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Biomedical subjects

H A Youssef

Publications and source records attributed to H A Youssef.

At least 37 records · Page 2Linked to original sources
PubMed1991

Duration of neuroleptic treatment and relapse rate: a 5-year follow-up study with haloperidol decanoate.

The role of neuroleptic drugs in controlling acute psychotic symptoms and reducing relapse is well established. It is the clinical management of chronically disabled patients that has major implications for health care planning. Drug discontinuation studies have indicated that patients with chronic schizophrenia should receive maintenance drug therapy for some years. This was a 5-year follow-up study to assess the long-term effects of depot haloperidol decanoate vs. other neuroleptics in 62 psychotic patients treated in the community. The study indicates that there were more relapses and hospitalization for patients maintained on other neuroleptics than for patients maintained on haloperidol decanoate. The study indicates that haloperidol decanoate even in low dosage is effective maintenance therapy is preventing relapse. Indeed, some of the good responders to haloperidol therapy may have benefitted from lowering the dosage of the drug. It is our experience that haloperidol decanoate is of good value in the management of psychotic illnesses that require long-term treatment. A more controlled longer-term study is needed to confirm our results.

Antipsychotic Agents↗
PubMed1991

Use of indium-111-labeled transferrin to study plasma extravasation during endotoxin shock and the effects of the beta-2 agonist terbutaline.

Endotoxemia and sepsis are common causes of respiratory distress (ARDS), which is characterized by increased pulmonary vascular permeability to plasma proteins resulting in "noncardiac pulmonary edema." The aim of this series was to study the effects of the beta-2 receptor agonist, terbutaline, on plasma extravasation in multiple organs, in sheep exposed to endotoxin shock. A double isotope technique was used and the radioactivity was recorded in different organs (lungs, liver, spleen, kidneys, intestine) by a computerized gamma camera. Tc-99m-labeled erythrocytes were used as a marker for intravascular volume and In-111m-labeled transferrin for tracing extravascular plasma leakage. An organ-transferrin index (organ-TI) was calculated for each organ which corrects for changes in blood distribution. Fourteen sheep were anesthetized and ventilated. After stabilization (t = 0) all animals received E. coli endotoxin 10 micrograms/kg by IV infusion during 30 min. At t = 30, seven animals (group T) received IV infusion of terbutaline, 20 micrograms/kg/hr, during 4 h, while the other seven received normal saline and served as controls (group E). The endotoxin infusion caused an immediate and significant increase in the transferrin index in the lungs and in the liver in both groups. The transferrin index continued to rise in the control group towards the end of the experiment (t = 240), while in group T it reached a maximum 60 min after endotoxin. Four hours after endotoxin the transferrin index was significantly higher in the controls than in the terbutaline treated group, both in the lungs and in the liver (P less than 0.01). No significant changes were recorded in the kidneys or over the intestine.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

Cognitive dysfunction in schizophrenia followed up over 5 years, and its longitudinal relationship to the emergence of tardive dyskinesia.

In this study, 51 chronic schizophrenic in-patients were evaluated for a range of demographic, clinical and medication variables, and followed up over five years. There was no significant overall change in cognitive function in this patient group as a whole, suggesting the absence of active disease at this stage of the illness. The only correlate of individual instances of cognitive deterioration over the study period was the emergence of new cases of tardive buccal-lingual-masticatory but not of limb-truncal dyskinesia, and the greater severity of such movement disorder. A positive family history was also identified prospectively as a predictor of the emergence of tardive dyskinesia in chronic schizophrenia.

Adult↗
PubMed1990

Psychotropic drugs in suicidal patients: a comparison of psychotropic medications in attempters and completed suicides.

The correlation between suicide rate and aspects of treatment have been little studied in suicidology in spite of medicalization of suicide. This study compares the medication of 30 patients who committed suicide during 1980-1989 from a catchment area in rural Ireland with 20 who attempted suicide in a neighbouring area where there were no suicides. More drugs had been given to patients who committed suicide and they received higher doses of neuroleptics and benzodiazepines than those who merely attempted suicide.

Adult↗
PubMed1989

Lysine acetyl salicylic acid in acute renal pain.

The effect of repeated doses of 1.8 g lysine acetyl salicylic acid (LAS) i.v. on severe pain secondary to acute renal colic (ARC) was studied in 45 consecutive patients. Clinically acceptable analgesia was obtained in 65% of the cases. No additional pain relief was achieved with the combination of pethidine 100 mg i.v. + metoclopramide 10 mg, i.m. (narcotics). Pain relief occurred within five minutes in one third of the patients while in the rest within 30 minutes. Significant reduction of systolic blood pressure (mean +/- S.D.) 23.8 +/- 19.5, pulse rate (mean +/- S.D.) 19.5 +/- 10.1 and vomiting were noted in patients who had pain relief. The incidence of nausea has increased after LAS administration. No other side effects were observed. LAS might therefore be applied as a first-hand alternative to narcotics for the treatment of ARC.

Acute Disease↗
PubMed1989

Characterization of abnormal respiratory movements in schizophrenic, bipolar and mentally handicapped patients with typical tardive dyskinesia.

A population of 76 patients with typical tardive orofacial dyskinesia, and from which cases of respiratory disease had been excluded, were evaluated for abnormal respiratory movements. Such abnormality was present in 34 patients (45%), and was unrelated to age, sex or smoking habits. However, patients with respiratory movement disorder showed more severe orofacial dyskinesia and higher blood pressure. Putative pathophysiological processes implicated in this often unappreciated component of the tardive dyskinesia syndrome are discussed.

Adult↗
PubMed1989

Effects of the beta-2 receptor agonist terbutaline on hemodynamics and gas-exchange in endotoxin shock.

The effects of the beta-2 receptor agonist, terbutaline, on hemodynamics and gas-exchange were evaluated in sheep exposed to endotoxin shock. Terbutaline was not given until signs of shock and lung injury had developed. Twenty sheep were anesthetized and ventilated without PEEP. After 90 min of stabilization (t = 0) all animals received E. coli endotoxin 10 micrograms/kg by i.v. infusion during 15 min. Thirty minutes later (t = 30) 10 animals (group TER) received i.v. infusion of terbutaline, 20 micrograms/kg/h, during 4 hours, while the other 10 served as controls (group S). The endotoxin infusion resulted in marked increase in pulmonary artery pressure (PAP) and a significant decrease in mean arterial pressure (MAP), respiratory compliance, arterial oxygen tension (PaO2) and oxygen delivery index (DO2) in both groups (t = 15 and t = 30). After 4 hours the PAP had decreased significantly in the terbutaline treated animals, but remained high in the controls (p less than 0.01). Also, MAP, PaO2, DO2 and compliance improved significantly in the terbutaline treated animals. The wet to dry weight ratio of the lungs was 4.85 +/- 0.2 in the terbutaline treated and 5.35 +/- 0.5 in the controls (p less than 0.05). It was concluded that terbutaline treatment improves gas-exchange and hemodynamics in sheep exposed to endotoxin shock.

Animals↗
PubMed1988

Primitive (developmental) reflexes and diffuse cerebral dysfunction in schizophrenia and bipolar affective disorder: overrepresentation in patients with tardive dyskinesia.

Primitive (developmental) reflexes are present in fetal and infant life, but disappear in adulthood. Their elicitation in later life usually occurs in association with cortical or diffuse cerebral dysfunction and suggests a new approach to the issue of whether tardive dyskinesia is particularly likely to occur in patients with organic brain disorder(s). Sixty-six patients with schizophrenia (age range 50-86) and 18 with bipolar affective disorder (age range 40-77) were assessed for the presence of involuntary movements and for the release of the grasp, palmomental, snout, corneomandibular, and glabellar reflexes. In each diagnostic group, patients with involuntary movements showed a significant excess of primitive reflexes in comparison with otherwise indistinguishable patients without such movements. These results complement recent reports that similar patients with involuntary movements also show greater cognitive impairment and point anew to an association between the presence of tardive dyskinesia and of organic brain dysfunction. They raise again the issue of whether or not such dysfunction may be a consequence of neurodevelopmental abnormality rather than of neurodegenerative processes.

Aged↗
PubMed1988

Calcium metabolism and abnormal involuntary movements (tardive dyskinesia) in psychosis.

Serum calcium levels were measured in 25 chronically ill psychotic inpatients with involuntary movements, in comparison with 25 otherwise indistinguishable patients without such a syndrome. Those with involuntary movements were significantly more likely to have a serum calcium level below the normal range. These results are discussed in terms of the role of calcium in neuronal dysfunction, and in broader aspects of the general biological disadvantage that appears to characterize older patients with this movement disorder.

Adult↗
PubMed1988

Involuntary orofacial movements in hospitalised patients with mental handicap or epilepsy: relationship to developmental/intellectual deficit and presence or absence of long-term exposure to neuroleptics.

Among 42 adult patients with mental handicap who had received treatment with neuroleptic drugs, the prevalence of orofacial dyskinesia increased with age and those with such involuntary movements were characterised by a considerably greater degree of mental handicap. Similar associations were found among a group of 15 patients with epilepsy. Two of seven other mentally handicapped patients and one of eight other epileptic patients showed indistinguishable orofacial dyskinesia, despite no record of them having received neuroleptic drugs.

Adolescent↗
PubMed1988

Tardive dyskinesia in bipolar affective disorder: aging, cognitive dysfunction, course of illness, and exposure to neuroleptics and lithium.

Cognitive function, course of illness, and medication history were assessed in 42 bipolar patients evaluated for the presence of involuntary movements. Among the 25 patients 55 years old or older, the 16 with involuntary movements were not distinguished from the nine without involuntary movements by past or current exposure to neuroleptics, anticholinergics, or carbamazepine, but they showed poorer cognitive function, had fewer major depressive episodes, and had received briefer exposure to lithium. The association between involuntary movements and cognitive dysfunction parallels that found in schizophrenia, suggesting that similar neurological processes may contribute to vulnerability to involuntary movements in the major functional psychoses.

Adult↗
PubMed1988

The expression of schizophrenia, affective disorder and vulnerability to tardive dyskinesia in an extensive pedigree.

The demography, psychiatric morbidity, and motor consequences of long-term neuroleptic treatment in the 14 children born to a father with a family history of chronic psychiatric illness and a mother with a late-onset affective disorder resulting in suicide are documented. Twelve siblings lived to adulthood, nine of whom were admitted to a psychiatric hospital in their second or third decade, and required continuous in-patient care; five remaining in hospital, with long-term exposure to neuroleptics, had chronic, deteriorating, schizophrenic illness and emergence of movement disorder. Two siblings showed no evidence of psychosis but developed a late-onset affective disorder. The implications for the issues of homotypia, vulnerability to involuntary movements, and interaction with affective disorder are discussed.

Adolescent↗
PubMed1987

Cognitive dysfunction, negative symptoms, and tardive dyskinesia in schizophrenia. Their association in relation to topography of involuntary movements and criterion of their abnormality.

Little is known of factors that, on an individual basis, confer vulnerability to the emergence of involuntary movements (tardive dyskinesia) during long-term neuroleptic treatment. In this study of 88 chronic schizophrenic inpatients, 22 variables (four demographic, 14 medication history, and four features of illness) were compared for any association(s) with the presence, by differing topographies and criteria of abnormality, and severity of involuntary movements. Irrespective of the criterion used, the presence of marked cognitive dysfunction-muteness bore a consistent and highly significant primary association with both the presence and the overall severity of orofacial dyskinesia; no such association was found in relation to the presence of limb-truncal dyskinesia. Flattening of affect was the only other variable consistently associated with the presence of orofacial movements. The reliability and prominence of the association between the presence of orofacial, but not of limb-truncal, movements and cognitive dysfunction-negative symptoms suggest that these varying topographies may not constitute a unitary syndrome. This strong association, not with indexes of neuroleptic exposure but rather with features of the illness for which that treatment was prescribed, suggests some neurologic process, more subtle than may previously have been appreciated, as a vulnerability factor of some importance. In schizophrenia it appears to be intimately related to the disease process.

Adult↗
PubMed1987

Morbidity and mortality in tardive dyskinesia: associations in chronic schizophrenia.

A population of 101 chronic schizophrenic inpatients were assessed for the presence or absence of tardive dyskinesia, and followed up 32 months later. At follow up, the mortality rates in 44 patients with and 57 patients without involuntary movements were 16% vs. 9% respectively; this difference widened when only the more prominent involuntary movements were considered. Of those surviving, patients with tardive dyskinesia were much more likely to contract an attack of respiratory tract infection, and to do so on multiple occasions, and tended to suffer from more cardiovascular disorders. They appeared more likely to show smoking-related pathology. Chronic schizophrenic patients with tardive dyskinesia constitute a more biologically disadvantaged group, suggesting a broader disease concept of the syndrome.

Aged↗
PubMed1986

An unusual cluster of tardive dyskinesia in schizophrenia: association with cognitive dysfunction and negative symptoms.

Factors associated with the emergence or nonemergence of involuntary movements (tardive dyskinesia) during long-term neuroleptic treatment were investigated in an atypical, isolated population of 31 schizophrenic inpatients with an unusually high prevalence of this syndrome. Patients with involuntary movements could not be distinguished from those without such movements by general characteristics or conventional indices of neuroleptic or anticholinergic treatment. However, they were more likely to show either marked cognitive dysfunction or muteness. These findings support the proposal that, at least in schizophrenia, subtle organic changes may contribute to vulnerability to the emergence of involuntary movements.

Adult↗
PubMed1986

Late onset involuntary movements in chronic schizophrenia: relationship of 'tardive' dyskinesia to intellectual impairment and negative symptoms.

Intellectual impairment, negative symptoms, and medication history were assessed in chronic schizophrenic patients with and without abnormal involuntary movements (tardive dyskinesia). Patients with involuntary movements had received neither longer nor more intensive treatment with neuroleptics or anticholinergics. However, the presence or absence of involuntary movements was prominently associated with the presence or absence of intellectual impairment/negative symptoms; these features are characteristic of the defect state/type II syndrome of schizophrenia, in which structural abnormalities of the brain may be over-represented. The role of subtle organic changes in conferring vulnerability to the emergence of such involuntary movements should be re-evaluated.

Adult↗