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[Elimination of disorders in the electrical stability of the heart during postinfarct cardiosclerosis by using a factor that induces GABA accumulation in the brain].

It was shown that disturbances of the heart electrical stability in postinfarction cardiosclerosis manifested in a fall of the electrical threshold of the heart fibrillation and the development of extrasystoles during the vagus stimulation. These disturbances were effectively eliminated by administration of GABA in the brain.

Animals↗

[Elimination of disorders of the elasticity and contractile function of nonischemic portions of the heart in myocardial infarct by using glucose and uridine].

A study of an isolated auricle showed that one day after the infarction the extensibility of the atrial myocardium was reduced, the Starling curve was depressed to result in about a two-fold decrease of the peak systolic tension, and atrial myocardial resistance to hypoxia and excessive calcium was also decreased. This complex of shifts was considerably diminished or eliminated altogether by means of building up an excessive glucose concentration or the administration of uridine, a cofactor of glycogen resynthesis. Therefore, the data obtained suggest that uridine can be used for correcting contractile disturbances of nonischemic compartments of the heart in myocardial infarction.

Animals↗

Psychiatric disorders in children with chronic renal failure.

Psychiatric assessment was done according to the DSM-IV TR criteria in 19 children with predialysis chronic renal failure (CRF) and 19 children with end-stage renal disease on regular hemodialysis. The prevalence rate of psychiatric disorders in all the studied patients was 52.6%. Adjustment disorders were the most common disorders (18.4%), followed by depression (10.3%) and neurocognitive disorders (7.7%). Anxiety and elimination disorders were reported in 5.1 and 2.6%, respectively. The disorders were more prevalent (P=0.05) in dialysis (68.4%) than in predialysis patients (36.8%). The presence of psychiatric disorders was not significantly correlated with sex, severity of anemia, duration of CRF or the efficiency or the duration of hemodialysis. In conclusion, psychiatric disorders were prevalent in our patients, especially in those on hemodialysis. Both adjustments with depression and depressive disorders were the most common psychiatric disorders. This array of disorders was more likely explained by the difficulties encountered in living with CRF rather than by demographic or physical factors.

Adolescent↗

Ergonomic considerations in work-related upper extremity disorders.

Correctly applied, an ergonomics approach can reduce the likelihood of work-induced disorders and can assist in accommodating individuals who have work-related disorders, but it cannot eliminate disorders that have been mistakenly attributed to work by social processes. A contextual model of work-related upper extremity disorders is proposed that explicitly acknowledges that factors extrinsic to work can shape perceptions of upper extremity disorders and influence the process of somatic interpretation and health outcomes. Experiences in the United Kingdom of ergonomic regulations associated with computer use and the media coverage of work-related upper extremity disorders are used to illustrate this model.

Arm Injuries↗

Young adult outcome of attention deficit hyperactivity disorder: a controlled 10-year follow-up study.

BACKGROUND: Our objective was to estimate the lifetime prevalence of psychopathology in a sample of youth with and without attention deficit hyperactivity disorder (ADHD) through young adulthood using contemporaneous diagnostic and analytic techniques. METHOD: We conducted a case-control, 10-year prospective study of ADHD youth. At baseline, we assessed consecutively referred male, Caucasian children with (n=140) and without (n=120) DSM-III-R ADHD, aged 6-18 years, ascertained from psychiatric and pediatric sources to allow for generalizability of results. At the 10-year follow-up, 112 (80%) and 105 (88%) of the ADHD and control children, respectively, were reassessed (mean age 22 years). We created the following categories of psychiatric disorders: Major Psychopathology (mood disorders and psychosis), Anxiety Disorders, Antisocial Disorders (conduct, oppositional-defiant, and antisocial personality disorder), Developmental Disorders (elimination, language, and tics disorder), and Substance Dependence Disorders (alcohol, drug, and nicotine dependence), as measured by blinded structured diagnostic interview. RESULTS: The lifetime prevalence for all categories of psychopathology were significantly greater in ADHD young adults compared to controls, with hazard ratios and 95% confidence intervals of 6.1 (3.5-10.7), 2.2 (1.5-3.2), 5.9 (3.9-8.8), 2.5 (1.7-3.6), and 2.0 (1.3-3.0), respectively, for the categories described above. CONCLUSIONS: By their young adult years, ADHD youth were at high risk for a wide range of adverse psychiatric outcomes including markedly elevated rates of antisocial, addictive, mood and anxiety disorders. These prospective findings provide further evidence for the high morbidity associated with ADHD across the life-cycle and stress the importance of early recognition of this disorder for prevention and intervention strategies.

Adolescent↗

[The elimination of disorders in the acquisition of a conditioned active avoidance reaction by using the C-termination fragment of lysyl vasopressin].

In experiments with male white rats it was shown that 0.001 and 0.01 mg/kg of lysyl vasopressin C-terminal fragment--Pro-Lys-Gly (PLG) being injected intraperitoneally fails to influence the acquisition of active and passive avoidance and also T-maze food rewarded behaviour. The injection of PLG removed by disturbances of active avoidance caused by cyproheptadine and oxytocin. The inhibition of passive avoidance and food-rewarded behaviour was not removed by PLG.

Animals↗

[Elimination of disorders of electric stability of the heart during post-infarct cardiosclerosis using adaptation to short-term stress and the antioxidant ionol].

The experiments were carried out on male Wistar rats (300-400 g) subject to open chest surgery under nembutal anesthesia. One group of rats with postinfarction cardiosclerosis (PC) was exposed to short-term immobilization stress for 15 days one month after the occlusion of the descending branch of the left coronary artery. The other group of rats with PC was administered synthetic antioxidant ionol (BHT) (60 mg/kg, per os) 3 days prior to the experiments. The electrical stability of the heart was evaluated by assessing ventricular fibrillation threshold (VFT) determined by stimulation of the right ventricular apex by single premature impulses (10 ms) and by measuring the amount of ectopic beats developing during 30-sec stimulation of the right vagus (2 mA, 20 Hz). VFT in rats with PC was significantly lower, as compared to sham-operated rats (2.9 +/- 0.2 and 6.4 +/- 0.2 mA, respectively), with pronounced extrasystoles appearing during vagal bradycardia. In stress-adapted animals with PC VFT returned to the level of sham-operated rats and the amount of premature beats decreased 3-4-fold, as compared to unadapted rats with PC. Ionol (BHT) was shown to have the same effect.

Adaptation, Physiological↗

[The diagnosis and elimination of disorders in cardiac electrostimulation in patients with an artificial pacemaker].

In 378 patients with artificial pacemaker (AP) 10-year follow-up revealed disturbances of continuous pacing and cardiac arrhythmia. Diagnostically significant were: ECG, Holter ECG monitoring, functional AP control. Cardiac arrhythmias were spontaneous and pacing-induced. Programmed AP corrects complications of cardiac pacing and arrhythmia without surgical intervention. Regular technical control of the stimulation system providing early diagnosis of AP defects is an important component of check-ups of patients with AP.

Adult↗

Correlates of restraint use in an institutional population: a replication.

BACKGROUND: Reducing inappropriate restraint is an important mission of services for people with intellectual disabilities (IDs). METHODS: In this study, 52 clients who had been restrained were compared with 52 other clients, individually matched on age, gender and level of IDs. Participants were mostly adults with severe and profound IDs in an institutional setting. RESULTS: The two groups differed on six Diagnostic Assessment for the Severely Handicapped-II (DASH-II) and three Aberrant Behaviour Checklist (ABC) scales. However, discriminant functional analysis demonstrated that only DASH-II Impulse control disorder and ABC Irritability and Elimination disorder scores predicted group membership but only moderately. CONCLUSIONS: Individual differences in maladaptive behaviours were only moderately predictive of restraint use.

Adult↗

Can children with a psychiatric disorder be treated in a general ward?

Because admission to a regional child and adolescent psychiatric unit is often fraught with difficulties children with psychiatric disorders were admitted to a general children's ward. Over the four years (1980-4) 24 patients accounted for 31 admissions. Of these, five had feeding disorders (anorexia, bulimia), seven neuroses, three psychoses, four elimination disorders, and five other diagnoses. All the children were later discharged to their homes, most having appreciably improved. Because of the proximity of the hospital to the child's natural environment work with the families and schools was not interrupted by the admission. The results of this approach are encouraging and could have implications for future planning of services for this category of patients.

Adolescent↗

Depression and incontinence.

The urologic literature suggests that there is an association between a variety of psychiatric disorders and incontinence. Most notably, depression is found in a significant percentage of patients with urinary incontinence. Depression also occurs in other conditions associated with urinary urge incontinence, such as aging and dementia, and in neurologic disorders such as normal pressure hydrocephalus. Correction of some neurologic disorders eliminates both depression and urge incontinence. Although chronic medical disorders such as urge incontinence may lead to depression, an alternative hypothesis is that these two conditions share a common neurochemical pathogenesis. Lowering monoamines such as serotonin and noradrenaline in the central nervous system (CNS) leads to depression and urinary frequency and a hyperactive bladder in experimental animals. Thus, depression may not only be the result of persistent urinary incontinence, but individuals with altered CNS monoamines could manifest both depression and an overactive bladder. The latter condition may lead to urge incontinence, urinary frequency, urgency, or enuresis. Uncovering further evidence for such a linkage could serve as the basis for the development of genetic markers and novel therapeutic interventions for these two conditions.

Depressive Disorder↗

Comments on pediatric elimination dysfunctions: the Whorf hypothesis, the elimination interview, the guarding reflex and nocturnal enuresis.

AIMS OF STUDY: This paper addresses pediatric elimination disorders including nocturnal enuresis from the perspectives of terminology (the Whorf hypothesis), the elimination interview, and the guarding reflex. METHODS: The elimination interview and a modern model of normal voiding function, including the guarding reflex, are explained. RESULTS: The language of voiding dysfunction influences our perception of it. Nocturnal enuresis, and all other voiding dysfunctions, should be evaluated by a careful elimination interview. The guarding reflex may fit into an evolving etiologic paradigm for nocturnal enuresis. CONCLUSIONS: (1) Words and phrases of eliminology should aim for simplicity, clarity and accuracy. (2) Urologists need to perfect their eliminology skills vis-à-vis the elimination interview. (3) The role of the guarding reflex in nocturnal enuresis and all other voiding dysfunctions should be critically examined.

Arousal↗

Sleep-disordered breathing in patients with Duchenne muscular dystrophy using negative pressure ventilators.

We studied the occurrence of nocturnal disordered breathing events and O2 desaturations in 12 patients with late-stage Duchenne muscular dystrophy (DMD) using negative pressure ventilators. We also assessed the effects of O2 supplementation and nasal continuous positive airway pressure (CPAP) on disordered breathing events in selected patients and examined sleep quality in a small subgroup. Average age was 23 + 2 years and FVC was 293 + 33 ml. Eleven of the 12 patients had more than five disordered breathing events per hour during nocturnal monitoring, and the lowest O2 saturation was < 85 percent in nine patients. Nasal O2 (2 L/min) during negative pressure ventilation in four patients did not alter the frequency of disordered breathing events, prolonged the mean and maximum durations of events, and failed to eliminate severe O2 desaturations in two patients. Nasal CPAP was used in two patients during negative pressure ventilation and completely eliminated disordered breathing events in both. Overnight polysomnography during negative pressure ventilation in three patients demonstrated frequent awakenings that fell in frequency following elective tracheostomy in two patients and use of nasal CPAP in one. We conclude that negative pressure ventilation in patients with late-stage DMD is associated with frequent disordered breathing events and severe O2 desaturations in many patients. Concomitant use of O2 supplementation may prolong the events, but a switch to positive pressure ventilation or addition of nasal CPAP is effective therapy.

Adolescent↗

Managing bowel elimination problems in patients with cancer.

PURPOSE/OBJECTIVES: To provide strategies for the assessment and management of bowel elimination disorders and to standardize approaches to prevent bowel disorders. DATA SOURCES: Articles, books, ongoing clinical research. DATA SYNTHESIS: The type and degree of bowel elimination problems vary with the type of tumor and treatment received. Prediction of potential bowel problems based on treatment given dictates a bowel management program to prevent problems and help patients deal with the outcome of the treatment. A standard care plan that includes assessment and intervention for various bowel elimination problems provides specific guidelines for nursing care. CONCLUSIONS: Bowel function in the patient with cancer inevitably will be affected while going through treatment or as the disease progresses. IMPLICATIONS FOR NURSING PRACTICE: Nursing care to relieve these problems can significantly affect the patient's quality of life. As patients are diagnosed with cancer and undergo cancer therapy, they can hope for bowel management through nursing guidance and patient education.

Constipation↗