The essential difference that emerged from a comparison of the fantasies of Rapidly Remitting and Nonremitting asthmatic children was found to be in the area of emotional awareness. The children who lost their asthmatic...The essential difference that emerged from a comparison of the fantasies of Rapidly Remitting and Nonremitting asthmatic children was found to be in the area of emotional awareness. The children who lost their asthmatic symptoms when separated from home were found to have some awareness of angry feelings toward parental figures whom they experienced as hostile and/or rejecting. They were also found to be aware, to some extent, of longings for a relationship with a person who would provide nurturing care or guidance. The Nonremitting children, on the other hand, were found to be lacking in any awareness of either angry feelings or longings for a nurturing relationship. A study of the test materials of both groups of children reveals that these feelings are present in all eight children. Yet they have been totally repressed in the Nonremitting children, while the Rapidly Remitting children have, apparently, not felt the need to resort to such massive repression. Thus a second area of difference, implied in the first, emerges when we compare these two groups of children in terms of defensive ego functioning. Abramson's emphasis on the central importance of the period in which the child's emotional conflict arose proved to be valid for this study. He predicted that those children whose asthma begins at or near the period of toilet training will be the same ones who will have most difficulty giving up their asthmatic symptoms. Although I have not been able to validate dates for onset of asthma, it's clear, I hope, from the foregoing discussion that the Nonremitting children all suffer from conflicts arising in the anal period of development. This is not so (or much less so) for the Rapidly Remitting children who, however, often have conflicts which are just as severe. Each of the Nonremitting children, on an unconscious level, is waging a battle with mother over who will get the upper hand: this is the central conflict. Though these children are outwardly compliant much of the time, they betray their inner antagonism by withholding and being stubborn. Each has developed very skillful, though passive, methods for resisting adult authority. What are the implications for these findings? Our Nonremitting children do not always show obvious signs of emotional disturbance. Because they tend to be well behaved, they are often considered healthy and well adjusted. While the Rapidly Remitting children are insisting (often dramatically) on getting help, the Nonremitters are busy "fitting in". Though they are slow to respond to individual psychotherapy and milieu treatment, they need it as much as do those who are more immediately reponsive to our therapeutic efforts.
Fifteen subjects with chronic allergic rhinitis had measurements of nasal airways flow/resistance (Rn) made before, and for 12 hours after, single doses of a sustained release decongestant combination, some of its compon...Fifteen subjects with chronic allergic rhinitis had measurements of nasal airways flow/resistance (Rn) made before, and for 12 hours after, single doses of a sustained release decongestant combination, some of its components given alone or together, and placebo, in a randomized double-blind trial. The magnitude of improvement in Rn was statistically greater for the the four active preparations than for placebo over the first 8 hours; the effects of phenylpropanolamine/chlorpheniramine were still present after 10 hours, while at the end of 12 hours only the full triple-drug capsule had significant activity. Patient-estimates of symptomatic improvement generally mirrored these physiologic changes although statistical differences among the active capsules were not delineated. The data confirm the ability of electronic posterior rhinometry to discriminate between the effects of active medications and placebo at the 95 per cent confidence level or better and suggest that observed decreases in elevated Rn mean reflected helpful clinical activity as well as increased nasal patency.
J Asthma Res
· 1975 Jun · PMID 1240881
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The use of intravenous isoproterenol in nineteen children with status asthmaticus who did not respond to standard anti-asthmatic therapy is reported. Six of the fourteen patients who responded favorably had normal blood...The use of intravenous isoproterenol in nineteen children with status asthmaticus who did not respond to standard anti-asthmatic therapy is reported. Six of the fourteen patients who responded favorably had normal blood gases within six hours ten within twelve hours and twelve within eighteen hours; all fourteen of the patients who responded favorably had normal blood gases within twenty-two hours after the drug was begun. Clinically, eleven of the fourteen patients who responded favorably showed improvement in respiratory distress within twelve hours of the institution of therapy. All patients who responded favorably showed some improvement within twenty-eight hours of treatment. There were five treatment failures; two were due to cardiovascular toxicity of isoproterenol, and three to progression in symptomatology that necessitated continuous ventilation with respirators.
J Asthma Res
· 1975 Jun · PMID 1219016
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Based on the theory that the dream represents an important conflict of wishes essentially occurring between the id and superego, with some participation by the adaptive ego, the first dream reported by the patient is con...Based on the theory that the dream represents an important conflict of wishes essentially occurring between the id and superego, with some participation by the adaptive ego, the first dream reported by the patient is considered to be the chief complaint of the unconscious. Eighteen first dreams, chosen at random, were tentatively interpreted in re the unconscious conflicts. These tentative interpretations were amplified by a battery of projective tests. It is proposed that the primary physician with a talent for understanding the nature of inner conflicts, revealed by the frist or early dreams, may slowly venture into the area of psychotherapy by including in the history of the patient a study of inner conflicts indicated by the dream material. In this way, the conscious chief complaint may be utilized by the physician with ability to impart to the patient his understanding of the inner fears of the patient. In general, it may be assumed that improved somatic therapy results when the patient realized that the physician is trying to treat not just the pathological organ, but the patient as a whole, including subtle processes within the psyche itself.
J Asthma Res
· 1975 Jun · PMID 1219014
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With the help of three illustrative cases, all of whom died during an acute asthmatic attack, it is proposed that patients with severe psychopathology who also have asthma are particularly susceptible to the more serious...With the help of three illustrative cases, all of whom died during an acute asthmatic attack, it is proposed that patients with severe psychopathology who also have asthma are particularly susceptible to the more serious complications of asthma. This is related to the circular reactions to anxiety and the patient's incapacity to cope with it. Often these patients are either unusually sensitive to the pharmacological agents used in the medical regime, or they overmedicate themselves. At the same time the reactions of the family and medical staff tend to increase anxiety in these patients. This finally leads to psychological decompensation, making medical treatment extremely difficult. Some therapeutic interventions in dealing with this problem have been suggested. These include the development of an asthma team which can provide supportive psychotherapy to high risk patients.
J Asthma Res
· 1975 Mar · PMID 1194191
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In a search for predictive factors in early childhood for later developing childhood asthma, sixty chidren who suffered in the first year of life from atopic dermatitis were examined at ages between 6-11 years. There wer...In a search for predictive factors in early childhood for later developing childhood asthma, sixty chidren who suffered in the first year of life from atopic dermatitis were examined at ages between 6-11 years. There were 40 boys and 20 girls, of whom 21 were asthmatic boys and 10 asthmatic girls. The non-asthma group was similar to the asthma group in age, sex and socio-economic background and familial-hereditary background. The psychosocial aspects of the study were not reported in this paper. The atopic dermatitis followed a different pattern in the asthmatic group than in the non-asthma group. A continuation of the atopic eczematous condition in infancy beyond two years appeared to be highly predictive for future childhood asthma. Severity of the eczema in infancy does not seem to be a strong predictor in boys and not at all in the small group of girls. Persistent eczema appeared twice as much in the asthmatic boys as in the asthmatic girls. There was no distinct difference between the asthmatic children and the non-asthmatic children in time of onset of the infantile eczema nor in the location of the atopic dermatitis.
We have reported our experience with cromolyn sodium in the management of fifteen children with chronic, intractable asthma. The overall improvement in 80% of children is in accordance with some of the studies reported i...We have reported our experience with cromolyn sodium in the management of fifteen children with chronic, intractable asthma. The overall improvement in 80% of children is in accordance with some of the studies reported in the literature. The most significant effect of the drug was in either reducing the dose of steroid needed for management or eliminating its requirement by the patient.