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At least 127 records · Page 7Linked to original sources

PubMed2000

Psychobiological problems in heavy 'ecstasy' (MDMA) polydrug users.

Twelve heavy recreational ecstasy drug users (30-1000 occasions), 16 light ecstasy users (1-20 occasions) and 22 non ecstasy user controls, with group mean ages around 21 years, were compared. Three self-rating questionnaires were completed when drug-free: the SCL-90 (an outpatient psychiatric symptom checklist), the impulsiveness venturesomeness and empathy (IVE) scale; and the uplifts, hassles, stresses and cognitive failures questionnaire. Heavy Ecstasy users reported significantly higher scores than controls on the following SCL-90 factors: paranoid ideation, psychoticism, somatisation, obsessionality, anxiety, hostility, phobic anxiety, altered appetite and restless sleep, together with greater IVE impulsiveness. Light ecstasy users generally produced intermediate scores, with significantly higher scores than controls on two factors and significantly lower scores than heavy ecstasy users on another two. Previous reports have described various psychiatric and psychobiological disorders in recreational ecstasy users, but it is not known how typical they are, being mainly based on individual case studies. This is the first study to describe psychological problems in a non clinical sample of young recreational ecstasy users. However, our ecstasy users were polydrug users, with both groups showing significantly greater usage of amphetamine, LSD and cocaine, than the controls. These other illicit drugs probably contributed to their adverse psychobiological profiles, while there is also the possibility of pre-existing differences between ecstasy users and non users. However, since repeated MDMA can cause serotonergic neurotoxicity in laboratory animals and man, these problems may reflect reduced serotonin activity induced by regular ecstasy use.

Adolescent↗

PubMed1997

Inadequate pain management and associated morbidity in children at home after tonsillectomy.

A telephone interview with the parents of 84 children who underwent tonsillectomy was conducted within 24 hours after discharge from an ambulatory surgery center. Parents were asked to rate the intensity of their child's pain and data were collected on the type, dose, and amount of analgesics administered, and the types of side effects the children experienced. The mean age of the children was 7 years (SD = 2.31), with an equal number of boys and girls. Overall mean pain intensity was 1.42 (SD = 0.71) and the worst pain intensity ranged from 0 to 3 (Mean = 1.93; SD = 0.83). Acetaminophen with codeine was the most common analgesic prescribed and administered. Children received an average of 3 doses in the first 24 hours after surgery. Seventy-seven percent of the parents stated that pain relief from the analgesic was adequate. Of the 23% who did not feel that pain control was adequate, only 7% contacted a physician. The majority of the children experienced restless sleep (62%), behavior changes (75%), and difficulty taking oral fluids because of complaints of pain (56%). Twenty-six percent of the children had one or more episodes of emesis. Our data suggest that children experience a significant amount of pain in the first 24 hours after tonsillectomy and that parents administer analgesics less frequently than the drugs are prescribed. In addition, children experience significant deleterious effects (i.e., poor oral fluid intake, sleep disturbance, behavioral changes, and emesis) associated with the undertreatment of pain, the analgesic administered, or the surgery itself.

Analgesics↗

PubMed2002

Association of asthma with extra-respiratory symptoms in schoolchildren: two cross-sectional studies 6 years apart.

Epidemiological information on symptoms affecting extra-respiratory organs and apparatuses in asthmatic children is scarce. The aim of this study therefore was to evaluate, at a population level, if and what extra-respiratory symptoms are associated with asthma. Two questionnaire-based, cross-sectional surveys were carried out on 1,262 students (651 males; mean age 9.57 years, age-range 6-14 years) in 1992 and on 1,210 students (639 males; mean age 9.02 years, age-range 6-14 years) in 1998, from two elementary and two junior high schools in Rome, Italy. Questionnaires included queries about asthma and its risk factors and extra-respiratory symptoms (headache, restlessness, sleep disturbances, urticaria, itching, and abdominal pain). Of responders, 11.9% (279/2,342) had a history of asthma. After adjustment for gender, family history of atopic disease, low birth weight, early respiratory problems, and damp house, asthma was significantly associated with recurrent abdominal pain (odds ratio [OR] 1.90; 95% confidence interval [CI]: 1.04, 3.16), itching (OR 3.15; 95% CI: 1.75, 5.68), and urticaria (OR 2.52; 95% CI: 1.02, 6.20). Asthma was reported by 10.2% (201/1,962) of children unaffected by this triad, by 20.1% (56/279; OR 2.20) with one of the symptoms, and by 31.6% (12/38; OR 4.04) with two or more symptoms. An emerging characteristic of pediatric asthma in our setting appears to be its association with certain extra-respiratory symptoms (abdominal pain, itching, and urticaria). A global, internistic approach to asthmatic children is increasingly required both in the clinical setting and in future epidemiological studies.

Abdominal Pain↗

PubMed1986

Fibromyalgia. 1. Review of a common rheumatologic syndrome.

Fibromyalgia is a nonarticular rheumatic syndrome of unknown cause characterized by diffuse musculoskeletal aching, pain and stiffness, easy fatigability, multiple discreet tender points, emotional distress, and often, light and restless sleep with intensification of symptoms upon awakening. Symptoms are modulated by environmental, physiologic, and psychological factors. Generally, findings from laboratory tests and roentgenograms are normal. In primary fibromyalgia, no underlying rheumatic or other systemic organic disease is present. Secondary fibromyalgia is a manifestation of underlying disease.

Fibromyalgia↗

PubMed2004

Recommendation for the assessment of tobacco craving and withdrawal in smoking cessation trials.

This paper addresses methodological issues in the assessment of nicotine withdrawal and craving in clinical trials of smoking cessation therapies. We define withdrawal as a syndrome of behavioral, affective, cognitive, and physiological symptoms, typically transient, emerging upon cessation or reduction of tobacco use and causing distress or impairment of behavioral function. Offset effects (effects related to removal of a direct nicotine effect) are sustained effects of cessation or reduction of tobacco use that cause distress or impairment. Withdrawal and craving are important as potential predictors of relapse, as mediators and markers of treatment effects, and as clinical phenomena in their own right. Symptoms recommended for assessment include craving, irritability, depression, restlessness, sleep disturbance, difficulty concentrating, increased appetite, and weight gain; anxiety deserves further study. We recommend reporting of data on each of these individual symptoms, and use of multiple-item assessments. Although some standardized measures of withdrawal have promising psychometric properties, no measure has yet fully established its reliability, validity, and broad applicability and, therefore, we do not currently favor universal adoption of any one measure. Assessment of objective indices of withdrawal (e.g., hormonal changes) is currently technically challenging and of unknown value. Although weekly assessment may suffice in some large trials, more intensive measurement can provide better sensitivity. Analyses of withdrawal should include baseline measures and be sensitive to potential instability in baseline. Analytic approaches should take into account potential bias when only abstinent subjects are examined. Conversely, heterogeneity should be considered when smoking subjects are included in intent-to-treat analyses. Withdrawal data from clinical trials focused on assessing abstinence rates may be biased because of progressive subject loss to dropout and relapse; different designs and approaches are needed to investigate the process and natural history of craving and withdrawal.

Clinical Trials as Topic↗

PubMed1982

Tracheal breath sounds for detection of apnea in infants and children.

Impedance respiratory monitoring is the standard technique for detecting apnea in infants. A miniature microphone/amplifier system has been used to sense breath sounds over the trachea in order to detect both central and obstructive apnea episodes in infants and children. The tracheal microphone has several advantages over other devices that sense airflow (thermistors, CO2 sampling catheters) because it is not easily dislodged during restless sleep. This simple device may be used in monitoring of neonates and infants; it may eventually replace impedance monitoring.

Amplifiers, Electronic↗

PubMedDate not supplied

Association of breast cancer and its therapy with menopause-related symptoms.

OBJECTIVE: To study the relationship between current menopause status, occurrence of menopause transition during cancer treatment, and prevalence and severity of possible menopause-related symptoms. DESIGN: Data from the Cancer and Menopause Study (CAMS), a tumor-registry-based cohort of breast cancer survivors (BCS) diagnosed before age 50, were used. Using a standardized symptom checklist, women reported whether they were not at all, slightly, moderately, quite, or extremely bothered in the past 4 weeks by hot flashes, night sweats, vaginal dryness, pain with intercourse, breast sensitivity, joint pains, frequent mood changes, restless sleep, weight gain, forgetfulness, and difficulty concentrating. Current menopause status (by standard categories based on menstruation) and whether a persistent menopause transition occurred during cancer treatment were the main exposures. Linear (symptom severity as continuous outcome) and logistic (symptom present vs absent) regression models were adjusted for age, ethnicity, current smoking, alcohol use, chemotherapy, tamoxifen, body mass index, and depression scores. RESULTS: Mean age of the participants was 50 years. The prevalence of symptoms was high. Hot flashes occurred in 17%, 51%, and 71% of pre-, peri-, and postmenopausal BCS, respectively. Hot flashes, vaginal dryness, and pain with intercourse were more severe in postmenopausal compared with perimenopausal BCS. Having had a transition during breast cancer treatment was associated with worse hot flash severity, independent of current menopause status. CONCLUSIONS: Menopause-related symptoms are common in BCS. Effective treatment options are needed. Having a treatment-related transition confers a persistent effect on hot flash severity. Clinicians should include this information when counseling women on potential outcomes of their cancer therapy.

Aged↗

PubMed1996

Snoring, apnoea and ENT symptoms in the paediatric community.

This study was designed to determine the prevalence of snoring and assess the extent of associated ENT symptoms in children up to 10 years of age. A questionnaire was presented to the parents of 245 children chosen at random from the General Practice list of the town of Frome, Somerset, UK. The prevalence of snoring was found to be 27%. This increased to 47% in the presence of an upper respiratory infection. Snoring was found to be significantly (P < 0.001) associated with a history of poor hearing, restless sleep, and having a cold. Less significant (P < 0.01) associations occurred with parental smoking, eczema, sleep talking, moving around the bed at night, sore throats, having a runny nose and mouth breathing. Snoring is a common symptom in children up to 10 years of age. Without evidence of other ENT disease the snoring child does not require referral to an ENT department for further investigation.

Child↗

PubMed2000

Long-term benzodiazepine use by elderly people living in the community.

OBJECTIVE: To investigate the prevalence of long-term benzodiazepine use in an elderly community sample, and factors associated with such use. METHOD: Data came from the Sydney Older Persons Study, a longitudinal study of people aged 75 or over. There were 337 subjects who were interviewed in 1991-93, and subsequently followed up after three and 4.5 years. At the first interview, subjects were assessed for socio-demographic characteristics, physical and mental health, and use of health services. At the first and subsequent interviews, subjects were asked about use of medications, including benzodiazepines. RESULTS: There were 16.6% who were using benzodiazepines at the time of all three interviews, while a further 19.6% were using them at one or two interviews. In a multivariate ordered logit regression model, long-term benzodiazepine use was associated with treatment for nervous conditions, restless sleep, being female, being divorced and greater contact with medical services. CONCLUSIONS: The prevalence of benzodiazepine use in the elderly is high and much of this use is long term. The high prevalence of benzodiazepine use stands in contrast to the findings from national surveys that the elderly living in the community tend to have better mental health than younger age groups. IMPLICATIONS: Efforts are needed to reduce the number of elderly people becoming long-term users. The use of benzodiazepines in this age group is of particular concern, because they may be a risk factor for falls and for cognitive impairment in the elderly.

Aged↗

PubMed1992

Clinical presentation of PTSD in World War II combat veterans.

Clinicians have increasingly recognized posttraumatic stress disorder (PTSD) among Vietnam veterans, but the disorder may be easily overlooked among World War II combat veterans. The authors review recent studies of PTSD in older veterans and describe five cases that illustrate the diverse clinical presentations of PTSD in this population. Symptoms included anxiety, cognitive and somatic complaints, depression, alcohol dependence, and amnestic periods. Despite the varied presentations, a fairly consistent patient profile emerged. Patients avoided reminders of war, showed an exaggerated startle response, and experienced restless sleep and chronic anxiety. Factors associated with exacerbations of symptoms were retirement and reminders of war experiences. Although past studies have emphasized resuppression of the trauma, the authors encourage a flexible approach to treatment, including exploratory techniques.

Adaptation, Psychological↗

PubMed2006

The sub-acute effects of recreational ecstasy (MDMA) use: a controlled study in humans.

All previous studies of the sub-acute effects of ecstasy have failed to adequately control for group differences in psychopathology and past and concurrent substance use. The present study was designed to avoid these limitations. At an initial pre-drug baseline, a sample of 38 regular ecstasy users provided full substance histories and completed measures of personality and self-reported psychopathology. We then collected daily subjective measures of mood, cognitive impairment, restless sleep, sexual desire, craving for ecstasy and concomitant use of other substances for the next 9 days. The 20 participants who subsequently opted to take ecstasy during the 9-day assessment period reported modest sub-acute effects of ecstasy on negative mood and subjective cognitive impairment compared to those who did not after controlling for baseline group differences in psychopathology and frequency of ecstasy use. There were no significant sub-acute effects of ecstasy on interest in sexual activity or craving for ecstasy. After further controlling for co-use of alcohol with ecstasy, and the sub-acute effects of ecstasy on sleep, the sub-acute effect on mood remained marginally statistically significant but the subacute effect on cognitive impairment did not. The present findings suggest that the sub-acute effects of ecstasy in regular recreational users are relatively modest and transient but that such genuine effects may have been masked by, perhaps more clinically significant, chronic sequelae of regular ecstasy use in all previous studies of recreational ecstasy users.

Adolescent↗

PubMed2002

Physical and emotional effects of whistleblowing.

This research examined the stress-induced health effects of whistleblowing and non-whistleblowing on nurses in Western Australia. A descriptive survey design was used to explore the physical and emotional problems experienced by nurses who did and did not blow the whistle on misconduct in the workplace. A questionnaire based on Lazarus and Folkman's Model of Stress and Coping was developed and posted anonymously to general and mental health nurses. Ninety-five nurses responded to the questionnaire, and 70 were identified as whistleblowers and 25 were identified as non-whistleblowers. Results indicated that 70% of whistleblowers and 64% of non-whistleblowers experienced stress-induced physical problems from being involved in a whistleblowing situation. The most common physical problems experienced by nurses were restless sleep, fatigue, headaches, insomnia, and increased smoking. In addition, 94% of whistleblowers and 92% of non-whistleblowers suffered stress-related emotional problems, the most frequent being anger, anxiety, and disillusionment. Whistleblowers and non-whistleblowers suffered a similar percentage of physical health problems, whereas non-whistleblowers suffered a higher percentage of emotional health problems, especially feelings of guilt, shame, and unworthiness. These findings suggest that whistleblowing situations are stressful and may cause physical and emotional health problems whether one blows the whistle or not.

Adolescent↗

PubMed2000

An open-label trial of St. John's Wort (Hypericum perforatum) in obsessive-compulsive disorder.

BACKGROUND: Recent interest in and evidence for the efficacy of St. John's wort (Hypericum perforatum) for the treatment of mild-to-moderate depression has led to speculation about its efficacy in other disorders. Hypericum's mechanism of action is postulated to be via inhibition of the synaptosomal uptake of serotonin. As such, there is a suggestion that Hypericum may be effective for obsessive-compulsive disorder (OCD). METHOD: Twelve subjects were evaluated with a primary DSM-IV diagnosis of OCD of at least 12 months' duration. Treatment lasted for 12 weeks, with a fixed dose of 450 mg of 0.3% hypericin (a psychoactive compound in Hypericum) twice daily (extended-release formulation). Weekly evaluations were conducted with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Patient Global Impressions of Improvement Scale, and the Clinical Global Impressions of Improvement scale (CGI) and monthly evaluation with the Hamilton Rating Scale for Depression. RESULTS: A significant change from baseline to endpoint was found, with a mean Y-BOCS change of 7.4 points (p = .001). Significant change occurred at 1 week (p = .020) and continued to increase throughout the trial. At endpoint, 5 (42%) of 12 were rated "much" or "very much improved" on the clinician-rated CGI, 6 (50%) were "minimally improved," and 1 (8%) had "no change." The most common side effects reported were diarrhea (N = 3) and restless sleep (N = 2). CONCLUSION: Significant improvement was found with Hypericum, with a drop-in Y-BOCS score similar to that found in clinical trials. The fact that a significant change was found as early as 1 week into treatment suggests a possible initial placebo response, although improvement grew larger over time. Results warrant a placebo-controlled study of Hypericum in OCD.

Adult↗

PubMedDate not supplied

[The age-related characteristics of the psychophysiological indices of sailors].

A study made during a long-continued voyage discloses some of the cause-effect connections in social and psychological, social and economic, physiological and hygienic factors. A particular feature of the present paper is the study of the above-named factors in age- and occupation-related aspects. The following factors were found out to have a negative effect on ship personnel (in a decreasing rank order): sailing for more than 6 months, continence, vibration, air temperature, noise, a chemical factor, ship diet, atmospheric moisture, and air motion. Most common during a long-continued cruise are symptoms of bodily discomforts manifested by undue fatigue, low working capacity, a restless sleep, abnormal irritability, depressed mood.

Adolescent↗

PubMed1984

Nighttime ventilation improves respiratory failure in secondary kyphoscoliosis.

Four patients with cardiorespiratory failure caused by secondary kyphoscoliosis were studied. Polycythemia, cor pulmonale, restrictive lung pattern (functional residual capacity (FRC), 17 to 27% predicted; vital capacity (VC), 11 to 23% predicted), and abnormal arterial blood gases, primarily hypoventilation (PaO2, 31 to 44 mm Hg; PaCO2, 52 to 73 mm Hg), were seen in all. Supplementary oxygen, digoxin, diuretics, 15 min of intermittent positive-pressure breathing with inspired pressure (PI) 25 cm H2O 4 times daily, and tracheostomy failed to produce improvement. However, 12 h of nighttime ventilation (NTV) with PI 28 to 35 cm H2O through a permanent tracheostomy proved effective. Within 72 h, dyspnea at rest, restless sleep, and frequent waking resolved. Within 8 to 22 days, the PaO2 was approximately 58 mmHg and the PaCO2 was approximately 41 mm Hg while breathing 21% oxygen spontaneously during the day. The right heart failure resolved within 2 to 7 wk, and the hemoglobin count decreased to approximately 165 g/L within 2 to 6 months. There was a mean increase of 700 ml (72%) in functional residual capacity and 430 ml (49%) in vital capacity. The patients were discharged 2 days to 5 wk after NTV commenced. Daytime activity increased, approaching a normal life style. The improvement was sustained over a mean follow-up period of 3.4 yr. Problems included recurrent episodes of tracheobronchitis, mild self-limiting hemoptysis, and speech modification. Nighttime ventilation may be an effective alternative for long-term treatment of cardiorespiratory failure caused by secondary kyphoscoliosis.

Adult↗

PubMed1996

An evaluation of the history of a marijuana withdrawal syndrome in a large population.

Case reports and laboratory research indicate the existence of a cannabis withdrawal syndrome. However, the data tell us little about the prevalence and clinical characteristics of a marijuana withdrawal syndrome in people who have used the drug but who did not enter treatment for cannabis dependence. Face-to-face semi-structured interviews applying standard diagnostic criteria were used in the present study to gather data from 5611 men and women, recruited between 1991 and 1995 through the Collaborative Study of the Genetics of Alcoholism (COGA). Almost 41% of the sample had no history of marijuana use (Group 1), 28% had consumed this drug less than 21 times in any single year (Group 2), and 31% used it at least that frequently (Groups 3 and 4). Almost 16% of the more frequent marijuana users related a history of a marijuana withdrawal syndrome, and these Group 4 subjects had used the drug almost daily for an average of almost 70 months. The typical withdrawal symptoms included "nervous, tense, restlessness", "sleep disturbance" and "appetite change". While Group 4 subjects were more likely to have developed dependence on most types of drugs, even when alcohol and drug use patterns were statistically taken into account, marijuana use was still significantly related to a self-report of a history of marijuana withdrawal.

Adult↗

PubMed1990

[Restless legs and sleep apnea syndrome--random coincidence or causal relation?].

We report three cases of restless-legs syndrome in which by polygraphic sleep recordings an accompanying sleep-apnea syndrome was detected. Etiopathological factors, in particular a dysfunction of the sleep regulating centers in the brain stem as a cause of both diseases are discussed. Our observations suggest that a polysomnographic recording including respiration parameters should be carried out in every patient suffering from restless-legs syndrome.

Arousal↗

PubMedDate not supplied

Diagnosis and management of sleep apnea syndrome and restless legs syndrome in dialysis patients.

Sleep complaints are very common in patients with end-stage renal disease (ESRD) and contribute to their impaired quality of life. Both obstructive and central sleep apnea syndromes are reported more often in patients on dialysis than in the general population. Impaired daytime functioning, sleepiness, and fatigue, as well as cognitive problems, are well known in patients with sleep apnea. Increasing evidence supports the pathophysiological role of sleep apnea in cardiovascular disorders, which are the leading cause of death in ESRD patients. Uremic factors may be involved in the pathogenesis of sleep apnea in this patient population and optimal dialysis may reduce disease severity. Furthermore, treatment with continuous positive airway pressure may improve quality of life and may help to manage hypertension in these patients. Secondary restless legs syndrome is highly prevalent in patients on maintenance dialysis. The pathophysiology of the disorder may also involve uremia-related factors, iron deficiency, and anemia, but genetic and lifestyle factors might also play a role. The treatment of restless legs syndrome involves various pharmacologic approaches and might be challenging in severe cases. In this article we review the diagnosis and treatment of sleep apnea and restless legs syndrome, with a focus on dialysis patients. We also briefly review current data regarding sleep problems after transplantation, since these studies may indirectly shed light on the possible pathophysiological role of uremia or dialysis in the etiology of sleep disorders. Considering the importance of sleep disorders, more awareness among professionals involved in the care of patients on dialysis is necessary. Appropriate management of sleep disorders could improve the quality of life and possibly even impact upon survival of renal patients.

Humans↗