Electrocardiographic appearance of a non-Q wave acute myocardial infarction in a patient with thyrotoxicosis. A case history

A patient with severe thyrotoxicosis developed the typical electrocardiographic (ECG) evolution of a non-q myocardial infarction. This occurred without evidence of myocardial necrosis and in the absence of coronary artery disease. Treatment with beta blockers resolved the ECG changes despite the persistence of the thyrotoxic state.     

Research in the community cauldron: A case history.

This paper considers a series of natural hazards that community researchers must face, including: being a "foreign body" to the system under examination; the time-consuming, longitudinal demands of studies in this area; the dangers of program instability and change; the need for community accountability; and the pro-action, anti-research orientation of many community program personnel. These hazards lead to riskier studies and to research that falls short of traditional standards of scientific rigor. However, unless investigators are willing to gamble with less precise, less well controlled approaches, and to build knowledge through gross successive approximations, many significant, exciting problems of community psychology will not be studied. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A neuropsychological investigation of multitasking in HIV infection: Implications for everyday functioning.

Objective: A subset of individuals with HIV-associated neurocognitive impairment experience related deficits in “real world” functioning (i.e., independently performing instrumental activities of daily living [IADL]). While performance-based tests of everyday functioning are reasonably sensitive to HIV-associated IADL declines, questions remain regarding the extent to which these tests' highly structured nature fully captures the inherent complexities of daily life. The aim of this study was to assess the predictive and ecological validity of a novel multitasking measure in HIV infection. Method: Participants included 60 individuals with HIV infection (HIV+) and 25 demographically comparable seronegative adults (HIV?). Participants were administered a comprehensive neuropsychological battery, questionnaires assessing mood and everyday functioning, and a novel standardized test of multitasking, which involved balancing the demands of four interconnected performance-based functional tasks (i.e., financial management, cooking, medication management, and telephone communication). Results: HIV+ individuals demonstrated significantly worse overall performance, fewer simultaneous task attempts, and increased errors on the multitasking test as compared to the HIV? group. Within the HIV+ sample, multitasking impairments were modestly associated with deficits on standard neuropsychological measures of executive functions, episodic memory, attention/working memory, and information processing speed, providing preliminary evidence for convergent validity. More importantly, multivariate prediction models revealed that multitasking deficits were uniquely predictive of IADL dependence beyond the effects of depression and global neurocognitive impairment, with excellent sensitivity (86%), but modest specificity (57%). Conclusions: Taken together, these data indicate that multitasking ability may play an important role in successful everyday functioning in HIV+ individuals. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Computer-assisted training in genetically-induced neuropsychological deficits. A case report of a patient with de Grouchy syndrome I (chromosome 18 p syndrome)

The present case study is a report on computer-based training approach in a male patient suffering from the de-Grouchy syndrome I (with a characteristic chromosomal deletion pattern), who along with psychotic symptoms displayed neuropsychological deficits. Participating in a well-established intervention programme aimed at a broad spectrum of psychological functions, the patient went through 36 training sessions. With regard to outcome assessments one focus was on improved performance in the training tasks, while the other one referred to transfer effects, as indexed by a neuropsychological test battery which was given before and after the entire programme. In both areas substantial gains from training emerged according to the collected data. In view of these results neuropsychological training approaches appear to have a perspective even in behavioural deficits with a genetic basis.     

Fusiform P1 segment artery aneurysm in a pediatric patient: technical case report

We report a case of cavernous sinus thrombosis in an 8-year-old boy, following a neglected and untreated nasal furuncle. This rare entity is manifested by hyperthermia, with headache, vomiting and involvement of the III-IV & VI cranial nerves. It is usually a complication of a facial infection. The diagnosis is established by CT-Scan or MRI. Without appropriate and early treatment, the prognosis is poor, with a fatal outcome or severe sequelae.     

A neuropsychological investigation into frontal lobe involvement in dementia of the Alzheimer type.

Studied frontal lobe involvement in dementia of the Alzheimer type (DAT) using 4 neuropsychological tests (verbal fluency, delayed alternation, subject-ordered pointing, and the Wisconsin Card Sorting Test) in 25 patients suffering from DAT and 12 age-matched normal controls. The first 3 tasks demonstrated that a frontal lobe impairment is present at all stages of the disease and is related to disease severity. Results offer information regarding the frontal component in DAT by providing neuropsychological support for the findings of an anterior pathology as reflected in blood flow and metabolism studies. The need for suitable frontal tasks with minimal memory involvement in the study of dementia is emphasized, and the delayed alternation task is recommended. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Taking a history of the patient with diplopia

The diagnosis and treatment of adult diplopia is challenging. Having a thorough and complete history of the patient can make this difficult process easier. This article describes the most important questions to ask when taking the history of a patient with diplopia and explains why a particular question is essential. Tips of what to search for in the patient's answers are also provided.     

Cholera in a Paris resident with no history of travel. A case report

BACKGROUND: Cases of imported cholera are frequently observed, but cholera almost never occurs in subjects who have never travelled to an endemic area. In the last 30 years, 4 cases have been reported. We report an indigenous case diagnosed in Paris in September 1996. CASE REPORT: The patient was hospitalized for severe dehydration and acute renal failure. Cultures of a fecal specimen grew Vibrio cholerae O1 Ogawa serotype. An epidemiological study was conducted to identify the vehicle and mode of contamination and suggested that this case was associated with the consumption of fresh sorrel imported from West Africa. No other cases were identified in contacts of the patient. DISCUSSION: Asymptomatic carriage of V. cholerae is rare. However, air travel has allowed people to arrive in non-endemic areas during the incubation period. The agent may also be transported in contaminated foods. Cholera should be suspected in all adults presenting acute watery diarrhea with severe dehydration. History taking should also look for risk exposure and these patients should be systematically asked about possible exposures.     

A clinical psychologist's work with a severely brain damaged patient: A case study.

A clinical psychologist describes his relationship with a 26-yr-old hospitalized male patient severely handicapped by extensive brain stem damage. The importance of that relationship to the patient, his family, and the psychologist is discussed. (1 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reduction of cyclosporine-induced gingival overgrowth following a change to tacrolimus. A case history involving a liver transplant patient

The authors present a case of a mandibular neurilemmoma discovered on routine radiographic examination of an asymptomatic young woman. The lesion was surgically removed and there was no radiographic evidence of recurrence. A review of the literature is presented and the differential diagnosis, prognosis and treatment of this benign neurogenic tumor are discussed.     

Posttraumatic stress disorder in a patient with no left amygdala.

Existing biological models of posttraumatic stress disorder (PTSD) posit that the amygdala plays a critical role in the development and expression of this disorder. However, increasing data indicate that the amygdalae are not functionally identical, raising the possibility that the 2 amygdalae may make differential contributions to the expression of PTSD. The authors present a unique patient who developed PTSD following a traffic accident that occurred 2 years after she had undergone removal of her left amygdala to treat pharmacologically intractable epilepsy. The authors propose that the right amygdala is preferentially involved in several processes related to the expression of PTSD symptoms, such that the disorder can occur even in the absence of the left amygdala. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A reconstruction of the left ventricle for post infarction left ventricular aneurysm complicated by ventricular septal perforation--a case report

The aging of bitemarks through the subjective interpretation of visual signs has created an area of controversy in the forensic science community. The healing dynamics of these bite wounds has been insufficiently studied and is poorly understood. A review of the literature related to bitemark aging was undertaken in an effort to summarize the currently published information on this misunderstood subject.     

Distinguishing left ventricular aneurysm from pseudoaneurysm. A review of the literature

A postmyocardial infarction left ventricular pseudoaneurysm occurs when a rupture of the ventricular free wall is contained by overlying, adherent pericardium. A postinfarction aneurysm, in contrast, is caused by scar formation resulting in thinning of the myocardium. Although the usual treatment for patients with pseudoaneurysm is urgent surgical repair, the imaging characteristics of pseudoaneurysm and aneurysm, for which treatment is more conservative, are quite similar. The literature on the natural history and imaging characteristics of the two entities is reviewed, and an approach to distinguishing between the two entities is proposed.     

Ruptured aneurysm of the sinus of Valsalva into the left ventricle: a case report and review of the literature

This report describes a case of right coronary sinus of Valsalva aneurysm which ruptured into the left ventricle. The diagnosis was made with two-dimensional transthoracic echocardiography which showed an abnormal structure extending from the aortic root into the left ventricle adjacent to the interventricular septum. Subsequent examinations with transesophageal echocardiography and aortic root angiography and surgical findings confirmed the diagnosis of transthoracic echocardiography. The patient underwent aortic valve replacement. At follow-up 12 months later, the patient was without symptoms and repeated echocardiographic examinations showed no recurrence.     

One-day test-retest reliability of neuropsychological tests in a personal injury case.

The difficulties inherent in differentiating practice effects from meaningful changes in neuropsychological retest data are well known to clinicians. Although gross actuarial guidelines are available on the basis of group studies, the application of such information to individual cases presents many interpretive complexities. This is particularly true when litigation is involved or the retest interval is very short. The case presented here involved examinations performed independently on successive days by 2 diplomate neuropsychologists. The majority of tests produced clinically equivalent results in both examinations. Increases of more than 2 SEMs were found on only 4 measures in the retesting and were associated with practice effects. Both neuropsychologists independently concluded that the examination did not reveal neuropsychological impairment, suggesting that clinical prediction is possible and may be valid in the forensic context. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Internal versus external control of reinforcement: A case history of a variable.

In this article the construct of generalized expectancies for internal vs external control of reinforcement is used as a model to present a brief on the importance of broad theory and training in theory construction and evaluation in psychology. Specifically, the extraordinary heuristic value of this construct is attributed to 4 characteristics: the nature of the definition, the careful imbedding of the construct in a theoretical context, the use of a broad behavior theory in construction of a measure of individual differences, and the programmatic nature of the original research as well as the format of the early publications. Reevaluation of the characteristic criteria for publication of research studies and for the evaluation of promotion or advancement for psychologists involved in research activities is also discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)