Subject(s)
Clinical Competence , Fellowships and Scholarships , Radiology, Interventional/education , Radiology, Interventional/standards , Vascular Surgical Procedures/education , Vascular Surgical Procedures/standards , Humans , Illinois , Postoperative Complications , Treatment Failure , Vascular Surgical Procedures/mortalityABSTRACT
In 1986 the authors mailed a one-page questionnaire to 135 North American medical schools requesting information about written expectations for students that contain noncognitive criteria. Eighty-eight questionnaires (65.2%) were returned, and 48 schools (54.5%) indicated they possessed written noncognitive criteria. Those schools having noncognitive criteria were asked to submit the criteria for review and were questioned about their reasons for establishing such criteria. Those schools not having noncognitive criteria were asked whether they perceived a need for such criteria and had plans for developing them. The study showed an increasing trend to create criteria that assist in administrative actions when problems arise. In the 31 sets of noncognitive criteria submitted for the study, the rank order of specific expectations was, from most to least frequently mentioned: honesty, professional behavior, dedication to learning, appearance, respect for law, respect for others, confidentiality, aid to others, substance abuse, and financial responsibility. The authors make recommendations for schools wishing to create noncognitive criteria and explain why they feel such criteria should receive the recognition and importance given to cognitive criteria.
Subject(s)
Schools, Medical , Students, Medical , Attitude , Canada , Surveys and Questionnaires , United StatesABSTRACT
The plasma beta-endorphin of obese human subjects and non-obese controls was compared following the intravenous infusion of 25 grams of glucose. The plasma beta-endorphin of the obese subjects was significantly higher than controls one hour and four and one half hours after glucose infusion. The increased beta-endorphin of the obese subjects was associated with falling blood sugar.
Subject(s)
Endorphins/blood , Glucose/pharmacology , Obesity/blood , Adult , Blood Glucose/metabolism , Chromatography, Affinity , Female , Humans , Injections, Intravenous , Male , Middle Aged , Radioimmunoassay , Time Factors , beta-EndorphinABSTRACT
The plasma beta-endorphin response to glucose ingestion was compared in 8 bulimics and 8 controls. The bulimics demonstrated a sustained elevation of plasma beta-endorphin unrelated to glucose ingestion throughout the 5-hour study period. It is hypothesized that such an elevation of beta-endorphin is the result of stress and that it may play an important role in the perpetuation of the binge-vomiting cycle.
Subject(s)
Endorphins/blood , Feeding and Eating Disorders/blood , Hyperphagia/blood , Adolescent , Adult , Blood Glucose/metabolism , Dietary Carbohydrates/administration & dosage , Female , Humans , Hyperphagia/psychology , Radioimmunoassay , beta-EndorphinABSTRACT
There is evidence that endogenous opiates are involved in the control of feeding in experimental animals. Several types of experimental obesity are associated with increased opiate production and/or increased numbers and sensitivity of opiate receptors. Research with experimental animals suggests that nutrients, particularly sugar, have an effect on feeding behavior that is mediated by opiates. For instance, the obesity-producing effect of a palatable diet in rodents is blocked by opiate antagonists. Stress induced feeding in rodents leads to preferential sucrose ingestion and is blocked by opiate antagonists and beta-endorphin. The effect of nutrients on the endogenous opiate system of humans is less clear. Clinical experience suggest that carbohydrates (sugar in particular) play a role in binge eating and obesity. Many binge eaters preferentially eat sweets during a binge. Many obese individuals consume more than half of their total daily calories as carbohydrates. Sweet snacking is a frequent behavior at times of stress. Recent evidence suggests that sugar can lead to increased beta-endorphin production in obese subjects.
Subject(s)
Feeding Behavior/drug effects , Feeding and Eating Disorders/physiopathology , Glucose/metabolism , Hyperphagia/physiopathology , Narcotics/pharmacology , Animals , Diet , Endorphins/pharmacology , Humans , Hyperphagia/etiology , Male , Naloxone/pharmacology , Obesity/etiology , Obesity/physiopathology , Time Factors , beta-EndorphinABSTRACT
Following the oral administration of 100 g of glucose, morbidly-obese subjects and non-obese controls demonstrated increased levels of plasma immunoreactive beta-endorphin. There was a slow rise in plasma immunoreactive beta-endorphin in the non-obese controls throughout the 3-h observation period. The obese subjects demonstrated a delayed and significantly greater rise of plasma immunoreactive beta-endorphin, when compared to the controls. These findings may have implications for further research in human obesity.
Subject(s)
Endorphins/blood , Glucose/pharmacology , Obesity/blood , Adult , Blood Glucose/metabolism , Female , Humans , Kinetics , Male , beta-EndorphinABSTRACT
When chronic pain fails to respond to therapy, the approach often have been based on outmoded concepts of the nature of pain. The current unified pain theory takes into account recent biochemical advances and can serve as a basis for more effective diagnostic and therapeutic approaches. Various treatment modalities are reviewed in the context of the psychology as well as the physiology of severe intractable pain.
Subject(s)
Pain , Analgesics/therapeutic use , Chronic Disease , Humans , Nervous System/physiopathology , Pain/etiology , Pain/physiopathology , Pain Management , Perception/physiology , Psychotherapy , Psychotropic Drugs/therapeutic useABSTRACT
Patients with chronic pain present many diagnostic and therapeutic challenges to primary physicians and psychiatric consultants. The authors present a series of twelve patients with chronic pain who were hospitalized on the psychiatric ward of a general hospital. Ten of the twelve patients presented decreased their medication use and were markedly improved at the end of their brief stay. Treatment goals, attitudes and interventions are discussed.
