Severity of bulimia: Relationship with depression and other psychopathology

There were 53 women (35 bulimics and 18 normal controls) who were compared on the Minnesota Multiphasic Personality inventory, the Symptom Checklist-90R, and the Beck Depression Inventory. The bulimics were separated into two groups, high (N = 18) and low (N = 17) frequency purgers, based upon a median split self-monitored purging data. Bulimics who purged less than 3 times per week (M = 1.71) were classified as low frequency purgers, and those who purged more than 3 times per week (M = 9.94) were classified as high frequency purgers. Comparisons of the three groups showed that both groups of bulimics differed from normals on measures of depression, but on other measres, i. e., anxiety interpersonal sensitivity and sociopathic trait, only the high frequency purgers differed from normals. Correlational analyses indicated that these same variables, and especially depression, were positively correlated with purging, suggesting that severity of bulimia may be associated with additional psychopathology. These findings were discussed in terms of the existing literature concerning the psychopathology of bulimia.     

Psychopathology associated with bulimia,binge eating,and obesity

Bulimic binge-purgers, bulimic binge-eaters, nonbulimic obese presenting for treatment for obesity, obese not in treatment, and normal control subjects were compared using the Minnesota Multiphasic Personality Inventory (MMPI), Symptom Checklist-90-Revised (SCL-90-R), and Beck Depression Inventory (BDI). Results suggested a continuum of severity, with the binge-purger group showing the highest levels of psychopathology, and the binge-eaters and clinical obese showing significantly more distress than the two control groups. Analysis of the frequency of clinically elevated scores on each scale of the MMPI and SCL-90R as well as the BDI as a function of group indicated that the clinical groups evidenced significantly greater psychopathology compared with their appropriate control groups. These results clarify some of the conflicting results of previous investigations of obesity which did not differentiate obese patients and nonpatients. The implications of these findings for treatment research on obesity are that perhaps a more broadspectrum form of treatment may be required in order to address the psychological problems of the chronically obese.     

Marital relationships and conflict resolution skills of bulimics

Twelve bulimic couples were compared to 14 maritally distressed couples and 15 normal control couples on measures of relationship satisfaction, conflict resolution styles, and beliefs about intimate relationships. Bulimics reported global relationship dissatisfaction with their marriages similar to that felt by women seeking marital therapy. Bulimics were also similar to females in distressed marriages in their reported use of few problem-solving skills and withdrawal from conflict. Bulimics and maritally distressed females subscribed to the dysfunctional belief that “partners cannot change.” These results provide support for the contention that bulimics experience dissatisfaction with their interpersonal relationships and that this dissatisfaction is accompanied by self-reported deficiencies in conflict resolution skills.     

Natural killer (NK) cells in chronic progressive multiple sclerosis patients treated with lymphoblastoid interferon

Natural killer (NK) cell functional activity, as defined by the lysis of 51Cr-labelled K-562 cells, and number, defined phenotypically by anti-Leu-11, are significantly decreased in chronic progressive multiple sclerosis (MS) when compared to normal controls. When age- and sex-matched populations are compared, NK cell functional activity is again significantly reduced in MS compared to controls but not when compared to a control group of other medical disease (OMD). The MS group could be differentiated from the OMD group, however, when results of NK cell functional activity are combined with NK cell phenotype. With the administration of lymphoblastoid interferon daily for 6 months, NK cell activity increased significantly at 48 h and at 1 week. By 1 month, activity decreased to a level slightly above placebo treatment values. The results likely reflect interferon's enhancement of mature NK cell activity combined with a variable effect on recruitment of pre-NK cells.     

Analysis of gender effects upon verbal and visual memory performance in adults

This study investigated gender effects on verbal and visual memory performance in normal adults (age range 18-91 years). The subjects were 140 volunteers (70 male, 70 female). Individuals in each male-female pair were matched within three years on age and two years on education. Shipley Vocabulary scores for the groups also were equivalent. Subjects were administered the Continuous Visual Memory Test (CVMT), Visual Reproduction subtest (VR), Verbal Selective Reminding Test (VSRT), and Expanded Paired Associate Test (EPAT). Results revealed no differences between males and females for either the Acquisition or Delayed phases of the CVMT and EPAT. Differences for the Delayed VR task also were not significant. Male-female differences for the Immediate VR task were marginally significant, although the mean difference was less than one point, females consistently outperformed males on the VSRT, particularly in the Acquisition phase. Differences on the Delayed task, while statistically significant, averaged only 12 point.     

Intraoperative transesophageal echocardiography during surgery for congenital heart defects

OBJECTIVE: This study was undertaken to further define the impact of intraoperative transesophageal echocardiography during surgery for congenital heart disease and to determine appropriate indications. METHODS: The impact of transesophageal echocardiography on patient care was assessed in 1002 patients who underwent this procedure during surgery for congenital heart defects. It had major impact when new information altered the planned procedure or led to a revision of the initial repair. The safety of intraoperative transesophageal echocardiography was evaluated by review of the prospective data sheets and the medical record. A simple relative cost analysis was also performed. RESULTS: Patient median age was 9.9 years (range 2 days to 85 years). Transesophageal echocardiography had prebypass or postbypass major impact in 13.8% of cases (n = 138/1002). Major impact was more frequent during reoperations (P <.03). Procedures that benefited most from the additional information were valve repairs (aortic or atrioventricular) and complex outflow tract reconstructions. Partial anomalous pulmonary venous connection, tricuspid valve repair (other than of Ebstein anomaly), simple atrioventricular discordance, aortic arch anomalies, and secundum atrial septal defects had major impact rates less than 5%. No major complications occurred. Minor complications occurred in 1% of patients and were most often observed in infants smaller than 4 kg. Routine use of transesophageal echocardiography for all patients with congenital heart defects proved cost-effective. CONCLUSIONS: On the combined basis of the observed rates of major impact, the minimal complications, and the relative cost advantage, we believe that routine use of transesophageal echocardiography during most intracardiac repairs of congenital heart defects is justified, particularly for patients undergoing repeat operations for congenital cardiac malformations.     

Aquaporins and brain edema

Aquaporins are a family of transmembrane proteins that selectively allow the passage of water through the plasma membrane. Their importance is highlighted by their ubiquitous presence from bacteria to mammals. In humans, they are found throughout the body and recent work has highlighted their function within the brain. They are intimately involved in the production of cerebrospinal fluid and the control of water movement at the blood-brain barrier. Aquaporin levels are up-regulated in animal models of trauma, stroke and water intoxication as well as around human malignant brain tumors. They have thus been implicated in the formation of brain edema. Knockout mice, without the aquaporin gene, appear to have reduced brain edema compared to their wild type brethren in models of brain edema. Currently, the clinical treatment of brain edema is limited. Increased knowledge of the aquaporins may open new targeted therapies for brain edema.     

Endoscopic release of the carpal tunnel: A randomized prospective multicenter study

A 10-center randomized prospective multicenter study of endoscopic release of the carpal tunnel was carried out. Surgery was performed with a new device for transecting the transverse carpal ligament while control hands were treated with conventional open surgery. There were 122 patients in the study; 25 had carpal tunnel surgery on both hands and 97 had surgery on one hand. Of the surgical procedures, 65 were in the control group and 82 were in the device group. The endoscopic device was coupled to a fiberoptic light and a video camera. A trigger-activated blade was used to incise the transverse carpal ligament. After surgery, the best predictors of return to work and to activities of daily living were strength and tenderness variables. For patients in the device group with one affected hand, the median time for return to work was 21 1/2 days less than that for the control group. Two patients treated with the endoscopic device required reoperation by open surgical decompression; only one of these had incomplete release with the device. Two patients in the device group experienced transient ulnar neurapraxia.