bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnosis of depression in people with severe/profound intellectual disability
Authors: Tsiouris J. A. 
Published: March 2003

AbstractThe Marston 30 Symptoms Checklist for detecting depression was used to determine whether or not the notion of ‘depressive equivalents’ can provide a few of the core characteristics necessary for the diagnosis of depressive disorders in people with severe/profound intellectual disability (ID). Diagnoses of major depression were made by a psychiatrist using the DSM‐III‐R criteria, combined with information from records, staff, team, parents, behaviour profiles, direct observations, mental status and follow‐up visits. Twenty‐two people with ID fulfilled the selection criteria from a larger sample of 150 patients who had been evaluated in 350 contact visits. Scores on the checklist for major depression for 15 subjects with severe/profound ID were similar to the core characteristics for diagnosis of major depression by DSM‐III‐R criteria. Evidence was found for the presence of depressive equivalents in the subjects, but these appeared to be secondary. The 15 participants with severe/profound ID were observed mostly during the depressive phase of bipolar I and bipolar II disorder, and major depression, recurrent type. Melancholic features were prominent in their presentation. Further studies of people with ID are needed to determine whether depressive equivalents are more prominent in cases of major depression with atypical features than in cases of major depression with melancholic features.
Benefits of the Treatment and Education of Autistic and Communication Handicapped Children (TEACCH) programme as compared with a non‐specific approach
Authors: Panerai S. , Ferrante L. , Zingale M. 
Published: March 2003

AbstractBackground Two educational treatments were compared, the Treatment and Education of Autistic and Communication Handicapped Children (TEACCH) programme and the integration programme for individuals with disabilities.Methods Two groups of eight subjects were matched by gender, chronological and mental age, and nosographic diagnosis (i.e. autism associated with severe intellectual disability, DSM‐IV criteria and Childhood Autism Rating Scale scored. The TEACCH programme was applied to the experimental group, while the control group was integrated in regular schools with a support teacher. The Psycho‐Educational Profile – Revised and the Vineland Adaptive Behaviour Scale were administered twice with a one‐year interval between assessments.Results The scores of the experimental group increased more than the control group scores. Statistically significant differences were obtained in both groups because of the differences in the two approaches.
Evaluating the use of multiple microswitches and responses for children with multiple disabilities
Authors: Lancioni G. E. , O’Reilly M. F. , Singh N. N. , Oliva D. , Piazzolla G. , Pirani P. , Groeneweg J. 
Published: March 2003

AbstractBackground The present study assessed the feasibility of (1) establishing multiple microswitches and responses (some of which had not been used before) with two children with multiple disabilities, and (2) maintaining such microswitches and responses in the children’s daily contexts.Methods The microswitches were introduced individually and then combined. During the last part of treatment and the follow‐up, each child had three microswitches.Results The data show that both children learned to use all three available microswitches. Moreover, they retained fairly high levels of responding with the microswitches in their daily contexts during follow‐up periods of 4 and 6 months.Conclusions The personal and practical implications of these findings are discussed.
Psychological treatment of reported sleep disorder in adults with intellectual disability using a multiple baseline design
Authors: Gunning M. J. , Espie C. A. 
Published: March 2003

AbstractBackground The literature on sleep disturbance in adults with intellectual disability (ID) is sparse. Although prevalence rates for sleep disorders appear similar to those of non‐disabled populations, previous treatment studies have largely been comprised of uncontrolled cases. Therefore, the present study adopted a single‐case experimental methodology to evaluate behavioural sleep intervention.Methods A screening questionnaire was posted to 384 adults with ID and the sleep pattern of respondents with possible sleep disorders was further assessed using a structured diagnostic schedule. From the sleep‐disordered subgroup, 12 participants were selected for a 4‐week behavioural sleep intervention that was evaluated using randomly allocated, multiple‐baseline, across‐subjects designs and within‐subject interrupted time series analyses (ITSAs).Results A total of 155 adults with ID (83 females and 72 males; mean age = 32 years, SD = 16.5 years), or their carers, completed the questionnaire (return rate = 40%). The application of sleep diagnostic criteria revealed that 17% had clinically significant difficulty getting to sleep and 11% had difficulty remaining asleep. Nine out of the 12 participants recruited for the intervention completed all the experimental phases, thus providing three sets of three multiple‐baseline designs. Visual inspection of within‐ and between‐subject effects suggested beneficial treatment‐specific effects across a range of target variables. The ITSA confirmed significant effects (P < 0.05) or trends (P < 0.10) for six out of the nine participants.Conclusions Behavioural sleep management may improve sleep pattern or sleep‐related functioning in the majority of adults with ID who have significant sleep problems. The single‐case methodology is helpful in addressing the heterogeneity of individual presentation, although clinical trial methodology is required to confirm these findings on a larger scale.
Prevalence of psychiatric disorders in children and adolescents with and without intellectual disability
Authors: Emerson E. 
Published: March 2003

AbstractBackground  There have been very few population‐based studies of the prevalence of psychiatric disorders among children and adolescents with and without intellectual disability (ID).Methods  Secondary analysis of the 1999 Office for National Statistics survey of the Mental Health of Children and Adolescents in Great Britain was performed. This survey collected information on a multistage, stratified, random sample of 10 438 children between 5 and 15 years of age across 475 postcode sectors in England, Scotland and Wales.Results  The prevalence of any diagnosed ICD‐10 disorder, conduct disorder, anxiety disorder, hyperkinesis and pervasive developmental disorders were significantly greater among children with ID than among their non‐ID peers. There were no statistically significant differences between children with and without ID with regard to the prevalence of depressive disorders, eating disorders or psychosis. Factors associated with an increased risk of psychopathology among children and adolescents with ID included age, gender, social deprivation, family composition, number of potentially stressful life events, the mental health of the child's primary carer, family functioning and child management practices.Conclusions  Children and adolescents with ID are at significantly increased risk of certain forms of psychiatric disorder. Careful consideration of the social and economic adversity facing such families will be necessary to ensure that support services are responsive to both the needs of child as well as the needs of the family in which they are living.
Working with sex offenders with intellectual disability: evaluation of an introductory workshop for direct care staff
Authors: Taylor J. L. , Keddie T. , Lee S. 
Published: March 2003

AbstractBackground  Sexual aggression by men with intellectual disability (ID) is a serious problem requiring attention from the relevant agencies. Training for staff working with this problem is often not given sufficient attention and is rarely evaluated. In the present study, an introductory workshop for direct care staff that aimed to increase knowledge and improve attitudes towards work with this client group was evaluated.Method  Sixty‐six staff working in inpatient and community settings completed a 2.5‐day workshop. Before training began, the participants completed a survey questionnaire concerning their experiences of work with this client group. An assessment of their knowledge and attitudes was carried out prior to and at the end of training in order to evaluate any changes. The participants also rated the effectiveness of the workshop and their level of satisfaction with the training at the end of the workshop.Results The participant s’ knowledge and attitudes improved significantly following the workshop. Staff with greater experience over time and those who had worked with fewer sex offender clients responded to different aspects of the training. The participants’ ratings indicated that they were highly satisfied with the training and found it to be effective.Conclusions  Brief workshop training is acceptable to and can be effective in improving the knowledge, attitudes and confidence of direct care staff working with sex offenders with ID. However, because the results are based on participant self‐report, caution should be exercised concerning their external validity.
Helicobacter pylori seropositivity is not associated with inflammatory parameters, lipid concentrations and degree of coronary artery disease
Authors: RegnstrÖM  , Jovinge  , BÅvenholm  , Ericsson  , DE Faire  , Hamsten  , Hellenius  , Nilsson  , Tornvall  
Published: March 2003

Regnström J, Jovinge S, Båvenholm P, Ericssond C‐G, de Faire U, Hamsten A, Hellenius M‐L, Nilsson J, Tornvall P (Karolinska Hospital and Danderyd Hospital, Stockholm, Sweden). Helicobacter pylori seropositivity is not associated with inflammatory parameters, lipid concentrations and coronary artery disease. J Intern Med 1998; 243: 109–13.ObjectivesTo determine the prevalence of chronic infection with Helicobacter pylori (HP) in patients with established coronary artery disease (CAD) and in healthy controls. Furthermore, to investigate whether HP infection is associated with inflammatory parameters, lipid concentrations and degree and progression of CAD.DesignA case–control study combined with a prospective angiographic study.SettingStockholm Metropolitan Area, Sweden.Patients and methodsA material consisting of 92 young men aged 40.9 ± 3.2 (mean ± SD) years, with previous myocardial infarction and documented coronary atherosclerosis, and 95 healthy sex‐matched controls, aged 43.2 ± 3.0 (mean ± SD) years, with similar socio‐economic status and ethnic background was analysed for the prevalence of HP seropositivity, plasma concentrations of the inflammatory parameters fibrinogen, tumour necrosis factor alpha and orosomucoid, and serum concentrations of lipids. The impact of HP seropositivity on degree and progression of CAD, as assessed by quantitative coronary angiography, was also determined.ResultsThe study population of mainly Scandinavian origin had a low prevalence of HP seropositivity in comparison with previously published European populations. No significant increase in HP seropositivity was found in patients compared with controls (42.2 vs. 32.6%). Furthermore, HP infection was not associated with increased levels of inflammatory parameters, lipid concentrations or with degree of angiographically determined CAD at baseline, or progression of CAD and clinical events over 5 years.ConclusionsHP infection is not associated with inflammatory parameters and lipid concentrations and could not be confirmed as a risk factor for CAD.
Endoscopic and pathological manifestations of the gastrointestinal tract in familial amyloidotic polyneuropathy type I (Met30)
Authors: Yoshimatsu Shin‐ichi , Ando Yukio , Terazaki Hisayasu , Sakashita Naomi , Tada Shuji , Yamashita Taro , Suga Moritaka , Uchino Makoto 
Published: March 2003

Yoshimatsu S, Ando Y, Terazaki H, Sakashita N, Tada S, Yamashita T, Suga M, Uchino M, Ando M (Kumamoto University School of Medicine; and Saiseikai Hospital, Kumamoto, Japan). Endoscopic and pathological manifestations of the gastrointestinal tract in familial amyloidotic polyneuropathy type I (Met30). J Intern Med 1998; 243: 65–72.ObjectivesTo evaluate the characteristic changes in the gastrointestinal tract in familial amyloidotic polyneuropathy (FAP) (Met30), both fibre gastroscopy and colonoscopy studies were performed in FAP (Met30) patients. Microscopic changes were also examined in autopsied and biopsied materials from patients with FAP, and compared with data from autopsied samples from patients with AL amyloidosis, and secondary amyloidosis patients.DesignEndoscopic and histopathological study.SettingKumamoto University Hospital, Kumamoto, Japan.SubjectsNine patients with FAP (Met30) underwent fibre gastroscopy and colonoscopy. Six autopsied and 23 biopsied gastrointestinal samples from FAP patients, four from autopsied amyloidosis (including two myeloma associated form), and two from autopsied secondary amyloidosis patients were examined for histopathological study.Main outcome measuresFibre gastroscopy and colonoscopy were employed for macroscopic study. Congo red and H‐E staining were performed for histopathological study. Macroscopic changes in the gastrointestinal tract and microscopic differences in the amyloid distribution pattern were compared between the different types of amyloidosis.ResultsFibre gastroscopy and colonoscopy for nine FAP patients revealed that four showed a fine granular appearance in the duodenum, three showed lack of lustre, and two showed mucosal friability in the gastrointestinal tract; however, no macroscopic abnormality was observed in four other FAP patients. Histopathological examination of tissue from FAP patients revealed that, although a small amount of amyloid was recognized in the submucosa perivascular layer, a significant amount of amyloid was seen in and around the nerves of the gastrointestinal tract, but very little in Auerbach's nerve plexus. In total, the amount of deposited amyloid in the tissues was small compared with that in other types of systemic amyloidosis, such as AL and secondary amyloidosis.ConclusionThese results suggest that the major reason why FAP patients show such severe gastrointestinal symptoms, compared with other types of systemic amyloidosis, may be because of the deposition of a significant amount of amyloid in the nerves in the gastrointestinal tract.
Hypertriglyceridemia and insulin resistance
Authors: HÖlzl  , Paulweber  , Sandhofer  , Patsch  
Published: March 2003

Hölzl B, Paulweber B, Sandhofer F, Patsch JR (St Johanns Spital, Salzburg; and University of Innsbruck, Innsbruck; Austria). Hypertriglyceridemia and insulin resistance (Case Report). J Intern Med 1998; 243: 79–82.Although the association between insulin resistance and hypertriglyceridemia has long been recognized, the question of the causal relationship of these two entities is still a matter of debate. To gain more insight into the relationship between hypertriglyceridemia and insulin resistance, we studied insulin sensitivity in two severely hypertriglyceridemic subjects in whom insulin resistance as a cause for hypertriglyceridemia could be positively ruled out. Rather, lipoprotein lipase deficiency due to a mutation in the lipoprotein lipase gene was identified as the cause. In the two study subjects, whole body glucose utilization was measured during a continuous infusion of somatostatin, glucose and insulin. Mean values of plasma glucose and insulin concentrations at 150, 160, 170 and 180 minutes were used to calculate steady state plasma glucose (SSPG) and steady state plasma insulin (SSPI) concentrations. SSPG of the two hypertriglyceridemic patients was in the range of those reported in the literature for healthy subjects without insulin resistance did not differ from those of two control subjects with normal plasma lipid levels. Therefore, the dyslipidemic state of the two patients, characterized by extreme elevation of triglyceride rich plasma lipoproteins and a severe reduction of HDL cholesterol, was clearly not associated with insulin resistance. From these findings we conclude that hypertriglyceridemia per se is not an obligatory cause for insulin resistance.
Diagnosis of pulmonary embolism by measurement of alveolar dead space
Authors: Olsson  , Jonson  , Olsson  , Wollmer  
Published: March 2003

Olsson K, Jonson B, Olsson CG, Wollmer P (Malmö University Hospital and Lund University Hospital, Sweden). Diagnosis of pulmonary embolism by measurement of alveolar dead space. J Intern Med 1998; 244: 199–207.ObjectivePulmonary embolism (PE) gives rise to alveolar dead space, which can be measured with a single breath test for CO2 (SBT‐CO2). The characteristics of the SBT‐CO2 are different in PE and other common conditions giving rise to alveolar dead space, notably airways disease. An analysis of alveolar dead space focusing on the late part of the breath (fDlate) has been suggested as a method for diagnosis of PE. Our aim was to evaluate this technique by comparison with lung scintigraphy.MethodsWe randomly selected patients with clinical suspicion of PE. SBT‐CO2 and lung scintigraphy were performed on the same day. The scintigraphies were reviewed and classified as high, intermediate and low probability of PE.ResultsOut of 223 patients able to be evaluated, there were 20 of the high, 29 of the intermediate and 174 of the low probability category. There were large differences between the means of fDlate in the high and the intermediate and in the high and the low categories. We obtained a sensitivity of 85% and a specificity of 93% for diagnosis of PE, based on high and low probability categories. If a patient with previous PE, but no scintigraphic evidence of current PE, is excluded the sensitivity increases to 90%.ConclusionsThis study provides further support for the measurement of fDlate by the SBT‐CO2 as a diagnostic test in patients with suspicion of PE. The test should be especially useful in small hospitals without access to pulmonary scintigraphy or pulmonary angiography.
Sheehan's syndrome: differential diagnosis in the acute phase
Authors: Dejager  , Gerber  , Foubert  , Turpin  
Published: March 2003

Dejager S, Gerber S, Foubert L&Turpin G (La Pitié Salpétrière, Paris, France). Sheehan's syndrome: differential diagnosis in the acute phase (Case Report). J Intern Med 1998; 244: 261–66.Many studies have been done in the later course of Sheehan's syndrome, but very few have documented the acute phase with clinical, endocrine and imaging data. We present the case of a young woman complaining of severe headache after delivery, who developed hypopituitarism. Magnetic resonance imaging (MRI) disclosed the presence of an enlarged non haemorrhagic pituitary gland. Follow‐up MRI showed a spontaneous and rapid shrinkage of the pituitary, within 20 days, which appeared as an empty sella 3 months later. Sheehan's syndrome may initially closely mimic hypophysitis, or the necrosis of an adenoma. We discuss the differential diagnoses, important for the best therapeutic management.
Evidence of gastrointestinal immune reactivity in patients with sarcoidosis
Authors: Papadopoulos K. I. , Sjöberg K. , Lindgren S. , Hallengren B. 
Published: March 2003

Abstract.Objectives.  The aim of the present study was to explore the frequency of clinical and serological manifestations of gastrointestinal immune reactivity in a large group of Swedish patients with sarcoidosis.Design.  In patients with documented sarcoidosis, the presence of pernicious anaemia and coeliac disease was examined. Antibodies to H+/K+ ATPase, gliadin (AGA‐IgA/IgG) and endomysium (IgA‐EMA) were analysed. In H+/K+ ATPase antibody‐positive patients, serum gastrin levels were measured and, when elevated, gastrointestinal biopsy was offered (biopsy performed in 6/9 patients); biopsy was also offered to those with positive EMA or AGA of either class (biopsy performed in 8/12 patients). Subjects from national and local studies were used as controls.Setting.  The patients were recruited at the Department of Pulmonary Medicine, and the study was conducted at the Department of Endocrinology, University of Lund, Malmö University Hospital, Malmö, Sweden.Subjects.  Of all patients (n = 89) with documented sarcoidosis attending the Department of Pulmonary Medicine between January 1980 and December 1991, 78 [34 females and 44 males; median age at the time of the study, 48 (range 22–81) years; median observation time since the diagnosis of sarcoidosis, 120 (range 1–468) months] were examined.Results.  Twenty‐nine patients (37.2%) had signs of gastrointestinal immune reactivity. H+/K+ ATPase antibodies were detected in 19 patients (24.4 vs. 4% in controls, P = 0.00015). Serum gastrin levels (median 45, range 22–720 pmol L–1) in those patients correlated with antibody titre (r2 = 0.882). Gliadin antibodies were detected in 12 patients (15.4 vs. 8.1% in controls, P = 0.042), of whom 11 (14.1 vs. 4.5% in controls, P = 0.00114) had AGA‐IgA alone. One patient had pernicious anaemia and another coeliac disease (EMA‐positive).Conclusion.  We have demonstrated a high frequency of gastric autoimmunity and gluten‐associated immune reactivity in patients with sarcoidosis, occurring in almost 40% of the cases, the former being the most frequent gastrointestinal immune manifestation. Despite a high frequency of humoral autoimmunity, the frequencies of clinical disease, pernicious anaemia and coeliac disease were not increased as compared with the control population.