Validity of self-administered symptom scales in clients with schizophrenia and schizoaffective disorders.

Few studies have used self-administered symptom scales as outcome measures with individuals who have schizophrenia. However, with the increase in community-based treatment for the serious and persistently mentally ill and the emphasis on client empowerment, their ability to monitor and report symptoms needs to be assessed. Two forms of self-administered items, symptom distress statements and symptom intensity statements, were formed from 10 BPRS symptoms and administered to 29 individuals with schizophrenia. Both forms of self-administered items were highly correlated with BPRS items, supporting concurrent validity. Self-administered responses for positive symptoms of schizophrenia and nonpsychotic symptoms may be more valid than self-administered responses for negative or deficit symptoms.

State-outcome consistency in smoking relapse crises: a reversal theory approach.

Previous investigations of smoking relapse crises have found limited within-subject consistency. Several investigators have suggested that greater consistency might be observed if situations were described phenomenologically. Reversal theory provides one phenomenological framework. Two relapse crises from each of 49 ex-smokers were compared, using reversal theory constructs. Maintaining abstinence in both crises was consistently associated with being in serious-minded (telic) and conformist states. Smoking in both crises was consistently associated with being in playful (paratelic) or negativistic states. Crises with different outcomes occurred in different state combinations. The findings suggest that coping strategies should be state-tailored for optimal effectiveness.

Reversal theory and smoking: a state-based approach to ex-smokers' highly tempting situations.

Reversal theory provides a new approach to understanding ex-smokers' behavior during highly tempting situations. Hypotheses derived from the theory were tested in 2 studies of the highly tempting situations of ex-smokers drawn from community smoking cessation programs. Study 1 consisted of interviews with 55 Ss (25 men and 30 women, mean age 37 years) conducted 3 months after cessation. Study 2 consisted of interviews with 104 Ss (45 men and 59 women, mean age 41 years) conducted 6, 9, 12, and 15 months after cessation. All interviews were coded using reversal theory constructs. Results supported the hypotheses that individuals in paratelic or negativistic states were more likely to lapse than individuals in telic/conformist states and that cigarette availability was related to lapses in paratelic, but not telic, states. Reversal theory constructs accurately classified 93% and 85% of the cases, suggesting that the theory provides an improved model for understanding behavior during highly tempting situations.

Female substance abuse: characteristics and correlates in a sample of inpatient clients.

This article reports on a study of 64 female substance abusers in residential treatment for chemical dependency. This study was conducted with the purpose of describing the associations between: (a) demographic characteristics, (b) presence and severity of addiction, (c) depression, and (d) self-esteem. All participants were drawn from inpatient females, and were administered questionnaires that included the following instruments: (a) Screening/Intake Assessment, (b) the Michigan Alcohol Screening Test, (c) the Addiction Presence and Severity Index, (d) the Provision of Social Relations Scale, (e) the Rosenberg Self-Esteem Scale, and (f) the Costello-Comrey Depression Scale. Multivariate analyses revealed that levels of self-esteem were related to detoxification status and social support. Depression levels were associated with social support, and severity of addiction was more pronounced for White clients than Black clients in this study. Implications for program development are discussed.

[Etiopathogenesis of age-related macular degeneration and present possibilities of treatment]. / Etiopatogenéza vekom podmienenej makulárnej degenerácie a súcasné moznosti jej liecby.

Age-related macular degeneration is the frequent cause of central visual acuity loss in the elderly patients group. The authors analyze in detail the pathogenesis of the process. The explanation of pathogenesis enables therapeutical intervention even though its possibilities are limited. Photodynamic therapy induces pharmacological thrombosis without any damage to the retina in the macular area. Pilot studies have demonstrated complete occlusion new vessels without any alteration of the photoreceptor layer. Age-related macular degeneration still remain a challenge for ophthalmologist and it also poses a serious social problem.

[The importance of albuminuria in the detection of diabetic nephropathy and its relation to the development of retinopathy and autonomic neuropathy in type I diabetes]. / Význam albuminúrie pre urcenie diabetickej nefropatie a ich vzt'ah k vývoju retinopatie a autonómnej neuropatie u diabetikov I. typu.

A series of 72 type I diabetics was grouped according to the mean value of 24-h albuminuria (AU) determined from three 24-h urine collections: group A (n = 49, normoalbuminuria, AU less than or equal to 26 mg/24 h), group B (n = 16, microalbuminuria, AU less than or equal to 26 mg/24 h), group C (n = 7, clinically significant proteinuria, AU greater than 260 mg/24 h). Glycosylated hemoglobin (GHb) was examined five times in three-month intervals. Systolic and diastolic blood pressure (BPs and BPD) were determined from four values taken in the course of one year. Glomerular filtration (GF) was established a single examination of 24-h creatinine clearance. Fluorescent angiography was used to examine the fundus of the eye. The function of the cardiovascular autonomic nervous system was assessed on the basis of three tests: variation of heart rate during deep respiration, response of heart rate to upright position, Valsalva's maneuver. Group C had the longest duration of diabetes, the highest GHb, the lowest GF, and the highest BPS and BPD values. The number of diabetics with different findings on the fundus of the eye (normal finding/simple retinopathy/preproliferative and proliferative retinopathy) was as follows: group A--15/31/3, group B--9/6/1, group C--0/3/4. Group C exhibited the most pronounced derangement of the cardiovascular autonomic nervous system, whose extent depended on the length of diabetes duration and on the quality of metabolic compensation. Between the groups A and B no significant differences were found in any of the parameters studied.(ABSTRACT TRUNCATED AT 250 WORDS)

[The Slovak study of the travoprost treatment efficacy]. / Slovenská stúdia efektivity liecby travoprostom.

PURPOSE: To confirm the efficacy of the travoprost treatment during twelve months follow-up in groups of patients: without previous treatment, with different previous anti-glaucomatous treatment, and with different stage of compensation. PATIENTS AND METHODS: The study evaluates the lowering of the intraocular pressure (IOP) in 143 patients (286 eyes). The intraocular pressure was measured by means of aplanation tonometry, before the treatment started, and after 1, 3, 9, and 12 months at 8-9 o'clock a.m. Patients were divided into eight groups according to the previous mono therapy or combined therapy substituted by travoprost mono therapy or its combination. A special group constituted patients with travoprost as a primary treatment. RESULTS: In the first group, with latanoprost substituted by travoprost, the intraocular pressure decreased by 7% (p < or = 0.0001). In the second group of patients, with travoprost as the primary glaucoma treatment, the intraocular pressure decreased by 22% (p < or = 0.0001). In the third group, the beta-blocker was substituted by travoprost, with 22 % (p < or = 0.0001) decrease of the IOP. In the fourth group, the combined therapy of beta-blocker with latanoprost was substituted by combination of beta-blocker and travoprost and the decrease by 8% (p < or = 0.0001) was significant during the first nine months of the follow-up period, later on, the decrease was not significant. The substitution of the combination of beta-blocker and latanoprost by travoprost mono therapy in the fifth group created only no significant lowering of the IOP during the whole follow-up period. If the travoprost mono therapy substituted the combination of beta-blocker with local carboanhydrase inhibitor in the sixth group, the IOP decreased by 20% (p < or = 0.001). In the seventh group, the combination of the local carboanhydrase inhibitor and latanoprost was substituted by combination of the local carboanhydrase inhibitor with travoprost, the IOP lowering was not significant. On the other hand, in the eighth group, different combinations of antiglaucomatics were substituted by travoprost, and this caused significant lowering of IOP by 20% (p < or = 0.0001). In all cases, the lowest decrease of IOP during the whole follow-up period in the eye with worse compensation is given. CONCLUSION: Travoprost lowered effectively the intraocular pressure in 6 out of 8 groups of patients, e.g. in 129 patients (out of 143 patients), the range of lowering was 7-28% bellow the initial level, the follow up period was 12 months. The decrease of the IOP was stable. The drug was well tolerated.

[Treatment of recurrent corneal erosion]. / Liecba recidivujúcej erózie rohovky.

The author presents an account on 27 patients with relapsing corneal erosion 6 to 60 months after phototherapeutic keratectomy. The results of this treatment confirm unequivocally that the method is safe, highly effective and relieves the patient rapidly and for a long period (possibly permanently) of complaints. A disadvantage is the high cost of the equipment.

[Additive effects of topical carbonic anhydrase inhibitors]. / Aditívny úcinok lokálnych inhibítorov karboanhydrázy.

The author investigated 23 patients with primary open angle glaucoma treated with pilocarpine, timolol, betoptic and latanoprost. Because of inadequate compensation of the basic disease dorsolamide was added and the patients were followed up for a 12-month period. All combinations decreased significantly the intraocular pressure during the long-term follow up. The greatest decrease was recorded after a combination of a prostaglandin analogue and dorsolamide.

[The pseudoexfoliative syndrome and its significance in cataract surgery]. / Pseudoexfoliatívny syndróm a jeho význam pre operáciu sivého zákalu.

OBJECTIVE: To find out factors or combinations of factors leading to increased occurrence of complications in operation on cataract in patients with pseudoexfoliative syndrome. SETTING: Eye Clinic SPAM, Bratislava. METHODS: Prospective non-randomized study in 2916 patient of different age and sex, followed for 6 months after the operation on cataract. The standardized operation protocol was used. Complications were followed during and after the operation in view of released supporting apparatus, loss of vitreous body, uveal reaction and the occurrence of secondary cataract. RESULTS: PEX occurred in 2.98% of the surgically treated patients of the group, most often in the age group of 75-84 years. The occurrence was independent of sex, but increased with age. There was not any relation between age and the type of cataract, incidence of complications, inflammatory reaction, and width of pupil, endo-telepathy and glaucoma. The incidence of per-operation complications in 13.7% is directly related to the syndrome, a narrow pupil, disorder of supporting (suspension) apparatus and worse visual acuity. From the 34 patients with PEX and increased inflammatory reaction, 22.9% suffered from secondary cataract after 6 months. A relationship between width of the pupil, time factor, hardness of cornea and the incidence of inflammatory reaction was demonstrated in 24.1%. CONCLUSION: PEX itself is the source of most severe complications in operation on cataract. The patients should be in dispensary care and operated on in time by an experience surgeon.

Effective services for bereaved spouses: a content analysis of the empirical literature.

To investigate the elements needed to serve bereaved spouses effectively, a content analysis of nine experimental studies on bereavement programs was conducted. A coding system was used to analyze the studies on five practice-related variables: characteristics of the client, the practitioner, the intervention, the research methodology, and the outcome. Comparisons between effective and ineffective programs indicated that planned brief intervention is effective in preventing or reducing symptoms of morbid grief among spouses who are at high risk or in high distress. Findings also revealed the need for practice and research on bereavement to use an ecological framework and to address issues of human diversity.

[Betoptic, a new possibility in the treatment of glaucoma]. / Betoptic, nové moznosti v liecbe glaukomu.

The authors present an account of their findings in connection with a new selective beta 1 adrenergic antagonist in the preparation Betoptic. They compared its effect on intraocular pressures, pulse rate, systemic blood pressure and vital capacity of the lungs in ten patients with primary open-angle glaucoma with the effect of Timoptol and placebo in equally sized groups. They found that the preparation reduces reliably the intraocular pressure, it does not reduce the pulse rate and does not influence the vital capacity and systemic blood pressure. They did not detect any local or general undesirable effects. It can be therefore used even in subjects where unselective beta blockers are contraindicated or poorly tolerated.

[Beta-blockers in the treatment of open-angle glaucoma]. / Betablokátory v liecbe glaukómu s otvoreným uhlom.

Authors report the results of comparative study of three betablockers used in the treatment of primary open-angle glaucoma commonly available on the market. The influence of non-selective betablockers (TIMOPTOL 0.5%, VISTAGAN 0.5%) and selective betablocker (BETOPTIC 0.5%) on the intraocular pressure, pulse frequency, systemic blood pressure and lung capacity was evaluated. Three different groups, each of 20 patients with newly diagnosed primary openangle glaucoma were assigned to be treated by studied drugs independently. Authors conclude that all three drugs reliably lowered intraocular pressure. BETOPTIC and VISTAGAN did not influence on pulse frequency, blood pressure and lung capacity. Apart from the fact that VISTAGAN is considered to be non-selective betablocker, its efficacy is comparable with those of selective betablockers.

[Correction of aphakia with transcleral fixation of the lens in the ciliary sulcus]. / Korekcia afakie sosovkou fixovanou transklerálne do ciliárneho sulkusu.

The posterior chamber intraocular lens particularly for ciliary sulcus fixation is a very good solution of correction of aphakia in cases when any part of capsule is missing. With proper surgical technique the obtained results are very good and the number of complications reported can be minimized. The authors demonstrate it in a group of 38 eyes with ciliary sulcus fixation. A very low occurrence of complications and good visual acuity including long follow-up confirm, that this method can be successfully used in the case od correction of aphakic patients.

[Factors influencing the effectiveness of argon laser trabeculoplasty]. / Faktory ovplyvnujúce efekt argón-laserovej trabekuloplastiky.

The effectiveness of argon laser trabeculoplasty in managing the primary open-angle glaucoma was observed in 103 patients (202 eyes) in period of 3 years. The authors are confirming its good effects, the maximum of it in three months after the trabeculoplasty. The best response was achieved in patients with the preoperative intraocular pressure lower than 25 mmHg and in the age group above 60 years. To obtain the good results after the operation in 87.12% of patients the local medical treatment was necessary, although in 51.98% the medication was reduced. The effectiveness of operation was decreasing with time, in 2 years was just 56.93% and in three years 23.27%. The significant improvement of outflow facility was observed in 85% of cases by electrotonography.

[Capsulectomy via the pars plana--one of the possible definitive treatments for opacification of the posterior capsule] ]. / Kapsulektómia via pars plana--jedna z mozností definitívneho riesenia opacifikácie zadného puzdra.

The author demonstrates on a group of 27 eyes a possible definite solution of a serious complication of successful operation of cataract, i.e. secondary cataract. The latter reduces due to its frequent incidence markedly the visual acuity. The approach with a vitrectome via the pars plana is a simple and permanent solution which beyond doubt has advantages as compared with YAG capsulotomy and polishing of the posterior capsule. The method is effective, cheap and the incidence of complications is minimal. Fluoroangiographic findings confirm its safety.

[Treatment of recurrent pterygia]. / Liecba recidivujúceho pterýgia.

The author's work confirmed that a single administration of 0.02% mitomycin C with exposure for 3.5 minutes during surgical excision of a pterygium is an effective treatment, which reduces the percentage of recurrences of pterygium and does not induce negative effects of mitomycin C.

[Use of computer-assisted corneal topography in ophthalmology]. / Vyuzitie pocítacovej rohovkovej topografie v oftalmológii.

The authors give an account of the possible application of corneal computer topography in some diseases of the cornea and in particular in refraction surgery.