Effects of suggestion on total respiratory resistance in mild asthmatics

Thirteen mild asthmatics were given inhalations of saline (described as either a neutral substance or a bronchoconstrictor) and Isuprel (described as either a bronchodilator or a bronchoconstrictor). Measurements of Total Respiratory Resistance (R_T) were taken before and after each inhalation. Following inhalations of saline described as a bronchoconstrictor, four subjects evidenced increases in R_T of 20 per cent or more (beyond their responses to saline described as a neutral substance). Some evidence was found of attenuation of the bronchodilative effect of Isuprel when it was described as a bronchoconstrictor. These data corroborate the findings obtained in other investigations, that one subgroup of the asthmatic population responds mainly to the pharmacological effect of the inhalant, while the other subgroup responds to its suggested effect. The observed bronchial changes could not be attributed to the stimulus value of the measurement technique.     

Behavioural aspects of Pollitt syndrome: a 32-year follow-up of a case described by R. J. Pollitt and colleagues in 1968

In 1968, R. J. Pollitt and colleagues described a syndrome characterized by abnormally brittle, sulphur‐deficient hair (trichothiodystrophy), intellectual disability (ID) and growth retardation. One of the two siblings originally described by the above authors has recently been re‐assessed by the present authors following a referral for advice about ritualistic behaviours. Her current clinical features are described, and the literature concerning trichothiodystrophy and ID is summarized.     

Did Antonio Vallisneri (1661–1730) really describe frontal sinus osteoma? Unexpected insights for paleo-neuroparasitology

It has been believed for a long time that the Paduan scholar Antonio Vallisneri (1661–1730) described the second historical case of the frontal sinus osteoma in 1733. By historico-medically reexamining this case, we conclude that the brain concretions he described were not a case of frontal sinus osteoma, while they appear to have been pathological outcomes of neurocysticercosis, whose larval stages would only be described by Johann Goeze (1731–1793) later, in 1784. Thus, this case becomes relevant for the history of neuroparasitology.     

Down's syndrome and fragile-X syndrome in a single patient

ABSTRACT. A profoundly mentally handicapped patient is described with the karyotype 47,X, fra (X) (q27), + 21. Her phenotype demonstrates features of both Down's Syndrome and fragilc-X syndrome. The authors believe only one other similar case has been described.     

Electroconvulsive Therapy in the Medically Ill Elderly

Treatment with electroconvulsive therapy (ECT) of medically ill geriatric patients with affective disorders is described. Of 135 patients to whom ECT was administered in 6 years, 55% were over 60 years of age. One-third (45) exhibited cardiovascular (62%), central nervous system (15%), or other medical conditions (22%) increasing the risks of the treatment. Treatment strategies are described.     

N-Methyl D-aspartate receptor antibody encephalitis associated with myelitis

Encephalitis associated with antibodies to the N-methyl D-aspartate receptor (NMDA-R) was first described in young women with ovarian teratoma. It has subsequently been described in men, children and in those without an underlying tumour. Characteristic clinical features include neuropsychiatric symptoms, seizures, movement disorders, hypoventilation and autonomic instability. Spinal cord disease in association with other typical clinical features has been described in only one patient previously. We report a patient presenting with myelitis, with typical features of NMDA-R associated encephalitis manifesting 3 months later.     

Fisher syndrome. An infantile case

A case of acute onset of partial ophthalmoplegia, ataxia and areflexia in a child is described. This case closely resembles those described by Fisher (Fisher syndrome). Clinical data, also in relation to the few cases previously reported, are discussed.     

An examination of leading mental health journals for evidence to inform evidence-based practice

OBJECTIVE: This study examined whether data needed to inform evidence-based practice can be found in leading mental health journals. METHODS: Research studies described in articles that were published in 12 leading mental health journals in 1999 were examined to determine whether they evaluated clinical interventions, used rigorous designs, were conducted in routine practice settings, and included well-defined diagnostic groups and heterogeneous samples. RESULTS: Twenty-seven percent (N=295) of the 1,076 articles that were reviewed described research that evaluated interventions. Of these 295 articles, 64 percent evaluated pharmacologic interventions and 33 percent evaluated psychosocial or psychotherapeutic interventions. Of the articles that evaluated interventions, 60 percent described randomized designs, but samples were modest; 25 percent of the studies reported 31 or fewer participants. Of the 295 articles, 84 percent described studies conducted in specialty mental health settings; very few (4 percent) described studies conducted in public mental health or managed care environments, which are common practice settings. Most samples were diagnostically well defined, but evidence of treatments for diagnoses other than schizophrenia and mood disorders was limited. CONCLUSIONS: This systematic review suggested that data needed to inform and advance evidence-based practice does not have the prominent place it deserves in leading journals. Only a quarter of the research studies that were examined evaluated clinical interventions, and articles that described pharmacologic interventions were published twice as often as articles that described psychosocial or psychotherapeutic interventions. Rigorous research designs predominated, but sample sizes were modest. Evidence was scarce on treatment effectiveness in routine practice settings.     

Association of schizophrenia and partial trisomy of chromosome 5p. A case report.

A normal balanced chromosome 5 translocation carrier (5:14) (p14.1; q32.3) produced one offspring with a 5p deletion syndrome (cri du chat syndrome) and two with a partial trisomy (one with schizophrenia and the other with refractory epilepsy). We had hypothesized that the translocation might be complex and involve 5q, overlapping with a schizophrenia associated area described by Bassett et al., (1988). Cytogenetic study, however, indicated that there was no overlap in the involved chromosome 5 trisomy for this individual with schizophrenia and the trisomic region previously described. The probands with the trisomy and the cytogenetic findings are described in this report. Alternative interpretations are suggested to explain the association of schizophrenia and chromosomal abnormalities.     

Tibial muscular dystrophy. A rare form of distal myopathy]

Tibial muscular dystrophy (TMD) is a dominantly inherited late onset distal leg myopathy only described in the Finnish population as yet. A similar disorder was described by Markesbery et al. in 1974 in one American family. Assignment of the TMD locus to chromosome 2q31 has been demonstrated (Haravuori et al., 1998). We recently described a French family with clinical and laboratory findings similar to TMD (de Seze et al., 1998). Molecular genetic results indicate that the distal myopathy in this family could be linked to the TMD locus confirming TMD exists outside the Finish population. This overview of TMD will allow to describe differential diagnoses such as other distal myopathies and scapuloperoneal syndromes.     

Benign idiopathic partial epilepsies in infancy.

In infancy, partial epilepsies have been considered with suspicion for their probable association with brain lesions. Japanese authors first described partial epilepsies in infancy with a favorable outcome and called them benign partial epilepsy in infancy with complex partial seizures. Similar, but familial, cases with onset during the first year of life were described some years later and called benign infantile familial convulsions. Similar familial cases with subsequent choreoathetosis were described in 1997 and called infantile convulsions and choreoathetosis. Benign infantile convulsions have also been described in association with mild gastroenteritis. Interictal electroencephalography (EEG) was always normal in all of these forms. More recently, a new epileptic syndrome characterized by partial seizures with onset between ages 13 and 30 months, a benign outcome, and characteristic EEG abnormalities in the vertex regions during sleep has been described. There is also an early-onset benign childhood occipital seizure susceptibility syndrome that can start in infancy.     

Surgical experience of minipterional craniotomy with 102 ruptured and unruptured anterior circulation aneurysms

The pterional approach was described in the 1970s and has become the most utilized cranial approach with many variations described, including the minipterional technique. Although described recently as an alternative to the pterional approach for anterior circulation aneurysms, to our knowledge a large series of cases using the minipterional approach in both ruptured and unruptured aneurysms has not been described. We present our clinical experience with the minipterional craniotomy in more than 100 ruptured and unruptured anterior circulation aneurysms. The results of 86 consecutive patients with 102 ruptured non-giant, anterior circulation aneurysms treated with early surgery utilizing the minipterional craniotomy were analyzed. Postoperative angiography was carried out in all cases. Outcome results were classified as excellent in 67 (77.9%), and good in seven (8.1%), while 16 (13.9%) patients died. The minipterional technique provides adequate surgical exposure and excellent outcomes for both ruptured and unruptured anterior circulation aneurysm clipping. It constitutes a safe and effective alternative to the pterional approach, with equivalent or potentially better aesthetic and functional outcomes.     

Alien hand and leg as the presenting feature of probable sporadic Creutzfeldt-Jakob disease: A rare presentation of a rare disease

Sporadic Creutzfeldt-Jakob disease (sCJD) can have varied clinical presentation depending upon the genotype at codon 129. The common presenting clinical features of sCJD are rapid onset cognitive impairment, ataxia, psychosis and visual signs (field defects, distortion, cortical blindness). Alien limb sign was first described in patients with corpus callosal tumors and later with other neurodegenerative conditions like corticobasal degeneration. Alien hand complaints as the presenting feature of sCJD has been described in literature, but simultaneous alien hand and leg has been rarely described as presenting feature of sCJD. We describe here a case of a 55-year-old man who presented with progressive left alien hand and leg as the sole clinical manifestation of probable sCJD.     

The tarsal tunnel syndrome after a proximal lesion.

Three patients in whom the first symptoms of the tarsal tunnel syndrome (TTS) emerged after an acute event proximal to but not affecting the ankle are described. These patients suggest that a pre-existing asymptomatic TTS may become manifest after a mechanism akin to that described in the "double crush" syndrome.     

Unwanted intrusive images in obsessive compulsive disorders

The nature and content of intrusive images in obsessional compulsive disorders (OCD) are described. They are primarily visual, usually vivid, effortless, fully formed, of brief duration, and remarkably stable. The persistence and changes of the images are described and some therapeutic possibilities considered.     

Pre-menarchal bulimia nervosa.

Although pre-pubertal anorexia nervosa has been well described, pre-pubertal bulimic behaviour in the context of this disorder appears to be uncommon. There have been no published reports of pre-pubertal bulimia nervosa occurring independently. Of 323 patients with bulimia nervosa attending an eating disorders research clinic between 1980 and 1989, the authors identified six patients who described pre-menarchal binge eating in the absence of a concurrent history of anorexia nervosa or massive obesity. Three (0.93%) of these patients described a pre-menarchal onset of bulimia nervosa, but there was no evidence that they were pre-pubertal. The implications of these findings are discussed.     

Differential influence of local anesthetic upon two models of experimentally induced peripheral mononeuropathy in the rat

Neuropathic pain remains a major complication of various forms of injury to peripheral nerves in humans. Recently, 2 models of peripheral mononeuropathy in the rat have been described which closely resemble the human condition. Bennett and Xie described one model induced by the placement of 4 loose ligatures around the entire sciatic nerve; Seltzer et al. have described a second model produced by the placement of a tight ligature around one-third to one-half of the sciatic nerve. It is the purpose of this work to compare the effect of these injuries on the time course and magnitude of hyperalgesia as measured by paw withdrawal latency to a radiant heat stimulus. In addition, to evaluate the hypothesis that neuropathic pain develops as a result of injury-associated discharges, some injuries were induced following anesthesia of the sciatic nerve. Our results show that the partial constriction neuropathy (PCN) described by Bennett and Xie develops in a faster time frame than that produced by the tight ligature, or partial transection neuropathy (PTN), described by Seltzer and co-workers. In addition, the PCN shows a reduction in both the duration and magnitude of behavioral hyperalgesia obtained for those animals in which local anesthetic (lidocaine) was applied to the sciatic nerve, while the PTN does not show this sensitivity. The data suggest that injury-related discharge is one important factor contributing to the generation of hyperalgesia in the PCN model. The mechanism(s) responsible for the generation of hyperalgesia in the early stages of the PTN model are not lidocaine-sensitive. The data are discussed in reference to the previously reported differences in these models of hyperalgesia and the involvement of central changes.