Medical Library

Lack of a close confidant: Prevalence and correlates in a medically underserved primary care sample.

The present study examined prevalence of lack of a close confidant in a medically underserved primary care sample, and evaluated demographic, medical, and psychological correlates of patients\’ deficits in close, personal contact. Adult patients (n = 413) reported on confidant status and symptoms of depression and anxiety. Sociodemographic and medical information were obtained through chart review. One-quarter of patients endorsed lack of a close confidant. Past month anxiety and depression symptoms, but not medical status, were associated with unmet socioemotional needs. Implications for primary healthcare interventions are discussed.

Newton T, Buckley A, Zurlage M, Mitchell C, Shaw A, Woodruff-Borden J.

Department of Psychological & Brain Sciences, University of Louisville, Louisville, Kentucky, USA.

Acute psychological benefits of aerobic exercise: A field study into the effects of exercise characteristics.

Eighty volunteers were tested in their natural exercise environment consisting of a fitness centre they regularly attended. Half of the sample exercised on a stationary bicycle, the other half on a treadmill. All participants filled in the Exercise-Induced Feeling Inventory before and after their 20 min of exercise that was performed at self-selected workload. The results revealed that exercise intensity and the other parallel measures like heart rate, perceived exercise intensity and estimates of burned calories were higher in participants who ran in contrast to those who cycled. There were no differences in self-reports of enjoyment of the exercise sessions and in the psychological improvements from pre- to post-exercise between the groups. It is concluded that significant psychological improvements occur even after a 20-min bout of exercise and these changes are independent of the workload or exercise intensity.

Rendi M, Szabo A, Szabó T, Velenczei A, Kovács A.

Faculty of Physical Education and Sport Sciences, Semmelweis University, Budapest, Hungary.

Mediating relationship between body mass index and the direct measures of the Theory of Planned Behaviour on physical activity intention.

This research examines (a) the interrelationships between body mass index (BMI), the direct measures of the Theory of Planned Behaviour (TPB) and physical activity intention and (b) the potential mediation effects of the direct measures of the TPB in the relationship between BMI and physical activity intention in a sample of Australian adults. A total sample of 1,062 respondents participated in a computer-assisted telephone-interview (CATI) survey comprised of a standardised introduction; questions regarding TPB and physical activity; and standard demographic questions. BMI for each participant was calculated from self-reported height and weight. Separate regression analyses were performed to examine the mediating effects of each of the direct measures of the TPB on the predictive relationship between the BMI and physical activity intention, as proposed by Baron and Kenny (Journal of Personality and Social Psychology, 51(6), 1173 - 1182, 1986). Findings indicated that the direct measure of attitude and perceived behavioural control mediated the relationship between BMI and physical activity intention. However, the direct measure of subjective norm failed to act as a mediating mechanism. To date there has been no research that has examined the mechanism by which body mass may affect physical activity behaviour. Given the current focus for health promotion specialists on promoting physical activity as a strategy for reducing overweight and obesity, a theoretical understanding of weight-related barriers to physical activity may aid in the development of future interventions and community physical activity programs, particularly those targeting overweight and obese populations.

Caperchione CM, Duncan MJ, Mummery K, Steele R, Schofield G.

Centre for Social Science Research, Central Queensland University, Australia.

Anxiety in recovery from severe burn injury: An experimental comparison.

Adjustment to burn injury is a slow process that often results in high distress and anxiety. This study aimed to investigate the impact on anxiety of viewing various types of photographic stimuli (including burn injuries), comparing a burn-injured and control sample. An experimental design was used comparing those recovering from a burn injury with age- and gender-matched controls. Thirty participants from a burns support group and their matched controls were asked to complete a trait anxiety measure (STAI Y-2). Participants then completed the state anxiety measure (STAI Y-1) after viewing different types of photographic stimuli (burn injuries, uninjured body parts, neutral) under controlled experimental conditions. Results demonstrated significant differences in anxiety levels between groups with respect to trait anxiety and state anxiety after each experimental condition. Age of injury was also found to be a significant influence over trait anxiety. A significant effect of experimental condition was found, as was a significant interaction between group and condition. Those with burn injuries were more anxious than controls - a difference that was further exaggerated when participants viewed photographs of burned or uninjured body parts in an experimental setting.

Hulbert-Williams NJ, Hulbert-Williams SL, McIlroy D, Bunting B.

Department of Primary Care and Public Health, North Wales Clinical School, Cardiff University, Wrexham, UK.

Longitudinal associations among quality of life and its predictors in patients treated for prostate cancer: The moderating role of age.

This study examined moderating effects of age on longitudinal associations among quality of life (QOL) and its demographic (e.g., age), clinical [e.g., prostate-specific antigen (PSA) level], and affective and cognitive predictors (i.e., distress, worries about recurrence, decisional regret, subjective life expectancy) in prostate cancer patients treated with external beam radiation (N = 391). Demographic and clinical characteristics were assessed at diagnosis, affective and cognitive variables at 6 months after diagnosis, and QOL at 12 months after diagnosis. Multiple-group analyses showed that among younger patients (</=68 years old, n = 199), lower levels of decisional regret were associated with better functional QOL, and lower Gleason scores and PSA levels were associated with lower levels of distress and longer expected survival time, respectively. Being employed was related to higher levels of functional QOL and frequent worries about recurrence. Among older patients (>68 years old, n = 192), lower levels of distress were associated with higher levels of functional QOL, and longer expected survival time was associated with better functional and physical QOL.

Diefenbach M, Mohamed NE, Horwitz E, Pollack A.

Urology & Oncological Sciences, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY, USA.

Psychological impact of illness intrusiveness in epilepsy - Comparison of treatments.

Chronic illnesses are associated with multiple stressors that compromise quality of life (QOL). Implicit in many of these is the concept of illness intrusiveness, the disruption of lifestyles and activities attributable to constraints imposed by chronic disease and its treatment. This study tested the illness intrusiveness theoretical framework in epilepsy and compared the impact of pharmacological and surgical treatments on illness intrusiveness and QOL. Cross-sectional data compared three epilepsy groups (N = 145): (a) 40 patients admitted for presurgical evaluation to an Epilepsy Monitoring Unit; (b) 52 patients treated pharmacologically; and (c) 53 post-surgical patients. Illness intrusiveness differed significantly across epilepsy patients with the differences primarily related to seizure control. Illness intrusiveness varied inversely with seizure control (p < .05). Seizure freedom, whether achieved by surgical or pharmacological treatments, was associated with maximal reduction of illness intrusiveness. Increased illness intrusiveness correlated significantly with decreased QOL and increased depressive symptoms. Perceived control over diverse life domains correlated positively with QOL and psychosocial outcomes. Path analysis supported the validity of the illness intrusiveness theoretical framework in epilepsy. Illness intrusiveness is an important determinant of the psychosocial impact of epilepsy and its treatment. Effective pharmacological or surgical treatment may reduce illness intrusiveness in epilepsy. Findings also offer encouragement that QOL in epilepsy, as in other chronic conditions, may be enhanced by multidisciplinary bio-psychosocial efforts. Health care providers should consider multifaceted interventions to reduce illness intrusiveness and, thereby, improve QOL.

Poochikian-Sarkissian S, Sidani S, Wennberg RA, Devins GM.

University Health Network, Division of Neurology, Krembil Neuroscience Program, University of Toronto, Toronto Western Hospital, Toronto, Ontario, Canada.

Errata.

Crescentic glomerulonephritis associated with non-tuberculous mycobacteria infection.

A 72-year-old woman with a previous diagnosis of non-tuberculous mycobacteria (NTM) pulmonary disease was admitted because of hemoptysis and acute renal failure. A chest x-ray showed interstitial infiltration over bilateral lung fields. A kidney biopsy showed immune complex-mediated crescentic glomerulonephritis and diffuse endocapillary hypercellularity with exudative neutrophils. Reactive NTM infection of the lungs was suspected when mycobacterial cultures of the sputum repeatedly yielded Mycobacterium avium. A lung biopsy revealed chronic inflammation without evidence of alveolar capillaritis. NTM pulmonary disease was further confirmed by tissue culture of the lung biopsy specimens. Anti-tuberculous drugs in combination with clarithromycin were given for the treatment of NTM infection. Because of the risk of aggravating underlying infectious disease, immunosuppressive therapy for crescentic glomerulonephritis was not carried out. Pulmonary symptoms promptly responded to treatment. Furthermore, renal function steadily improved after the initiation of anti-NTM therapy. To our knowledge, this is the first report of crescentic glomerulonephritis associated with NTM infection.

Wen YK, Chen ML.

Division of Nephrology, Changhua Christian Hospital, Changhua, Taiwan.

Mycobacterium chelonae Peritonitis in a Patient on Peritoneal Dialysis.

Non-tuberculous mycobacteria peritonitis is uncommon with the majority of cases reported in patients on peritoneal dialysis with diagnostic and therapeutic challenges. Here we present a case of Mycobacterium chelonae peritonitis and review other cases in the literature to discuss the clinical spectrum, diagnostics, regimens and duration of treatment, and outcome.

Lee KF, Chen HH, Wu CJ.

Division of Nephrology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan.

Unusual manifestation of diarrhea-associated haemolytic uraemic syndrome in an adult.

Hemolytic-Uremic Syndrome (HUS) is an uncommon disease characterized by microangiopathic hemolytica anaemia, thrombocytopenia, and acute renal failure. There are two forms of HUS: diarrhoea (D+)- and non-diarrhoea (D-)-associated HUS. We report the case of a 21-year-old woman presented to our department with jaundice, anaemia, thrombocytopenia, and anuria, preceded by a diarrheal prodrome, secondary to infection with Escherichia coli O157:H7. The whole clinical and laboratory investigation led to the diagnosis of HUS. Her condition was complicated with cholestasis, liver dysfunction, bleeding from the vagina, and myocardial involvement. She was treated only with fresh frozen plasma transfusions and hemodialysis, and despite the long duration of anuria (22 days), the patient showed subsequent improvement over days until full recovery one month later.

Anagnostis P, Stangou M, Leontsini M, Athyros VG, Karagiannis A.

Second Propedeutic Department of Internal Medicine, Aristotle University, Hippokration Hospital, Thessaloniki, Greece.