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PubMed1979

A better outlook for schizophrenics living in extended families.

Cases of schizophrenia and schizophreniform attacks living in extended families have been compared to cases with similar diagnoses in nuclear families. Both diagnostic groups living in extended families presented earlier: they had lower rates of withdrawal symptoms and higher rates of behavioural disturbances and subjective suffering. Inter-generational conflict was a significantly more common precipitating factor in patients living in extended families; this was therapeutically utilized to induce family support. Patients from extended families had a lower tendency to deteriorate into with drawn, affectively blunted residual states.

Adult↗
PubMed1977

A comparison of clomipramine hydrochloride (Anafranil) and behaviour therapy in the treatment of obsessive neurosis.

A six-week trial of 300 mg clomipramine hydrochloride (Anafranil, Geigy Pharmaceuticals) was compared to a six-month twice weekly therapeutic programme with two widely used behavioural techniques, flooding and thought-stopping. Clomipramine had a substantial ameliorating effect on the number and severity of obsessional symptoms, reducing the total obsessive symptomatology by half. The trends suggested that the drug was as effective as flooding and more effective than thought-stopping in reducing the ruminative symptoms, and was especially effective in reducing pervading doubt. It was considerably less effective than behaviour therapy in reducing the compulsive symptoms. This suggests, and confirms the authors' clinical impression, that a combination of pharmacotherapy and behaviour therapy is the optimal treatment of choice for ritualistic patients who are almost always very ruinative, doubtful and highly anxious. Clomipramine had the most substantial anxiolytic effect of three groups and seemed to be as effective as behaviour therapy in reducing phobias.

Adult↗
PubMed1979

Disassembly of microtubules in the Lesch-Nyhan Syndrome? (Lesch-Nyhan syndrome and microtubules).

The Lesch-Nyhan syndrome is an unusual disease. It combines neurological disorders, behavioural disturbances, metabolic changes and haematological symptoms. The syndrome is caused by an X-chromosomal transmitted enzyme deficiency of the 'salvage pathway' in purine metabolism. The hitherto unexplained pathogenesis was the reason for investigations into metabolism and morphology of the blood cells of a patient suffering from the syndrome. Along with the defect in guanine nucleotide resynthesis there was a defect of microtubules in platelets and a sphaerocytosis in red cells, which could be the result of a disassembly of structural proteins. The development and maintenance of the highly heteromorphic structure of nerve cells and the neuronal function including axonal transport of cell organelles and transmitters is dependent on microtubules. Thus a disassembly of microtubules could be the mechanism in the pathogenesis of this complex syndrome.

Adenine Phosphoribosyltransferase↗
PubMed1977

[Influence of vitamin B 6 deficiency in early weaned piglets on the digestibility and conversion of protein and energy].

Early-weaned piglets were subjected during 2 metabolic periods (11th-18th and 32nd-39th days of the experiment) to conversion experiments to study the influence of vitamin B6 depletion on the digestibility of the crude nutrients, metabolizable energy and on nitrogen conversion using the difference procedure. The depleted piglets (0.4 mg vitamin B6/kh diet) and the pair-fed control animals raised under equal conditions (6.5 mg vitamin B6/kh diet) were first fed a pre-starter ration, and from the 24th experimental day, a starter feed. As the period of depletion increased, the vitamin B6 sub-provided piglets revealed deficiency symptoms such as reduced appetite, lethargic behaviour and less movement. Whilst in the first half of the experiment the control animals reached significantly higher weight gains at lower expenditure of dry matter and digestible energy per kg of weight gain, no differences were observed between both groups in the second period. On the other hand, during the 1st metabolic period the digestibility of all crude nutrients and energy in the depleted piglets proved slightly, but significantly higher than in the pair-fed control animals. In the second half of the experiment ther were just casual differences. After a 2-week vitamin B6 deficient nutrition, the piglets had a 4.1% lower nitrogen retention as compared with the pair-fed control. After a depletion period of 5 weeks, this difference reached 14.4%. As nitrogen excretion in the urine increased, a higher renal energy excretion was observed. Thus the vitamin B6 deficient animals had available less metabolizable energy (in % of digestible energy) than the control piglets.

Animal Feed↗
PubMed1976

The neurological complications of cardiac transplantation.

Review of the neurological complications encountered in 83 patients who received cardiac homografts over a seven-year period leads to the following conclusions: (1) Neurological disorders are common in transplant recipients, occurring in over 50 per cent of patients. (2) Infection was the single most frequent cause of the neurological dysfunction, being responsible for one-third of all CNS complications. (3) The infective organisms were typically those considered to be usually of low pathogenicity: fungi, viruses, protozoa and an uncommon bacterial strain. (4) Other clinical neurological syndromes were related to vascular lesions, often apparently from cerebral ischaemia or infarction occurring during the surgical procedure, metabolic encephalopathies, cerebral microglioma, acute psychotic episodes and back pain from vertebral compression fractures. (5) The infectious complications and probably the development of neoplasms de novo, are related to immunosuppressive therapy which impairs virtually all host defence mechanisms and alters the nature of the host's response to infective agents or other foreign antigens. (6) Because neurological symptoms and signs were usually those of behavioural changes or deterioration in intellectual performance, the neurological examination was often of little value in diagnosing the nature or even the anatomical site of the neuropathological process. (7) The possibility of an infectious origin of the neurological manifestations must be aggressively pursued even in the absence of fever and a significantly abnormal spinal fluid examination. The diagnostic error made most frequently was to ascribe neurological symptoms erroneously to metabolic disturbances or to "intensive care unit psychosis" when they were in fact due to unrecognized CNS infection. (8) Maintenance of mean cardiopulmonary bypass pressures above 70 mmHg, particularly in patients with known arteriosclerosis, may reduce operative morbidity. (9) Though increased diagnostic accuracy is possible with routine use of a variety of radiological and laboratory techniques, two further requirements probably must be met before a significant reduction in the frequency of neurological complications will occur: the advent of greater immunospecificity in suppressing rejection of the grafted organ while preserving defences against infection; and a more effective armamentarium of antiviral and antifungal drugs.

Adolescent↗
PubMed1976

["Behavior-analytical" treatment in severely defective schizophrenic patients].

The troublesome symptoms of the seriously defective schizophrenics depend sometimes upon their unexpected sensitive experiences, which are not reported verbally and are guessed merely through the precise observations of the behaviour. By the treatment of the disturbances so found, the troublesome symptoms disappear. As an example of this "behaviour-analytical treatment" an old, defective schizophrenic with incontinence and negativism was introduced in this report, whose background suggested an intensive mysophobia, and was treated successfully. Some forsaken inmates of the asylums might be helped in this way.

Aged↗
PubMed1976

[Psychoanalysis and group dynamics as a method of socialization].

The troublesome symptoms of the seriously defective schizophrenics depend sometimes upon their unexpected sensitive experiences, which are not reported verbally and are guessed merely through the precise observations of the behaviour. By the treatment of the disturbances so found, the troublesome symptoms disappear. As an example of this "behaviour-analytical treatment" an old, defective schizophrenic with incontinence and negativism was introduced in this report, whose background suggested an intensive mysophobia, and was treated successfully. Some forsaken inmates of the asylums might be helped in this way.

Conflict, Psychological↗
PubMed1978

[Voice and vibration sensations in the speech forming organs: clinical and theoretical aspects of rare symptoms specific for schizophrenia].

When studying 750 psychiatric in-patients with psychoses of various diagnostic groups, the symptoms of voice sensations and vibration feelings could only be found among patients with paranoid schizophrenia. In addition, these symptoms were located exclusively in body areas that are involved in the peripheral motor production of voice and speech (areas of head, throat, thorax). In 11 of 15 such cases that could be identified, the sensations of voices and vibrations occurred simultaneously and in identical body parts; in the remaining 4 cases only voices without vibration sensations were reported. Therefore these symptoms can be considered as highly specific for schizophrenia. According to the terminology of Bleuler these two symptoms are because of their rareness to be taken as accessoric symptoms; according to the terminology of Kurt Schneider they have the value of first rank symptoms because of their highly diagnostic specifity for schizophrenia. The pathogenesis of these symptoms is on the one hand discussed under the perspective of language development and the changing function of language for behaviour control; on the other hand, the pathogenesis of these symptoms is discussed from the viewpoint of cybernetic, or neurophysiological-neuroanatomical foundation of speech production and speech control. Both models of explanation have in common that the ideational component of speech is noticed as acustic halluzinations and the motor proprioceptive part of speech is noticed as sensation of vibrations, both in a typically schiphrenic manner, i.e. dissociated and ego-alienated.

Adult↗
PubMed1979

[Treatment of orthostatic disorders of circulatory regulation by means of DET MS retard].

30 patients suffering from troubles in orthostatic circulatory regulation in the sense of a so-called hypersympathicotonic reaction were treated with DET MS retard for 4 weeks and permanently controlled concerning objective changes (circulation by modified Schellong-test on the tilting table) as well as subjective changes (symptoms). The evaluation of the findings shows the stabilisation of the regulation of blood pressure, an extensive economization of the circulatory behaviour during orthostasis, and a statistically evident improvement of clinical symptoms.

Adult↗
PubMed1976

Studies on the production of enterotoxins by Bacillus cereus.

Evidence is presented for the existence of three distinct enterotoxins detected in concentrated cell-free culture filtrates of selected Bacillus cereus strains. The first was a product capable of stimulating the adenylate cyclase-cyclic-AMP system in intestinal epithelial cells and, possibly through this, causing fluid accumulation in ligated ileal sections ("loops") of young rabbits. This was elaborated by a strain isolated from an incident of diarrhoea and which caused diarrhoea in 6 of 10 monkey feedings. The second was tentatively identified as a factor which caused fluid accumulation in rabbit loops but not, apparently, through stimulation of the adenylate cyclase-cyclic-AMP system; this was elaborated by a strain isolated from raw rice which failed to produce symptoms in eight monkey feedings. Together, the behaviour of these two factors indicates that diarrhoea caused by B. cereus enterotoxin may be a cyclic-AMP-mediated event. The third, here referred to as "pyogenic toxin", caused severe tissue damage in the ileal mucosa and was elaborated by a strain isolated from a brain abscess. A factor produced by a strain isolated from an outbreak of vomiting which caused vomiting in 10 of 24 monkey feedings could bot be detected in tests reported here but appears to be a fourth enterotoxin type. Cytopathic effects in tissue cultures, suckling mouse tests, and assays of glycerol production by fat cells were not found to be of value in the detection of any of the enterotoxins.

Adenylyl Cyclases↗
PubMed1975

Incongruous referrals.

A survey of 1344 patients registered at a new health centre in Glasgow assessed the prevalence of symptoms and referrals together with subjective, gradings of medical symptoms in terms of pain, disability, and perceived seriousness, and of social symptoms in terms of worry or inconvenience. These grading scales were used to define referral behaviour which appeared to be incongruous in the light of the respondents' own perceptions of their symptoms. In this way incongruous referrals indicated the size of the medical and social symptom "iceberg" and "trivia". For both medical and social symptoms the "icebergs" were larger than the "trivia"; the medical-symptom "iceberg" was two to three times greater than the medical-symptom "trivia".

Adult↗
PubMed1976

Evaluating signs and symptoms: comparison of structured interview ans clinical approaches.

Are research interview techniques adequate in assessing signs and symptoms? This question is investigated by obtaining two sets of interview schedule ratings on 49 patients, one by a research psychiatrist applying the interview and one by the patient's psychiatrist using all available information. The latter was considered a clinical standard with which a cross-sectional research interview could be contrasted. These two data sets were subjected to several types of analysis commonly undertaken with research interview ratings. Results indicated that the research interview adequately represents symptom data, but is seriously lacking in the assessment of observed behaviour. The effect of this difference depends on the goals of the study and the nature of the data analysis. If overall group findings are desired, or if analysis relies primarily on symptom data, results with a research interview may be similar to results based on a far more extensive evaluation. On the other hand, if conclusions are to be drawn on individual patients, or if data analysis relies heavily on observed behaviour, then data derived from research interviews are questionable.

Behavior↗
PubMed1977

Treatment of chronic schizophrenia.

The comprehensive treatment of schizophrenia requires the full resources of a clinical team that is able to offer treatment for the acute psychotic state in a hospital environment, and appropriate rehabilitation following resolution of the florid symptoms. Following a second or subsequent relapse, maintenance therapy with long-acting injections of depot antipsychotics will be required for an unknown period. Although drugs form an essential part of all treatments, it is essential to examine the environment for precipitating factors and to involve the patient's family in the rehabilitation. Recent studies have reported that some patients still have a relatively poor prognosis; although this proportion may be in the minority, the strain on the whole family of an even moderately handicapped patient can be enormous, and it is important to examine the needs of the whole family in evaluating care within the community. The effect of antipsychotic drugs is much wider that the mere control of acute symptoms and can influence the patterns of social behaviour and rehabilitation, in addition to offering protection against stress. The proper use of depot injections requires that they be kept under constant review. The current widespread practice of prescribing anti-cholinergic drugs on a prophylactic basis, or even as the inital treatment of extrapyramidal side-effects, needs revision.

Antipsychotic Agents↗
PubMed1978

Some self-reported symptoms of temporomandibular joint dysfunction in a population in Northern Norway.

The distribution of a number of self-reported symptoms of temporomandibular joint (TMJ) dysfunction, parafunctions and treatment behaviour was studied by means of a questionnaire answered by 94% of a population group of 358 persons aged 20-69 years in Northern Norway. Nine subjects reported pain from the temporomandibular joint (TMJ) when opening their mouth and/or when chewing, while twenty-one subjects had clicking sounds in the TMJ. Seventeen persons had been grinding their teeth during the previous week. Only seven individuals had ever sought medical or dental advice because of TMJ disorder. Tooth grinding and symptoms of TMJ dysfunction were most common in young people, in people with twenty teeth of more and/or in people from high social classes, whereas differences according to sex and income were small. The low frequency of subjective symptoms of TMJ dysfunction and parafunctions in this population was related to demographical, social, dental and methodological influences.

Adult↗
PubMed1976

The influence of taking uterine biopsies on the concentration of some steroids in the blood and in the uterus, on the ovarian activity, and on the sexual behaviour of the mare.

It has been shown that stimulation of the uterus of mares by the daily taking of biopsies can result in the occurrence of oestrous symptoms. This is accompanied by some follicular growth and a progesterone content in the blood often higher than 1 ng/ml. The following observations suggest that this progesterone originates in the uterus and not in the ovaries: (1) no active corpora lutea appeared to be present in the ovaries after ovariectomy, (2) ovariectomized mares showed the same oestrous symptoms in similar experiments and even mating took place, (3) in the uterine biopsies the concentration of the compound referred to as "5.4", which is assumed to be easily convertible into progesterone, had already increased considerably in the second biopsy, (4) administration of stilboestrol reduced the rise of the progesterone level in the uterine biopsies as well as in the blood. The absence of oestradiol-17 beta in the ovarian follicles and the fact that ovariectomized mares also come into heat suggest that oestrogens cannot be held responsible for the oestrous symptoms in these mares. Our experiments demonstrate that the uterus can be involved in sexual behaviour and the formation of steroids.

Animals↗
PubMed1978

Transcultural aspects of psychiatric patients in Qatar.

The illness behaviour of Qatari psychiatric patients is defined by the nature of their symptomatology. The importance of somatic symptoms in determining the patient role and patient-doctor relationship is discussed in the light of cultural characteristics of the Qatari community. Delusory cultural beliefs related to possession, sorcery and envy provide a conceptual framework for explanation of many disorders. Inter-generational conflict is an important factor in neurotic disorders. Failure to report symptoms in an abstract fashion is characteristic of qatari patients. The cultural and religious heritage absorbs many behaviours which would otherwise be considered symptomatic of psychiatric disorder.

Culture↗