Unique tubular lesion after lithium.
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Biomedical subjects
Publications and source records attributed to B Davies.
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A cardiovascular study of a new antidepressant, nomifensine, revealed no significant cardiac effects in eight ambulant patients who received up to 200 mg of nomifensine per day for three weeks. In an electro-physiological study of cardiac conduction, nomifensine had significantly less effect on cardiac activity than amitriptyline and doxepin. Results of the clinical and the experimental studies suggest that nomifensine may be of value in treating the depressed patient with heart disease.
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The short-term effects of pressor amines were investigated in four patients with postural hypotension caused by autonomic failure. In supine patients p-tyramine alone or with a monoamine-oxidase inhibitor produced pronounced supine hypertension without abolishing the symptoms associated with a postural fall in blood-pressure. Phenylephrine or ephedrine maintained a normal blood-pressure on standing but caused supine hypertension. Thus the effects of p-tyramine with or without a monoamine-oxidase inhibitor were unpredictable and did not include relief of postural hypotension. Phenylephrine or ephedrine had some beneficial effect, but since all these drugs influence standing pressure only at the expense of pronounced supine hypertension, alternative therapy must be sought.
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Ten patients who suffered from a primary depressive illness were treated with a new antidepressant drug butriptyline (150 mg/day). Six of the patients showed marked clinical improvement, as judged by depression rating scores, at the end of 22 days of treatment. No simple relationship was found between clinical response and plasma butriptyline concentration. Butriptyline is an effective antidepressant agent, well tolerated and with few side effects.
Patients with moderately severe depressive illness were matched for age, sex, severity of symptoms and number of previous episodes of affective illness. Eleven pairs of patients were randomly assigned to four weeks' treatment with either viloxazine (100 mg three times a day) or imipramine (50 mg three times a day). Both treatments were associated with significant reductions in the scores on depression rating scales. With a sequential testing plan based on repeated significance tests and formed into a skewed restricted plan, no difference in the two treatments was shown. Significantly fewer side effects were reported by patients receiving viloxazine.
Cigarette smoking was found to have no effect on the steady-state plasma levels of nortriptyline in a group of 22 smokers and 31 nonsmokers. Smokers achieved a mean steady-state nortriptyline concentration of 191.2 +/- 141.3 ng/ml; nonsmokers had a level of 169.3 +/- 92.4 ng/ml. Age, sex, and number of cigarettes smoked had no effect on the plasma concentrations achieved.
In a 5-week study of 22 depressed patients treated with nortriptyline, significant changes in plasma levels, both elevated and reduced, were deliberately produced in the third and fourth weeks of each patient's treatment. Correlation of plasma nortriptyline levels and changes in the severity of depression, as measured by the Hamilton Depression Scale, showed no significant relationships. The implications of the study are discussed.
The daily excretion of adenosine 3'5' cyclic monophosphate (c-AMP) in a group of 19 patients with a severe depressive illness was found to be significantly decreased when compared with that from a group of euthymic patients being treated for other disorders in the same ward. The daily excretion of the depressed patients increased during the period of treatment and recovery from the illness. Treatment with a tricyclic antidepressant caused a greater increase than electroconvulsive treatment (ECT). There was no difference between the mean plasma c-AMP concentration of the depressed and euthymic groups. The mean CSF-c-AMP concentration was not different from the mean plasma c-AMP concentration in 12 patients with severe depression. There was no direct correlation between the CSF and plasma concentrations within patients. It was concluded that there may be a reversible disturbance in the renal metabolism of c-AMP in patients with severe depression.
Measurements of free noradrenaline and adrenaline were made in the urine of 28 men sampled after rest and exercise prior to, and following six and twelve weeks of an excercise programme. The training consisted of thirty minutes of running and walking four times per week at an intensity estimated at 75% of the age-predicted maximum heart rate. A fifteen minute standardized cycle ergometer work test was conducted on all subjects prior to the training and following six and twelve weeks of training. Noradrenaline and adrenaline excretions in the urine were measured before and after the work test.
A group of eighty healthy women was studied following two months of programmed exercise (3 x 15 mins/per week) at 60 to 80 percent of age-predicted maximum heart rate. Physical work capacity corresponding to a heartrate of 170 bts. (PWC-170) was determined using a bicycle ergometer. Anthropometric and lung function variables were also ascertained prior to (T1) and following training (T2). The post training measurements of this exercise group, compared with measurements of a sedentary control group, displayed significant changes in PWC-170, resting systolic blood pressure and fat index. There were no significant changes in vital capacity, forced expiratory volume in one second (FEV1), strength and perceived exertion measures (RPE). The implication of these findings are discussed.
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Sarcoid patients frequently show depression of skin delayed hypersensitivity reactions suggesting depression of thymic (T) lymphocyte function. In vitro demonstration of such depression, however, to date, is inconclusive. We have used the macrophage migration inhibition test with Kveim "antigen" (KMIF), and spontaneous sheep red cell rosetting (SRC) techniques as indicator systems. We found that a positive KMIF test obtained in 7 of 16 subjects (13 sarcoid and 3 non sarcoid) in the presence of foetal bovine sera (FBS) became negative in the presence of sarcoid patients sera. Using lymphocytes from a single normal healthy subject the SRC tests were performed in the presence of sarcoid, normal healthy sera and FBS. With sarcoid sera 38% of lymphocytes showed rosetting as compared with normal human sera, 54%, and with FBS, 57%. Where lymphocytes were pre-incubated for one hour in the various sera the percentage of rosetting cells were even further reduced, sarcoid sera 23%, as compared to normal human sera, (49%), and FBS, (54%). Thus, using two tests of lymphocyte function our preliminary results suggest the presence of T cell inhibitory factors in sarcoid sera.
Sixty-two patients with moderately severe anxiety symptoms were treated in a double bline 3-week trial with either oxprenolol, diazepam or placebo. The Hamilton Anxiety Scale and a Target symptom improvement score were the main measures of change used. All treatment groups significantly improved in the three weeks of the trial. However in the third week of treatment improvement was greater in the diazepam and oxprenolol groups. Observer preferences significantly favoured the diazepam group. The implications of the study were discussed.