Treatment emergent affective switch: a controlled study.

OBJECTIVE: To study the clinical features of treatment emergent affective switch (TEAS) in comparison with spontaneous mania. METHODS: Twelve patients with TEAS within a 12-week period (average) of starting standard antidepressant medication were compared with 12 patients with spontaneous mania. RESULTS: Patients with TEAS were older, had longer duration of illness, more previous episodes, higher prevalence of subclinical hypothyroidism, and reported more previous episodes of mania associated with antidepressant use. TEAS was less severe, with a lower incidence of psychotic symptoms, lower Young Mania Rating Scale index score and rarely required hospitalization. The interval from intervention to response and remission was similar in both groups. CONCLUSION: TEAS was less severe, but had similar duration when compared with spontaneous mania. These results cannot directly answer the question of whether there is a causal relationship between antidepressant use and TEAS. While it is also possible that patients with longer duration of illness and higher cycle frequencies are more likely to experience episodes, it is difficult to attribute lesser severity of TEAS episodes to these clinical factors. Our observations are consistent with the suggestion that patients with longer duration of illness and previous history of TEAS may be at a greater risk of switching to mania during the use of antidepressants.

The Jerusalem seventy year olds longitudinal study. II: Background results from the initial home interview.

Basic background information is presented from a representative sample of 605 West Jerusalem Jewish residents aged 70 years in 1990/91. A followup survey of the original cohort is planned for 1996, in addition to a similar sized control group of persons not studied in 1990/91. This paper describes the demographic characteristics, marital status, household composition, migration patterns, language comprehension, education, employment status, religious practices, household conditions, health status, health service utilization, health practices, use of medications, social contacts and activities of daily living of the study population. Only 16% of the study population were born in Israel, the remainder were born in forty different countries in four continents. This article also presents some ethnic comparisons within our cohort. Some significant differences were found between ethnic sub-groups in self-reported chronic diseases. However, many of these differences disappeared when socio-economic covariates were considered. Differences were also found when specific countries were considered. Compared to Polish-born Jews, Moroccan-born Jews had lower economic status, less education, more family contacts and less faith in physicians. Moroccan-born Jews also reported more morbidity for cerebrovascular disorders, emphysema and glaucoma.

Physical growth of Swiss children from birth to 20 years of age. First Zurich longitudinal study of growth and development.

Physical growth from birth to adulthood in healthy Swiss children born 1954-1956 is described. The data are based on the First Zurich Longitudinal Study in which 137 individuals of each sex have been followed from birth to adulthood between 1954 and 1976. Distance standards of 20 anthropometric measurements such as weight, height and head circumference are presented as mean values and standard deviations or as median values (for weight and skinfold thickness) with smoothed empirical centiles. Velocity standards are provided for seven anthropometric parameters. The following standard growth charts for clinical use are presented: weight, length/height and head circumference in the perinatal period, in the age range of 0-48 months and in the age range of 1-18 years (including some data on puberty), as well as weight for length/height and height velocity (cross-sectional and peak height centered). Comparison of the growth standards with those of previous Swiss studies and of recent foreign studies revealed only minor differences. Various aspects relevant for the clinical use of growth standards, such as measurement error or secular trend, are discussed.

The SPONASTRIME dysplasia: familial short-limb dwarfism with saddle nose, spinal alterations and metaphyseal striation. Report of 4 siblings.

We report clinical, anthropometric and radiological findings in 4 siblings with a new type of skeletal dysplasia. 4 normally intelligent girls exhibit dwarfism between -3.4 and -4.6 standard deviations with accentuated shortening of the lower limbs, moderate deformity of the vertebral bodies, mildly striated metaphyses, saddle nose, frontal bossing, and relatively large head. The family pedigree suggests autosomal recessive inheritance. We propose the designation of SPONASTRIME dysplasia, derived from spondylar and nasal alterations with striation of the metaphyses.

Intermittent ketoconazole therapy of chronic mucocutaneous candidiasis in childhood.

We report the clinical and laboratory findings in two children with chronic mucocutaneous candidiasis (CMC) treated successfully with intermittent long-term ketoconazole therapy. Both had chronic infection of the nails, skin and mucous membranes with positive cultures for candida. Both were resistant to multiple local and systemic antifungal agents. After institution of ketoconazole therapy there was a dramatic improvement with clearing of the oral (one week), skin (two months) and nail lesions (5 months). After 8 months the drug was stopped and clinical remission persisted for 10 and 7 months respectively. Relapse of oral candidiasis was treated with a short course of ketoconazole (4-16 weeks) leading to complete healing of the lesions. Clinical improvement was not related to an amelioration in lymphocyte transformation. There was no change in the progressive deterioration of the lymphocyte responses to candida antigen which was probably due to persisting candida cell wall components (e.g. mannan).