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PubMed1992

Nizatidine versus placebo in active benign gastric ulcer disease: an eight-week, multicenter, randomized, double-blind comparison. The Nizatidine Benign Gastric Ulcer Disease Study Group.

STUDY OBJECTIVE: To determine if 150 mg nizatidine twice daily or 300 mg nizatidine at bedtime are similarly effective and to compare each dose with placebo in healing benign gastric ulcers and relieving peptic ulcer symptoms. METHODS: This study was a randomized, double-blind, placebo-controlled parallel comparison. The study was conducted at 74 gastroenterology and internal medicine clinics in the United States and Canada. Four hundred fifty-six patients with active benign gastric ulcer documented by endoscopy participated in the study. On the basis of a computer-generated randomization list, patients were assigned sequentially to receive either 150 mg nizatidine twice daily (n = 151), 300 mg nizatidine once daily at bedtime and identically appearing placebo capsules in the morning (n = 153), or placebo capsules twice daily (n = 152). Treatment lasted for 8 weeks unless healing was documented by endoscopy after 4 weeks. Antacid tablets (aluminum hydroxide, magnesium hydroxide, simethicone combination) were supplied for relief of symptoms. MEASUREMENTS AND MAIN RESULTS: Both doses of nizatidine significantly improved healing rates at 8 weeks compared with placebo. Daytime and nighttime symptom severity was improved by both nizatidine regimens at end point (p less than 0.015 versus placebo, two-tailed test). Antacid use was similar for all groups in the end point analysis. Patient well-being was significantly better in patients treated with nizatidine than in patients in the placebo group ((p less than 0.04, two-tailed test). No clinically significant differences in the incidence of adverse clinical or laboratory events were noted. CONCLUSION: Nizatidine, 300 mg at bedtime and 150 mg twice daily, resulted in greater healing of benign gastric ulcers than placebo treatment after 8 weeks. Relief of the symptoms of gastric ulcer was significantly better in the patients receiving nizatidine treatment versus placebo treatment.

Capsules↗
PubMed1988

CGP 12.103 A versus clomipramine in the treatment of depressed inpatients--results of a double-blind study.

In a double-blind study, which was conducted as an interindividual comparison, 41 depressed inpatients were divided into two test groups according to a randomized list and received either the test substance CGP 12.103 A (19 patients) or the comparative substance clomipramine (22 patients). The study was conducted over a period of 28 days and the dosage of each substance, after being gradually increased, was stabilized at 150 mg. Except for a significantly varied distribution of syndrome patterns, the two treatment groups were comparable with regard to relevant criteria. Both treatment groups showed a significant improvement as assessed by both the degree of severity of depression and the Hamilton Depression Rating Scale; on each scale, however, the clomipramine treatment group exhibited a tendency toward better antidepressive efficacy. According to the self-evaluations of the patients, which were conducted with the help of v. Zerssen's Self-Rating Scale, this tendency was not significant. The Kusta activation parameter indicated a tendentially stronger manifestation in the case of clomipramine. In the final evaluation the onset of efficacy for the CGP 12.103 A group lay in the mean on treatment day 6, for the clomipramine group on treatment day 10. The physician's overall assessment of therapeutic effect found no differences between the two treatment groups on day 14 and on day 28. Expected side effects were observed in the CGP 12.103 A group in nine patients, in the clomipramine group in 14. All in all, the test substance CGP 12.103 A, the (-) or R-enantiomer of the antidepressant oxaprotiline, which itself is derived from maprotiline, showed no essential differences in its antidepressive efficacy compared with clomipramine.

Anthracenes↗
PubMed1978

Validity and sensitivity of ratio scales of sensory and affective verbal pain descriptors: manipulation of affect by diazepam.

The results of two experiments suggest that sensory and affective verbal descriptors provide a valid scaling method which discriminates between the sensory intensity and the affect, or unpleasantness, of electrocutaneous stimuli. Twenty-four subjects judged the sensory intensity and affect of noxious electrocutaneous stimuli by choosing verbal descriptors from randomized lists and by cross-modality matching to time duration and to handgrip force. The psychophysical functions for sensory intensity generated by the descriptor and the cross-modality functions for sensory intensity generated by the descriptor and the cross-modality methods are the same. Psychophysical functions for affect generated by thedescriptor and the cross-modality methods are different. However, only the descriptor method produces psychophysical functions for affect that are significantly different from all the sensory functions. This result suggest that only the descriptor method distinguishes between sensory intensity and affect. The discriminative power of the descriptor method is demonstrated further in an experiment in which 32 subjects rated either the sensory intensity or the affect of the electrocutaneous stimuli immediately before and after an i.v. administration of 5 mg diazepam. This common minor tranquilizer significantly lowered affective descriptor responses (P less than 0.005) without altering sensory descriptor and sensory and affective handgrip responses. These experiments indicate that sensory and affective verbal pain descriptors may be used as a valid and sensitive tool for the evaluation of pain and pain control methods.

Adolescent↗
PubMed1978

Evidence for language recoding in autistic, retarded and normal children: a re-examination.

In a replication and extension of earlier studies by Hermelin & O'Connor, language recoding abilities in autistic, retarded and normal children matched for mental age and digit span, were compared in a verbal recall task. Random word lists, sentences, and anomalous sentences, eight or 12 items in length (for high and low memory span subgroups) were presented and the number of words recalled from each type of input was scored. All low span children recalled sentences better than random lists with normal children superior to retarded and autistic children and the latter group poorer than the retarded group. Autistic children showed a recency effect with both types of input. There were no group differences amongst high span children and sentences were again better recalled than random lists. In Expt II sentences were better recalled than anomalous sentences, with autistic and retarded children equivalent in performance and poorer than normal children. Although low span autistic children were clearly deficient in recall of sentence material when compared with the two control groups, the effect of conditions showed that they were able to use structure to improve recall. Since high span autistic children did not perform differently from controls it is suggested that results from this kind of study may not be generalizable, and that claims for a specific coding deficit in autistic children need further substantiation.

Autistic Disorder↗
PubMed1991

Semantic organization and verbal episodic memory in patients with mild and moderate Alzheimer's disease.

The objective of the present research was to investigate the relationship between semantic organization and cue utilization in mildly and moderately demented patients with Alzheimer's disease (AD). In Experiment 1, subjects were presented with two lists of words: a list with semantically unrelated words and a list with words from four semantic categories presented randomly intermixed. Free recall was assessed and following the organizable list, subjects received a cued recall test. Normal controls, as opposed to mildly and moderately demented patients, showed higher performance in the organizable list as compared to the random list. In addition, normal controls and mildly demented patients benefited from semantic cues in the organizable list and performed at a higher level in total recall as compared to free recall. In Experiment 2, subjects were presented with two lists of words: a list with words from four semantic categories presented randomly intermixed and a list with words from four semantic categories presented clustered, together with information about the organization of the list. Free recall and cued recall, with the category names serving as cues, were assessed. Free recall performance of normal controls was higher in the clustered than in the organizable list, whereas no such effect was observed for the AD patients. Normal controls and mildly demented patients performed at a higher level in total as compared to free recall in both lists, whereas this effect was present only in the clustered list for the moderately demented patients. The overall pattern of results indicates that there are conditions under which memory facilitation from semantic organization may be obtained in AD.

Aged↗
PubMed1978

Color context as a factor in encoding and as an organization device for retrieval of word lists.

One hundred twenty female undergraduates were presented hierarchically organized or randomly arranged word lists within a context of hierarchically organized or randomly arranged color patterns. Recall scores were significantly higher with a hierarchic color pattern than with a random color pattern; this facilitating effect occurred for both hierarchic organizations and random arrangements of the word lists. The results suggest that Ss may use context as both a cueing of differentiating factor in encoding and as an organizational device for retrieval.

Color Perception↗
PubMed1987

A microcomputer program for the generation of random grid squares in quantitative analysis.

Subjectivity in selecting random grid squares for routine quantitative analysis can be circumvented through a combination of finder grids and a computer program. The simple BASIC program described in this paper generates a list of random grid-square numbers, which are sequentially analyzed. The concept was applied in the quantitation of asbestos and other microparticles in environmental samples. The use of finder grids and this program can also be useful in quality-control programs and in cross-referencing analyses, as well as in the study of biological specimens.

Asbestos↗
PubMedDate not supplied

Patients' interpretations of probability terms.

STUDY OBJECTIVES: To assess the meaning ascribed by patients to qualitative expressions of probability commonly used in medical care and to determine patient preferences for obtaining information when communicating with their physicians about medical risk numerically and/or qualitatively. DESIGN: Cross-sectional survey of consecutive patients. SETTING: A university-based Department of Veterans Affairs medical center. PARTICIPANTS: 133 patients sequentially seen in a general medicine clinic. MEASUREMENTS AND MAIN RESULTS: Subjects were given a randomly ordered list of 12 common terms, each a qualitative expression of probability. They were asked to indicate what they understood to be the numerical meaning of each word. The patients' probability estimates were found to comprise two groups of five terms each, with high intercorrelations among the probabilities assigned to the terms in each group. Mean probabilities assigned to terms in the first group all were greater than 60%, and mean probabilities assigned to terms in the second group all were below 50%. When asked whether they wanted chance information to be provided in numerical or qualitative terms, 32% reported that they wanted it only numerically; 35.3% wanted it only qualitatively; 21.8% wanted the information either way; and 8.3% wanted the information both ways. CONCLUSIONS: The numerical meanings that patients ascribe to probability terms fall into identifiable patterns. While patients vary in the actual values they assign to terms, the relative meanings of terms show consistent trends.

Analysis of Variance↗
PubMed1985

Acceptability and intelligibility of tracheoesophageal speech.

The original Blom-Singer voice prosthesis, introduced in 1979, has been recently modified to provide lower airway resistance. A tracheostoma breathing valve, introduced in 1982, permits unrestricted two-way breathing, yet eliminates the need for manual occlusion of the stoma. To date, the acceptability and intelligibility of tracheoesophageal (TE) speakers, using these prostheses, has not been extensively studied. Forty-six naive listeners rated the acceptability and intelligibility of 15 TE speakers, all of whom were wearing the tracheostoma breathing valve and a prototype low-pressure prosthesis. Acceptability was judged on an equal-appearing interval scale. Intelligibility judgments were based on randomized word lists of 50 items. Results suggest a high level of acceptability and intelligibility among both male and female TE speakers.

Evaluation Studies as Topic↗
PubMed1987

Accuracy of references in nursing journals.

The purpose of this study was to quantify and classify errors in reference lists of randomly selected, recently published issues of nursing journals (n = 17) and to assess whether these errors prevented retrieval of the cited documents. Randomly selected references, 65 from clinical journals and 47 from non-clinical journals, were compared to the original sources for accuracy. Errors were classified as minor (not preventing retrieval) and major (preventing retrieval). Errors occurred more frequently in references in clinical journals, 38.4% of those reviewed, as compared to 21.3% in of non-clinical journals. Additionally, 4.6% of the clinical references contained major errors, but no major errors were located in references from the non-clinical journals. These findings have implications for all readers.

Bibliographies as Topic↗
PubMed1986

Desamino-D-arg8-vasopressin (DDAVP), unlike ethanol, has no effect on a boring visual vigilance task in humans.

It has been suggested that vasopressin (VP) and its analogues such as desamino-D-arg8-vasopressin (DDAVP) affect cognitive (including mnemonic) and attentional processes in man. We describe the effects of DDAVP and ethanol (EtOH) on young, healthy human volunteers, using a recently developed visual search task which assesses attention and vigilance. Over a 1-h session, the subject has to detect the occurrence of certain digits in a long list of random characters. A low dose of EtOH (0.33 ml/kg) tended to improve, and a higher dose (1.0 ml/kg) disrupted performance. DDAVP (20 or 60 micrograms/subject) had no effect whatsoever. It is concluded that intranasal administration of the peptide analogue does not markedly affect attention performance in human subjects.

Anxiety↗
PubMed1987

Articulatory rehearsal in Alzheimer type dementia.

This study investigated the relationship between articulation rate and memory span in a sample of 21 patients with early Alzheimer type dementia (AD), comparing their performance with 21 matched controls. Memory span was measured using auditorily and visually presented digits. The AD patients were moderately impaired in both conditions. Articulation rate was measured either by requiring subjects to read lists of random digits or repeatedly count from 1 to 10. The AD patients were able to read the digits as fast as the controls but were slower in the counting task. The measures of memory span and articulation rate correlated significantly for the controls but not for the AD patients, indicating that the normal association between articulation and memory span is disrupted. These results are discussed in relation to previous results and suggest that articulatory rehearsal processes in primary memory are unimpaired at the early stages of AD.

Aged↗
PubMed1992

Outpatient wound preparation and care: a national survey.

STUDY OBJECTIVE: To sample the practice styles of emergency physicians caring for acute traumatic wounds. DESIGN: Written survey. SETTING: US emergency departments obtained from the American College of Emergency Physicians mailing list. SUBJECTS: Randomly selected ACEP members. MAIN RESULTS: One hundred fifty-one of 285 (53%) survey mailings were returned. Eighty-six percent of respondents were primarily clinicians, and the majority (61.6%) worked in EDs with annual patient visits between 21,000 and 50,000. The majority of respondents (64.2%) were certified by the American Board of Emergency Medicine. Nineteen percent managed wounds based on provider preference despite the existence of written wound management protocols. We identified a variety of practices that are contrary to current literature and textbook recommendations. Fifty-eight (38%) soaked wounds, whereas 21% used either 10% povidone iodine or hydrogen peroxide to cleanse wounds. One hundred one (67%) scrubbed the entire wound surface using, among other methods, cotton gauze (59%) or a coarse, bristle-laden sponge (38%). Forty (27%) irrigated wounds using techniques that have not been proven to deliver the 5 to 8 psi necessary for adequate tissue cleansing. Delayed primary closure, a treatment option for lacerations at increased risk for infection, was infrequently or never practiced by 76% of respondents. All respondents administered IV antimicrobials at least occasionally for simple outpatient lacerations. CONCLUSION: Methods of preparing, treating, and following outpatient wounds vary among emergency physicians, and these results support the idea that no de facto standard of care exists for this clinical problem. Outpatient wound care techniques routinely practiced (ie, soaking, scrubbing, use of full-strength hydrogen peroxide or full-strength povidone iodine) may be harmful based on limited animal and human research, whereas other proven techniques (ie, delayed primary closure) are infrequently practiced by many emergency physicians.

Ambulatory Care↗
PubMed1991

The level-of-focal-attention hypothesis in oral reading: influence of strategies on the context specificity of lexical repetition effects.

Two experiments examined the influence of level of focal attention--text or lexical--on benefits from lexical repetition in speeded oral reading of coherent texts and random word lists. Experiment 1 showed that with coherent targets, direction of attention to the text level resulted in benefit only from a previous reading of the same coherent paragraph. However, when attention was directed to the lexical level, equal benefit resulted from a previous reading of either the same coherent paragraph or a scrambled version of the paragraph. Experiment 2 showed that level of focal attention did not influence benefit with scrambled targets. Thus, the linguistic structure of the target is important to repetition benefits and their modulation by attentional strategies.

Analysis of Variance↗
PubMed1991

Effects of fetal androgen on childhood behavior.

The effects of fetal androgen excess or deficiency on postnatal behavior were examined in 7 males and 14 females with congenital adrenal hyperplasia or hypoplasia aged 3 to 21 years. The subjects were divided into 3 groups: those with androgen excess (A+) comprised a group of 13 patients with classical 21-hydroxylase deficiency and one with 11-beta-hydroxylase deficiency; a normal or reduced androgen (a+) group was represented by one patient with late-onset 21-hydroxylase deficiency and one with congenital adrenal hypoplasia; and a group with absent androgen (A-) consisted of 5 patients with a cholesterol side-chain cleaving-enzyme deficiency. Behavior was evaluated as male (M) or female (F) according to the pattern of play, classification of which was based on data of prevalent play in 1,275 preschool and 400 school boys and girls. Play prevalent in both sexes was classified as neutral (N). The mothers of the patients were requested to check the preferred play during childhood from a randomized play list. The androgen excess group showed M or bisexual (M/F) type, whereas all of the androgen deficient group revealed F type irrespective of gender. In preschool children, coincidence of M or F play type with genetic sex, social sex and androgen exposure was 38%, 53% and 90%, respectively, indicating androgen-dependency of playing patterns. This persisted into school age, although the coincidence rate was slightly changed by environmental effects. These results suggest that fetal androgen plays a role in the sexual differentiation of the central nervous system.

Adolescent↗
PubMed1991

The language of breathlessness. Use of verbal descriptors by patients with cardiopulmonary disease.

The main objective of the present study was to test the hypothesis that patients with cardiopulmonary disease can reliably identify different sensory qualities of their experience of breathlessness. A secondary aim was to examine whether there was any relationship between such specific descriptors of the sensation of breathlessness and a patient's clinical diagnosis. A randomly ordered list of 45 descriptors of breathing discomfort related to exertion was administered on two occasions to 208 patients with cardiopulmonary disease; patients identified the descriptors that applied to their own experience. A total of 169 patients were considered reliable in that their responses were repeatable between questionnaires; there was evidence that an individual's reliability could be assessed by asking repeat questions within a questionnaire. With these patients, individual descriptors generated different degrees of yes and no response and were answered with a variable consistency, suggesting that some questions may be more useful than others in discriminating between the quality of patients' sensations. Overall, patients with obstructive disorders (asthma and chronic obstructive airways disease [COAD]) answered yes more often than those with restrictive or cardiac conditions, possibly reflecting differences in severity of disease. A cluster analysis separated the descriptors into 12 groups which appeared to describe different aspects of breathing discomfort. Relative to their response to other clusters, COAD patients were more inclined to identify distress, asthma patients to indicate wheeziness, restrictive patients to report rapid breathing, and the cardiac group to describe a need to sign. A second cluster analysis separated patients into 12 groups based on responses for the descriptor clusters.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1976

Transfer of categorial clustering set in mildly retarded adolescents.

The relative effectiveness of instructions to adopt an organizational strategy vs. exposure to category labels was investigated. Twenty-four retarded adolescents were assigned to each of three conditions (blocking plus instructions, blocking plus labels, and blocking) for pretraining and training. Immediately after training, all subjects received a transfer task consisting of a new randomly organized list containing words from the same (training) categories for one-half of the subjects and from different categories for the other half. When exposure to category labels accompanied blocking, results indicated increased clustering and recall during the training phase and a trend toward increased clustering during the transfer phase.

Adolescent↗