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

This research sought to quantify the handicapping effect of skin conditions in a far more rigorous way than had previously been attempted. One hundred people who had attended a hospital outpatient clinic during a specified period for treatment of their acne, psoriasis or eczema were interviewed in their homes. A comprehensive and structured interview schedule was used and interviewees were encouraged to talk at length about the impact that their skin conditions had had on their lives. Detailed data were collected that show the serious effect that these diseases can have in several domains. The findings record not only the physical discomfort and inconvenience sufferers may meet but also the consequences for their personal and social life and daily functioning. There is evidence from interviewees' employment experiences of limited opportunities, and functional and interpersonal difficulties in the workplace. 64% of people said that their skin disease affected their socio-economic activity. The extent to which sufferers experienced embarrassment, anxiety, a lack of confidence and depression is documented. 40% of people felt that their social life was affected and there was evidence of particular stresses and demands in personal relationships. The social impact of skin disease is discussed.
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PMID:Skin disease and handicap: an analysis of the impact of skin conditions. 315 80

We studied the role of somatosensory amplification, as measured by a self-report questionnaire, in symptomatology, overall discomfort, and disability in 115 patients with upper-respiratory-tract infections who visited an adult medical walk-in clinic. Multiple regression analyses indicated that amplification was a statistically significant predictor of the patients' localized but not systemic symptoms, of reported overall discomfort, and of their social and vocational disability. These relationships held true while controlling for differences in medical morbidity and sociodemographic characteristics. Amplification was closely related to, but distinct from, three measures of dysphoria: depression, anxiety, and hostility. The tendency to amplify a broad range of bodily sensations may therefore be an important factor in experiencing, reporting, and functioning with an acute and relatively mild medical illness.
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PMID:The amplification of somatic symptoms. 318 94

We performed a double-blind study of the dose-response relationship of intrathecal morphine (0, 0.3, 1, and 2.5 mg) for postoperative pain relief in 33 subjects who underwent total knee or hip replacement surgery. Assessments commenced 1 hour after the opioid injection, which was given at the end of surgery, and continued for 24 hours. Pain measurements, supplementary analgesia requirements, and adverse effects were recorded. Intrathecal morphine provided effective, long-lasting pain relief. All doses delayed the initial perception of discomfort (T-Pain) and also postponed the onset of severe pain requiring analgetic supplementation (T-Morphine) (1.25 hours control with placebo injections; greater than 20 hours with intrathecal morphine 0.3, 1, and 2.5 mg: P less than 0.05). Although 0.3 mg usually provided good analgesia it was unsatisfactory in three of 10 patients (30%), whereas 1 and 2.5 mg were absolutely reliable. Respiratory depression (increased PaCO2), common after the administration of 1 or 2.5 mg intrathecal morphine, was slow in onset and prolonged. The respiratory depression after 2.5 mg was more profound than after 1 mg, and produced apnea necessitating large-dose naloxone therapy. Pruritus was unique to intrathecal morphine administration, but nausea, vomiting, and urinary retention were common in all the groups. We conclude that no ideal dose of intrathecal morphine exists because, even with small quantities, minor adverse effects are evident. Doses between 0.3 and 1 mg, however, should provide good analgesia free from the major complication, respiratory depression.
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PMID:A dose-response study of intrathecal morphine: efficacy, duration, optimal dose, and side effects. 318 98

Meperidine HCl was administered intramuscularly by hand-syringe to a number of individuals representing several species of cetaceans (n = 95) and pinnipeds (n = 36). Dosage administered was 0.11 mg/kg, 0.23 mg/kg or 0.45 mg/kg, with the majority of animals receiving the middle dosage. Meperidine HCl provided moderate restraint in cetaceans without obvious deleterious effects. Restraint was achieved rapidly, with maximum effect occurring 20 min after intramuscular injection and lasting for 2 to 3 hr. Analgesia appeared to last as long as 4 hr and was sometimes accompanied by a restoration of appetite in animals suffering from physical discomfort. Higher doses produced increased sedation and analgesia without noticeably depressing respiration. Meperidine HCl provided moderate restraint for phocids and walrus (Odobenus rosmarus) without apparent detriment. California sea lions (Zalophus californianus) showed little restraint, but demonstrated profound respiratory depression.
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PMID:The use of meperidine hydrochloride for chemical restraint in certain cetaceans and pinnipeds. 319 67

Based on data from a larger longitudinal study of medical students and physicians, this study establishes the incidence of some menstrual symptoms in a nonclinical population of 82 healthy, female, first-year medical students and investigates the correlation of self-reported anxiety and depression scores with these symptoms. Findings show that nearly half reported the frequent occurrence of at least one menstrual symptom that appeared to cause discomfort but did not interfere with performance. The data suggest an association between anxiety and depression scores and certain self-reported menstrual symptoms in this population. The study suggests the need for further investigation of the nature of the relationship between dysphoric moods and menstrual symptoms in healthy women.
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PMID:Anxiety, depression, and menstrual symptoms among freshman medical students. 319 81

Ambulatory patients with upper respiratory infection were studied to determine the relative contributions made by tissue pathology, psychologic and perceptual attributes, and demographic characteristics to reported discomfort and disability. Patients (n = 115) attending a medical walk-in clinic completed self-report questionnaires to assess somatization, anxiety, depression, hostility, amplification, discomfort, disability, and demographic characteristics. Clinicians rated the extent of disease apparent on physical examination. Using stepwise multiple regression, demographic factors and physical findings explained 25% of the variance in reported discomfort. The addition of somatization scores increased the variance explained to 49%. The best model, including somatization and amplification, accounted for 54% of the variance. A model composed of demographic characteristics, physical findings, and somatization accounted for 25% of the variance in reported disability. The authors conclude that psychologic variables are important in the experience of discomfort, even after the extent of physical disease and demographic characteristics have been taken into account.
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PMID:Discomfort and disability in upper respiratory tract infection. 323 Apr 56

Somatizing patients experience or express emotional discomfort and psychosocial distress as physical symptoms. Somatization occurs in a broad spectrum of illnesses, in association with a wide variety of mental disorders, including depression, anxiety, and the somatoform disorders. Primary care providers must detect and treat these patients. Diagnosis is based on positive criteria. Care rests upon conservative medical management and evaluation; a physician-patient relationship based on acceptance, caring, and trust; reinforcement of positive behaviors and elimination of destructive ones; and the gradual use of the relationship to promote healthy relating in the patient.
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PMID:Somatization in primary care: patients with unexplained and vexing medical complaints. 328 44

After a brief description of the newest and special form of motion sickness known as "space sickness" arising in space flight, and the various hypotheses on its aetiopathogenesis, motion sickness in general and the air or plane sickness deriving from atmospheric flying are discussed. The aetiopathogenesis of air sickness derives from abnormal stimulations that are primarily vestibular but also visual and somesthesic, and generated by irregular movements or variations in attitude of the plane. Reflex action than produces effects that are primarily neurovegetative (nausea, vomiting, pallor, scialorrhea, sweating, bradycardia) and neuropsychological (depression, drowsiness, headache, discomfort and general debility with altered cenesthesia). After a description of the symptoms, the prevention and treatment of air sickness are discussed.
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PMID:[Motion sickness in the aerospace environment]. 331 14

Seventy-four "high-risk" pregnant women interested in participating in a clinical trial comparing chorionic villi sampling and amniocentesis were initially assessed on five background measures and for anxiety, depression, hostility, and concern about abortion. The 61 women who then agreed to be randomized into the chorionic villi sampling and amniocentesis groups were assessed three additional times between 9 and 22 weeks' gestational age. Physical discomfort experienced during the diagnostic procedure was also assessed. Women in the chorionic villi sampling group underwent a reduction in anxiety up to 10 weeks earlier and reported less procedure-related discomfort than women in the amniocentesis group. The group X time interaction for depression was also significant, with women undergoing chorionic villi sampling reporting an earlier decrease in depression than women undergoing amniocentesis. No differences were found between the two groups in hostility or concern about abortion. Findings were discussed in the context of evidence linking prenatal maternal emotionality to an increased risk of obstetric complications.
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PMID:Emotional responses of pregnant women to chorionic villi sampling or amniocentesis. 331 65

The concept of 'quality of life' has had a paradigmatic effect in psychosomatic medicine by focussing on the measurements of psychological distress. This concept has been phenomenologically described under such names as discomfort and psychological boredom. Elements of fatigue, anxiety and depression seem to be core symptoms of dysfunctions in quality of life. An objective and nomothetic approach to quality of life has been demonstrated in this review when referring to the instrumental use of rating scales, e.g. the General Health Questionnaire. Furthermore, it has been recommended to follow the multiaxial approach of DSM-III including dimensions of personality, psychosocial stressors and social functioning.
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PMID:Quality of life in psychosomatic research. A psychometric model. 332 35


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