Search

Introduction Changing drug dosage is common in clinical practice. Recent evidence showed that psychological factors may affect the therapeutic outcome. The aim of this study is to test whether verbal communication about drug dosage changes motor performance and fatigue in Parkinson's Disease (PD) patients. Methods We performed clinical (Unified PD Rating Scale), motor (number of finger flexions and perceived fatigue), and electrophysiological measurements (readiness potential, RP) in PD patients during medication-off and medication-on conditions in three groups. The first group got a full dose of l -dopa and was told it was a full dose. The second group got half dose and was told it was half dose. The third group got half dose, but it was told it was a full standard dose. Results We found that overt half dose was less effective than the full dose for clinical improvement, motor performance, and readiness potential. However, if half dose was given along with verbal instructions that it was a full dose, clinical improvement, motor performance and readiness potential were not significantly different from the full dose. Conclusions Our findings indicate that verbal communication about dose reduction is as effective as the 50% dose reduction itself, demonstrating that deceptive information about the dose may have an important impact on the therapeutic outcome. Moreover, the supplementary motor area, source of the RP, seems to be involved in this psychological effect.

Objective: This study was aimed at analyzing the degree of intercostal nerve impairment in posterolateral and muscle-sparing thoracotomy and at correlating the nerve damage to the severity of long-lasting postthoracotomy pain. Methods: Neurophysiologic recordings were performed 1 month after either posterolateral or muscle-sparing thoracotomy to assess the presence of the superficial abdominal reflexes (mediated in part by the intercostal nerves), the somatosensory-evoked responses after electrical stimulation of the surgical scar, and the electrical thresholds for tactile and pain sensations of the surgical incision. Results: The patients who underwent a posterolateral thoracotomy showed a higher degree of intercostal nerve impairment than the muscle-sparing thoracotomy patients as revealed by the disappearance of the abdominal reflexes, a larger reduction in amplitude of the somatosensory-evoked potentials, and a larger increase of the sensory thresholds to electrical stimulation for both tactile perception and pain. In addition, these neurophysiologic parameters were highly correlated to the postthoracotomy pain experienced by the patients 1 month after surgery, indicating a causal role for nerve impairment in the long-lasting postoperative pain. Conclusions: This study shows for the first time the pathophysiologic differences between posterolateral and muscle-sparing thoracotomy and suggests that the minor long-lasting postthoracotomy pain in muscle-sparing thoracotomy patients is partly due to a minor nerve damage. In addition, because nerve impairment is responsible for the long-lasting neuropathic component of postoperative pain, it is necessary to match specific treatments to the neuropathic pain-generating mechanisms. (J Thorac Cardiovasc Surg 1998;115:841-7)

Objectives For some people, erotic trigger of daydream, either credible or imaginary, is so strong to make it the core feature of sexual activity. The first extensive study on women erotic fantasies was carried on by Crepault in 1981. He used a self-report semi structured questionnaire in order to assess broad-spectrum women erotic fantasies in an extensive way. Women were involved in that study since they were considered freer of speaking about erotic fantasies than men. The present study aimed to compare the results obtained by Crepault in 1981 to the ones of a new women group, in order to highlight differences in erotic fantasies contents. Methods The sample is composed by 80 women from northern Italy, with a mean age of 31 (sd: 8) years and a mean educational level of 15 (sd: 3) years. We used a self-report semi structured questionnaire investigating the use of erotic fantasies and the typologies of erotic fantasies that women use in the following situations: sexual excitement, masturbation, sexual act. Results In our sample erotic fantasies are mainly used to trigger sexual activity or to increase sexual pleasure. Erotic fantasies contents differ depending on situations. Specifically, tenderness and affectivity contents prevail during sexual act, while more aggressiveness and passion emerge during masturbation. Conclusion The triggering role of erotic fantasies seems to be unchanged. Moreover, speaking about erotic fantasies and sharing them with partner seem to be still difficult, because we enter in the field of private intimacy.