Steven L Fahrion

Biobehavioral treatment of essential hypertension: a group outcome study.

In a group outcome and follow-up study of 77 patients with essential hypertension, significant reductions were seen in systolic and diastolic blood pressure (BP) and in hypotensive medication requirement. A multimodality biobehavioral treatment was used which included biofeedback-assisted training techniques aimed at teaching self-regulation of vasodilation in the hands and feet. Of the 54 medicated patients, 58% were able to eliminate hypotensive medication while at the same time reducing BP an average of 15/10 mm Hg. An additional 19 (35%) of the medicated patients were able to cut their medications approximately in half while reducing BP by 18/10 mm Hg. The remaining 4 (7%) medicated patients showed no improvement in either BP or medication requirement. Similar reductions in BP were seen in initially unmedicated patients. Seventy percent of the 23 unmedicated patients achieved average pressures below 140/90 mm Hg, with an additional 22% of these patients making clinically significant reductions in pressure without becoming normotensive, and with 8% unsuccessful at lowering pressures to a clinically significant extent. Follow-up data available on 61 patients over an average of 33 months indicated little regression in these results with 51% of the total patient sample remaining well-controlled off medication, an additional 41% partially controlled, and 8% unsuccessful in lowering either medications and/or blood pressures to a clinically significant extent.

Age and sex modulate effects of stress on the immune system: A multivariate analysis

Multivariate analyses indicate that both age and sex can modulate examination stress effects on immune factors. Stress lowered eosinophil counts in females but raised them in males. Age modulated stress effects on CD4 and CD8 cells, hemoglobin, and erythrocytes. CD4 decreased more in older subjects; CD8 increased in older and decreased in younger subjects; hemoglobin decreased in younger but not older subjects; erythrocytes increased in older and decreased in younger subjects. Initial age and/or sex differences in levels of neutrophils and lymphocytes were not statistically altered by stress. Stress effects not modulated by age or sex increased serum IgA and IgM, CD19, and stimulated phagocytic activity but decreased serum IgG, CD3, basophils, and unstimulated phagocytic activity. The immunological effects of stress are multiple and are influenced by variations in age and sex of the person.

A comparison of Alexithymia in American and Japanese dialysis patients

A comparison of alexithymia in American and Japanese dialysis patients was performed using the Beth Israel Hospital Questionnaire (BIQ) and the MMPI Alexithymia Scale (MMPI-AS) including structured interviews. No significant differences between the USA and Japan were observed in all dialysis patients with both BIQ and MMPI-AS. However, the alexithymia score in US hemodialysis (HD) patients was significantly lower than that in Japanese HD patients, whereas the alexithymia score in American continuous ambulatory peritoneal dialysis (CAPD) patients was significantly higher than that in Japanese CAPD patients. These results may suggest the possibility that the differences in dialysis policy between USA and Japan have secondary effects on alexithymia, which is one of the psychosomatic factors reflecting self-control ability in dialysis patients.