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Biomedical subjects

D M Taylor

Publications and source records attributed to D M Taylor.

At least 55 records · Page 3Linked to original sources
PubMed2000

Atypical antipsychotics and weight gain--a systematic review.

OBJECTIVE: To review systematically data relating to weight changes with atypical antipsychotics. METHOD: We conducted a Medline search on October 29 1999 and covered the period 1980-99. All recovered papers were examined for further relevant reports. In addition, we wrote to pharmaceutical manufacturers and 10 practising clinicians to ask them to provide other relevant reports known to them. RESULTS: Eighty reports mentioning change in body weight were retrieved. Data relating to weight changes were of variable quality. Weight changes were indicated by a variety of measures. The majority of reports related to short-term changes. CONCLUSION: All atypical drugs, with the exception of ziprasidone, have been associated with weight increases. Clozapine seems to have the highest risk of weight gain, followed by olanzapine and quetiapine. There is probably a lower risk with risperidone, sertindole and zotepine and a still lower risk with amisulpride. Ziprasidone appears not to be associated with weight gain. In the absence of more compelling data, these rankings must be considered approximate and preliminary. Longer, more robust trials are needed.

Amisulpride↗
PubMed2000

Psychotropic interactions with warfarin.

OBJECTIVE: Improving knowledge about the cytochrome p450 system means that potential drug interactions can be predicted. Interactions involving warfarin may be thus avoidable. As many patients who have suffered from a stroke or other thromboembolic events may also develop psychiatric disorder, knowledge about possible interactions with psychotropics is essential for prescribers. METHOD: A Medline and hand search of published literature was complemented by contacting manufacturers. RESULTS: The antidepressants citalopram, nefazodone and sertraline have relatively low interaction potential with warfarin; fluoxetine and fluvoxamine relatively high. Carbamazepine appears to reduce warfarin's anticoagulant effect. Other antipsychotics, antidepressants and anxiolytics have only a theoretical risk of interaction. Lithium, gabapentin, sulpiride and amisulpride are predominantly renally excreted and so are not likely to interact with warfarin. CONCLUSION: Many psychotropics are involved in predictable interactions with warfarin. Drugs with a known low interaction potential should be chosen instead of those known or predicted to interact.

Anticoagulants↗
PubMed2000

Inactivation of transmissible degenerative encephalopathy agents: A review.

The unconventional agents that cause transmissible degenerative encephalopathies, such as bovine spongiform encephalopathy, scrapie, and Creutzfeldt-Jakob disease (CJD), are relatively resistant to inactivation by standard decontamination procedures. The only methods that appear to be completely effective under worst-case conditions are strong sodium hypochlorite solutions or hot solutions of sodium hydroxide. Other procedures that result in significant degrees of inactivation are described. The infectivity levels in histologically-fixed tissue can be reduced substantially by treatment with concentrated formic acid without adversely affecting the microscopic quality of the tissue.

Animals↗
PubMed2000

Ethnicity in America and feeling "American".

Ethnic group acculturation remains a concern in the United States today. In the present study, the authors explored the extent to which members of three ethnic groups (White American women, African American women, and Cuban American women) perceived themselves to be "American," how much each group felt that its members were perceived as being American by White Americans, and how these perceptions related to beliefs about their own group's economic and social status. The results showed that African Americans felt American but felt that they were not perceived as such by White Americans. African Americans also reported feeling economically and socially excluded. In contrast, Cuban Americans reported neither feeling they were American nor believing they were perceived as such by White Americans, but feelings of inclusion increased with length of residence. Implications of these results for the common ingroup identity model are discussed.

Acculturation↗
PubMed2000

Discharge instructions for emergency department patients: what should we provide?

Effective communication between the physician and patient is required for optimum post-emergency department management. Written emergency department discharge instructions, when used to complement verbal instructions, have been shown to improve communication and patient management. This review examines the purpose, advantages, and disadvantages of three commonly used types of discharge instruction. The desirable features of discharge instructions are described. It is recommended that structured, pre-formatted instruction sheets be provided to all patients discharged to home, that emergency departments establish uniform policies to promote best practice in communication, and that the use of discharge instructions be considered as an emergency department performance indicator.

Communication↗
PubMed2000

Emergency department discharge instructions: a wide variation in practice across Australasia.

OBJECTIVES: All patients discharged from the emergency department (ED) should be given discharge instructions (DIs). This study aimed to describe the DI practices of EDs in Australasia and to examine the differences between public and private EDs. METHODS: A voluntary, questionnaire-based survey of public and private EDs throughout Australia and New Zealand. RESULTS: 58 of 74 (78.4%) EDs provided instruction notes upon discharge although 51 (68.9%) gave them to only "some" patients. There were no significant differences between the public and private EDs (p>0.05). Thirty seven (50%) EDs provided pre-formatted instruction sheets although 22 (29.7%) EDs gave them to only "some" patients. There were no significant differences between the public and private EDs (p>0.05). Only five (6.8%) EDs retained a copy of the instruction sheets and no (O%) ED provided sheets that included all recommended features. Sixty six (89.2%) EDs provided information sheets although 44 (59.5%) EDs gave them to only "some" patients. Private EDs gave information sheets to significantly more patients than public EDs (p=0.04). CONCLUSIONS: The DI practices of individual EDs varied and the rates of DI provision were low. EDs should improve their DI practices. Pre-formatted instruction sheets, containing all recommended features, should be provided to all patients with a copy kept in the medical record. Consideration should be given to the use of DI practices as an ED performance indicator.

Australia↗
PubMed2000

Refractory schizophrenia and atypical antipsychotics.

Treatment resistant or refractory schizophrenia is a difficult to define condition of largely unknown prevalence. For 10 years, clozapine has been the standard treatment in this condition and is recognized unequivocally as being effective. However, clozapine is sometimes poorly tolerated and has the potential for severe toxicity. Partly as a result of this, other atypicals have recently been evaluated as treatments for refractory schizophrenia. In order to evaluate the evidence base relating to the drug treatment of refractory schizophrenia, we developed a refractoriness rating based on previous work. Using this rating, we assessed all trials of atypicals in schizophrenia unresponsive to at least one drug. Overall, clozapine was consistently shown to be effective in refractory schizophrenia, even when stringently defined. Data relating to olanzapine and risperidone are equivocal at best, and there is some evidence to suggest that they are less effective than clozapine. There is essentially no cogent evidence to support the use of any other atypical in refractory schizophrenia. Clozapine remains the drug of choice in this condition.

Antipsychotic Agents↗
PubMed2000

The psychometric and cardiac effects of pseudoephedrine in the hyperbaric environment.

STUDY OBJECTIVES: To examine the psychometric and cardiac effects of pseudoephedrine at 1 and 3 atmospheres (atm) of pressure (0 and 66 feet of sea water, respectively), and to make recommendations about the agent's safety in the diving environment. DESIGN: Double-blind, placebo-controlled, crossover study. SETTING: Monoplace hyperbaric chamber of a university hospital. SUBJECTS: Thirty active divers (mean age 38 yrs). INTERVENTION: A bank of seven tests was used to assess cognitive function during four different simulated dive combinations: placebo-1 atm, placebo3 atm, pseudoephedrine-1 atm, and pseudoephedrine-3 atm. MEASUREMENTS AND MAIN RESULTS: Heart rate and cardiac rhythm were recorded during all dives. Repeated-measures analysis of variance was used to analyze the effects of pseudoephedrine, depth, and drug-depth interaction. No significant, independent effects of pseudoephedrine were seen on any of the seven psychometric test scores (p>0.05), although the drug tended to increase anxiety scores (p=0.092). Depth resulted in a significant increase in anxiety scores (p=0.021) and a significant decrease in verbal fluency test scores (p=0.041); it had no significant effects on the other five psychometric tests (p>0.05). Pseudoephedrine caused a significant increase (p=0.036) in mean heart rate, and depth caused a significant decrease (p=0.013). Neither pseudoephedrine nor depth affected cardiac rhythm. CONCLUSION: Pseudoephedrine does not cause significant alterations in psychometric performance at 3 atm of pressure that might increase the risk of diving. Depth causes significant adverse effects on anxiety levels and semantic memory at 3 atm. Pseudoephedrine and depth have significant but opposite effects on heart rate; although, these effects are unlikely to be clinically significant during diving. It is unlikely that pseudoephedrine adds significant risk to the diver.

Adult↗
PubMed2000

The psychometric and cardiac effects of dimenhydrinate in the hyperbaric environment.

STUDY OBJECTIVES: To examine the psychometric and cardiac effects of dimenhydrinate at 1 and 3 atmospheres (atm) of pressure (0 and 66 feet of sea water, respectively), and to make recommendations about the drug's safety in the diving environment. DESIGN: Double-blind, placebo-controlled, crossover study SETTING: Monoplace hyperbaric chamber of a university hospital. SUBJECTS: Thirty active divers (mean age 38 yrs). INTERVENTIONS: A bank of seven tests was used to assess cognitive function during four different dive combinations: placebo-1 atm, placebo-3 atm, dimenhydrinate-1 atm, and dimenhydrinate-3 atm. MEASUREMENTS AND MAIN RESULTS: Heart rate and cardiac rhythm were recorded during all dives. Repeated-measures multivariate analysis of variance was used to analyze the effects of dimenhydrinate, depth, and drug-depth interaction. Dimenhydrinate resulted in a significant decrease in scores of mental flexibility (trail-making, part B, p<0.05) but had no effect on scores in the six other psychometric tests (p>0.05). It had no effect on mean heart rate (p>0.05), although frequent unifocal ventricular ectopic beats occurred in two subjects after ingestion of the drug. Depth resulted in a significant decrease in verbal memory test scores (p=0.001) and mean heart rate (p<0.001). CONCLUSION: Dimenhydrinate adversely affects mental flexibility. This effect, when added to the adverse effect of depth on memory, may contribute to the dangers of diving.

Aged↗
PubMed1999

Survival of scrapie agent after exposure to sodium dodecyl sulphate and heat.

Fifty mg aliquots of macerated mouse-brain infected with the 22A strain of scrapie agent were treated by exposing them without mechanical mixing to (a) distilled water for 2 h, (b) 5% sodium dodecyl sulphate (SDS) for 2 h, (c) autoclaving at 121 degrees C for 15 min in distilled water, (d) autoclaving at 121 degrees C for 15 min in 5% SDS, or (e) boiling in 5% SDS for 15 min. Prior to injection into mice, all samples were washed by a procedure that is described and was shown not to reduce infectivity titres. Although the infectivity titre of the sample that was autoclaved in SDS was reduced considerably, infectivity was present in all of the samples exposed to cold or hot SDS.

Animals↗
PubMed1999

Successful preimplantation genetic diagnosis for sex Link Lesch--Nyhan Syndrome using specific diagnosis.

Lesch-Nyhan syndrome (LN) is a severe X-linked recessive disorder caused by a deficiency of the enzyme hypoxanthine phosphoribosyl transferase (HRT). Clinical features displayed by affected boys are particularly severe and disturbing and include hyperuricaemia, Characteristic neurological features including self-mutilation, choreothetosis, spasticity and mental retardation. A couple with a boy diagnosed with LN and a history of pregnancy termination was referred to the Hammersmith Hospital. Their affected son was born in 1982 after an uncomplicated pregnancy and vaginal delivery. Eight subsequent pregnancies had been unsuccessful. There were five therapeutic terminations and three spontaneous abortions, one at least directly caused by the sampling procedure during amniocentesis. From 1989 to 1991 two unsuccessful preimplantation genetic diagnosis (PGD) cycles by sexing were performed by DNA amplification. The mutation was characterized and a nested PCR protocol was designed which allowed the efficient amplification of the affected loci followed by the detection of the mutant allele by restriction digestion. Three PGD cycles were performed using this specific diagnostic test before a successful pregnancy was achieved resulting in the birth of a healthy unaffected baby girl.

Embryo Transfer↗
PubMed1999

Inactivation of prions by physical and chemical means.

Prions are very resistant to inactivation, and accidental transmission has occurred through the use of inadequate decontamination procedures. Strong sodium hypochiorite solutions achieve inactivation but other chlorine-releasing compounds are less effective. 2M sodium hydroxide leads to substantial but incomplete inactivation; other chemical procedures such as the use of proprietary phenolic disinfectants are much less less effective. Infectivity can survive autoclaving at 132-138 degrees C, and under certain conditions the effectiveness of autoclaving actually declines as the temperature is increased. The small resistant subpopulations that survive autoclaving are not inactivated by simply re-autoclaving, and they acquire biological characteristics that differentiate them from the main population. Despite the limitations of autoclaving, combining autoclaving (even at 121 degrees C) with a sodium hydroxide treatment is extremely effective. Protein-fixation (e.g., by ethanol or formalin) substantially enhances the thermostability of these agents. This suggests that future successful inactivation strategies might best be developed by studying procedures that avoid protein-fixation.

Animals↗
PubMed1999

Continuously recorded suckling behaviour and its effect on lactational amenorrhoea.

The hypothesis that the month-specific rate of return to ovarian cyclicity after childbirth is causally related to suckling pattern was tested for a population of New Mexican women recruited within the service area of New Mexico Highlands University and for a nationwide USA subpopulation of women recruited through membership of the Couple to Couple League (CCL). Survival analysis for time-dependent covariates was used, and significant predictors of the first postpartum menses were found. Important differences were detected in the suckling pattern for the two groups and a 5:2 differential was found in their respective rates of menstrual cycle recovery. Although the two groups were comparable perinatally, daily and time-windowed breast-feeding performance fell off at twice the rate for the New Mexico population when contrasted with the CCL sample. For both populations, the introduction of solid feeds was a strong and significant predictor of returning menstrual cyclicity, independent of suckling pattern.

Adult↗