Focal cerebral perfusion defects demonstrated by 99mTc-hexamethylpropyleneamine oxime SPECT in elderly depressed patients.

High resolution single photon emission computed tomography (SPECT) was used to evaluate regional cerebral blood flow (rCBF) in 14 acutely depressed elderly patients and 29 normal subjects. SPECT images of the two groups were randomized and blindly read. Foci of decreased radionuclide uptake were assessed by number and location.

Videotaping psychotherapy.

The use of videotapes of psychotherapy sessions by patients, therapists, and supervisors is discussed. The review of videotape helps patients see themselves and their therapists more realistically. As patients become familiar with their behavior and expressions, they begin to see how behavior is linked to underlying feelings.

Carbamazepine use in children and adolescents with features of attention-deficit hyperactivity disorder: a meta-analysis.

Objective: In the United States approximately 750,000 children receive psychostimulants to treat attention-deficit hyperactivity disorder (ADHD); up to 25% may not respond. The purpose of this study was to evaluate the reports in the international literature concerning the efficacy of carbamazepine (CBZ) in children with ADHD features by means of meta-analysis.

Method: A review of the world literature located 29 reports that dealt with behavior problems, activity levels, and CBZ in children.

Cardiovascular factors influencing survival in dialysis patients.

Cardiovascular disease is the most common cause of death among dialysis patients. Cardiovascular abnormalities that predispose to mortality include acute myocardial infarction, chronic ischemic heart disease, atherosclerotic peripheral vascular disease, congestive heart failure, left ventricular hypertrophy, dilated cardiomyopathy, hypertrophic hyperkinetic heart disease, prior cardiac arrest, and possibly systemic hypertension. This review explores the influences of cardiovascular disease on survival in patients with end-stage renal disease treated with dialysis.

Relation of duration of morbid obesity to left ventricular mass, systolic function, and diastolic filling, and effect of weight loss.

Longer duration of morbid obesity is associated with higher LV mass, poorer LV systolic function, and greater impairment of LV diastolic filling. Weight loss-induced decreases in LV mass and improvements in LV systolic function and diastolic filling are due in part to favorable alterations in LV loading conditions.

Influence of left ventricular mass on left ventricular diastolic filling in normotensive morbid obesity.

To identify factors influencing left ventricular (LV) diastolic filling in patients with morbid obesity, we performed transthoracic and Doppler echocardiography on 50 subjects whose actual body weight was > or = twice their ideal body weight and on 50 normal lean control subjects. The transmitral Doppler E/A ratio and E wave deceleration half-time were used to assess LV diastolic filling. Significant negative correlations were seen between the E/A ratio and the LV internal dimension in diastole (r = 0.

Clinical effects of recent cocaine use on patients with acute schizophrenia.

Objective: Dopamine function has been hypothesized to be involved in both producing schizophrenic symptoms and mediating cocaine's reinforcing properties. As a result, cocaine abuse in schizophrenic patients may be seen as a natural experiment that may alter the phenomenology and neurobiology of schizophrenia. This report concerns the clinical effects of cocaine abuse and cessation in schizophrenic patients at two times: when patients presented to the psychiatric emergency service and again after 4 weeks of hospitalization.

Interrelationship of left ventricular mass, systolic function and diastolic filling in normotensive morbidly obese patients.

Objective: To determine the interrelationship of left ventricular (LV) mass, systolic function and diastolic relaxation in morbidly obese subjects.

Method: We obtained echocardiograms (M-mode, two dimension) and cardiac Doppler studies (pulse wave, continuous wave colour flow) on 50 subjects whose actual body weight was > or = twice ideal body weight. LV mass/height index was calculated from echocardiographic data (Penn Convention).

Prevalence of intraatrial thrombus in patients with atrial flutter.

In summary, left atrial thrombus occurs with disproportionately high frequency in patients hospitalized with atrial flutter. Male gender and a left ventricular ejection fraction < 40% are predictors of left atrial thrombus formation in such patients.

Psychiatry Today : Biology vs. Psychology.

This research addresses preferences and theoretical leanings of present-day psychiatrists along the continuum defined at one end by biology and at the other by psychology. A questionnaire was devised and sent to 5,702 randomly selected members of the American Psychiatric Association in 1990. The response rate was 307%.

The prevalence of rheumatologic disorders in patients with chest pain and angiographically normal coronary arteries.

The purpose of this study was to determine the prevalence of musculoskeletal disorders in patients with chest pain and angiographically normal coronary arteries. The authors studied 40 consecutive patients with chest pain presenting at an Internal Medicine Clinic who had undergone coronary angiography and were found to have < 30% stenosis of all major coronary arteries. Patients with any known noncardiac cause of chest pain were excluded from the study.

Continuous ambulatory peritoneal dialysis and the heart.

Objective: To review clinical research pertaining to continuous ambulatory peritoneal dialysis (CAPD) and the heart.

Data Sources: A Medline computer search was employed to identify appropriate references from 1970 - 1994. Indexing terms were: continuous ambulatory peritoneal dialysis, hemodialysis, heart or cardiac, left ventricle, coronary artery disease, and survival.

Pathogenesis, recognition, and management of common cardiac arrhythmias. Part I: Ventricular premature beats and tachyarrhythmias.

Cardiac arrhythmias are disorders of impulse formation, impulse conduction, or both. Part I of this two-part review discusses clinically relevant cardiac electrophysiology, as well as the pathogenesis, recognition, and management of ventricular premature beats and ventricular tachyarrhythmias. Part II will review the pathogenesis, recognition, and management of supraventricular premature beats and supraventricular tachyarrhythmias.

Cues to the assessment of affects and moods: speech fluency and pausing.

Clinicians' rating of the negative syndrome of schizophrenia are highly correlated with the rate and duration of the patient's pauses. To test the degree to which pausing provides the cue for clinicians' impressions we selected audio recordings of interviews with schizophrenic patients who showed moderate levels of negative signs and, through the use of a computerized digital editor, transformed the recordings by either doubling or halving the duration of all of the patient's pauses. Other aspects of the patients' speech were unchanged.

Clinical and acoustic measures of the negative syndrome.

We studied 12 male schizophrenia patients in a 6-week treatment trial comparing two neuroleptics and placebo. Efficacy in regard to negative symptoms was of interest, and Alphs' Negative Symptom Assessment (NSA) was included. The NSA includes behaviorally anchored ratings such as "prolonged time to response" and "restricted speech output.

The syntactic role of pauses in the speech of schizophrenic patients with alogia.

This study examines the relation between alogia and pausing. The authors analyzed the flow of speech of 17 male schizophrenic patients during an interview, particularly the pauses that occurred within and between syntactic clauses and those that occurred as the turn switched from the interviewer's question to the patient's response. The strongest predictor of alogia ratings was the duration of switching pauses; the frequency of long within-clause pauses was also significantly related to alogia, but the frequency of between-clause pauses showed a trend toward a negative relation with alogia.

A multimethod, multichannel assessment of affective flattening in schizophrenia.

Flat affect was examined across multiple contexts (during interviews and emotional films), multiple channels of expression (facial and vocal), and different assessment techniques (clinical ratings, observational ratings of facial expression, and acoustic analyses) in 23 medication-free schizophrenic patients. Patients participated in three different interviews during which either clinical ratings were made or their voices were audiotaped for later acoustic analyses. Patients were also videotaped while they viewed positive and negative emotional films.