Evaluating the capacity to work of the mentally ill

This study explored the relationship between psychiatric symptomatology and the functional capacity to work. Subjects were diagnosed using DSM-III criteria and were grouped into categories of psychotic or nonpsychotic, and disabled or nondisabled, in regard to adjudication for mental impairment from the Social Security Administration (SSA). There were significant relationships between disability status and work capacity, in the direction of better performance for the nondisabled subjects. This finding reflected concordance between the evaluation procedure used in the study and the SSA's disability determination process. There was considerable overlap in work performance among subjects, however, suggesting that a functional assessment of work capacity might improve disability determination in certain cases. Results suggested that these work assessments might be as short as one or two days.     

Foot-ulcer prevention in the elderly diabetic patient.

Diabetic foot ulceration is frequently the result of repetitive trauma, foot deformity, malfunction, or ill-fitting footwear. The failure of such ulcers to heal is most often a consequence of the failure to provide protection from continuing trauma. Risk evaluation of the diabetic patient, with appropriate correction or accommodation of deformity or mechanical pressure, can be expected to reduce the incidence of serious infection secondary to ulceration.     

Discounting of delayed rewards in opioid-dependent outpatients: exponential or hyperbolic discounting functions?

Recent theories of substance abuse have used value discounting of delayed rewards to partly explain the decision to take drugs. Normative-economic theory holds that an exponential function describes the effects of delay on discounting, whereas the matching law posits a hyperbolic discounting function. The ability of these functions to describe 18 human heroin-dependent individuals' monetary- and heroin-reward delay-discounting functions was assessed. In the 1st condition, participants chose between immediate and delayed hypothetical monetary rewards. Delayed rewards were $1,000, and the immediate reward amount was adjusted until choices reflected indifference. In the 2nd condition, participants chose between immediate and delayed heroin (the delayed amount was that which each participant reported he or she could purchase with $1,000). The hyperbolic function produced significantly higher R2 values and significantly lower sums of squared error values. Consistent with previous findings, delayed heroin rewards were discounted at a significantly higher rate than were delayed monetary rewards.     

Serum levels of CA 125 during the first trimester of normal outcome, ectopic and anembryonic pregnancies

Single serum samples were obtained during the first trimester of pregnancies with a retrospectively normal outcome (n = 150), ectopic pregnancies (n = 38) and anembryonic pregnancies (n = 78). Serial samples during the first trimester were also obtained from 43 women achieving pregnancy following successful treatment for infertility and with a retrospectively defined normal outcome. Significant variation in serum CA 125 levels in relation to gestational age was observed in pregnancies with a normal outcome (P less than 0.0001). Peak serum CA 125 levels were observed at 6-7 weeks, the mean level at this gestation being 40.1 U/ml (range 31.7-50.7 U/ml) in the normal conception/normal outcome group and 36.5 U/ml (range 25.6-52.0 U/ml) in the assisted conception/normal outcome group. A rise and fall in serum CA 125 levels during the first trimester was observed in 42 of 43 assisted conceptions monitored serially, with peak levels ranging from 7 to 1398 U/ml (median 48.8 U/ml) occurring at 28-61 days (median 45 days) gestation. Mean serum CA 125 levels were higher in the anembryonic pregnancy group at 4-5 and 6-7 weeks gestation than in both normal pregnancy outcome groups (P less than 0.01).     

Characterization of Orbiviruses of the Kemerovo serogroup: Isolations and serological comparisons

Summary Nine Orbiviruses of the Kemerovo serogroup were isolated from ticks collected in seabird colonies situated in the U.K., Faeroe Islands, Norway, Morocco and California, U.S.A. Comparison by serological tests with previously reported members of the Kemerovo serogroup demonstrated that viruses isolated from the hard tick,Ixodes uriae, were members of the Great Island subgroup, whereas viruses from soft ticks,Argas monolakensis andOrnithodoros maritimus, belonged to the Chenuda subgroup. Members of the Chenuda group differed from the Great Island group in their ability to produce plaques inXenopus cell cultures and in the time taken to produce clinical signs in infected mice.     

Duplex imaging and incidence of carotid radiation injury after high-dose radiotherapy for tumors of the head and neck

Radiation-induced carotid artery disease following high-dose (greater than 50-Gy) radiotherapy for head and neck cancer may become more common as improved treatment results in longer survival. Duplex ultrasound scans were obtained in 91 consecutive patients to determine whether increased incidence and severity of extracranial carotid disease correlate with prior radiotherapy. Fifty-three patients who underwent radiotherapy an average of 28 months previously and 38 patients who received no radiotherapy were studied. Thirty percent of the irradiated group had lesions of the carotid arteries that were either moderate or severe vs only 6% of the control patients. Five patients were symptomatic; all had undergone radiotherapy. Long-term follow-up with sequential duplex ultrasound examinations is indicated in patients receiving high-dose radiotherapy for head and neck tumors, to detect radiation-induced carotid artery disease and prevent late sequelae.     

Silent brain lesions in patients with isolated idiopathic optic neuritis. A clinical and nuclear magnetic resonance imaging study

Eight of 16 patients with isolated idiopathic optic neuritis were found to have one to several brain lesions by nuclear magnetic resonance scanning. The brain lesions were predominantly located in the periventricular white matter; their appearances, locations, and extents were similar to those seen in recent nuclear magnetic resonance studies of patients with definite multiple sclerosis. All of these brain lesions were clinically silent and were missed by computerized tomography. Idiopathic optic neuritis may be the only manifestation of a multicentric disease process that is disseminated in the central nervous system in the majority of cases.     

DNA content and cell cycle analysis of bone marrow cells in myelodysplastic syndromes (MDS)

DNA distribution in bone marrow cells from 10 normal subjects and 34 patients with MDS (24 with refractory anaemia (RA) and 10 with excess blasts (RAEB] was determined by flow cytometry using a FACS III. DNA histograms were resolved into G0/1, S and G2/M compartments by fitting Gaussian distributions and the DNA content of G0/1 cells, expressed as DNA index (DI), was determined. In 19 MDS patients the DI was outside the normal range, those with RA tending to be hyperdiploid. Two patients with RAEB had a second G0/1 peak. In five cases of RA the number of cells in G0/1 was below the normal range and the mean value was significantly lower than normal for this group as a whole (P = 0 X 018). Eleven (RA) patients had a higher percentage of cells in G2/M than normal (P = 0 001). In RAEB patients there is a suggestion of increased numbers in G0/1 and a decrease in S phase and G2/M cells. All three of the deaths amongst RA patients and four out of the five deaths in RAEB patients since the beginning of this study were associated with an abnormal DI at the initial investigation.