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An exploratory investigation of causal thinking of arthritics.

Research in academic achievement situations suggests that the causes people give for achievement events are linked to subsequent behaviors, emotions, and expectations. An attributional analysis of the causes arthritics gave for their condition tested the limits of the attributional model in the situation of chronic illness. Results indicated that the assumption that causal thinking occurs needs further testing. Fifteen percent of the subjects did not give causes. Those not giving causes were significantly more anxious, more depressed, and more hostile than those who had constructed causes. In terms of the dimensions of attribution theory, the results suggest that when causes are given, they do not easily fit within the classification scheme currently proposed. Suggestions for testing of the attributional model in clinical situations are offered.

Activities of Daily Living↗

[Microvascular decompression of the trigeminal nerve - a causal therapy of trigeminal neuralgia?].

Preliminary experiences with the microvascular decompression of the trigeminal nerve within the cerebello-pontine angle ("Jannetta's operation") in ten patients are reported. All nine patients with typical tic douloureux were found to have a cross-compression of the nerve by the superior cerebellar artery. This vessel was separated from the nerve and held in place by a piece of Gelfoam. All nine patients were painfree immediately following surgery. Their sensation within the trigeminal area was unchanged compared to the preoperative state. The remaining patient suffered of atypical facial pain and did not reveal a cross-compression of the trigeminal nerve neither by an artery nor by a vein. Microvascular decompression seems to be a causal therapy in trigeminal neuralgia and is a non-destructive operation. Although our period of postoperative observation is short (up to five months), the results are very promising and correspond to the experiences reported by other authors. Advantages and disadvantages compared to the radiofrequency lesion (electro- and thermocoagulation) of the trigeminal nerve are discussed.

Humans↗

[Active HCO3(-)Secretion in the gastric-mucosa. A causal factor in peptic ulcer disease? (author's transl)].

Studies during the last few years have revealed evidence of active secretion of HCO3(-) in the gastric mucosa both in vitro and in vivo. This transport process presumably has considerable importance for the protection of the gastric epithelium, disturbance must be considered a causal factor in the pathogenesis of gastric ulcer. The HCO3(-)-transport is subject to autonomic control. It is inhibited by drugs with an ulcerogenic action and stimulated by anti-ulcerogenic prostaglandins. The results available up to now raise the probability of the physiologic and pathophysiologic significance of the HCO3(-)-transport system. Clinical investigations must demonstrate the therapeutic efficacy of control of the alkali secretion in the gastric mucous membrane.

Biological Transport↗

Maternal causal attributions at hospital discharge of high-risk infants.

Interviews were conducted at hospital discharge with mothers of 43 infants with severe perinatal complications posing risks to development. Information gathered included mothers' beliefs about the causes of the infant's medical problems, expectations of caretaking difficulties, and self-reported mood on the Profile of Mood States. Of the various demographic characteristics studied, only maternal parity was related to causal attributions, with mothers of later-born infants more likely to blame themselves and mothers of first-born infants more likely to blame others and to attribute the infant's condition to chance. Mothers who blamed others reported greater mood disturbance and greater anticipated caretaking problems than did mothers who attributed the infant's condition to a maternal behavior during pregnancy. These findings were discussed in relation to studies of attributional processes and coping with misfortune.

Attitude↗

[Between hallux rigidus arthrosis and gout is no causal relationship].

The following assertion - continuously being alleged - is examined: Hallux rigidus arthrosis is said to occur in patients suffering from gout more frequently than average, and it should be valued as a symptom of chronic gout. Results of our own findings are as follows: 1. Hallux rigidus arthrosis becomes manifest in general on the right side or bilaterally, respectively; on the left side, however, it occurs rarely in an isolated state. 2. In patients with hallux rigidus arthrosis hyperuricaemia, gout, and obesity are seen more frequently than in adults of the normal population - these three diseases often are combined with static mutations in the region of the lower extremities. 3. No criteria can be stated as to causal relationship between hyperuricaemia (or gout) and hallux rigidus arthrosis. Obesity has to be considered a connecting link between both of them, and it is accelerating their genesis. 4. Hallux rigidus arthrosis represents - same as the arthrosis of Heberden - the more frequent possibility for confusing it with gout.

Adult↗

Sequential inhibition of sexual receptivity by progesterone is prevented by a protein synthesis inhibitor and is not causally related to decreased levels of hypothalamic progestin receptors in the female rat.

In the estrogen-primed ovariectomized female rat, the administration of progesterone facilitates sexual receptivity and activates proceptivity for many hours. If the progesterone dose is large (e.g., 2.5 mg), a refractory period follows, during which time animals are less sensitive to additional progesterone. This refractory period has been termed "sequential inhibition" and has been correlated previously with decreased levels of cytosol progestin receptors in the mediobasal hypothalamus-preoptic area (MBH-POA). Our present results indicate that the "sequential inhibition" of mating behavior by progesterone appears to involve a protein synthetic step that is not related causally to decreased levels of cytosol progestin receptors in the MBH-POA. Animals which received subcutaneous injections of the protein synthesis inhibitor, anisomycin (100 mg/kg in saline), 15 min prior to and again 3 hr after progesterone (2.5 mg in propylene glycol) treatment, displayed greater sexual receptivity at 24 hr than did animals which received subcutaneous saline injections. However, cytosol progestin receptor levels in the MBH-POA of animals which received anisomycin plus progesterone were decreased at 24 hr, relative to animals which received saline plus progesterone. Anisomycin did not produce positive or negative behavioral effects at 24 hr when administered 15 min prior to and again 3 hr after propylene glycol, suggesting that the behavioral effects of anisomycin appear to be related to selective blockade of progesterone action. In separate experiments, we administered single subcutaneous injections of anisomycin at various times relative to progesterone (2.5 mg) treatment. According to the time course of effective anisomycin application, the presumed protein synthesis which is responsible for the inhibition of mating behavior occurs between 3 and 13 hr after the administration of progesterone.

Animals↗

Improving accuracy in multiple regression estimates of population using principles from causal modelling.

This paper reports a mildly restricted procedure for using a theoretical causal ordering and principles from path analysis to provide a basis for modifying regression coefficients in order to improve the estimation accuracy of the ratio-correlation method of population estimation. The modification is intended to take into account temporal changes in the structure of variable relationships, a major element in determining the accuracy of post-censal estimate. The modification of coefficients is conservative in that is uses rank-ordering as a basis of change. Empirical results are reported for counties in Washington state that demonstrate the increased accuracy obtained using the proposed procedure.

Humans↗

Antisense oligonucleotides: an experimental strategy to advance a causal analysis of development.

A variety of modified and unmodified oligonucleotides (ODNs) have been examined as antisense inhibitors of gene expression. Of particular interest has been the application of antisense inhibitory experimental strategies to advance a suggested causal relationship between signal transduction and inductive epithelial-mesenchymal interactions during mandibular morphogenesis, early tooth development, tooth enamel formation, lung branching morphogenesis, kidney, muscle and heart development. Epidermal growth factor (EGF), platelet-derived growth factor (PDGF), and a number of transforming growth factor beta (TGF-beta) isotype mediated signal transductions have been demonstrated to regulate inductive processes associated with significant processes in development including mouse molar tooth morphogenesis. Antisense strategies have also been useful in studies designed to associate a specific morphogen signal with homeobox (HOX) gene regulation in several embryonal carcinoma cell lines. The application and results from a number of antisense inhibitory strategies serve to support the utility of this experimental paradigm for future investigations of tooth development. This review discusses the experimental strategy, a number of technical issues and the rationale for future investigations of tooth development.

Animals↗

Intravaginal estrogen creams and endometrial cancer: no causal association found.

In two case-control studies of estrogens and endometrial cancer, women were asked about previous use of intravaginal estrogen creams. In a set of cases and controls chosen by conventional procedures from a tumor registry, the odds ratio was 0.90. In an alternative set of cases and controls who had all received dilatation and curettage or hysterectomy, the odds ratio was 0.82. Despite the reported relationship between oral estrogens and endometrial cancer and although intravaginal estrogen creams are readily absorbed by the vaginal mucosa, we detect no causal association for their use.

Connecticut↗

[Complex cardiac lesion diagnosed more than 20 years after the causal injury].

Penetrating wounds of the heart, when not immediately fatal, may give rise to complex lesions associating valvular regurgitations and fistulous connections. The authors report the case of a patient with mitral and aortic regurgitation associated with an aorto-left atrial fistula of traumatic origin and causing invalidating cardiac failure. The interest of this particular case lies in the duration of the interval between the causal trauma and the appearance of symptoms (over 20 years). Complete surgical repair of the lesions provided a good functional result. The authors discuss the different types of lesions which may be caused by wounds of the heart and their modes of presentation.

Aortic Valve Insufficiency↗

[Hyperfibrinogenemia and cardiovascular risk--epiphenomenon or causal relationship?].

During the last decade, a variety of experimental, clinical and epidemiological data have been published, documenting an association between fibrinogen and atherosclerosis as well as with its most frequent clinical complications, myocardial infarction and stroke. Although the design of epidemiological studies was not strictly comparable, and studies were carried out in very different populations, with various methods of fibrinogen measurement, the results are remarkable consistent. Together with clinical and experimental data, they strongly suggest a causal role for fibrinogen in atherogenesis and in the pathophysiology of acute ischemic syndromes. Hence, fibrinogen should be determined in patients at high risk for cardiovascular complications. The clinical benefit of lowering fibrinogen in certain patient groups or alternatively, the inhibition of specific fibrinogen induced effects, should be studied in randomised trials.

Arterial Occlusive Diseases↗

Identification of 15 different candidate causal point mutations and three polymorphisms in 19 patients with protein S deficiency using a scanning method for the analysis of the protein S active gene.

To screen for point mutations causing protein S deficiency, we used a sequence of techniques specifically for the study of the protein S active gene, PS alpha. This strategy comprises amplification of exons and intron/exon junctions by means of the polymerase chain reaction (PCR) and electrophoresis of the amplified fragments in polyacrylamide gel containing a gradient of denaturing agents (denaturing gradient gel electrophoresis). Only fragments with altered melting behavior are sequenced after asymmetric PCR. Beside the frequent polymorphism already described on Pro 626, we detected 18 different sequence variations by studying exons II, IV, V, VIII, X, and XV in 19 of 100 consecutive patients with protein S deficiency. Fifteen were candidate causal mutations, 4 of which were associated with a qualitative deficiency (type IIa or IIb). The remaining three sequence variations were probably polymorphisms.

Base Sequence↗

[Atrial septal aneurysm and brain infarct: a causal connection?].

In four patients, 2 women aged 24 and 35 and 2 men aged 37 and 47 years, an ischaemic stroke was observed and an atrial septal aneurysm was found as a possible cardiac source of embolism to the brain. Atrial septal aneurysm is a bulging of the fossa ovalis region, that can be visualised by (preferably transoesophageal) echocardiography. In the four patients there were only few other risk factors for ischaemic stroke (migraine, smoking, oral contraceptives). Cerebral angiography was normal in all cases. Recent literature suggests that a causal relationship exists between atrial septal aneurysm and ischaemic stroke. It is still uncertain what treatment is best.

Adult↗

Hemorrhagic enteritis of turkeys: electron microscopy of the causal virus.

Spleens of turkey poults inoculated with hemorrhagic enteritis virus were examined by electron microscopy. Negatively stained infectious extracts of spleen tissue contained adenolike virions averaging 75-80 nm in diameter. Intranuclear virions, either scattered or in crystalline arrays, were observed in thin sections of spleen tissue four days after inoculation. The chromatin was condensed and marginated in the nuclei of most cells which contained virions. Some virions in sections appeared as hollow cores with a double-layered capsid. The outer capsid was 75-80 nm in diameter, and the inner capsid 35-40 nm. Virions were not observed in cells or extracts of spleens from uninoculated poults. The detection of intranuclear virions at the time when symptoms appeared and specific antigen titer increased suggests that the adeno-like virions are the causal agent of hemorrhagic enteritis of turkeys.

Adenoviridae↗

Hypertension in Africa: an overview of prevalence rates and causal risk factors.

The goal of this paper has been to summarize the existing data on the epidemiology of hypertension in Africa and to provide the basis for designating important known risk factors. We hope that this document will serve as the basis for a comprehensive evaluation of the disease burden from hypertension on the continent and the potential for prevention to reduce the health risk from this condition. Given the difficulty in maintaining long-term drug therapy in the African setting, and the increasing scientific basis for primary prevention, the time has clearly come to organize community campaigns to control the causal risk factors for hypertension.

Adolescent↗

Event detection on patient monitoring data using Causal Probabilistic Networks.

Applications are described of the knowledge-representation technique Causal Probabilistic Networks for the detection of events related to the patient and the monitoring equipment, in the context of intensive care patient monitoring. The purpose of the event detection is to reduce the number of false alarms generated by the patient monitor, and to generate alarms related to patient or equipment events rather than to threshold violation. A PC-based system has been developed and tested on patient data. A system for real-time use in patient monitoring is under development.

Diagnosis, Computer-Assisted↗

Test of the Health Promotion Model as a causal model of workers' use of hearing protection.

The Health Promotion Model (HPM) was tested as a causal model to predict workers' use of hearing protection (N = 645). Measures indicated an excellent fit of the theoretical model. The exploratory analyses found the same cognitive-perceptual factors most important in predicting use. However, in contrast to the theoretical model, two modifying factors (job category and situational factors) had direct effects on use. The hypothesized model accounted for 49.3% of variance and the exploratory models accounted for 50.7% to 52.7% of variance in hearing protection use. Results of testing the HPM are consistent with the recently proposed revision of the model by Pender, Walker, Frank-Stromborg, and Sechrist (1990a, 1990b). The strongest effects on behavior came from the behavior-specific influences and demographic characteristics. Situational factors had a direct effect on the health behavior.

Cognition↗