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Biomedical subjects

A Anand

Publications and source records attributed to A Anand.

At least 127 records · Page 7Linked to original sources
PubMed1994

Psychotic speech: a neurolinguistic perspective.

The existence of an aphasia-like language disorder in psychotic speech has been the subject of much debate. This paper argues that a discrete language disorder could be an important cause of the disturbance seen in psychotic speech. A review is presented of classical clinical descriptions and experimental studies that have explored the similarities between psychotic language impairment and aphasic speech. The paper proposes neurolinguistic tasks which may be used in future studies to elicit subtle language impairments in psychotic speech. The usefulness of a neurolinguistic model for further research in the aetiology and treatment of psychosis is discussed.

Aphasia↗
PubMed1994

Linguistic impairment in early psychosis.

Twenty-four, first-admission, psychotic subjects and 24 control subjects were administered a linguistic instrument to elicit impairments in syntax, semantics, cohesion, and use of metaphors. In the same session, the subjects were also rated on the Scale for Thought, Language, and Communication Disorders (TLC). Results indicated a significant impairment of all four linguistic categories in psychotic subjects. The impairment in semantics, however, was differentiated the most between the patient and control groups. The psychotic patients scored significantly higher on the TLC. Scores of impairment on the linguistic tasks did not correlate with scores on the TLC.

Adolescent↗
PubMed1994

Hematocrit and bleeding time: an update.

The bleeding time is prolonged in anemic patients independent of their platelet count and is shortened by elevating the hematocrit. It is theorized that an increase in circulating red blood cells increases platelet radial movement and interaction with endothelium. Platelet dysfunction in uremia is well known but poorly understood. Anemia is one contributory factor; others may involve storage pool deficiency, increased vessel wall prostaglandin production, and abnormal platelet arachidonic acid metabolism. Ameliorating anemia with red blood cell transfusions has been shown to shorten the bleeding time without affecting other platelet function values. Recently, recombinant human erythropoietin has been shown to shorten the bleeding time, with a parallel rise in hematocrit level to 30%. Clinicians should be aware that a diminished hematocrit may contribute to the bleeding tendency already present in patients with thrombocytopenia.

Anemia↗
PubMed1994

Neuroendocrine and behavioral responses to intravenous m-chlorophenylpiperazine (mCPP) in depressed patients and healthy comparison subjects.

OBJECTIVE: This double-blind study was undertaken to compare central serotonergic function in depressed patients and healthy comparison subjects by examining neuroendocrine and mood responses to intravenous infusion of the serotonin agonist m-chlorophenylpiperazine (mCPP). METHOD: The participants were 20 drug-free patients with DSM-III-R major depression and 18 healty comparison subjects. After an overnight fast, the subjects received an intravenous infusion of mCPP, 0.1 mg/kg, or placebo saline. Blood was obtained for measurement of serum prolactin, growth hormone (GH), and cortisol. Visual analogue scales were used to assess mood. RESULTS: The depressed patients had a blunted GH response and felt less drowsy than the comparison subjects; prolactin, cortisol, and the remaining behavioral ratings showed no differences between the two groups. CONCLUSIONS: In light of findings with other provocative agents, the blunted GH response to mCPP may reflect a defect in GH production in depression and could be a marker of the depressed state. The lack of differences in the other neuroendocrine variables suggests that the functioning of postsynaptic serotonergic receptors responsive to mCPP may be relatively intact in depression.

Adult↗
PubMed1994

An exploratory evaluation of ECT in haloperidol-treated DSM-IIIR schizophreniform disorder.

In a double-blind, prospective study, 30 consecutive treatment-naive adult men with first-onset psychosis and DSM-IIIR provisional schizophreniform disorder (without good prognostic features) were randomized into true electroconvulsive therapy (ECT) and sham ECT groups. Both groups received haloperidol in a fixed dose of 15 mg at night. The ECT schedule comprised six bilateral, sinusoidal wave treatments administered on alternate days, thrice a week. Weekly ratings for the first 6 weeks showed an absence of significant difference between the groups in the number of patients responding and in the rate of attenuation of psychosis; severity of depression, while less in the true ECT group after the first 3 weeks, did not differ between the groups at any subsequent time point. Clinical ratings were repeated at 6 months, and social functioning was assessed; again, no group differences emerged. It is concluded that ECT does not meaningfully improve response in unselected schizophreniform disorder that is treated with an adequate dose of neuroleptic.

Adolescent↗
PubMed1994

Epidemiology, clinical manifestations, and outcome of Clostridium difficile-associated diarrhea.

OBJECTIVE: Clostridium difficile gastrointestinal disease is an important nosocomial infection and is associated with recent antibiotic use. This study evaluated C. difficile-associated diarrhea (CDAD) over a 2-yr period. METHODS: All 60 patients with C. difficile enterotoxin in their stools, and diarrhea, were retrospectively analyzed at a 615-bed teaching hospital. Institution antibiotic usage and discharge medical diagnoses were correlated with the study patients. RESULTS: Thirty-eight study patients (53%) had major or extreme admitting symptoms. Only four (7%) had no co-morbid illness. The incidence of CDAD increased significantly (p < 0.05) after 4 wk of hospitalization. No demographic or temporal clustering was discovered. Leukocytosis (60%), leftward polymorphonuclear shift (47%), dehydration (30%), weight loss (23%), and oliguria (12%) were the major clinical findings. Among these subject 51 (85%) had been on ceftriaxone and/or ceftazidime in the preceding 6 wk; ceftriaxone/ceftazidime was highly significantly associated (p < 0.01) with more cases than expected by usage alone. No patient on ticarcillin/clavulanate developed CDAD, although it was the most commonly used antibiotic (p < 0.00001). Higher mortality was associated with older debilitated nursing home residents. CONCLUSIONS: Third-generation cephalosporin use correlated with the development of CDAD; ticarcillin/clavulanate usage did not. Morbidity and mortality associated with CDAD is significant, is worse in debilitated older nursing home patients, and is more likely to occur in hospitalizations lasting longer than 4 wk.

Aged↗
PubMed1994

Evaluation of recalcitrant pain in HIV-infected hospitalized patients.

Chronic refractory severe pain in HIV-infected patients is a common and often neglected problem. Little data exist evaluating its epidemiology, clinical features, and treatment. Our study assessed all HIV-infected inpatients referred to the pain control service over a 2-year span. All (24) inpatients with HIV infection with chronic refractory severe pain referred to the pain control service (PCS) over a 2-year period were prospectively followed daily by trained specialists who graded the pain, recommended appropriate therapy, and assessed outcome. Ten surviving patients had further long-term outpatient follow-up. The patients included 14 intravenous drug abusers, five of whom were on methadone maintenance. Localized lower-extremity pain was present in 58%. Pain had been present for > or = 1 month in 21 (88%) and for > or = 6 months in 12 (50%). No patient had been on pain control around the clock. After PCS consultation, all surviving patients (21 of 21, 100%) had partial or total pain relief within 2 weeks (eight within 1 week) using around-the-clock opioid analgesia adjusted daily as necessary. No differences were seen between substance abusing/methadone patients and others. No significant adverse reactions or new addiction problems were found. Our conclusion is that effective pain control can be achieved using around-the-clock opioid analgesia in terminal HIV-infected patients with severe, chronic, refractory pain, even if the patients are substance abusers.

Administration, Cutaneous↗