tumors 1 1/2 to 4 years after therapy. Color duplex scanning allowed a rapid overview of tumor vasculature and facilitated study of individual vessels.

Blood Flow Velocity↗
PubMed2003

Percutaneous sonographically guided microwave coagulation therapy for hepatocellular carcinoma: results in 234 patients.

OBJECTIVE: The objective of our study was to evaluate the long-term results of percutaneous microwave coagulation therapy for the treatment of hepatocellular carcinoma in a large patient population. SUBJECTS AND METHODS: Survival rates were determined in 234 patients with 339 nodules of hepatocellular carcinoma who had undergone percutaneous microwave coagulation therapy (208 men, 26 women; mean age, 54.8 years; mean tumor size, 4.1 +/- 1.9 cm; range, 1.2-8.0 cm; mean follow-up period, 27.9 months). Patients were those who had been rejected as candidates for surgery by the surgery department, who fit our study's criteria, and who agreed to participate. After baseline imaging studies were performed, the patients were followed up using the same combination of imaging (sonography, CT, or MR imaging) and posttreatment biopsy. RESULTS: After percutaneous microwave coagulation therapy, color Doppler flow signals disappeared in 92.0% (263/286) of the lesions. No enhancement was apparent in 89.2% (190/213) and 89.1% (41/46) of the lesions on contrast-enhanced CT and MR imaging, respectively. Posttreatment biopsies of 194 nodules showed no evidence of surviving tumor tissue in 180 nodules (92.8%). Resections of six lesions revealed complete tumor necrosis in five. The 1-, 2-, 3-, 4-, and 5-year cumulative survival rates were 92.70%, 81.60%, 72.85%, 66.37%, and 56.70%, respectively. The relationships between survival curves and the degree of hepatocellular carcinoma tumor differentiation and between survival curves and tumor size were statistically significant (p = 0.021). No severe complications were seen. CONCLUSION: Sonographically guided microwave coagulation proved to be safe and effective for the treatment of hepatocellular carcinoma. This therapy resulted in a high percentage of cases without evidence of residual tumor and satisfactory long-term results.

Administration, Cutaneous↗
PubMed2001

Ethnocultural allodynia.

The authors introduce and define ethnocultural allodynia as an abnormally increased sensitivity to relatively innocuous or neutral stimuli resulting from previous exposure to painful culturally based situations. Ethnocultural, gender-specific, and cognitive-behavioral techniques are used in clinical vignettes to illustrate the pervasive ethnic, racial, and gender effects of ethnocultural allodynia in the lives of people of color. Therapy components for the treatment of ethnocultural allodynia are described, including psychoeducation regarding racism and its sequelae, racial socialization, inoculation, and racial stress management.

Cognitive Behavioral Therapy↗
PubMed1999

Prognosis of parathyroid function after successful percutaneous ethanol injection therapy guided by color Doppler flow mapping in chronic dialysis patients.

Selective percutaneous ethanol injection therapy (PEIT) of the parathyroid glands has been shown to be effective in chronic dialysis patients with severe secondary hyperparathyroidism. In this study, we examined whether it was possible to maintain parathyroid function within target range (intact parathyroid hormone [iPTH], 160 to 360 pg/mL) in the long term after successful destruction of hyperplastic tissue. PEIT was performed in 46 patients resistant to calcitriol pulse therapy, and all glands larger than 5 mm in diameter were destroyed by ethanol, guided by power Doppler flow mapping. Serum iPTH levels decreased from 633.3 +/- 359.9 to 226.3 +/- 204.7 pg/mL at 3 weeks and were maintained at 289.9 +/- 222.4 pg/mL at 1 year after PEIT. Total alkaline phosphatase activity decreased from 384.9 +/- 160.1 to 234.0 +/- 110.5 IU/L at 1 year after PEIT. In 19 patients, iPTH levels decreased into relative hypoparathyroidism (iPTH < 160 pg/mL) at 3 weeks after PEIT; however, they recovered at 1 year after PEIT (191.1 +/- 29.6 pg/mL). Parathyroid function was maintained within target range in 80.4% of the patients at 1 year after PEIT with appropriate medical therapy. Surgical parathyroidectomy was not required in any patient. Conversely, in eight other patients with recurrent hyperparathyroidism after subtotal parathyroidectomy, iPTH levels recovered in only 50% of the patients at 1 year after PEIT. Thus, destruction of hyperplastic tissue should be optimized in such patients. Recurrent nerve palsy was observed in only one patient, but was reversible. In conclusion, selective PEIT guided by color Doppler flow mapping is an effective and safe adjunct to medical therapy with a low risk for hypoparathyroidism.

Administration, Cutaneous↗
PubMed1980

[Disorders of the ability to distinguish colors during digitalis therapy (author's transl)].

31 hospitalized patients treated with beta-methyl digoxin and 34 treated with beta-acetyl digoxin were examined for color vision disturbances and compared with a control group (n = 17). The serum digoxin concentration was determined radioimmunologically. A significant correlation (p less than 0,01) was found between the severeness of the disturbances in color vision and the concentration of digoxin in the serum. The disturbances concerned different wave length regions. The lapse of time for disturbances in the distinguishing colors is being described in a case of suicidal intoxication.

Acetyldigoxins↗
PubMed2001

Changes of tumor vascularity during gene therapy monitored with color Doppler US.

Using contrast-enhanced color Doppler (CD) sonography, we assessed alterations of tumor blood flow induced in 25 murine Morris hepatomas transfected with a gancyclovir- (GCV-)sensitizing Herpes simplex virus thymidine kinase (HSVtk) suicide gene in combination with systemic GCV treatment and compared findings with a control tumor. CD measurements were quantified by the color pixel density (CPD) and the mean encoded flow velocity (mean color value, MCV), using computer-assisted image analysis, and compared with histologic arteriole counts. During 5 days, the tumor volume remained constant. In HSVtk-expressing tumors, the median CPD dropped from 16% at baseline to 5% on day 5 (p = 0.001), remaining constant in controls. The MCV decreased from 1.9 cm/s to 1.6 cm/s in the HSVtk-expressing tumors (p = 0.001) and rose from 1.8 cm/s to 2.0 cm/s in the controls (p = 0.002). In an accompanying histologic arteriole assay, we found no alterations attributable to treatment.

Animals↗
PubMed1999

Metastatic adenopathy from nasopharyngeal carcinoma: successful response to radiation therapy assessed by color duplex sonography.

BACKGROUND AND PURPOSE: Although the role of gray-scale sonography for neck nodes is well documented, it plays a limited role in the evaluation of nodal response to treatment. This preliminary limited study sought to determine color duplex sonographic changes in successfully treated metastatic nodes from nasopharyngeal carcinoma. METHODS: Fourteen patients with nodal metastases from nasopharyngeal carcinoma were studied. A pretreatment sonogram was obtained for all patients. Patients were divided into two groups of seven: in one group, repeat sonograms were obtained 8 weeks after completion of treatment; in the second group, sonograms were obtained 16 weeks after treatment. The features studied included distribution of intranodal vascularity, resistive and pulsatility indexes, and peak systolic velocity. In 11 patients, follow-up sonograms were obtained 1 year after treatment. RESULTS: The majority (90%) of malignant nodes from nasopharyngeal carcinoma have an increased central and peripheral vascularity, a high resistive index (0.8), and a high pulsatility index (1.8). After radiation therapy to the nodes, a reduction in intranodal vascularity and a statistically significant reduction in the resistive index (0.58 to 0.59) and pulsatility index (0.91 to 0.93) are found. Although a similar reduction in the peak systolic velocity is observed, it is not statistically significant. CONCLUSION: Our preliminary findings suggest that after radiation therapy for malignant nodes in nasopharyngeal carcinoma, a reduction in intranodal vascularity is found, and the resistive and pulsatility indexes may return to benign parameters as early as 8 weeks after completion of treatment.

Adult↗