bluuebunny/crossref_metadata_2025_split huggingface dataset:
Insulin Coma Therapy of Schizophrenia: Some Critical Remarks on Dr. Sakel's Report
Authors: Mayer-Gross W. 
Published: August 2008

From Dr. Sakel's address there emerge two questions regarding the indications for insulin treatment in the psychoses which are worth discussing on this occasion:(1) General indications for the treatment: Should every case of schizophrenia undergo insulin therapy, i.e., be admitted to a hospital as soon as the illness has been diagnosed ?(2) Special indications and procedure: What is the role of convulsions in insulin therapy ? What proof is there of the presumed antagonism between coma and convulsion ? Are there any facts supporting the idea that insulin fixes the results of convulsion therapy ?
The Psychiatric Aspects of Temporal Arteritis
Authors: Vereker R. 
Published: August 2008

Temporal arteritis, also called giant cell arteritis, or cranial arteritis, was first described in 1932 by Horton and Magath. This syndrome is caused by a reversible inflammation of the cranial arteries, especially the temporal arteries (which are visibly inflamed), causing headache, mental and neurological disturbances as well as general toxic signs, and almost always occurring after the age of fifty-five years.Pathology.—In the arteries involved there is a subacute inflammation of the adventitia and media with focal necrosis of the media, fragmentation and destruction of the internal elastic lamina with gross hypertrophy of the intima, often leading to occlusion of the vessel. In many cases giant cells are found in the media. Besides the cranial arteries other vessels are sometimes involved, e.g., the carotids (Scott and Maxwell 1941; Gilmour 1941), subclavian, coronary and femoral arteries (Cookeet al., 1946), post-auricular (Dick and Freeman 1940).Aetiologyis unknown. There is no evidence of tuberculosis or syphilis. A low-grade bacterial or virus infection of the arteries has been postulated, but repeated bacteriological examinations of the biopsied arteries have failed to isolate any organisms. The predilection which the condition shows for the temporal and cranial arteries is unexplained.
An Investigation of the Adrenocortical Response of Mental Patients to E.C.T. and Insulin Hypoglycaemia
Authors: Shattock F. Mackenzie , Micklem Lorna P. 
Published: August 2008

Somatic disturbances in schizophrenia include metabolic, circulatory and endocrine changes frequently associated with disorders of the pituitary gland and adrenal cortex. Depression of the metabolic rate is often severe (Hoskins, 1932), the systolic blood-pressure is sometimes as low as 80 mm. Hg (Hoskins, 1934; Rheingold, 1939; Shattock, 1950), and the pulse pressure only a few millimetres. Peripheral vascular deficiency and atrophy of the tissues (Bleuler, 1920; Mapother, 1924; Minski, 1937; Shattock, 1950), asthenia and various cutaneous changes are common; amenorrhoea is almost the rule.It is remarkable that these disturbances are reversible, and that they are relieved or greatly alleviated during mental remission. Physical health is restored during a spontaneous remission, and a gradual improvement can be observed during a course of insulin comas. Sometimes a dramatic recovery follows electroconvulsion when this initiates a mental remission; somatic improvement is then rapid and the vascular deficiency may be relieved within a few hours (Shattock, 1950). Unfortunately these remissions are often brief, and as relapses become more frequent after repeated treatment, physical and mental deterioration may be noticeable a few days after the initial improvement. The point of interest is a concordance of physical and mental changes, and not the therapeutic value of E.C.T. used as an adjunct to insulin treatment or as a means of moderating extreme restlessness in chronic patients.
The Effect of Sex Hormones in Oligophrenia
Authors: Rudolf G. de M. 
Published: August 2008

The intelligence, as measured by standard tests, ceases growing after about 14 or 16 years of age, and slowly decreases from about 25 or 30 years of age (Wechsler, 1945). The sex glands are developing as the intelligence ceases to develop.In view of these observations, consideration was given to the possibility that the defective developed mentally to a degree below the normal because too great a quantity of the appropriate sex hormones was circulating in the blood stream. In consequence, the opposite hormone was administered, stilboestral being given to males and pernandren to females.
Schizophrenia: A New Approach
Authors: Osmond Humphry , Smythies John 
Published: August 2008

Mr. Gladstone, with that candour which a great Statesman can afford, once said, “Government is a rough business, and the results are most unsatisfactory.” Unfortunately no great psychiatrist has described the present state of our knowledge and treatment of schizophrenia in an equally robust phrase; but surely, “rough business and unsatisfactory results” would not be an unfair summing up ?We have now known of this illness for nearly half a century, and yet our understanding of it is slight and our useful information scanty. This is not because we have been idle, but because our efforts have been poorly rewarded. Thousands of papers are written every decade; tens of thousands of observations are made; there is no lack of opportunity for studying patients when about one hospital bed in five in this country is occupied by a schizophrenic, yet we are still entirely ignorant of the cause of this disease. There are, it is true, numerous theories, but none is generally accepted. We have one form of treatment, deep insulin, which produces remission of symptoms in some cases and what seems to be a cure in others, but even the value of this treatment is hotly disputed. Because deep insulin is a purely empirical procedure the psychiatrist is always tempted to become preoccupied with details of technique so that he forgets, or at least becomes less aware of our fundamental ignorance.
A Comparative Study of the Causation of Mongolism, Peristatic Amentia, and Other Types of Mental Defect
Authors: Engler M. 
Published: August 2008

Mental deficiency has been defined by Tredgold as a state of arrested or incomplete development of the mind. Numerous scientists have for long endeavoured to ascertain the cause or causes of this frequent abnormality. The protagonists of one school of thought made exaggerated claims that the great majority, if not all cases, were due to hereditary factors. Other investigators were able to demonstrate that certain special types of mental defectives owed their deficiency to agents acting after fertilization, and so came to the conclusion that genetic elements were only concomitant and not primary causative factors in many, if not in all types of defectives, and that research on these lines should eventually establish extrinsic causation in all these cases.Thus one has gradually come to distinguish between two main groups of mentally abnormal individuals; those in whom endogenous or hereditary factors could be proved or at least suspected. (Tredgold speaks of primary aments, Strauss of endogenous types, and those in whom exogenous noxious influences could be demonstrated or suspected, and whom Tredgold termed secondary aments, Strauss calls exogenous types.) According to Tredgold and many other investigators, from between 70 to 80 per cent. of all defectives are to be found in the first group, while roughly 20 to 30 per cent. belong to the second. Penrose's figures in support of a hereditary causation are even higher.
“Psychiatry Ltd.”
Authors: Curran Desmond 
Published: August 2008

I am satisfied one of the results, if not the objective, of medical education is for doctors to judge their success, or the state of progress of any branch of medicine, against a pathological rather than a sociological criterion. This is the inevitable effect of the amount of time and attention given to pathology in the medical curriculum, and is further reinforced by what is asked in examinations.Traditionally, the problem for the doctor is to try to determine the pathological lesion, using this term at best in a wide sense, and to control this if he can; and the pathological criterion of disease he has in mind is an objective physical criterion, demonstrable in life or after death.As we all know, no pathological lesion in this traditional sense is demonstrable in a large number of patients who go, or are brought, to see doctors. All physical examinations and investigations prove negative. Medicine is therefore faced with the dilemma in these cases of either (a) coming to the conclusion that there is nothing wrong, which is often clearly untenable, or (b) of expanding its scope almost indefinitely to cover every type of maladjustment.
A Preliminary Report on Fatigue and Pain Tolerance in Depressive and Psychoneurotic Patients
Authors: Hemphill R. E. , Hall K. R. L. , Crookes T. G. 
Published: August 2008

Pain and fatigue, subjectively experienced, are two of the commonest complaints made by patients suffering from a variety of psychoneurotic and psychotic disorders. Neither phenomenon has so far been adequately studied with the available objective techniques, and the present paper embodies results of preliminary experimental investigations of fatigue and pain tolerance, together with a review of some of the clinical aspects of the problem.In psychiatric disorders pain rarely produces overt signs which allow the observer to judge its severity, and the excruciating pain complained of by some patients appears to be accompanied by much less emotional reaction than, for example, the pain experienced by the normal individual after a burn, a crushed finger, or an abdominal catastrophe.
Experiments on the Prolongation of Induced Epileptiform Convulsions in the Cat
Authors: Ruf Hugo 
Published: August 2008

THE present paper offers a brief summary of work which has been published in German journals dealing with the prolongation of induced convulsions. In the course of my experimental research the following phenomena were demonstrated:(1)Continuousconvulsionslastingup to oneand a half hours were produced by the administration of oxygen and adrenaline, preceded by the injection of phenyl-methyl-aminopropane.(2)Prolonged convulsions of 33 minutes were produced by the intravenous injection of 2 ml. of a io per cent. metrazol solution and continuous oxygen in suffiation.(3)Isolated continuous convulsive activity of the cerebellum was produced lasting 30 minutes after cessation of respiration and of all cortical electrical activity. This was achieved by continuous insuffiation of oxygen together with the injection of adrenaline and strychnine.(4)Activation of a prolonged convulsion up to 11 minutes, without further electric stimulation, was effected via the thalamus by the injection of adrenaline after administration of phenyl-methyl-aminopropane and continuous oxygen in sufflation.
Studies in Schizophrenia: II. Estimation of Serum-Cholesterol
Authors: Fleischhacker H. H. , Bullock F. N. 
Published: August 2008

IN a previous paper (Bullock, Clancey and Fleischhacker, 1951) an attempt was made to separate schizophrenic reaction syndromes, due to diagnosable and often successfully treatable disease of known etiology, from idiopathic or cryptogenic schizophrenia. It was shown that the criteria of idiopathic schizophrenia are—(1)Positivey: (a) Mentally, the classical symptoms of inadequacy and inappropriateness : of thought (paralogia), of affect (parapathema), to which one may add of volition (paraboulema), usually accompanied by hallucinations, paranoid ideas, etc.(b) Physically, a slightly pathological C.S.F., due essentially to an increase of the globulin fraction.(2)Negalively: the absence of generally acknowledged organic disease of the brain, or any physical disease which is known to produce such disorders of the central nervous system or the C.S.F., as mentioned under (i).
Some Clinical and Aetiological Aspects of Depersonalization with a Case Report of Identical Twins
Authors: Robin Ashley A. , Harrison E. J. 
Published: August 2008

A search of the literature has not revealed a report of the depersonalization syndrome occurring in identical twins, although Palmer (1946) published a report of twins in which one patient was described as suffering from “all round loss of interest with some depression…. His thoughts … milled round in a ceaseless turmoil concerning his loss of contact with people and things. There was some complaint of unreality and loss of sexual desire…. His condition was one of distressed perplexity. The illness had come on gradually.” The second patient had “tried to get his twin brother to ‘pull himself together,’ when one Saturday he became intoxicated and for a wager attempted bestiality. He woke up next morning feeling unutterably guilty and depressed, and rapidly developed feelings of unreality. His compelling symptom was the fear that his mind was disintegrating.”These cases appear essentially depressive and progressed to a woeful, hypochondriacal state six years later.
Salivary Cortisol Is Related to Atherosclerosis of Carotid Arteries
Authors: Dekker M. J. H. J. , Koper J. W. , van Aken M. O. , Pols H. A. P. , Hofman A. , de Jong F. H. , Kirschbaum C. , Witteman J. C. M. , Lamberts S. W. J. , Tiemeier H. 
Published: August 2008

Background: Dysregulation of the hypothalamic-pituitary-adrenal axis has been suggested as an independent risk factor for ischemic heart disease. The aim of our study was to evaluate whether two markers of the hypothalamic-pituitary-adrenal axis activity, the level of salivary cortisol and the diurnal salivary cortisol pattern, are associated with atherosclerosis of the carotid arteries in an elderly population.
Methods and Results: A total of 1866 participants of the Rotterdam Study, a population-based cohort study in the elderly, provided four salivary cortisol samples throughout 1 d, and underwent ultrasonography to examine the presence of plaques in the common, internal, and bifurcation sites of both carotid arteries. Two summary measures of the separate cortisol values were computed: area under the curve (AUC), which is a measure of total cortisol exposure while awake; and the slope, which is a measure of diurnal cortisol decline.
Results: Total cortisol exposure while awake (AUC) was associated with higher plaque scores (β = 0.08 per sd of AUC, 95% confidence interval 0.00–0.16; P = 0.04) in a fully adjusted linear regression model. Persons with an AUC in the highest tertile had a higher number of plaques of carotid arteries compared with those in the lowest tertile (3.08 vs. 2.80, 95% confidence interval of difference 0.09–0.48; P = 0.005). There was no relation between diurnal cortisol decline and plaque score.
Conclusion: Our results support the hypothesis that increased total cortisol exposure is independently associated with atherosclerosis of the carotid arteries.
Pentanucleotide Repeat Polymorphism, Lipoprotein(a) Levels, and Risk of Ischemic Heart Disease
Authors: Kamstrup Pia R. , Tybjærg-Hansen Anne , Steffensen Rolf , Nordestgaard Børge G. 
Published: August 2008

Context: Lipoprotein(a) is a cardiovascular risk factor. Levels of lipoprotein(a) are predominantly determined by apolipoprotein(a) gene variation, including a pentanucleotide repeat promoter polymorphism.Objective: We tested the hypothesis that apolipoprotein(a) pentanucleotide repeat genotype predicts elevated lipoprotein(a) levels and risk of myocardial infarction (MI) and ischemic heart disease (IHD) in the general population.Design: We used a cohort study of the Danish general population, The Copenhagen City Heart Study, including 10,276 individuals of which 860 and 1,781 developed MI and IHD, respectively, during up to 31 yr of follow-up, and a case-control study including 1,814 IHD patients and 5,076 controls. Follow-up was 100% complete.Results: Allele frequencies were 0.0018, 0.0018, 0.6750, 0.1596, 0.1465, 0.0146, and 0.0004 for 6, 7, 8, 9, 10, 11, and 12 repeats, respectively. Mean lipoprotein(a) levels were 40, 36, and 27 mg/dl for individuals with 14–15, 16, and 17–22 repeats (sum of repeats on both alleles), respectively (trend, P &lt; 0.001). Cumulative incidence of MI and IHD was increased for individuals with 14–15 vs. at least 16 repeats (log rank, P &lt; 0.001 and P = 0.002). Multifactorially adjusted hazard ratios for 14–15 and 17–22 vs. 16 repeats were 3.1 (95% confidence interval, 1.6–5.8) and 1.0 (0.9–1.2) for MI and 2.2 (1.3–3.6) and 1.0 (0.9–1.1) for IHD. In the case-control study, multifactorially adjusted odds ratios for 14–15 and 17–22 vs. 16 repeats were 2.9 (1.1–7.8) and 0.9 (0.8–1.0) for MI and 2.5 (1.0–6.0) and 0.9 (0.8–1.0) for IHD.Conclusions: Apolipoprotein(a) 14–15 pentanucleotide repeats predict elevated levels of lipoprotein(a) and a 3- and 2-fold increased risk of MI and IHD in the general population.
Antipsychotic Medication Utilization Trends Among Texas Veterans: 1997–2002
Authors: Yang Min , Barner Jamie C , Lawson Kenneth A , Rascati Karen L , Wilson James P , Crismon M Lynn , Worchel Jason , Mascarenas Cynthia A 
Published: August 2008

Background An antipsychotic utilization pattern has evolved substantially over the past 20 years or so due to the introduction of the second-generation antipsychotics (SGAs) and the increasing understanding of their adverse effect profile. Objective To understand antipsychotic utilization trends (including monotherapy, antipsychotic switching, and combination therapy) and to investigate factors associated with antipsychotic index medication selection (SGAs vs first-generation antipsychotics [FGAs]) among Texas veterans. Methods Data were taken from the Veterans Administration North Texas Health Care System (VANTHCS) and South Texas Veterans Health Care System (STVHCS) from January 1996 to December 2003. Adults with continuous enrollment (1 y before and after the Index date) who had newly initiated antipsychotic therapy were included. Prescriptions were followed for up to 12 months. Descriptive analyses examined utilization trends; logistic regression evaluated factors associated with antipsychotic index medication selection. Results: A total of 8096 patients were included in the study (VANTHCS n = 4477; STVHCS n = 3619), with the majority being male (93.6%) and white (62.6%) and nearly naif aged 55 years or older (44.1%). Between 1997 and 2002, antipsychotic prescriptions changed from primarily FGAs (1997:71.7%; 1999; 25.2%; 2002: 5.7%) to SGAs. Over the 6-year time frame, risperidone (31.0%) and olanzapine (30.7%) were most commonly prescribed. The overall combination therapy slightly increased over time (4.3%), switching to another antipsychotic remained stable (14.2%), and antipsychotic monotherapy remained dominant (81.5%). Hispanic and black patients were less likely than white patients to be initiated on SGAs. Patients who were older, had hypertension, and were in STVHCS were less likely to start on SGAs. Patients with dyslipidemia, bipolar disorder, and treatment in recent years were more likely to start on SGAs Conclusions: SGAs have replaced FGAs as first-line medications for patients with mental disorders. Race, age, physical comorbidities (ie, dyslipidemia, hypertension), and treatment initiation year were important factors in index medication selection.
Neuralgic Amyotrophy Associated with Antibiotic Therapy
Authors: Finstad Kody , Ramon Guajardo Jesus , Scoville Caryn 
Published: August 2008

Objective TO report a case of neuralgic amyotrophy associated with antibiotic therapy. Case Summary: A 22-year-old male with cystic fibrosis had been nonadherent to treatment for 4 years; when he returned to the clinic with symptoms, his forced expiratory volume in 1 second dropped from 84% predicted to 43% predicted. He was admitted to the hospital for treatment after failing to improve on oral ciprofloxacin and inhaled tobramycin. Treatment was initialed with intravenous tobramycin 560 mg daily and piperacillin/tazobactam 4.5 g infused every 6 hours. He continued inhaled tobramycin 300 mg twice daily, his home doses of pancreatic replacement enzymes and vitamins, albuterol 2.5 mg by high flow nebulizer (HFN) 4 times daily, and dornase alpha 2.5 by HFN daily. Sputum cultures were positive for methicillin-resistant Staphylococcus aureus, and intravenous vancomycin 1 g every 8 hours was added to the treatment regimen on hospital day 7. The patient developed bilateral shoulder pain followed by decreased function of his upper extremities 2 days later. He was treated with oral ibuprofen 600 mg every 6 h and oral cyclobenzaprine 5 mg daily, which improved his pain, but the shoulder stiffness remained throughout his hospital stay and persisted for 2 months following discharge. These symptoms resolved but recurred rapidly (within 24 h) and were more debilitating following a second exposure to the same antibiotics at the same doses 8 months later when the patient was readmitted for treatment of another cystic fibrosis-retated pulmonary exacerbation. Discussion: To our knowledge, this is the first case report illustrating neuralgic amyotrophy triggered by exposure to the antibiotics vancomycin, tobramycin, and piperacillin/tazobactam. After analysis of the case, ruling out other possibilities and using the Naranjo probability scale, we found that there is a highly probable likelihood that the symptoms presented by our patient were secondary to his drug therapy. Neuralgic amyotrophy is a rare condition of unknown etiology that has never before been associated with administration of these antibiotics, individually or in combination. Because of the specifics of the clinical history, we were unable to ascertain whether this complication was due to a single antibiotic or to the combination. It is quite possible that vancomycin was the only culprit, but impossible to ensure with the available evidence. Conclusions: Clinicians should be aware of this adverse reaction when facing similar complex neurologic symptoms in patients who are receiving the antibiotic treatment described here, especially vancomycin.