Tracing long-term effects of early trauma: a broad-scope view of Holocaust survivors in late life

This study addressed long-term effects of extreme trauma among Holocaust survivors (N = 126) in an older (75-94 years) sample of the Israeli Jewish population. Survivors were compared with European-descent groups that had immigrated either before World War II (n = 206) or after (n = 145). Participants in the latter group had had Holocaust-related life histories but did not consider themselves survivors. Controlling for sociodemographics, the results indicated that survivors fared worse than prewar immigrants in certain psychosocial domains, mainly cumulative distress and activity, rather than in health-related ones. Survivors and postwar immigrant comparisons had almost no differences. The study highlights the need for a wide view of functioning facets and comparison groups in delineating late posttraumatic effects.     

Airbag-induced bilateral corneal graft dehiscence

PURPOSE: To report a case of bilateral corneal graft dehiscence caused by blunt trauma. METHODS: Case report of bilateral simultaneous corneal graft dehiscence with expulsion of the lens and iris as a result of airbag-induced trauma. RESULTS: Both corneal buttons were resutured, the prolapsed iris tissue was repositioned in the right eye, and anterior vitrectomy was performed bilaterally. Topical and systemic antibiotics, topical steroids, cycloplegic agents, and antiglaucoma drugs were initiated. Repeated B-scan ultrasound examinations demonstrated an attached retina in both eyes. Three weeks after admission, the right eye was reoperated for removal of remnant lens material and additional anterior vitrectomy. The patient was fitted with polycarbonate spectacles with an optical correction of +8 in both eyes. Visual acuity improved to 20/200 and 0.5/60 in the right and left eyes, respectively. The right corneal graft regained transparency, but the left one remained hazy. CONCLUSION: Airbag deployment during motor vehicle collisions is a significant cause of ocular morbidity. The reported risk of airbag-related eye injury is 2.5% for any eye injury and 0.4% for severe eye injury. Patients undergoing corneal surgery should be counseled about the weakness of the donor-recipient interface and should consider wearing protective glasses.     

Sexual function and behavior in social phobia

BACKGROUND: Social phobia is a type of performance and interpersonal anxiety disorder and as such may be associated with sexual dysfunction and avoidance. The aim of the present study was to evaluate sexual function and behavior in patients with social phobia compared with mentally healthy subjects. METHOD: Eighty subjects participated in the study: 40 consecutive, drug-free outpatients with social phobia (DSM-IV) attending an anxiety disorders clinic between November 1997 and April 1999 and 40 mentally normal controls. The Structured Clinical Interview for DSM-IV Axis I Disorders and the Liebowitz Social Anxiety Scale were used to quantitatively and qualitatively assess sexual function and behavior. RESULTS: Men with social phobia reported mainly moderate impairment in arousal, orgasm, sexual enjoyment, and subjective satisfaction domains. Women with social phobia reported severe impairment in desire, arousal, sexual activity, and subjective satisfaction. In addition, compared with controls, men with social phobia reported significantly more frequent paid sex (p < .05), and women with social phobia reported a significant paucity of sexual partners (p < .05). CONCLUSION: Patients with social phobia exhibit a wide range of sexual dysfunctions. Men have mainly performance problems, and women have a more pervasive disorder. Patients of both genders show difficulties in sexual interaction. It is important that clinicians be aware of this aspect of social phobia and initiate open discussions of sexual problems with patients.     

Control of vocal loudness in young and old adults.

This study examined the effect of aging on respiratory and laryngeal mechanisms involved in vocal loudness control. Simultaneous measures of subglottal pressure and electromyographic (EMG) activity from the thyroarytenoid (TA), lateral cricoarytenoid (LCA), and cricothyroid (CT) muscles were investigated in young and old individuals while they attempted to phonate at three loudness levels, "soft," "comfortable," and "loud." Voice sound pressure level (SPL) and fundamental frequency (F ) measures were also obtained. Across loudness conditions, subglottal pressure levels were similar for both age groups. Laryngeal EMG measures tended to be lower and more variable for old compared with young individuals. These differences were most apparent for the TA muscle. Finally, across the three loudness conditions, the old individuals generated SPLs that were lower overall than those produced by the young individuals but modulated loudness levels in a manner similar to that of the young subjects. These findings suggest that the laryngeal mechanism may be more affected than the respiratory system in these old individuals and that these changes may affect vocal loudness levels.     

The Incidence, Pathophysiology, Treatment and Prognosis of Cheyne-Stokes Breathing Disorder in Patients with Congestive Heart Failure

Definition: Cheyne-Stokes respiration is a breathing disorder characterized by recurrent central sleep apneas, mainly during sleep, alternating with a crescendo-decrescendo pattern of tidal volume. Pathophysiology and Prognosis: The pathophysiology of Cheyne-Stokes respiration, involving the cardiovascular, pulmonary and sympathetic nervous system, is still not well understood. Although 50% of moderate to severe congestive heart failure patients suffer from significant Cheyne-Stokes respiration, studies been undertaken to determine the prevalence of this phenomenon and its implications regarding patients' life expectancy and quality of life were conducted only in recent years. Other studies suggest that Cheyne-Stokes respiration has a negative prognostic value upon congestive heart failure patients. Treatment: Novel therapeutic approaches have been attempted in order to treat Cheyne-Stokes respiration; they include oxygen delivery, various pharmaceutical treatments aimed to stabilize the ventilatory system and other pharmaceutical treatments aimed to improve the left ventricular ejection fraction. However, none of them was effective. Objectives: This review summarizes some of the current knowledge regarding Cheyne-Stokes respiration pathophysiology, prevalence, prognostic implication and available treatments. Definition: Das Cheyne-Stokes-Atemmuster wurde erstmalig zu Beginn des 19. Jahrhunderts beschrieben und kennzeichnet eine Atemstörung, bei der vor allem während des Schlafs Atempausen (Apnoephasen) auftreten. Diese Apnoephasen wechseln mit einem Atemmuster mit Kreszendo/Dekreszendo-Charakter ab. Pathophysiologie und Prognose: Die Pathophysiologie der Cheyne-Stokes-Atmung, die kardiovaskuläre, pulmonale und zentralvenöse Aspekte umfasst, ist noch weitgehend unklar. Obwohl nahezu 50% der Patienten mit schwerer Herzinsuffizienz eine Cheyne-Stokes-Atmung aufweisen, wurden erst in den letzten Jahren die Prävalenz dieser Begleiterkrankung und die möglichen Auswirkungen auf die Lebenserwartung und die Lebensqualität charakterisiert. Erste Studien lassen vermuten, dass Patienten mit Cheyne-Stokes-Atmung eine deutlich schlechtere Prognose als Patienten mit Herzinsuffizienz ohne Cheyne-Stokes-Atmung aufweisen. Behandlung: Ziel der bisher eingesetzten Therapie ist es, das Atemsystem zu stabilisieren und die kardiovaskuläre Funktion zu optimieren, um dadurch das Leben der Patienten zu verlängern. Doch weder die Verabreichung von Sauerstoff noch der Einsatz verschiedener pharmakotherapeutischer Konzepte zeigten bisher einen nachhaltigen Erfolg. Gegenstand: In dieser Übersicht werden wichtige Aspekte der Pathophysiologie der Cheyne Stokes Atmung, seine prognostische Bedeutung sowie vorhandene Therapiekonzepte besprochen und kritisch bewertet.     

A solid-phase antibody binding-inhibition test,for the assay of Plasmodium berghei antigen and antibodies,using radioiodinated protein A

Sonicated red blood cells (RBC) of rats infected with Plasmodium berghei (Pb) were used to coat plastic tubes with Pb antigens. The antigen-coated tubes were employed to detect Pb antigens and antibodies, with high efficiency. Anti-Pb antibodies were estimated by treating the tubes with rabbit or rat anti-Pb sera and assaying the bound Ig with radiolabeled Staphylococcus PrA. Pb antigens were detected by their capacity to inhibit the binding of the anti-Pb antibodies. Using a rabbit-Pb serum, sonicated, infected RBC (50% parasitemia) gave detectable inhibition up to 1 : 10⁶ dilution.