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Biomedical subjects

C E Coffey

Publications and source records attributed to C E Coffey.

At least 73 records · Page 4Linked to original sources
PubMed1987

Use of caffeine to lengthen seizures in ECT.

During a course of ECT, seizure duration may become too brief for clinical benefit. Use of higher-energy stimuli may lengthen seizures but may also increase the risk of toxicity, and it is not possible when maximum settings are reached. The authors present the cases of six drug-free depressed inpatients whose seizure durations in ECT declined despite maximum settings on three different ECT devices. In all cases, pretreatment with caffeine lengthened seizures (mean increase = 107%), and clinical improvement followed. Caffeine was well tolerated, even in patients with cardiovascular diseases.

Aged↗
PubMed1985

Neurologic complications of Rocky Mountain spotted fever.

Rocky Mountain spotted fever, a serious systemic infectious illness, is common in the southeastern United States. Approximately one fourth of the cases in the United States occur in North Carolina. Widespread organ involvement occurs, with central nervous system involvement being common and occasionally severe. Since the onset of treatment with drugs such as tetracycline or chloramphenicol, the mortality has been 4%. Residual deficits are rare, but the disease retains potentially serious neurologic manifestations that must be considered and aggressively treated. A high index of suspicion should be maintained during the tick season in endemic areas. The simultaneous occurrence of illnesses such as influenza, mycoplasmal infection, and aseptic meningitis makes diagnosis a challenge.

Adolescent↗
PubMed1984

Dyskinesias associated with lithium therapy in parkinsonism.

Five patients with the "on-off" phenomenon of parkinsonism who developed dyskinesias associated with a reduction in akinesia during treatment with lithium carbonate are described. The data show that lithium-induced dyskinesias may occur in the absence of lithium neurotoxicity and at normal serum lithium concentrations. These observations are interpreted in the context of recent evidence that indicates that lithium may "stabilize" dopaminergic and cholinergic receptor sensitivity.

Adult↗
PubMed1984

Myocardial infarction and stroke.

We used a computer data bank to evaluate 740 consecutive patients admitted to a cardiac care unit with myocardial infarction. Stroke occurred in 18 (2.4%) patients in the hospital; the anterior circulation was involved in 76% of strokes. Hospital mortality was 61% in patients with stroke and 13% in patients without stroke. Atrial arrhythmia was a significant (p less than or equal to 0.03) risk factor for stroke, but peak creatine kinase and ventricular arrhythmia were not. Cardiac pump failure, apical or anterior-lateral myocardial infarction, and history of previous stroke were associated with an increased risk of stroke. Clinical and pathologic data suggested an embolic etiology for most strokes that complicate acute myocardial infarction.

Adult↗
PubMed1983

Frontal lobe personality syndromes. Ominous sequelae of head trauma.

Head trauma frequently results in frontal lobe dysfunction. This can cause a number of personality changes characterized by disturbances in affect and in regulation of emotions. Behavioral changes and alterations in cognition may occur also and are often accompanied by neurologic signs. The changes are frequently debilitating, and unfortunately in too many cases the lesion and its effects are not reversible and the patient's prognosis for returning to useful and independent life is very poor. A well-planned approach on the part of the physician can aid patient and family in difficult adjustments during rehabilitation and afford the best chance for recovery.

Adult↗
PubMed1983

The price of psychotropic drugs: a neglected factor.

Of the various factors that determine the choice of psychotropic drugs, economic cost to patients is often not adequately considered. The authors present results of a small survey of private pharmacy prices for psychopharmacologic agents, and compare these prices with wholesale prices and prices from alternative retail sources. They report a large degree of price variability, which sometimes even overshadows price differences between trade and generic preparations. Problems with bioequivalency among different preparations, the ramifications of prescribing the largest possible dose unit, and other issues related to drug cost are discussed.

Adult↗
PubMed1983

Natural history of cerebral complications of coronary artery bypass graft surgery.

We reviewed 1,669 patients who survived coronary artery bypass graft surgery between 1969 and 1981. A total of 75 cerebral complications were identified, including (1) altered mental state, (2) stroke, and (3) seizure in 64 patients (3.8%). Altered mental state (delirium, hypoxic-metabolic encephalopathy) occurred in 57 (3.4%). Postoperative arrhythmias were associated with an increased risk of altered mental state. Cerebral infarction occurred in 13 (0.8%). Patients who suffered stroke had a higher occurrence of carotid bruits and history of peripheral vascular disease. Seizures occurred in five patients (0.3%). Mortality in patients with a neurologic complication was 29%.

Brain Diseases↗
PubMed1982

Treatment of the "on-off" phenomenon in Parkinsonism with lithium carbonate.

Six patients with severe parkinsonism complicated by the "on-off" phenomenon were treated with lithium carbonate in addition to regular antiparkinson medications. A randomized double-blind crossover trial of lithium versus placebo was conducted, followed by an open trial of lithium therapy. Five patients had markedly reductions in akinesia (mean, 70%) and improved by one grade in Parkinson staging. This result was more striking in male than in female patients, and in all responders benefit has been maintained during the open phase of lithium treatment (mean follow-up of 36 weeks). In no patient was a reduction in akinesia observed during placebo treatment. Lithium carbonate appears to offer a new and potentially effective approach to treatment of the on-off phenomenon.

Adult↗
PubMed1982

Familial benign intracranial hypertension and depression.

Two sisters developed benign intracranial hypertension (BIH) two weeks following the resolution of a major depressive episode. The association of BIH and a major affective disorder in genetically related individuals has not been previously reported to our knowledge. Both conditions are associated with disturbances in the hypothalamic-pituitary-adrenal axis. Falling corticosteroid levels in a resolving depression may result in impaired cerebrospinal fluid absorption and subsequent BIH.

Adult↗