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Biomedical subjects

D Baldwin

Publications and source records attributed to D Baldwin.

At least 109 records · Page 6Linked to original sources
PubMed1991

Bilateral cerebellopontine angle tumors in neurofibromatosis type 2.

In a series of over 500 cases of cerebellopontine angle tumors, 19 patients had bilateral neurinomas. Four of these tumors arose from the facial rather than the acoustic nerve. A conservative policy regarding surgery had been adopted in an effort to prevent hearing loss for as long as possible. Nevertheless, all patients operated on in this series are now totally deaf. The results of managing these patients surgically and conservatively are discussed.

Adult↗
PubMed1991

Performance of psychomotor skills: a comparison of two teaching strategies.

This study compares two teaching strategies: textbook assignment and videotape with no faculty assistance, and textbook assignment and videotape with faculty assistance (demonstration of skills and supervised practice) to determine their effect on outcome performance (measurement of blood pressure) and on the student's perceived level of confidence. The intent of the study was to ascertain if the use of mediated instruction without faculty input would decrease faculty-student contact time without adversely affecting performance outcomes. Results of the study revealed that faculty contact is an important factor when students are learning to perform a basic psychomotor skill. It was concluded that mediated instruction is not appropriate as a complete substitute for faculty contact.

Clinical Competence↗
PubMed1990

Insight.

Explore the source record for details and available documents.

Cognition↗
PubMed1990

The duration, nature and recurrence rate of brief depressions.

1. It has been shown in placebo controlled studies of prophylactic treatment of suicidal behaviour in patients not suffering from major depression that brief episodes of depression predict further suicidal behaviour. 2. In a prospective follow up study of patients with a history of repeated suicidal behaviour it appears that almost all suffered recurrent episodes of brief depression, mainly of moderate to severe intensity. Two thirds of the episodes lasted between two and four days. The recurrences were frequent, irregular, and apparently unpredictable. 3. The episodes were distinguishable from major depression only by the short duration.

Adult↗
PubMed1990

Plasma-level response relationships with fluoxetine and zimelidine.

The results of pharmacokinetic studies of two recent 5-HT uptake inhibitors, zimelidine and fluoxetine, have pointed to the inadequacy of open-dose rising studies for establishing the most appropriate dose of new antidepressants. High plasma concentrations of the active metabolites, norzimelidine and norfluoxetine, were associated with a poorer therapeutic response in patients suffering from major depression. High drug plasma concentrations are also associated with increased side effects. Large fixed-dose placebo controlled studies with fluoxetine have confirmed the findings of the small pharmacokinetic study that lower doses are more effective. Fixed-dose pharmacokinetic studies are recommended as part of the program to establish the best dose of new antidepressants.

Depressive Disorder↗
PubMed1990

Lead poisoning: clinical, biochemical, and haematological aspects of a recent outbreak.

The clinical, biochemical, and haematological aspects of a recent outbreak of lead poisoning, in which exposure was related to the oxyacetylene cutting of red lead painted ironwork, were investigated. Initial suspicion was raised when a blood film showed punctate basophilia which remains a simple and useful method of picking up lead toxicity. Estimations of blood lead concentration and conventional laboratory data confirmed the diagnosis. Although there was prominent punctate basophilia, spectrophotometric analysis showed only negligible accumulation of pyrimidine-5'-nucleotides despite severe suppression of pyrimidine-5'-nucleotidase activity. The pattern of the red cell glycolytic intermediates, investigated for the first time, suggested that lead may also affect glycolysis at the hexokinase step. Once the diagnosis was made intravenous chelation treatment was begun with a rapid improvement in symptoms. Long term follow up is required to assess any sequelae of intoxication. These cases emphasise the classic features of lead poisoning, and despite the currently available diagnostic tests, lead intoxication may still go unrecognised unless a thorough occupational history is taken.

5'-Nucleotidase↗
PubMed1989

Antibodies to human immunodeficiency virus type 1 in the urine specimens of HIV-1-seropositive individuals.

Specific antibodies to human immunodeficiency virus type 1 (HIV-1) were detected in 200-fold concentrated urine samples, but none were detected in unconcentrated urine specimens, from 100 randomly selected HIV-1--seropositive individuals by enzyme-linked immunosorbent assay (ELISA) and Western blot techniques using the manufacturer's recommended procedures. Using modified methods for both the ELISA and Western blot tests, antibodies to HIV-1 have also been detected in the unconcentrated urine specimens from the same HIV-1--seropositive individuals. No difference in the frequency of antibodies to HIV-1 were found between unconcentrated and 200-fold concentrated urine samples when tested by the modified methods. HIV-1 core antigen (p24) was not detected in either the concentrated or the unconcentrated HIV-1--seropositive adult urine samples; none of these individuals showed overt clinical or laboratory evidence of renal dysfunction. The titer of the antibodies to HIV-1 found in the urine specimens was found to be parallel with the titer of antibodies to HIV-1 in the corresponding individual's serum. Further elucidation of the pathophysiology and the nature of the specific antibodies to HIV-1 observed in the urine of HIV-1--seropositive individuals is under investigation in our laboratories.

Adolescent↗
PubMed1989

Why do amitriptyline and dothiepin appear to be so dangerous in overdose?

Data from different analyses of reported deaths from overdose with antidepressants in the U.K. reveal that amitriptyline and dothiepin are the antidepressants most likely to be associated with death from overdose. All widely used tricyclic antidepressants (TCAs) except clomipramine and lofepramine appear to be dangerous in overdose, whereas the newer antidepressants such as mianserin, trazodone, viloxazine and the TCA lofepramine appear to be relatively safe. The toxicity of amitriptyline and dothiepin appears to be greater than all antidepressants including other TCAs and it is important to try to understand why. A number of explanations will be considered: 1. Dothiepin and amitriptyline may be inherently more toxic than other TCAs. 2. Dothiepin and amitriptyline may induce suicide more than other antidepressants. It is assumed that antidepressants are neutral with regard to inducing suicide but this may not be true. There is, for example, evidence that alprazolam and other benzodiazepines induce suicidal behaviour. 3. Amitriptyline and dothiepin are often presented in subtherapeutic and ineffective doses and it is possible that increased suicides may result from inadequately treated depression. 4. There may be a selective overreporting of deaths with amitriptyline and dothiepin. 5. Amitriptyline and prothiaden may be selectively given to the suicide prone on the mistaken assumption that they are safe.

Amitriptyline↗
PubMed1989

Intermittent 3-day depressions and suicidal behaviour.

Intermittent short-lived episodes of depression were examined in a group of 20 recurrent suicidal attempters without major depression, classified misleadingly as borderline personality disorders on DSM-IIIR, during careful prospective follow-up for between 4 and 6 months. The duration of depressions clustered tightly around a median of 3 days with two thirds lasting between 2 and 4 days. They occurred erratically and unpredictably with a median interval of 18 days and were seen to be moderate to severe measured on the MADRS in 70% of episodes.

Crisis Intervention↗
PubMed1989

Prophylactic treatment of depression: a public health issue.

The majority of depressive illness is a chronic and relapsing, frequently occurring illness, which carries significant social and economic consequences for the sufferer. Depression is also associated with increased morbidity and mortality from physical illness and suicide. Long-term antidepressant treatment is needed for at least 6 months after the resolution of the symptoms of an acute episode to consolidate recovery. In recurrent depression, treatment over a much longer period is required to reduce the risk of a new episode occurring. It is clear from the prophylactic studies, which require careful and appropriate methods, that some half of the recurrent episodes of depression are preventable by adequate prophylactic treatment with antidepressants. This effect has been clearly demonstrated with some of the newly introduced 5-HT uptake inhibitors. The disadvantages of long-term treatment have to be weighed against the risks and costs, personal, social and economic, of the illness.

Antidepressive Agents↗
PubMed1988

Supplemental oxygen and dependent positioning as adjunctive measures to improve forefoot tissue oxygenation.

Fifty-seven patients with resting pain or tissue necrosis were found to have a forefoot transcutaneous tissue oxygen (tcPO2) level less than 30 mm Hg. The adjunctive measures of foot dependency (36 cm below heart level) and nasal oxygen of 3 L/min were evaluated in these patients. In general, the improvement in tcPO2 levels with these adjunctive measures was not related to basal levels of forefoot or arm tcPO2. One can expect an increase in tcPO2 level of approximately 22 mm Hg while employing the dependent position and an additional benefit of 12 mm Hg with the administration of nasal oxygen. Of the 35 patients with a basal forefoot tcPO2 level of less than 10 mm Hg, 11 did not respond to these adjunctive measures.

Aged↗
PubMed1988

Disrupted retention of the classically conditioned nictitating membrane response in rabbits with aluminum-induced neurofibrillary degeneration.

Rabbits underwent classical conditioning of the nictitating membrane response (NMR) to a tone conditioned stimulus and an air puff unconditioned stimulus until they emitted 90 percent or greater conditioned responses (CRs) for two consecutive days. They then received intraventricular injection of aluminum chloride, hydrochloric acid or saline. Ten days post injection they were tested for retention of the conditioned response. Animals injected with saline or hydrochloric acid emitted an average of greater than 90 percent CRs. Aluminum injected rabbits, in contrast, emitted an average of only about 40 percent CRs. This disruption of retention of conditioning in aluminum treated rabbits could not be attributed to deficits in sensory or motor processes or to illness. Neuropathological analysis revealed widespread neurofibrillary tangle formation in the aluminum treated animals. Furthermore, the degree of neurofibrillary degeneration was significantly negatively correlated with retention of the CR. The results are considered in the context of using the rabbit NMR preparation as a model system for studying age-related conditioning disorders.

Aluminum↗
PubMed1988

Substance use and the resident physician: a national study.

A national study of substance use and abuse among resident physicians indicates that except for tranquilizers and barbiturates most illicit use of drugs began prior to medical school and residency. Relatively few residents were aware of substance abuse policies or educational programs in their institutions.

Cross-Sectional Studies↗