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

Sixty consecutive patients who had undergone replacement of dental amalgam fillings and a protocol of nutritional support and heavy metal detoxification using dimercapto-propanyl-sulfate and neural therapy were surveyed. A questionnaire was mailed to the patients and 42 responded, resulting in a response rate of 70%. The reasons for undergoing treatment were many, ranging from a patient's desire to avoid potential health problems in the future to treatment of serious current disease. Although medical diagnoses were made when possible before treatment, this survey studied only the patients' estimations of their most distressing symptoms and their evaluations of response to treatment. The most common complaints were problems with memory and/or concentration; muscle and/or joint pain; anxiety and insomnia; stomach, bowel, and bladder complaints; depression; food or chemical sensitivities; numbness or tingling; and eye symptoms, in descending order of frequency. The most distressing symptoms were headache and backache, fatigue, and memory and concentration problems. Headache and backache responded best to treatment, but all symptoms showed considerable improvement on average. Of the respondents, 78% reported that they were either satisfied or very satisfied with the results of treatment, and 9.5% reported that they were disappointed.
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PMID:Results of dental amalgam removal and mercury detoxification using DMPS and neural therapy. 1089 13

A case of basilar migraine (BM) with alternate numbness as the initial symptom is described. The patient's chief complaint was alternate numbness in the right and left upper extremities. After angiography the patient fell into a drowsy state, followed by excitation, and finally confusion. The EEG power topography showed slow alpha, theta and delta power in the right occipital area, and alternatively in the right and left parietal area. These findings suggest that the cause of BM is not only based on a vasoconstriction mechanism, but also cortical spreading depression. BM should be suspected as a cause of sensory symptoms.
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PMID:Alternate numbness in the upper extremities as the initial symptom of basilar migraine: an electrophysiological evaluation using EEG power topography. 1103 Feb 14

Pain complaints were assessed in 150 depressed inpatients at admission (D0), after 10 days (D10) and 28 days of treatment (D28) using the Symptom Check List, 90 items, revised version (SCL-90R). Pain complaints were present in 92% of patients at D0, several pain complaints being reported by 76% of patients. Headache and chest pain were more frequent in women, whereas myalgia and numbness were more frequent in men. Pain complaints were related to depressive and anxious complaints as assessed by the SCL-90R, but not to age, suicide attempts and depression severity as assessed by the psychiatrist. Pain complaints decreased between D0 and D10, whereas depression scores decreased both between D0 and D10 and between D10 and D28. As compared to responders to treatment at D28, nonresponders had lower Montgomery and Asberg Depression Rating Scale scores at D0 and higher pain complaint scores at D0 and D10.
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PMID:Pain complaints in depressed inpatients. 1106 May 14

Trigeminal neuralgia is a recurrent severe shooting neuropathic pain which can be managed both pharmacologically and surgically. However, there are no prospective data that compare these two therapeutic strategies. This study therefore aimed to assess long-term outcome in patients with intractable trigeminal neuralgia treated with oxcarbazepine and later with surgery. Fifteen patients (11 females) with trigeminal neuralgia intractable to available drugs (carbamazepine, phenytoin and baclofen), were prospectively followed for 13 years (1986-1999) with a total follow up time from onset of disease of 16 +/- 6 years (mean +/- SD), range 8-30 years. All patients were contacted in 1999 and 12 replied, two had died and one had last replied in 1996. Patients were first treated with oxcarbazepine 1200 +/- 600 mg daily dosage (mean +/- SD) and subsequently with surgery of their choice. The outcome measures used were: McGill Pain Questionnaire, Hospital Anxiety and Depression Scale, patient satisfaction questionnaire and clinicians' global evaluation. Pain control was initially achieved in all patients and oxcarbazepine was used continuously or intermittently for 4.0 +/- 3 years (mean +/- SD). Thirteen patients experienced some mild side effects and a dose-dependent hyponatraemia was noted. Subsequently, 12 patients required surgery (five microvascular decompressions and seven surgery at the level of the Gasserian ganglion) to control their pain and were followed up for 4.3 +/- 1.7 years post surgery (mean +/- SD). Three patients required repeat surgery to control their pain, which was successful in two. A further two patients continued with low dose medication post initially successful surgery. Three patients reported numbness and one hearing loss after surgery. Kaplan Meier analysis 3 years after oxcarbazepine use and then 3 years after surgery showed that the mean time for recurrence of pain after oxcarbazepine treatment was 10 months whilst for surgery it was 28 months (P<0.0001). Pain free periods and types of complications post surgery varied and depended on the type of surgery performed. Due to the small numbers, it was not possible to analyse the different types of surgical procedures individually. Outcomes after any type of surgery were better on all evaluations and eight patients felt that they should have had surgery earlier. Oxcarbazepine is a potent antineuralgic drug with very good acceptability and tolerability. However, its effectiveness was rather short term necessitating surgical intervention. As surgery was associated with better outcome, patients may therefore benefit from having surgery earlier rather than later in the disease process in order to improve quality of life, freedom from medication and the need for regular follow up. Surgery does not provide pain relief for all patients. This is the first study that has compared outcome in a group of patients who have had both pharmacological and surgical treatments. As these data cannot be extrapolated to other antineuralgic drugs, similar comparative studies would be appropriate.
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PMID:Long-term cohort study comparing medical (oxcarbazepine) and surgical management of intractable trigeminal neuralgia. 1183 25

The aim of the study was to assess adherence with antiretroviral medication in a sample of HIV patients in Hong Kong and identify predictors of adherence. The study used a cross-sectional correlational design. Adherence behaviour was assessed with the use of self-reports. Other scales assessed knowledge with HIV medication, coping, health locus of control, anxiety, depression and fatigue. A blood sample was also obtained to assess CD4+ counts and viral load. Sociodemographic characteristics and medical information were obtained from the medical records. A high adherence rate was found in this sample of 136 predominantly Chinese patients. There were only 13.7% of the patients being classified as non-adherent. Predictors of adherence included high self-efficacy in terms of being certain that the medication schedule will be followed all or most of the time as directed, low tension-anxiety scores, and low intensity of nausea and vomiting (R2=0.304). An expanded regression model revealed additional factors influencing adherence, including coping variables, pain and numbness in the hands and feet, age, disease stage, internal locus of control, fatigue, family support and taking medication twice daily. This model explained 49% of the variance in adherence. The results suggest that adherence is a multidimensional concept. Every effort should be made to assess in individuals those variables found to affect adherence and alter them whenever possible. Continuous support of patients and individualized medication programmes that will help patients adjust their treatment to their lifestyle are recommended.
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PMID:Factors associated with adherence to antiretroviral medication in HIV-infected patients. 1197 33

This paper reviews the psychopathology, the nosology and classification principles of stress-related disorders, with focus on how they are characterized in ICD-10 and DSM-IV. The presence of a stressor and the reexperience of the event are the two criteria present in the three diagnostic systems: ICD-10 Research Diagnostic Criteria (RDC), ICD-10 Diagnostic Guidelines (DG), and DSM-IV. ICD-10 RDC and DSM-IV, being more strict, add two more criteria: avoidance and increased physiological arousal. ICD-10 RDC allows this to be substituted by 'inability to recall', while ICD-10 DG add a few more symptoms which are not necessary for the diagnosis but may be typical (numbness), common (anxiety and depression) or rare (acute bursts of fear or aggression). DSM-IV is the only system which mentions symptoms specific for children.
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PMID:The classification of stress-related disorders in ICD-10 and DSM-IV. 1214 93

Multiple sclerosis is a complex neurological condition affecting sensory and motor nerve transmission. Its progression and symptoms are unpredictable and vary from person to person as well as over time. Common early symptoms include visual disturbances, facial pain or trigeminal neuralgia and paraesthesia or numbness of feet, legs, hands and arms. These, plus symptoms of spasticity, spasms, tremor, fatigue, depression and progressive disability, impact on the individual's ability to maintain oral health, cope with dental treatment and access dental services. Also, many of the medications used in the symptomatic management of the condition have the potential to cause dry mouth and associated oral disease. There is no cure for multiple sclerosis, and treatment focuses on prevention of disability and maintenance of quality of life. Increasingly a multi-disciplinary team approach is used where the individual, if appropriate his/her carer, and the specialist nurse are key figures. The dental team plays an essential role in ensuring that oral health impacts positively on general health.
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PMID:Multiple sclerosis and oral care. 1222 18

Terrorist attacks, situations of armed conflict, and all forms of catastrophe tax our abilities to cope, understand, and respond. Because of their developmental status, children are even more emotionally vulnerable to the devastating effects of a disaster. When tragedy strikes a family, community, or the nation, helping children cope and regain a sense of safety is critical. A child with posttraumatic stress disorder (PTSD) develops symptoms such as intense fear, disorganized and agitated behavior, emotional numbness, anxiety, or depression after being directly exposed to or witnessing an extreme traumatic situation involving threatened death or serious injury. Victims of repeated abuse or children who live in violent neighborhoods or war zones, or who have witnessed extensive media coverage of violent events, may experience PTSD.
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PMID:The aftermath of violence: children, disaster, and posttraumatic stress disorder. 1222 92

Although death is inevitable, it continues to remain a taboo issue for society. A failure to discuss the unavoidable may represent a safeguard to avoid dealing with mortality and related fears. Many patients who are terminally ill spend their days feeling alone, misunderstood, and afraid. Kubler-Ross attempted to strip death of its negative connotations and to provide a venue for the terminally ill to have a voice. Using information from more than 200 clinical interviews, Kubler-Ross revealed a trend in emotions over time in most, but not all, of her patients, which enabled her to formulate a model of coping with death that included 5 interdependent emotional stages: denial, anger, bargaining, depression, and acceptance. This model has become the most widely accepted and popularized model on death and dying, often cited as the Five Stages of Grief." However, given the lack of research concerning Kubler-Ross's model, completing work in this area seems warranted. The purpose of this case study was to examine one individual's emotional journey after being diagnosed with terminal colon cancer. More specifically, the goals were twofold: (1) to provide the participant with a voice and to allow her story to be told by examining the major external events (ie,surgery, chemotherapy) occurring since the diagnosis that affected her emotional and physical well-being and (2) to determine whether the participant's emotional journey paralleled Kubler-Ross's model, to what extent, and whether new emotions or stages occurred. The participant, a 50-year-old female, was diagnosed with stage 4 Duke Stage D colon cancer. Qualitative information was collected in face-to-face interviews, newspaper articles about the participant, and e-mail correspondence (as form letters to a group of friends and supporters) and subsequently analyzed for trends. The overall results revealed clear existence of the 5 stages of grief as outlined in the Kubler-Ross model. Analyses also revealed that the stages often overlapped or occurred simultaneously. Additionally, the participant regressed to earlier stages when subjected to negative external factors. Four other highly salient emotions were also prevalent throughout the participant's experience with colon cancer, namely joy, fear, hope, and numbness. The findings from this case study help to validate Kubler-Ross's stages. Further, the importance of the voice of the participant cannot be overemphasized. This case study clearly depicts the unique thoughts and emotions during one woman's struggle with colon cancer, sentiments that are often overlooked in quantitative analysis.
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PMID:Dealing with colon cancer: one woman's emotional journey. 1246 45

Reports base rate data for 50 controls and 170 personal injury claimants' self-reported symptoms associated with neuropsychological impairment. These base rates were obtained from claimants with no history of brain injury or toxic exposure and no documented neuropsychological impairments. Personal injury claimants reported high rates of complaints generally recognized as being associated with neuropsychological impairment. For example, 93% reported anxiety or nervousness, 92% sleeping problems, 89% depression, 88% headaches, 79% fatigue, 78% concentration problems, 77% irritability, 65% impatience, 61% feeling disorganized, 59% confusion, 56% loss of efficiency with everyday tasks, 53% memory problems, 44% dizziness, 39% numbness, and 34% word finding problems. These results underscore the need for caution when relying, on self-reported symptoms as evidence of brain damage in patients involved in litigation.
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PMID:Neuropsychological complaint base rates of 170 personal injury claimants. 1458 32


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