Individual psychotherapy with mentally retarded individuals: a review and call for research

Although most mental health professionals doubt the capacity of mentally retarded patients to benefit from psychotherapy, a review of case studies, writings, and research revealed that mentally retarded patients responded positively to treatment. Practitioners familiar with this population developed six major recommendations for adapting psychotherapeutic approaches to mentally retarded patients. In order for therapy to be successful, it is recommended that clinicians adapt standard technique to the patient's cognitive level, be directive in approach, be flexible during therapy, engage significant others in the therapeutic process, carefully manage transference and countertransference issues, and directly address the issue of mental retardation as a disability. The results of three research studies suggested that mentally retarded patients benefit from psychotherapy, although a fourth study showed negative results. There is a great need for systematic research to develop a knowledge base to support the growing applications of psychotherapeutic methods to this population.     

INTRA-AORTIC BALLOON RUPTURE CAUSING FEMORAL ENTRAPMENT

Rupture of an intra-aortic balloon counterpulsator (IABCP) demands immediate removal. We report a case of thrombus formation within a Datascope IABCP secondary to IABCP rupture, necessitating surgical exploration for removal. There is a disturbing pattern of balloon ruptures with this type of IABCP.     

Copper deficiency-induced hypercholesterolemia: effects on HDL subfractions and hepatic lipoprotein receptor activity in the rat

Male Sprague-Dawley rats (10 per group) were fed diets adequate (control) or deficient (CuDef) in copper for 6 wk. In the CuDef group, plasma total cholesterol, high density lipoprotein (HDL) cholesterol and apoA-I levels were significantly higher than in controls. Apolipoprotein analysis of the HDL fractions revealed a relative enrichment of apoE in the CuDef group. Size analysis of 1.21 density lipoproteins by nondenaturing gradient gel electrophoresis demonstrated the presence of more material migrating in the size range of HDL1 in the CuDef group. Separation of HDL into apoE-rich and apoA-I-rich fractions by heparin-affinity chromatography confirmed the presence of increased apoE-rich HDL in the CuDef group. To determine the mechanism responsible for higher apoE-rich HDL in the CuDef group, the lipoprotein receptor binding activity in hepatic membranes from the control and CuDef group was assayed. Kinetic analysis of the binding data revealed that the lipoprotein binding assay was primarily measuring the activity of the HDL receptor, which is not apoE mediated. When corrected for differential enrichment of plasma membrane, hepatic membranes from the CuDef group bound significantly fewer lipoproteins than did controls. Furthermore, the hepatic receptor binding activity was negatively correlated with the proportion of HDL enriched with apoE.