BACKGROUND: As part of conducting a randomized control trial (RCT) to treat chronically high utilizing patients with medically unexplained symptoms (MUS), we developed the chart rating method reported here to identify and classify MUS subjects. METHOD: Intended at this point only as a research tool, the method is comprehensive, uses ...

We examine Gulf War illnesses--which include the fatigue, joint pain, dermatitis, headaches, memory loss, blurred vision, diarrhea, and other symptoms reported by Gulf War veterans--in relation to other medically unexplained physical symptoms such as multiple chemical sensitivity, chronic fatigue syndrome, and fibromyalgia. Our intent is to examine the diagnosis negotiations ...

Patients with depersonalization disorder experience episodes in which they have a feeling of detachment from themselves. Symptoms of depersonalization may occur in individuals who have other mental disorders, or who have various medical conditions, or who have taken certain medications. A woman developed depersonalization symptoms after initiation of minocycline therapy. ...

Existential Psychological Theory was employed as a conceptual and theoretical foundation for the use of hypnotically facilitated therapy in the management of intractable pain, nausea, and vomiting in 3 end-stage, terminally ill cancer patients. The existential principles of death anxiety, existential isolation, and existential meaninglessness were addressed with a combination ...

Medical surveillance was used in the workplace to determine and monitor the level of hand-arm vibration syndrome (HAVS) and carpal tunnel syndrome (CTS) present in workers exposed to upper extremity vibration. Ergonomic intervention in the form of new tools with lower vibration levels and the use of International Standards Organizaiton ...

This study aimed to evaluate the correlation between symptoms and endoscopic findings in reflux esophagitis. Subjects, 8031 persons without medication for gastrointestinal disease, were briefly asked about the presence of heartburn, dysphagia, odynophagia, and acid regurgitation by associated medical staff before endoscopy for assessment of esophagitis utilizing the Los Angeles ...

Although response to intranasal steroid therapy has been reported in patients with allergic rhinitis, efficacy of some nasal steroids is noteworthy.This study was undertaken to evaluate the efficacy of a two-week course of Fluticasone (Flixonase) nasal spray vs. Beclomethasone (beconase) nasal spray in patients with symptoms of allergic rhinitis referred ...

Irritable bowel syndrome (IBS) is a commonly encountered condition seen in multiple medical specialties. Recent research has brought dramatic advances in our understanding of the epidemiology, burden of illness, diagnosis, and management of IBS. It is now widely accepted that the prevalence of IBS is between 10% and 20% of ...

OBJECTIVE: In our study, we explored the associations among anxiety, the dimensions of Cloninger's theoretically based and empirically validated psychobiological model of personality (Temperament and Character Inventory, TCI) and fatigue in order to clarify the personality risk factors for fatigue. METHODS: Fifth-year students (n=89) and freshmen (n=162) at Saga Medical ...

This paper reports the first year's experience of a consultative, interdisciplinary, integrated palliative medicine program in a community hospital system. Prospective data collection was performed on 308 consecutive consultations. A computer database was developed and used to analyze demographics, reason for consultation, complexity of medical problems, current medications and allergies, ...

OBJECTIVES: To determine prospective changes in clinical status related to chronic fatigue over an 18-month period, and to test demographic and clinical predictors of outcome. METHODS: A cohort of 100 patients with unexplained chronic fatigue (UCF), which encompasses both chronic fatigue syndrome (CFS) and idiopathic chronic fatigue (ICF), completed questionnaire ...

A large body of evidence has accrued that neuropsychiatric disturbances, such as agitation, are extremely common in Alzheimer's disease. These disturbances are associated with considerable morbidity including earlier nursing home admission, more rapid progression, exacerbation of functional and cognitive deficits, and increased caregiver distress. When attention to social or environmental ...

At any one time, most 16-18-years-old and up to half of adults have acne. In 60% of all teenagers, the condition will be sufficiently severe for them to self-treat or seek medical advice. Up to half of 12-20-year-olds with acne develop psychological or social problems. Oral isotretinoin, which is used ...

OBJECTIVES: This study was designed to compare the long-term consequences of percutaneous transluminal coronary angioplasty (PTCA) and continued medical treatment. BACKGROUND: The long-term effects of percutaneous coronary intervention need evaluating, especially in comparison with an alternative policy of continued medical treatment. METHODS: The Second Randomized Intervention Treatment of Angina (RITA-2) ...

We treated a patient who developed transient multifocal encephalopathy with extrapyramidal symptoms (oromandibular dystonia, oculogyric crisis, and limb dystonia) in temporal proximity to ondansetron administration on emergence from general anesthesia. No other medications known to cause extrapyramidal reactions were administered. Although these symptoms resolved fully, the presentation was dramatic and ...

Trained interviewers visited 631 inner city households to determine community prevalence and predictors of antibiotic use. Infectious disease symptoms were reported in 911 (33.2%) of 2,743 household members in the previous 30 days: medical attention was sought by 441 (48.4%) of 911 persons, and 354 (8.9%) of 911 took antibiotics ...

Although the association between gastroesophageal reflux (GER) and typical esophageal symptoms, such as heartburn and regurgitation, is straightforward, this is not the case for the relation between GER and respiratory symptoms. The strongest link is the finding of abnormal reflux in the proximal esophagus or pharynx. This finding, in conjunction ...

The sleeping state is accompanied by many changes in gastroesophageal function that may be of importance in the pathogenesis of gastroesophageal reflux disease (GERD). At nighttime, gastric acid production is increased, gastric emptying is delayed, esophageal clearance is markedly delayed, and upper esophageal sphincter pressure diminishes significantly. Further, unlike daytime ...

Although SSRIs are widely used and generally considered safe, an abrupt cessation of SSRI use may result in a discontinuation syndrome that can mimic serious illness and can be distressing and uncomfortable. Several pharmacokinetic and pharmacodynamic factors influence the frequency and onset of these symptoms. Rapid identification of SSRI discontinuation ...

BACKGROUND: Short-term discontinuation of psychiatric medications is required in many types of research studies. Yet there are few studies of the clinical impact of psychotropic discontinuation. We studied the impact of a short-term medication washout in unipolar depressed patients consecutively admitted to hospital for neuroimaging and cerebrospinal fluid (CSF) studies. ...

Pheochromocytomas are rare tumours of catecholamine-producing chromaffin cells leading to hypertension and symptoms of catecholamine excess. They can be benign or malignant, sporadic or familial tumours. Genetic syndromes associated with pheochromocytoma are MEN II, VHL disease and neurofibromatosis type 1. Usually, pheochromocytomas occur in the adrenal medulla. Clinical manifestations include ...

Chronic cough is a debilitating symptom for which patients commonly seek medical attention. Among adult non-smokers who are not taking an angiotensin-converting enzyme inhibitor and have a normal or near normal chest radiograph, postnasal drip syndrome caused by a variety of rhinosinus conditions, asthma and non-asthmatic eosinophilic bronchitis and gastro-oesophageal ...

The main objective of this study was to use structural equation modeling (SEM) to clarify the relationship between subjective cognitive complaints and neuropsychological functioning in 160 adults with HIV infection. Participants completed questionnaires assessing cognitive complaints, symptoms of depression, and HIV-related medical symptoms. Neuropsychological tests included measures of attention, verbal ...

Further to a thorough analysis of the problem of acute diarrhoea and the therapeutic options, recommendations were defined following a multidisciplinary approach. These guidelines take into account the reality of frequent self-medication. They further differ as a function of age (children, primarily treated by ORS and for whom self-medication is ...

Fibromyalgia is characterized by widespread pain, persistent fatigue, nonrestorative sleep, and generalized morning stiffness. The diagnosis is based on patients' reports of pain and fatigue, clinical findings of multiple tender points, and exclusion of a range of connective tissue and other medical disorders. Treatment of fibromyalgia is multidisciplinary with an ...

We have reported 1-year outcomes and antacid medication use in 100 patients undergoing laparoscropic Nissen fundoplication. As a follow-up study, we queried these same patients to determine whether their outcomes endured 4 years after fundoplication. One hundred patients undergoing laparoscopic Nissen fundoplication between 1992 and 1997 were asked, at 1 ...

OBJECTIVE: To present a quantitative review of the empirical literature on somatisation and alexithymia. METHODS: Medline and PsycLIT searches for relevant studies were conducted. Meta-analytical techniques were applied to quantify the strength of the associations that were found. RESULTS: A small to moderate relationship was found between general alexithymia and ...

More information is needed regarding the medical care utilization and costs of individuals who report depressed mood, persistent anxiety, brief anxiety, panic, and trouble controlling violent behavior. We present findings from a 1-year prospective follow-up study of a stratified random sample of adult HMO enrollees (N = 10,377) originally interviewed ...

Two pilots who had experienced vasovagal syncope were grounded by the aeromedical service. Pilot A had experienced three episodes of syncope in medical settings, none during flight. Pilot B had experienced four episodes of syncope in emotional/medical settings, one during flight. Whether a pilot who experienced one or more episodes ...

OBJECTIVES: To assess the natural history of lower urinary tract symptoms (LUTS) in a cohort of previously untreated men over five years. METHODS: Men participating in a health-screening project completed the International Prostate Symptom Score (IPSS) in 1996. In 2001, men older than 45 years with no prostate surgery or ...

Elderly persons are especially exposed to folate deficiency, where normal/subnormal folate levels do not exclude tissue deficiency. Accompanying diseases, medication, and lifestyle factors may contribute to/cause deficiency. Symptoms of deficiency can be hematological, neurological, or neuropsychiatric, but it is likely that there are also cardiovascular manifestations as well as associations ...

Any terrorist attack using weapons of mass destruction will result in substantial psychological trauma and stress. Primary care and emergency clinics will likely see patients who have stress-related emotional or physical symptoms, or exacerbations of preexisting health concerns. Significant psychological and behavioral reactions to an attack with weapons of mass ...

BACKGROUND AND PURPOSE: In the last 10 years, stroke has become a medical emergency. Subsequently, early recognition of stroke symptoms and rapid activation of the medical system are essential. We sought to investigate what witnesses or victims of an acute stroke syndrome recognize and report in the actual situation. METHODS: ...

Saw palmetto is an herbal product used in the treatment of symptoms related to benign prostatic hyperplasia. The active component is found in the fruit of the American dwarf palm tree. Studies have demonstrated the effectiveness of saw palmetto in reducing symptoms associated with benign prostatic hyperplasia. Saw palmetto appears ...

Gastroesophageal reflux disease (GERD) is one of the most common complaints in general medical practice. Symptoms of GERD have a high prevalence, which greatly affects health economics and patient health-related quality of life (HRQOL). The majority of patients who present with reflux symptoms lack esophageal mucosal injury and thus have ...

Since the Gulf War, investigation continues of symptoms and illnesses among its veterans. Yet, identifying a specific "Gulf War Syndrome" remains elusive. With new disease entities, causal associations are relatively easily established when the condition is serious, verifiable, and has excess disease rates in specific groups. In common conditions, many ...

This article discusses body dysmorphic disorder (BDD) among cosmetic surgery patients. BDD is characterized as a preoccupation with a slight or imagined defect with some aspect of physical appearance that leads to significant disruption in daily functioning. Although the prevalence of BDD within the general population is unknown, recent evidence ...

Superior vena cava (SVC) syndrome often presents with slowly progressive symptoms worsening over weeks or may cause abrupt symptoms and constitute a true medical emergency. Percutaneous intervention is the treatment of choice. We report a case of SVC stenting in a middle-aged woman with SVC obstruction secondary to portacath insertion ...

A pan-territory telephone survey was conducted in Hong Kong of Chinese women concerning urinary symptoms and their treatment preferences; 1500 women replied. One hundred and ninety-four (13%) of the 1500 subjects had urinary symptoms. Of these 194, 155 (10.3%) had stress incontinence, 64 (4.3%) had urgency, 10 (0.7%) had urge ...

This cross-sectional study examines whether lack of awareness of symptoms is a predictor for nonadherence. The study consecutively recruited 134 participants with Diagnostic and Statistical Manual of Mental Disorders, 4th edition, diagnoses of schizophrenia spectrum disorders at acute psychiatric units. Outcome was measured by a combination of self-reports, utilizing the ...

Fatigue is a common disabling symptom of multiple sclerosis (MS). It is often considered a state of exhaustion distinct from depressed mood or physical weakness. Fatigue can be assessed by either self-report scales or performance-based measures; however, neither method captures all features of fatigue. Fatigue in MS frequently leads to ...

BACKGROUND: Clinicians may encounter symptoms of xerostomia, commonly called "dry mouth," among patients who take medications, have certain connective tissue or immunological disorders or have been treated with radiation therapy. When xerostomia is the result of a reduction in salivary flow, significant oral complications can occur. TYPES OF STUDIES REVIEWED: ...

Sexual dysfunction in general and erectile dysfunction in particular are common problems in the overall population but also frequent symptoms of both untreated and treated depression. Erectile dysfunction and associated sexual dysfunction secondary to antidepressant therapy may occur in up to 90% of men with antidepressant-emergent sexual side effects; accurate ...

OBJECTIVE: To verify the official criteria of ICD-10 diagnosis of acute stress reaction (ASR) among earthquake victims. METHOD: Data on psychosocial variables and the diagnosis of ASR were collected from 91 subjects. RESULTS: The diagnosis of ASR was made in 70% of the sample. However, the restrictive duration criterion (i.e. ...

Gastroesophageal reflux disease (GERD) is a chronic condition that affects a large proportion of the adult population. Persistent untreated GERD can lead to esophageal strictures, premalignant Barrett's esophagus, and an increased risk of adenocarcinoma of the esophagus. Currently, the most effective medical treatment targets gastric acid suppression, allowing healing of ...

A single causal agent can often give rise to a cascade of consequences that can be envisioned as a branching pathway in which symptoms are the terminal nodes. In three studies, we investigated whether reasoning about root causes on the basis of such symptoms would conform to a diversity effect ...

To our knowledge new-onset psychotic symptoms have not been reported in connection with the September 11, 2001 terrorist attacks on the World Trade Center and the Pentagon. We describe two cases of brief psychotic disorder in adults who experienced the terrorist attacks from afar through television coverage. The patients were ...

Topiramate (Topamax) is an anti-epileptic medication for which acute toxicity is infrequently reported. A 5-yr-old girl, not previously taking topiramate, developed neurological symptoms after acute ingestion of this medication. She was intermittently agitated, complained of "not being able to feel anything," demonstrated arching movements of the back, and perseverated upon ...

BACKGROUND: Chronic fatigue syndrome (CFS) is characterized by profound fatigue, which substantially interferes with daily activities, and a characteristic symptom complex. Patients use a variety of prescribed and self-administered medications, vitamins, and supplements for relief of their symptoms. The objective of this study was to describe utilization of medications and ...

Out of the concept of neurasthenia, the main non-psychotic diagnosis of nineteenth-century psychiatry besides hysteria, and on the basis of psychophysiological problems of his own, self-diagnosed as neurasthenia, Freud developed the notion of 'actual neurosis', a 'contentless psychic state' manifested by various somatic symptoms and a depressive mood, which he ...