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Biomedical subjects

A Schulman

Publications and source records attributed to A Schulman.

At least 73 records · Page 4Linked to original sources
PubMed1983

Hemodialysis in the treatment of chronic schizophrenic patients: a double-blind crossover study.

In order to examine the reported beneficial effects of hemodialysis in chronic schizophrenic patients, a double-blind crossover study was carried out. Of the 47 patients considered for treatment, 10 diagnosed as chronic schizophrenics according to the Feighner and DSM-III criteria were accepted to the study. Seven of these patients completed the full program, four of whom belonged to a large family with a high incidence of schizophrenia. All patients were on antipsychotic medication throughout the study. Psychopathological evaluations were performed regularly in a blind fashion using the Comprehensive Psychopathological Rating Scale (CPRS) and the Nurse Observation Scale for Inpatient Evaluation (NOSIE-30). Samples of blood, urine, cerebrospinal fluid, and dialysate were obtained for examination. Three patients improved during active dialysis and two patients improved during sham treatment. Improvement in the five patients took place during the first treatment period. This study failed to demonstrate a therapeutic effect of hemodialysis superior to the sham procedures.

Adult↗
PubMed1983

Influence of hemodialysis on monoamine oxidase kinetics in platelets from chronic schizophrenic patients.

Platelet monoamine oxidase (MAO) activity in seven chronic schizophrenic patients undergoing hemodialysis treatment was studied. The treatment was performed in a double-blind crossover design. A significant increase in MAO activity was observed after 5 h of active dialysis, whereas inactive dialysis did not significantly alter the enzyme activity. The increase in MAO activity could be explained by the observed significant decrease in apparent Km values for the amine (phenethylamine) studied. During a treatment period of 8 weeks, the MAO activity was not significantly altered with either active or sham dialysis. No relation between clinical ratings and platelet MAO activity was observed. Plasma from the seven patients was collected before and after 5 h of active or inactive dialysis and incubated with rat brain mitochondrial MAO (RBM-MAO). No difference was noted in the RBM-MAO-activity-regulating properties of the plasma sampled during either sham or active dialysis.

Adult↗
PubMed1983

Levomepromazine elimination in patients during active and sham hemodialysis.

The effect of active and sham dialysis on the plasma concentration of levomepromazine was studied in seven schizophrenic patients undergoing hemodialysis treatment in a double-blind crossover study. Samples of blood were collected before, after 2 h and 5 h of treatment, and once a week during the treatment program. The plasma concentrations decreased during both active and sham dialysis. The data indicate that there was no significant difference in the elimination of the drug between active and sham hemodialysis.

Adult↗
PubMed1983

Concentrations of 5-hydroxyindoleacetic acid and homovanillic acid in the cerebrospinal fluid of chronic therapy-resistant schizophrenics before and after hemodialysis therapy.

The concentrations of the monoamine metabolites 5-hydroxyindoleacetic acid (5-HIAA) and homovanillic acid (HVA) have been determined by high-performance liquid chromatography in samples of lumbar cerebrospinal fluid from chronic therapy-resistant schizophrenics, both before and after either inactive or active hemodialysis for 10 weeks. A reasonable test-retest reliability was found for 5-HIAA during the inactive dialysis, but this was not found during active dialysis.

Adult↗
PubMed1983

Chromatographic analysis of urine and dialysate from schizophrenic patients undergoing hemodialysis.

Maladjustments in the central nervous system may result in altered concentrations of neuropeptides in cerebrospinal fluid and urine. Urinary protein-peptide precipitates from psychiatric patients have previously been observed to have different chromatographic profiles with regard to the ultraviolet absorbancy at 280 nm. Hemodialysis has previously been reported to improve some schizophrenic patients and has been recommended in treatment trials. Seven chronic schizophrenic patients were selected for hemodialysis in a double-blind crossover study. Specimens of 24-h urine collections were obtained the day before, the day of, and the day after active and sham dialysis. The chromatographic profiles obtained on Sephadex G-25 gel columns did not change with active dialysis. Materials with ultraviolet absorbancy at 280 nm also precipitated from dialysates and showed the same pattern following active and inactive dialysis. Thus, no biochemical evidence for removal of any pathogenetic humoral substance during hemodialysis could be provided.

Adult↗
PubMed1983

Serum lipids and lipoproteins in schizophrenic patients with normal renal function treated with hemodialysis.

To study the effect of hemodialysis on serum lipids and lipoproteins, five patients with normal renal function who had undergone hemodialysis for schizophrenic symptoms for 10 weeks in a crossover study were investigated. Active or sham (no dialysate flow through the filter) dialysis was instituted randomly. Serum lipids were isolated by ultracentrifugation and precipitation before and after each period. High density lipoprotein (HDL) cholesterol levels were constantly low and correlated negatively with serum alkaline phosphatase concentrations (p less than 0.05). Serum and very low density lipoprotein (VLDL) triglycerides and VLDL cholesterol increased during active, and to a lesser extent during sham, dialysis. Dialysis of this intensity does not affect HDL. The low levels may be secondary to subclinical cholestasis from neuroleptic drug treatment. Some individuals may develop hypertriglyceridemia of unknown pathogenesis during hemodialysis. Both these lipoprotein abnormalities are risk factors for the development of atherosclerosis.

Adult↗
PubMed1983

Small-bowel obstruction masking synchronous large-bowel obstruction: a need for emergency barium enema.

Synchronous obstruction of large and small bowel may be missed radiologically and even at laparotomy when the small-bowel obstruction masks the large-bowel obstruction. The five patients reported illustrate this problem. It can only be diagnosed in certain patients by barium enema after small-bowel obstruction has been shown on plain radiographs. In four patients, this was especially applicable: patients with known or suspected abdominopelvic malignancy with loops of small bowel and pelvic colon involved by either tumor spread or irradiation fibrosis after treatment. One patient had ischemic strictures manifesting rather unusually in this manner.

Aged↗
PubMed1982

[Cholecystography and ultrasonics in the diagnosis of gallstones].

Oral cholecystography and ultrasonography of the gallbladder were performed in 190 patients with the aim of diagnosing gallstones. At surgery gallstones were found in 23 patients and a roundworm in 1 patient. The results obtained with the two methods are comparable. Since neither radiation nor contrast agents are employed in ultrasonography, it is suggested that this be regarded as the primary special examination in the diagnosis of gallstones.

Cholecystography↗
PubMed1982

Air in unusual places: some causes and ramifications of pneumomediastinum.

Five unusual cases of pneumomediastinum are described. In three the probable cause was thoraco-abdominal straining against a closed glottis during violent exercise, in criminal assault, or competitive sport. The resultant increase in intra-alveolar pressure produces an air leak which passes via the pulmonary interstitium into the mediastinum. It can then pass up into the neck to produce widespread subcutaneous emphysema and down through the diaphragmatic hiatuses to produce extraperitoneal emphysema. This may outline the lower surface of the diaphragm to stimulate intraperitoneal air, but it can also leak through the parietal peritoneum to result in actual intraperitoneal air. Therefore, in the patient who has been hospitalised after violent physical stress with or without blunt trauma, pneumomediastinum does not necessarily indicate tracheobronchial or oesophageal rupture and subdiaphragmatic air does not necessarily indicate bowel rupture. Probably any form of exercise in which the Valsalva manoeuvre is performed may cause pneumomediastinum, as may other causes of increased intra-alveolar pressure such as mechanical ventilation, bronchospasm, coughing and vomiting. Vomiting is a likely contributing cause in the pneumomediastinum of diabetic ketosis, of which a case is described. Another case is presented in which air passed in the opposite direction, from perforated extraperitoneal bowel up into the mediastinum.

Adolescent↗
PubMed1982

Sonographic diagnosis of biliary ascariasis.

In a prospective 6 month study, sonographic diagnosis of biliary ascariasis was made in 12 patients: In five, the diagnosis was confirmed by other means, mainly intravenous cholangiography. In three, such confirmation was not sought, but all had proven intestinal infestation. One possible and three definite false-positive diagnoses were made. There were no established false-negative diagnoses. The echogenic, nonshadowing images of the worms were seen in the main bile duct and/or gallbladder as single strips (on one occasion with its digestive tract seen as an anechoic "inner tube"), as multiple strips giving a spaghettilike appearance, as coils, or as more amorphous fragments. Follow-up sonograms were obtained in six patients and showed expulsion of the worms by medical treatment.

Adolescent↗