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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We have characterized five subtypes of cocaine abusers on the basis of clinical presentation, family history data, and response to specific treatment interventions. These include depressed patients who value the euphorigenic effects of the drug, patients with bipolar or cyclothymic disorder who use cocaine to augment manic or hypomanic symptoms or to alleviate depression, adults with ADD, residual type, who find that cocaine has a paradoxical effect of increasing attention span and decreasing motor restlessness, patients with narcissistic and borderline personality disorders who use cocaine for its social prestige and because it bolsters self-esteem, and patients with antisocial personality disorder who use cocaine as part of an overall pattern of antisocial behavior. Although not all cocaine abusers fit neatly into these categories, careful psychiatric evaluation and subtyping is essential in designing a specific treatment program for these patients. As the prevalence rate of cocaine abuse increases, studies that examine the efficacy of various treatment approaches for specific subtypes of cocaine abusers will be essential. It is hoped that our work will be a step in that direction.
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PMID:Subtypes of cocaine abusers. 377 2

Changes in plaque pH and microhardness of bovine enamel slabs were evaluated with a seven-day intra-oral cariogenicity test (ICT). The test enamel slabs were mounted in prosthetic appliances with a Dacron mesh cover for enhancement of microbial colonization. Three percent solutions of sucrose, sorbitol, and xylitol were evaluated as four daily extra-oral immersions of 10 min each, for seven days, and the results were compared with baseline experiments (no daily immersions). The pH was measured with antimony electrodes on one-day and seven-day ICT plaque samples that were challenged with a one-minute immersion in the studied substrates. Plaque samples in the baseline experiments were challenged with 3% sucrose. The enamel softening was assessed with measurements of microhardness. Sucrose challenge caused pH depression with both the baseline and the sucrose-immersed plaque. Sorbitol and xylitol challenge did not depress the plaque pH. Compared with the baseline, sucrose immersions caused enamel softening; sorbitol and xylitol did not.
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PMID:Enamel microhardness change and plaque pH measurements in an intra-oral model in humans. 386 May 37

BALB/c mice were exposed to fresh cigarette smoke, a mixture of SO(2) (5 ppm) and CO (50 ppm), or both for periods up to 18 weeks. After varying exposure times, animals were intratracheally inoculated with 10(8) sheep erythrocytes and sacrificed 7 days later, during which time the various exposure regimes were continued. Plaque-forming-cell responses were measured in spleens and a pool of the cervical and mediastinal lymph nodes, together with serum hemagglutinating and hemolytic responses, and compared with those of age-matched control animals. Both the organ and serum responses exhibited stimulation in the early phase of exposure, before a depression with prolonged exposure. The greatest depression was seen in animals that had been chronically exposed to both fresh cigarette smoke and the gas mixture.
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PMID:Cigarette smoking, air pollution, and immunity: a model system. 461 21

Spontaneously hypertensive male and female rats (SHR) were compared with Wistar/Kyoto (W/K) controls at 15 wk and 80 wk of age. Treatment of the young and old hypertensives with thymosin, fraction 5, lowered the blood pressure within 4 wk of the start of treatment. Following 10 wk of injections, the blood pressures of the hypertensive rats remained at a depressed level for about 6 wk. The thymic hormone raised the depressed spontaneous T-cell rosette formation of the aged hypertensive rat and increased the lymph node T-cell response to the mitogens, Con A and PHA. Thymosin administration over a period of 7 wk increased the size of the aged hypertensive thymus. No similar effect was observed in the W/K. Spleen cell production of prostaglandin E (PgE) was markedly higher in the young hypertensive and immune complex deposition was found in the glomeruli and tubules of the aged SHR kidneys. Thymosin lowered the high level of PgE to normal and decreased the immune complex deposition in the kidney. IgG1 levels were considerably depressed in the SHR as compared to the W/K. Following thymosin administration levels of IgG1 increased 2-fold in both rat strains. Plaque-forming cells from the spleens of the untreated SHR were about 3-fold less than those of the age-matched W/K. Following treatment with thymosin the number of plaque-forming cells of both groups demonstrated a substantial further decrease. Spontaneous hypertension in rats is similar, in certain respects to autoimmune-like diseases in humans with a depression in T-cell activity as well as immune complex deposition; both conditions being altered by exposure to a thymic extract.
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PMID:Immune response modulation in the spontaneously hypertensive rat. 634 14

During the last 4 years (1979-1982), 4117 patients have been examined in our out-patient department. Since the most important dates of each patient are electronically registered, it was easy to ascertain the frequency of the depressive conditions with the computer. This amounts to 819 and corresponds to 19.9% of the patients examined during that period. The depressive states were divided in 4 categories: 1. depressive reactions, 2. depressive developments, 3. neurotic depressions, and 4. endogenous depressions. Of all depressive patients, only 27 were treated with drugs. The others were treated with the classical methods of the child- and youthpsychiatry, that is psychotherapy including family-therapy, educational measures and interventions in the social field. Patients with a depressive reaction never received any drugs. The few patients who suffered from an endogenous depression all received thymoleptica in combination with a Lithium salt. However, one dozen patients with a neurotic depression respectively with a depressive personality development received various drugs, whereby the antidepressants were leading, but not prescribed alone. Neuroleptica as well as psychotonica were prescribed, especially for children suffering from an infantile psychoorganic syndrome (MBD, ADD) with a depression. Psychotrope substances have their place in the treatment of depressive conditions in childhood. Their scarce and critical use is in the interest of the children.
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PMID:[Clinical aspects of depressive states]. 666 94

The primary immune response to SRBC in BALB/c mice was depressed when they were injected with a fraction (FAd) obtained from Trypanosoma cruzi epimastigotes grown in LIT medium. Plaque-forming cell (PFC) number was 50% less than controls when FAd was injected i.v. 15 min before antigen in doses ranging from 70 microgram up to 400 microgram of protein. Similar depression was observed when 100 microgram FAd was injected up to 6 h before antigen. There was no shift in the peak response to SRBC, neither was depression detected, when a total of 100 microgram FAd protein was given in 20 microgram amounts twice a day before immunization. Mice injected with FAd fraction only showed no increase in background PFC. Both secondary IgM and secondary IgG PFC were depressed when FAd was given before the boosting injection. However, only IgG PFC were depressed when FAd was injected before the priming dose. The delayed-type hypersensitivity reaction to DNFB was depressed when animals were injected either during the 3 days after sensitization or with a single dose of 100 microgram of protein of FAd on day of challenge. Bone marrow colony-forming units in spleens of mice injected with FAd were depressed and nodules in the treated animals were smaller than in controls. We conclude that FAd affects humoral and cell-mediated immune responses by interfering with cell division at some stage of the cell cycle.
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PMID:A fraction (FAd) from Trypanosoma cruzi epimastigotes depresses the immune response in mice. 700 Jun 83

We present a prevalence study of psychiatric morbidity in people over 50 years of age with learning disability (LD), using a new semistructured clinical interview specifically for use with people who have LD (the 'PAS-ADD'). Assessment involved parallel interviewing of subject and informant, these two sets of information being combined to reach a final diagnosis using ICD-9 and DSM-III-R criteria. Detection of dementia involved interviews with informants, plus investigation of loss of cognitive function over a three-year period. The experimental sample was a mixed community and institutional group (n = 105), including, as far as possible, all people in a single administrative district (Oldham) matching the age and ability criteria. Prevalence of psychiatric disorder excluding dementia was 11.4% (n = 12), most of which were depression and anxiety. Seventy-five per cent of these cases were unknown to mental health services. However, immediate care staff were usually aware of the symptoms, although often unaware of their clinical significance. Prevalence of dementia was also 11.4% (n = 12), with a combined case prevalence of 21.0% (n = 22). The PAS-ADD proved a flexible interview, effective in use with people of varying linguistic level and intellectual ability: 61.9% (n = 65) of the sample were able to be interviewed, fully adequate clinical interviews being obtained with a group of 38 people whose mean IQ was only 39. In the remaining 38.1% (n = 40), diagnosis relied exclusively on informant data. Overall, the combination of subject and informant data was essential for sensitive case detection.
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PMID:Psychiatric morbidity in older people with moderate and severe learning disability. II: The prevalence study. 1143 74

Psychological disturbances may lead patients to neglect oral hygiene. This study investigated whether a number of psychosocial factors (depression, state and trait anxiety, total and average perceived stress, and loneliness) could predict dental plaque levels in patients with adult onset rapidly progressive periodontitis (RPP) and routine chronic adult periodontitis (RCAP), before periodontal treatment. It was also examined whether RPP and RCAP patients differed on plaque and smoking. Plaque was scored in a sample of 6 teeth in each of 80 subjects, 40 with RPP, 40 with RCAP, before psychosocial questionnaire completion. Multiple regression was performed between plaque as the dependent and psychosocial factors, gender, education, form of periodontitis and smoking as independent variables. Only gender contributed significantly to prediction of plaque, t=-2.70, p=0.01, partial regression coefficient -0.37, 95% CI: -0.64 to -0.10, indicating that plaque was on average 0.37 lower for females than males, after adjusting for the other predictor variables. It was confirmed that RPP and RCAP patients did not differ significantly on plaque, univariate t-test(69.99)= 0.65, p=0.13. However, RPP patients smoked significantly more than RCAP patients t(69.72)=2.36, p=0.02. There was also a marginally significant correlation between depression and smoking, r=0.16, p=0.07. One possible reason advanced for the lack of an association between psychosocial factors and plaque, and the absence of a difference in plaque between RPP and RCAP patients is the fact that the patients involved in the present study were seen as secondary referrals. The gender difference in plaque levels and the greater incidence of smoking in RPP patients may be of significance in planning interventions with patients with periodontitis.
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PMID:Psychosocial factors, dental plaque levels and smoking in periodontitis patients. 966 86

The Mini PAS-ADD is an assessment schedule for psychiatric disorders in people with an intellectual disability. It is designed to provide a link between the mental health expertise of psychiatrists and psychologists, and the detailed knowledge of individual service users possessed by support staff. In broad terms, the aim of the Mini PAS-ADD is to enable non-psychiatrists accurately to recognize clinically significant psychiatric disorders in the people who they care for, so that they can make informed referral decisions. The instrument comprises 86 psychiatric symptoms and generates a series of subscores on: depression, anxiety and phobias, mania, obsessive-compulsive disorder, psychosis, unspecified disorder (including dementia), and pervasive developmental disorder (autism). The present paper reports the results of a study investigating internal consistency, inter-rater agreement and validity in relation to clinical opinion, using a sample of 68 people with intellectual disability who were in contact with psychiatric services. In terms of the instrument fulfilling its main intended function, i.e. accurate case recognition, the crucial question was whether the support workers, with their lesser knowledge of psychopathology, were also able to correctly identify cases identified by expert clinicians. The validity results in this respect (81% agreement on case recognition) were sufficiently good that it is to be anticipated that the Mini PAS-ADD should have a significant impact on the identification of psychiatric disorders in the community of people with intellectual disability.
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PMID:Reliability and validity of the Mini PAS-ADD for assessing psychiatric disorders in adults with intellectual disability. 978 40

This review article integrates empirical findings from various scientific disciplines into a proposed psychoneuroimmunological (PNI) model of the acute coronary syndrome (ACS). Our starting point is an existing, mild, atherosclerotic plaque and a dysfunctional endothelium. The ACS is triggered by three stages. (1) Plaque instability: Pro-inflammatory cytokines (IL-1, IL-6, TNF-alpha) and chemoattractants (MCP-1, IL-8) induce leukocyte chemoattraction to the endothelium, and together with other triggers such as the CD40L-CD40 co-stimulation system activate plaque monocytes (macrophages). The macrophages then produce matrix metalloproteinases that disintegrate extra-cellular plaque matrix, causing coronary plaque instability. Acute stress, hostility, depression and vital exhaustion (VE) have been associated with elevated pro-inflammatory cytokines and leukocyte levels and their recruitment. (2) Extra-plaque factors promoting rupture: Neuro-endocrinological factors (norepinephrine) and cytokines induce vasoconstriction and elevated blood pressure (BP), both provoking a vulnerable plaque to rupture. Hostility/anger and acute stress can lead to vasoconstriction and elevated BP via catecholamines. (3) Superimposed thrombosis at a ruptured site: Increases in coagulation factors and reductions in anticoagulation factors (e.g. protein C) induced by inflammatory factors enhance platelet aggregation, a key stage in thrombosis. Hostility, depression and VE have been positively correlated with platelet aggregation. Thrombosis can lead to severe coronary occlusion, clinically manifested as an ACS. Thus, PNI processes might, at least in part, contribute to the pathogenesis of the ACS. This chain of events may endure due to lack of neuroendocrine-to-immune negative feedback stemming from cortisol resistance. This model has implications for the use of psychological interventions in ACS patients.
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PMID:Molecular and cellular interface between behavior and acute coronary syndromes. 1223 62


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