Patients at risk on a cardiac rehabilitation unit: Implications for a liaison model

A subgroup of 20 of 75 patients on a cardiac rehabilitation unit was identified as having a perception of their health status and social support systems as poor, and a cognitive style of “vigilance.” Staff also had maximal uncertainty about the diagnoses and behavior of these patients, and about how to deal with them. These patients had more diagnosed myocardial infarctions than the other patients in the unit. A liaison model is proposed that would focus on facilitating staff-patient communications for such patients, who have special needs for information, as a means of helping them to cope with their illness and of facilitating rehabilitation.     

The depression-pain syndrome and its response to antidepressants

In an attempt to elucidate the relationship between depression and pain, the authors studied 300 pain center patients; 261 (87%) of these patients referred for diagnosis and treatment of their pain syndromes were depressed. In another study of 196 private patients with depression, 116 (59%) also had recurring benign pain. When treated with antidepressant medications, 96 of these 116 (83%) obtained significant relief of their pain syndromes. The frequency with which antidepressants can significantly alleviate pain associated with depression highlights the importance of the link between pain and depression, which may be partially explained by the close relationship of enkephalins and biogenic amines     

Widespread presence of histologically occult cytomegalovirus

Disseminated cytomegalovirus (CMV) has been investigated by in situ hybridization in formalin-fixed paraffin-embedded tissue sections with biotinylated DNA probes. Two cases of disseminated CMV infection were studied at autopsy by this highly specific technique. The presence of CMV in cytomegalic cells is readily shown. In addition, CMV has been detected and localized in many normal-appearing cells. This occult infection occurs in cardiac myocytes, hepatocytes, spleen and lymph node reticular cells, endometrial stromal and glandular cells, and breast stromal cells, as well as in cells in the renal glomerulus, tubule, and interstitium, adrenal cortex and medulla, fallopian tube submucosa, myometrium, and anterior pituitary. Cytomegalovirus infection of endothelial cells has been further documented by immunohistochemical methods utilizing antibody to Factor VIII. These findings suggest that CMV disseminates hematogenously throughout the body, initiating necrotizing foci of infection. The appearance of many diffuse foci suggests that local viral spread occurs via endothelial cell infection. Surprisingly , lymphocyte involvement was not observed.     

A supertypic HLA-DR specificity (DR4+5) defined by murine monoclonal antibody

The hybridoma technique was used to produce a monoclonal antibody specific for a polymorphic determinant on human la antigens. BALB/c mice were immunized with a B-lymphoblastoid cell line derived from an HLA-DR3/DR4 positive donor. Hybridoma culture supernates were screened in two stages by means of the microcytotoxicity assay. Supernates were first tested against the la-positive immunizing cell line and against la-negative cells. Cultures identified as producing antibody cytoxic for the immunizing cell line but not for la-negative cells were subcultured and the supernates then tested against a selected panel of HLA-D homozygous cell lines (HCL). In this manner, it was possible to identify a microwell of hybrid cells producing an antibody that reacted with a polymorphic HLA-DR determinant. Cells from this culture, designated 17.15, were cloned twice by limiting dilution. Specificity was evaluated with a panel of 39 HCL and B cells from 70 normal donors. Antibody 17.15 recognized a supertypic DR "4 + 5" specificity, which was also present on DRw9 and some DR7 positive cells. These findings suggest that the cross-reactivity groups DR "4 + 5" (MB-3) and DR "4 + 7" (MT-3) defined by alloantisera may share a common supertypic specificity that is recognized by monoclonal antibody 17.15.     

Marital migraine: A refractory daily headache

Of forty patients with daily chronic common migraine headaches, only four (17%) of 23 married patients, but 12 (71%) of 17 unmarried patients, responded to prophylactic drug treatment. Unmarried migraine patients were more likely to acknowledge emotional stress and to seek psychotherapy. Daily migraine appears to be a response to marital stress. Married individuals who deny the presence of emotional stress in their lives and refuse to seek psychotherapy have a low response rate. Marital therapy is an unexplored potential modality of treatment for such patients.     

Short-Term Intensive Group Psychotherapy for Patients with ‘Functionl’ Complaints

Short-term intensive group psychotherapy has been developed as a means of treating outpatients referred for disabling “functional” complaints. In this preliminary outcome study, a majority of the 60 patients presented with refractory physical complaints. After intensive therapy for a mean of three weeks, psychopathology as measured by multiple standardized tests subsided from moderate-to-substantial to slight-to-mild. This improvement was maintained without significant deterioration through the six-month follow-up evaluation     

Review: psychosocial issues in pediatric inflammatory bowel disease

OBJECTIVE: To review and critically evaluate research on psychosocial issues in pediatric inflammatory bowel disease (IBD) and to provide recommendations for future research. METHODS: A literature search was conducted using the Medline and PsychInfo computerized databases as well as the bibliographies of relevant articles. RESULTS: Most of the existing research has compared children with IBD to healthy populations and other illness populations. Compared to healthy children, children with IBD may be at greater risk for difficulties in behavioral and emotional functioning as well as in family and parent functioning, but all such functioning appears similar to that found in other illness populations. It is unclear if the increased risk reaches clinical significance and what role the severity of the disease plays in adjustment. CONCLUSIONS: Future research should use a developmental perspective to investigate the process of adaptation to IBD, risk factors of poor adjustment, and the role of psychosocial factors in health outcomes in pediatric IBD.     

International psychosocial and systemic issues in women's mental health

Summary To clarify perspectives on women's mental health needs, services and policy, a survey was undertaken of the 54 World Psychiatric Association Section of Women's Mental Health members. To complement this, a workshop was convened at the Berlin Congress of Women's Mental Health. International experts from psychiatry, psychology, nursing, sociology, advocacy groups, and consumers highlighted the importance of the context of women's lives, poverty, education, autonomy, reproduction, relationships, violence, discrimination, infectious diseases, special populations and specific topics. Consensus was that emphasis should be on health promotion, public health, health policy and broad determinants of health, rather than focusing solely on services. Social, economic and cultural aspects must be addressed, as well as biological, for only by a change in society's attitudes, will women realize their full mental health. Strong gender perspectives should guide health policy and services, paying attention to how gender roles may enhance or damage health. Effective multidisciplinary participation, working with women, is essential to facilitate optimal international women's mental health.     

Isolation of a new feline sarcoma virus (HZ1-FeSV): Biochemical and immunological characterization of its translation product

A new strain of feline sarcoma virus, designated HZ1-FeSV, was isolated from a 4-year-old domestic cat with multicentric fibrosarcoma. A primary tumor cell line was established and virus produced from that line was found to induce foci in feline embryonic lung fibroblasts (FLF3) and mink lung fibroblasts (CCL64) in tissue culture and fibro-sarcomas in inoculated 10-week-old kittens. The derivation of transformed nonproducer clones of FLF3 and CCL64 cells containing helper virus-rescuable, focus-forming activity indicated that HZ1-FeSV was defective for replication. The only discernible translation product of the HZ1-FeSV genome in cultured cells was a 100,000-Da polyprotein (P100) which contained amino-terminal sequences of the FeLV gag gene precursor protein covalently linked to a sarcoma virus-specific domain. Immunoprecipitates containing P100 exhibited a protein kinase actvity capable of phosphorylating tyrosine residues of P100. Immunologically, P100 was highly cross-reactive with gag-fes polyproteins encoded by two previously characterized strains of FeSV, the GA- and the ST-FeSV. By comparison of methionine-containing tryptic peptides, the HZ1-FeSV protein was shown to be more closely related to the GA-FeSV protein than to the ST-FeSV protein, but to be distinguishable from both other proteins.