Tricuspid valve endocarditis

TVE is mainly a disease of intravenous drug abusers. Although the infecting organisms are often highly virulent, they frequently respond to medical treatment. The prognosis for patients with TVE is fairly good. About 25% of TVE patients require surgical intervention. Persistent sepsis and intractable congestive heart failure are indications for surgery. Tricuspid valvulectomy without prosthetic replacement is the surgical intervention of choice. Right-sided heart failure is the principal complication after valvulectomy without a prosthesis. A significant percentage of patients require insertion of prosthetic valves at a future date.

Age and first experience with psychoactive drugs

By utilizing the Gutman Scaling technique and by plotting acquisition curves, a number of different patterns of involvement with different psychoactive drugs were discerned. A stable, sequential, and cumulative hierarchy of experience with drugs was found to be established at age 15, but different peak years exist for trying different drugs. It was also found that drug use may be cumulative for some drugs and not for others. Special emphasis has been given to discussing the research implications that have arisen from the present study.

Intervention and prevention of drug-taking behavior: a need for divergent approaches

This article undertakes a review of recent approaches to studying the relationship between personality and drug-taking behavior, and the implications that such research has for treatment. Emphasis is given to the need to perceive drug-taking behavior as a multidimensional phenomenon, in which the choice of drug, reason for its use, and personality and social factors, among other variables, need to be interrelated. The relationship between this approach and intervention procedures is explored, and the need to develop differential intervention strategies for drug-related problem behavior is also discussed.

Development and organization of services for alcoholics in Leningrad, USSR

This report provides a brief, general overview of how alcoholism is reported to be dealt with in one of the Soviet Union's largest cities. It attempts to describe both the philosophical and applied approaches practiced, and affords an opportunity to compare these approaches with those in the United States. Specifically, the paper presents a brief historical review and description of services provided to clients at alcohol treatment centers in the city of Leningrad, USSR, and discusses contemporary Soviet attitudes toward alcoholism.

Confirmatory analyses of reasons for experiencing psychoactive drugs during adolescence

This study established empirically defined reasons for experiences with psychoactive drugs by adolescents. By means of cross-validating procedures involving a series of principal component analyses of data obtained from three separate sample groups, three common motives or reasons for trying/taking drugs were derived: a tension-reduction, or coping motive; a drug-effect motive; and a peer-related motive. The implications of the findings for further research and for treatment and prevention programs are reviewed.

Symptomatic renal artery stenosis superimposed on chronic glomerulonephritis

We present two patients with proved chronic glomerulonephritis who had severe refractory hypertension and chronic renal failure. In both patients normal-sized kidneys were demonstrated in addition to vascular bruits and Grade III hypertensive retinopathy. These findings raised the suspicion of an etiological condition other than chronic glomerulonephritis underlying the hypertension and renal failure. Renal angiography revealed bilateral severe renal artery stenosis. In both cases renal revascularization was followed by a drop in blood pressure to normal or near normal levels. In selected cases with severe hypertension and chronic renal failure, renal artery stenosis should be considered, despite the coexistence of chronic glomerulonephritis.

Adaptive modification of the vestibulo-ocular reflex by mental effort in darkness

The vestibulo-ocular reflex (VOR) can be suppressed in darkness if a subject tries to imagine that he looks at a head fixed target. This mental suppression of VOR was used to induce adaptive changes in VOR gain during 3 h of active head oscillations in complete darkness. VOR gain changes were tested by asking the subject to look at a visual target; then passively or actively the head was turned in darkness while the subject "fixated" the same target. Corrective saccades occurring at the end of the movement when lights were turned on give an elegant measure of VOR gain. Three hours of training induced in 3 subjects a mean of 10.9% and 11.4% decrease of VOR gain for passive and active conditions, respectively. This demonstrates that reflex adaptation can be obtained without external cues, and probably with only an internal reconstruction of target and eye movement.

Alcohol use by juvenile offenders

Reasons for alcohol use were examined in a sample of detained and adjudicated juveniles at a state residential facility. By means of factor analysis, patterns of self-reported reasons for using alcohol were identified. The findings suggest that alcohol appears to have become primarily associated with coping and/or altering mood. The implications of this finding are briefly discussed with respect to treatment and prevention.

Progression of isolated aortic stenosis: analysis of 29 patients having more than 1 cardiac catheterization

Factors related to progression of nonrheumatic aortic stenosis (AS) were analyzed in 29 adult patients who underwent serial hemodynamic studies over a mean of 71 months. AS was congenital in 8 patients and degenerative in 21. The patients were divided into 2 groups on the basis of the change in aortic valve area between the 2 studies. Twelve patients had a greater than or equal to 25% reduction in aortic valve area (Group I) and 17 patients had less than 25% decrease in aortic valve area (Group II). There were no significant differences between the 2 groups in age, interval between studies, cardiac output, left ventricular end-diastolic pressure, left ventricular peak systolic pressure and origin of AS (congenital or degenerative). Group I patients had significantly larger initial aortic valve areas than did Group II patients (1.3 +/- 0.9 cm2 versus 0.8 +/- 0.4 cm2, p = 0.02). Also, the initial peak transaortic pressure gradients were lower in Group I than in Group II (27 +/- 19 versus 58 +/- 38 mm Hg, p = 0.01). Group I patients had a significantly greater increase in pressure gradient and a greater reduction in cardiac output than did Group II patients (24 +/- 21 mm Hg in Group I versus -0.1 +/- 24.5 mm Hg in Group II, p = 0.01, and -1.0 +/- 1.3 liters/min in Group I versus 0.10 +/- 1.4 liters/min in Group II, p = 0.03). Thus, AS progressed in 41% of a selected group of patients who underwent repeated cardiac catheterization.(ABSTRACT TRUNCATED AT 250 WORDS)

Psychological aspects of drug-taking behavior

A review of recent research identifying antecedents and correlates of drug-taking behavior is presented, together with a brief discussion of their implications for prevention of drug use. Emphasis is given to the need to perceive drug-taking behavior as a multidimensional phenomenon, in which the choice of drug, personality, and social factors, among many other variables, need to be interrelated. The efficacy of an interactionist approach is presented as a means of furthering an understanding of drug-taking behavior.

A factor analytic study of the relationship of experience seeking and trait anxiety to drug use and reasons for drug use

The relationship of measures of sensation seeking and trait anxiety to drug use and reasons for drug use was studied among a sample of 92 detained or adjudicated adolescent males in a residential detention facility. Experience seeking was found to be related to drug use in general, and especially use of "hard" drugs. Anxiety tended to be related to drug avoidance, except in the case of marijuana and alcohol use. Reasons for drug use which related with experience seeking were excitement and thrill oriented, whereas reasons associated with anxiety were related to feelings of discomfort for this sample. In general, experience seeking was a stronger factor than trait anxiety in these findings. Implications for more action-oriented and less insight-oriented treatment are discussed in light of these results.

Drugs and youth: a review of the problem

Recent research concerning motives for alcohol and drug use is summarized and reviewed in the context of seeking common reasons for using alcohol and other drugs. Common motives were found which correlated with both drinking and other drug-taking behavior, and specific motives were also found which were related to use of alcohol, marijuana, and other drugs. The implication of these findings for both primary and secondary prevention efforts is discussed.