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PubMed1996

Adolescent aggression and imagery: contributions from object relations and social cognitive theory.

Object relations and social cognitive theory can be combined with the use of imagery in a self-control program with aggressive adolescents. Object relations provide a rationale for merging fantasy and reality processes while social cognitive theory (and its operationalization through cognitive behavioral therapy) provides a general framework in which behavioral and cognitive change techniques are utilized. This is embedded in a developmental paradigm that promotes the integration of the past, present, and future as a means of encouraging developmental maturity and identity. A case study demonstrates how the elaborated procedure of imagery manipulation can effectively alter behavior in a relatively brief time. While concerns remain regarding the amalgamation of psychodynamic and cognitive theories, the theories can give rise to a judicious blending of techniques that appear to have good effect in the case described.

Adolescent↗

PubMed1977

On Kibarashi-gui (binge eating).

The authors presented 16 cases that displayed episodes of pathological over-eating, i.e. kibarashi-gui (binge eating). The cases were divided into three groups, and symptomatology of the eating bouts and associated psychiatric symptoms were described. Constellations of symptoms differed from group to group. The first group, Group A, was concluded as the pure kibarashi-gui (binge eaters), and Group B can be regarded as a variant of anorexia nervosa. Discussion was focused on the similarities and differences between kibarashi-gui and anorexia nervosa. Kibarashi-gui is explained as a defeat of self-control or competition. Discussions on the origin of the sex difference of eating disorder were done. And, the concept of slimness or beauty in women was assumed as the most important factor in eating disorders.

Adolescent↗

PubMed1994

Theoretical approaches to behavior change in myofunctional therapy.

The effectiveness of myofunctional therapy depends not only on the quality of the individual exercises but also considerably on the patient's compliance. In this paper, factors are described which may decisively influence patients motivation to cooperate during treatment. Based on experience in dealing with patients, clinical studies and psychological knowledge, theoretical approaches to patient motivation are discussed, namely aspects of verbal communication, control, reward, behavior agreement as well as verbal self-control and self-reward.

Behavior Therapy↗

PubMedDate not supplied

Mantoux test site granuloma: an appraisal of the diagnostic value in sarcoidosis.

Out of 146 cases, 92 (64%) cases with active sarcoidosis showed granulomas in biopsy at 4-6 weeks after Mantoux test (MT). No granuloma was seen in anyone of the 162 sites injected with other allergens in 27 of MT site positive cases, serving as self-control. False positive biopsies were not seen. Another control group of 40 patients with other respiratory disorders like tuberculosis failed to produce any granulomatous response at the site of MT. Mantoux test site biopsy may prove a valuable diagnostic test in sarcoidosis in India.

Biopsy↗

PubMed1997

Effect of an omega-3/omega-6 fatty acid-containing commercial lamb and rice diet on pruritus in atopic dogs: results of a single-blinded study.

A commercial, lamb and rice, dog food with an omega-6:omega-3 fatty acid ratio of 5.5:1 was fed in a single-blinded, self-controlled clinical trial to 18 atopic dogs. The pruritus in 8 of these dogs (44.4%) was satisfactorily controlled within 7 to 21 d, returned within 3 to 14 d after the diet was withdrawn, and was again controlled when the diet was reinstated. Plasma and skin levels of examined fatty acids changed in all 18 dogs when their diet was switched to the test diet. Dogs responding to the test diet had a different pattern of fatty acid change as compared to the dogs which failed to respond to the diet, suggesting that there are subsets of atopic dogs with different fatty acid metabolism capabilities.

Animals↗

PubMed1996

Regulation of energy balance and adiposity: a model with new approaches.

Obesity etiology and treatment have been fraught with disappointment for researchers, because the mechanisms regulating fuel homeostasis and adiposity are incompletely understood. It can now be hypothesized in the light of new evidences that the control of body weight and composition depends upon an axis with three interrelated and self-controlled components: 1) food intake; 2) nutrient turnover and thermogenesis and 3) body fat stores, all of which underly complex feedback mechanisms. This approach considers two of the most relevant recent findings in the field (leptin and beta 3-adrenoceptors), adding new views to previous metabolic models of obesity. This perspective supplies some additional clues to the understanding of body composition regulation as well as the potential involvement of genetic and hypothalamic disorders in the onset of obesity.

Adipose Tissue↗

PubMed1997

[Clinical study of severe anorexia nervosa: the role of intravenous hyperalimentation therapy].

In order to understand the psychopathology of severe anorexia nervosa (AN), and determine appropriate therapeutic approaches, a clinical study was conducted on 13 patients with severe AN who were hospitalized and were treated with intravenous hyperalimentation (IVH). The patients were divided into three types based on their clinical symptoms and initiating factors: Type I (Restricting Type; "Non-dieters"), Type II (Restricting Type: "Dieters"). Type III (Binge-eating/Purging Type). The clinical features of each type were evaluated. Based on this evaluation, the basic approach and the role of IVH in the treatment of each type are described as follows. Type I: The patients experience loss of appetite and subsequently, suffer involuntary weight loss as a result of psychological or physical stresses at school and/or home. Since the patients do not intentionally restrict food intake, they cannot explain the loss of appetite. The age at onset of this type is the youngest among the three groups. The patients are introverted, passive and not good at expressing their emotions. Therefore, it is often difficult to deepen the emotional commitment further. It is possible to understand the pathology of Type I through the psychosomatic model. IVH therapy promotes benign regression for Type I patients, so that the mother-child relationship may be restored. As the therapeutic progress, the mother child relationship occasionally become ambivalent. In such a case, it is important for the treatment team to support independent activities of the patients. Type II: The patients lose weight by intentionally restricting necessary food intake for reasons such as beauty or sports. Any experience of failure in studies or sports or trouble in complex personal relations can trigger the onset of AN. Weight loss is looked as a great achievement, whereas weight gain is recognized as a serious failure of self-control. Since type II patients understand the necessity of receiving treatment, it is possible to establish a trusting relationship during therapy. Their prognosis is generally good. The psychotherapeutic approach for Type II patients is most effective in the context of a weight gain program utilizing behavior therapy. It is important for the therapist to integrate psychological approach with physiological approach using IVH, and to modify cognitive distortion and body image disturbance. Type III: The patients have regularly engaged in binge eating or purging (or both) in the progress of AN. But as they intensely fear becoming fat, they refuse to maintain a minimally normal body weight. Therefore, they exhibit recurrently inappropriate compensatory behavior in order to prevent weight gain. In the therapeutic sessions, they often become ambivalent and unstable, showing dissatisfaction and reacting strongly against their therapists. The age at onset is the oldest of the three types. The prognosis is not good in many cases. IVH therapy may be required only in life-threatening situation for Type III patients. And severe bulimic patients may require sufficient drug treatment. The patients should be trained for interpersonal relationships at the day care unit or the occupational therapy unit. And they should be encouraged to adapt to real life.

Adolescent↗

PubMed1996

[Evaluation of the accuracy of arterial pressure measurements with different types of devices used for self-monitoring].

The self-control is the important item in hypertension treatment. The results of blood pressure measurements were received by using various types using different of oscillometric equipment (thumb, wrist and arm manket) and compared with the outcomes of mercury sphygmomanometer which was used in the same trial. The satisfactory correlation of results from different types of equipment was confirmed with the exception of the thumb oscillometric apparatus results.

Adolescent↗

PubMed1996

[Fertilization in vitro and embryo transfer by combined long-acting gonadotropin releasing hormone agonist and gonadotropin for superovulation in patients with refractory polycystic ovary syndrome].

OBJECTIVE: To investigate the efficacy of the treatment for polycystic ovary syndrome (PCOS) patients by combined long acting gonadotropin-releasing hormone agonist (GnRHa) and gonadotropin. METHODS: Nineteen women with PCOS who had failed to conceive on treatment with conventional fertilization in vitro-embryo transfer (IVF-ET) protocol underwent 26 cycles of IVF-ET by combined long-acting and gonadotropin stimulation. A self-control group consisted of 19 PCOS women who had received 19 treatment cycles with conventional IVF-ET stimulation protocol more than 6 months previously. RESULTS: A comparison of these two groups showed that treatment with combined long-acting GnRHa and gonadotropin improved the in vitro fertility rate (76.2%) and pregnancy rate (38.5%). CONCLUSION: Patients with refractory PCOS should be referred for IVF-ET, using long-acting GnRHa before gonadotropin as the stimulation protocol.

Adult↗

PubMed1997

Effect of progesterone therapy on arginine vasopressin and atrial natriuretic factor in premenstrual syndrome.

OBJECTIVES: To explore the possible role of natriuretic peptides and vasopressin in luteal phase fluid retention in premenstrual syndrome (PMS) and to determine the effect of progesterone therapy on these hormones. DESIGN: Self-controlled prospective study. SETTING: University-based medical research centre. PATIENTS: Six patients with PMS were studied during the symptomatic luteal and asymptomatic follicular phases. The follicular phase response was used as the control for each subject. INTERVENTIONS: An intravenous infusion of 3% saline solution was administered on an early follicular and a late luteal phase day in 2 menstrual cycles. Progesterone was administered orally during the second luteal phase. OUTCOME MEASURES: Osmolality, arginine vasopressin (AVP), atrial natriuretic factor (ANF), and brain natriuretic peptide (BNP) levels in plasma, osmolality, sodium, potassium, cyclic adenosine monophosphate (cAMP) and cyclic guanosine 5'-phosphate (cGMP) concentrations in urine, and thirst sensation. RESULTS: Mean basal plasma ANF and osmolality levels and the threshold for AVP release and thirst were lower, and mean urinary cyclic nucleotide levels and AVP sensitivity (amount of AVP secreted per unit rise in plasma osmolality) were higher, in the luteal phase than in the follicular phase. With saline loading, there was an increase in plasma osmolality, AVP and ANF and in urinary sodium and cyclic nucleotide levels. Plasma ANF and osmolality levels remained lower in the luteal phase compared with the follicular phase, but AVP levels at the end of the saline infusion were higher in the luteal phase than in the follicular phase. Progesterone therapy caused an increase in plasma ANF and osmolality levels and the AVP threshold and a decrease in AVP levels and sensitivity and urinary cyclic nucleotide levels. BNP levels did not change with phase or treatment. The differences in AVP threshold with phase and treatment were statistically significant (p < 0.001). There was a significant phase effect for plasma ANF (p = 0.02) and a significant or near-significant interaction effect of phase and treatment for plasma ANF (p = 0.06) and urinary cAMP (p = 0.047) and cGMP (p = 0.066). The effect of phase and treatment was not significant for the other measurements. CONCLUSIONS: Luteal phase fluid retention may be due to a relative deficiency of ANF and a lower threshold for AVP release. The symptomatic improvement produced by progesterone treatment may be due to its stimulation of ANF and inhibition of AVP release or synthesis.

Adult↗

PubMed1997

[Patient-controlled exercise therapy in temporomandibular joint pain-dysfunction syndrome].

Self-controlled gymnastics in SADAM relaxes the masticator muscles, allows precise assessment of occlusion and helps the patient acquire occlusion-conscience. The technique is entirely patient controlled.

Dental Occlusion↗

PubMedDate not supplied

[Interneuronal relationships in the basolateral amygdala of cats trained for choice in the quality of food reinforcement].

The alimentary instrumental conditioned bar-pressing reflex was elaborated in cats by the method of "active choice" of either short-delayed reinforcement with bread-meat mixture of delayed more valuable reinforcement with meat. The animals differed in behavior strategy: some animals preferred bar-pressing with the long delay (the so-called "self-control" group), other animals pressed the bar with short delay (the so-called "impulsive" group). The multiunit activity in the basolateral amygdala was recorded with chronically implanted nichrome microelectrodes. The interactions between the spike trains of the neighbouring neurons selected from the multiunit activity were evaluated by means of statistical crosscorrelation analysis. It was shown that the number of correlations between the discharges of neurons was significantly higher in the "impulsive" cats. In both groups the number of cross-correlations was maximal in cases of a difficult choice, i.e., during the omission of the conditioned bar-pressing response. In "impulsive" cats the number of interneuronal correlations was highest with the latencies in the range of 0-30 msec. We suggest that the basolateral amygdala is involved in the system of structures which determine the individual-typological characteristics of animals.

Amygdala↗

PubMed1996

[Characteristics of psychosocial nursing care--the dimensions of psychosocial nursing care to promote empowerment among patients].

UNLABELLED: Nurses provide the psychosocial nursing care to promote the patients' empowerment. In spite of recognizing the importance of psychosocial nursing. The research reported here is part of a large study designed to explore the psychosocial nursing intervention strategies. This part of the study is focused on characteristics of psychosocial nursing care as identified by nurses. Research design was descriptive and qualitative. Subjects were a convenient sample of nurses who have more than 5 years experience and agreed to participate in this research. Data was collected through semistructured interviews. Data was recorded on a tape and transcribed, then analyzed based on Grounded Theory Approach. SUBJECTS: The number of subjects consisted of 39 nurses. The average age and duration of clinical experience was 36.6 years old and 12.6 years. RESULT: Sixteen of the characteristics of psychosocial nursing to promote the empowerment among the patients were identified; 1) respect the patients' decision making, 2) clinical judgment from multiple perspectives, 3) predictability, 4) flexibility, 5) classification of the patients by comparison, 6) monitoring, 7) relief from reality, 8) relief from pain and suffering, 9) enhancement of the patients' ego strength, 10) nurture of hope, 11) support individualized daily living styles, 12) encouragement of the patients'own problem solving abilities, 13) respect of individuality, 14) self-utilization, 15) self-control based on professional identity, 16) utilization of team power. DISCUSSION: Nurses choose from the sixteen dimensions of psychosocial nursing and organizing them in order to stabilizing the patients' conditions.

Decision Making↗

PubMedDate not supplied

[An approach to the structuring of printed materials in education technology for the independent study of the pharmacotherapy of emergency states].

In view of the fact that the sources of information (text-books, manuals, monographs) used in higher medical institutions lack a clear-cut system of directing the learning activities of those being thought, we have devised a variant of a manual that stipulates that a goal be defined, the content of pharmacotherapy of urgent states chosen, teaching material organized, a system of individual tasks set, results of learning controlled, auto-education and self-control exercised. The above type manuals are supposed to be a means of directing the activity aimed at learning to apprehend and must be a mainstay in the realization of the programme-deliberate management of quality of training a specialist.

Drug Therapy↗

PubMed1997

[Diabetic foot--an attempt at defining the risk factors for amputation].

The study included 65 patients--42 males and 23 females aged 67 +/- 17 with the diabetic foot syndrome. They were divided into 2 groups: those who underwent amputation (25 patients) and 40 who were treated conservatively. Amputations were preceded most frequently by ulceration (17 cases), phlegmona (5 cases) or dry necrosis (3 cases). The high percentage of amputations in the studied patients could be explained, at least in part, by poor general condition and advanced local changes. In the group of patients, who underwent amputation--in relation to those treated conservatively a decrease in filtration function was found (46.0 +/- 24.3 vs 89.5 +/- 26.2) and a higher percentage in the prevalence of microalbuminuria or proteinuria (80% vs 45%) as well as a higher percentage of cigarettes smokers in this group (72% vs 40%). The majority of the studied patients was characterized by poor education, lack of self-control of glycaemia, no efficient metabolic control of diabetes, measured by glycated haemoglobin and the presence of neuropathy and retinopathy. In addition, in 4 patients among the whole studied group (including 1 patient who underwent amputation), diabetes was newly diagnosed. These results indicate the necessity of improving education, early diagnosis of insulin independent diabetes, more frequent foot examinations and the elimination of amputation risk factors. Prophylaxis of diabetes foot associated with the proper treatment of diabetes is a necessary condition for decreasing of the amputation rate according to St. Vincent Declaration.

Aged↗

PubMed1997

Evaluation of a measure of learned resourcefulness for elders.

Learned resourcefulness is important in promoting independence and healthy, productive lifestyles among older adults, and therefore it is essential to have a measure of learned resourcefulness that is reliable and valid for this population. However, for elders published psychometric tests of Roseblaum's Self-Control Schedule (SCS), which is the measure of learned resourcefulness, are limited to internal consistency estimates. This study examined the ease of administration and psychometric properties of the SCS in three samples of healthy elders (age 65+). The findings yield promising evidence that the instrument is fairly easy for elders to understand when administered during face-to-face interviews. Evidence of reliability and validity is considerable, and the SCS shows acceptable internal consistency and construct validity. These findings support the potential usefulness of the measure of learned resourcefulness for adults.

Adaptation, Psychological↗

PubMed1998

[Evaluation of transcatheter hepatic segmental or subsegmental infusion of SMANCS for treatment of hepatocellular carcinoma].

A total of seventeen patients with hepatocellular carcinoma (HCC), nineteen HCCs, who underwent as an initial treatment transcatheter hepatic segmental or subsegmental arterial administration of SMANCS alone for hepatocellular carcinoma (HCC), were studied to evaluate the efficacy and complication of that treatment. The initial treatments provided CR in eight patients (47%), and repeat administrations of SMANCS achieved CR in an additional four patients (24%). The initial treatment provided a dense deposit of Lipiodol in the twelve tumors (63%), in five of which Lipiodol was thereafter washed out in some portions of the tumor. Complete necrosis was obtained in nine (75%) of fourteen hypervascular tumors, and in two (40%) of five intermediately vascular or hypovascular tumors. Segmental or subsegmental administration of SMANCS was well tolerated with self-controlled abdominal pain or fever well responding to medication. Ascites was seen in three cases, and atrophy of the segment infused occurred in five patients. Cholinesterase significantly reduced at one week and one month, then recovered to baseline two to three months after initial treatment. The cumulative survival rates were 77% at 1 year, 66% at 2 years, and 53% at 5 years in the whole patients. The survival rate was 100% at 5 years in the Child A group. In the patients who obtained CR using SMANCS alone, the survival rates were 89% at 1 year, 74% at 2 years and 56% at 5 years. Although this method may transiently deteriorate hepatic function, segmental or subsegmental administration of SMANCS may be an excellent therapeutic method for treatment of HCC and promising for use in properly selected patients.

Adult↗

PubMed1976

Which neuroses need specialist care?

In order to differentiate the neurotic patient who both needs and responds to psychiatric care from the majority of neurotic patients, who do not need this, carefully matched pairs of neurotic patients being treated at psychiatric and nonpsychiatric clinics in Montreal were followed up for 1 year. Improvement was substantial regardless of treatment, and the psychiatrically treated, on the whole, improved only slightly more than the others. However, one type of patient improved greatly under psychiatric care while improving almost not at all without it--introverts who considered themselves unhealthy but found life manageable, had avoided taking time off work or using anxiolytic drugs and appeared to handle their frustrations without repressing their irritation or losing self-control. It is suggested that it is mainly this type of neurotic that should receive specialist referral.

Adolescent↗