Drive and timing components of respiration in young children following induction of anaesthesia with halothane or ketamine.

Timing and drive components of respiration were studied in 18 young children following induction of anaesthesia with ketamine and were compared with results from ten children following induction of anaesthesia with halothane. During one minute of quiet breathing, signals from a pneumotachograph attached to the anaesthetic mask were analysed for tidal volume (Vt), respiratory frequency (f), minute volume (Ve), inspiratory and expiratory times (Ti, Te) and flow pattern. Following induction of anaesthesia with ketamine, children breathed more slowly and deeply than children receiving halothane, but there was no significant difference in Ve or in Vt/Ti, suggesting that respiratory drive was similar in the two groups of children. In the children receiving ketamine, Ti was more than twice as long, and thus the ratio Ti/Te was significantly increased, in comparison with the group receiving halothane. In addition to the prolonged Ti in the children induced with ketamine, there was a more rapid increase in volume in early inspiration than in late inspiration, which is an apneustic breathing pattern. There was a slower decrease in volume in early expiration, with occasional early expiratory breath holding lasting up to three seconds, in the ketamine-induced children. The unique breathing pattern demonstrated with ketamine, consisting of large Vt, increased Ti/Te ratio, apneustic inspiratory pattern, and expiratory braking, contributed to an increased mean lung volume above functional residual capacity, of 2.40 ml.kg-1 body weight, in comparison to 1.27 ml.kg-1 in the children receiving halothane.

Sexuality changes in prostate cancer patients receiving antihormonal therapy combining the antiandrogen flutamide with medical (LHRH agonist) or surgical castration.

The results of a written questionnaire with 44 patients (pilot study) indicated that before the beginning of treatment for advanced prostatic cancer, most subjects had an active sexual life, as illustrated by a normal erotic imagery, an adequate sexual desire and a normal frequency of intercourse. More than three-quarters (80%) of subjects had at least one coitus a week. Slightly more than 50% were able to easily achieve an erection by erotic imagery or by a preferred sexual fantasy; 50% never experienced erectile problems. When compared with their previous sexual functioning, 70% of subjects noticed during the antiandrogenic treatment a major reduction in their interest for sexual intercourse which was maintained in only 18% of patients. It became impossible for 57% to induce an erection by erotic imagery. However, 19% claimed an ability to maintain an erection during sexual activity, as compared to 56% before treatment, but erections usually lacked full rigidity. Twenty-two percent of patients mentioned having nocturnal or morning erections. Despite this dramatic decrease in sexual activity in most patients, complete antiandrogen blockade left sexual activity in approximately 20% of patients. Due to the treatment's excellent tolerance, the findings suggest that such combined androgen blockade could be beneficial for the treatment of sex offenders.

Clomipramine and 'drive' in people with anorexia nervosa: an in-patient study.

Drugs can sometimes be helpful within the overall treatment and management of anorexia nervosa. In this study we have examined the impact of clomipramine on food and activity in anorectics engaged in a treatment programme enabling them to regain normal body weight. Consumption of the drug was associated with increased appetite, hunger and calorie consumption during the early stages of treatment. There was no impact on ultimate outcome. In this study it was evident that the drug was unnecessary for weight gain, but it may be helpful in other programmes, both short and long term, where the patient has sufficient trust (to tolerate the enhanced hunger experience) but is not involved in the same behavioural constraints. However, its possible value in such programmes has not been proven here. Meanwhile, we take our findings as further evidence that clomipramine increases drive behaviour and appetite in humans and may be beneficial in the treatment of affective disorders because of this effect.

Mood-dependent learning. I. Endogenomorphic and psychoreactive depressions--influence of positive and negative feedback on expectancy shifts.

Influenced by Seligman's definition of 'learned helplessness' we studied the change of expectancy after positive and negative reinforcement before the onset and in the course of treatment of endogenomorphic and psychoreactive depressions. Before the onset of treatment patients do not exhibit any systematic change of expectancy after positive or negative reinforcement, in the course of treatment reaction to reinforcement is demonstrable, the type of treatment administered during the observation period causes differences in behavior.

The two-syndrome concept: origins and current status.

The two-syndrome concept postulates two "dimensions of pathology" underlying schizophrenia--a reversible (and potentially neuroleptic-responsive) component and a sometimes progressive and relatively irreversible component associated with the deficit state and poor long-term outcome. Negative symptoms (narrowly defined) appear to be more closely associated with the latter component (the type II syndrome), as also are cognitive impairments, abnormal involuntary movements, and behavioral deterioration. This syndrome is assumed to be more closely related than the type I syndrome of positive symptoms to the structural brain changes inferred from pneumoencephalograms, computed tomography scans, and recent post-mortem studies. However, since both syndromes often occur in the same patient--sometimes at the same point in time--they presumably have the same etiology.

Modifications of libido and sex drive during treatment of minor depression with viloxazine.

The effects of viloxazine hydrochloride on the libido and sex drive of 20 outpatients suffering from minor depression were assessed. For this purpose the Zung Self-Rating Depression Scale and a questionnaire devised by the authors to evaluate libido and sex drive were used. A dose of 300 mg viloxazine/day for 4 weeks was administered. Test-retest assessments showed a significant improvement of depression and an increase in libido and sex drive. These latter effects were marked, but did not appear to be related to the improvement of depression.

[Psychic disturbances in women during oral contraception (author's transl)]. / Psychische Störungen bei hormonaler Kontrazeption der Frau.

Methodically accurate psychiatric and psychological investigations have shown that psychological disorders in connection with oral contraception are more frequent than in generally known. The psychological changes in the sense of the endocrine psychosyndrome appear as fine disorders of mood, impulse and elemental urge. Not least, they have general mental hygienic significance, because in connection with them activity and spontaneity and also the ability to work are disturbed. From these psychobiological findings a qualitative differential sensitivity of the organism (as a reaction to different pharmacological substances) can be read. These results can initiate a comprehensive formulation of the psychosomatic personality theory.

PIP: Methodically accurate psychiatric and psychological investigations have shown that psychological disorders in connection with oral contraception are more frequent than is generally known. The psychological changes in the sense of the endocrine psychosyndrome appear as fine disorders of mood, impulse, and elemental urge. They have a significant impact on mental hygiene since there is a disturbance in activity, spontaneity, and the ability to work. From these psychobiological findings, a qualitative differential sensitivity of the organism (as a reaction to different pharmacological substances) can be read. These results can initiate a comprehensive formulation of the psychosomatic personality theory. (author's)

A controlled study of a tetracyclic antidepressant--maprotiline (Ludiomil).

Maprotiline (Ludiomil) is a dibenzo bicyclooctadiene pharmacologically related to the tricyclic antidepressants and stereochemically having a tetracyclic structure. A controlled, double-blind comparison of maprotiline and imipramine in a group of 71 female outpatients with primary depression is presented. Maprotiline was found to be at least as effective as imipramine and significantly better in depressive neurosis. It also showed a bipolar action, being effective in both agitation and retardation.

Cognitive and hormonal factors accecting coital frequency.

Sexual behavior of female undergraduates was assessed by daily questionnaries. Of the 24 subjects, 13 were taking oral contraceptives ("pill" subjects) and 11 were using other methods of birth control ("nonpill" subjects), primarily diaphragm or male prophylactic methods. Three main results were obtained: (1) Intercourse rates were lowest during menstruation and highest immediately following menstruation. (2) Self-rated sexual arousal on a given day correlated with the type of heterosexual encouters on that day rather than with period of the menstrual cycle. (3) Pill subjects reported intercourse on more days than nonpill subjects but reported a lower number of intercourse sessions on day with intercourse than nonpill subjects. These results are interpreted within a general framework of sexual behavior which recognizes the sexual behavior of humans as primarily influenced by cultural and cognitive factors. The possibility is discussed that female sexual behavior might also be found to be affected by hormones if more sensitive measures were used.

PIP: Coital frequency was studied in 24 female undergraduate students. 13 of the women were using oral contraceptives (OC), while the remainder used more conventional methods of contraception. The frequency of coitus was lowest during menstruation and highest in the period immediately following menstruation. Self-rated sexual arousal was correlated with the type of sexual attention paid, rather than with a given day during the menstrual cycle. OC users reported coital activity on more days of the cycle than non-pill subjects, but engaged in coitus with less frequency on intercourse days than women using conventional contraception. The results indicate that hormones have very little influence on eroticism and sexual activity in humans. Rather, learning and cultural conditioning are the principal factors guiding human sexual activity.