Negative correlation between alpha-1-acid-glycoprotein plasma level and response to haloperidol in the acute treatment of schizophrenia.
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Adolescent↗
Biomedical subjects
I Levinson
Publications and source records attributed to I Levinson.
Methadone withdrawal psychosis.
BACKGROUND: Methadone is a typical mu-opioid receptor agonist that is widely used for maintenance and detoxification treatment of opiate-dependent patients. Although methadone withdrawal syndrome is well described, it generally does not include psychosis. METHOD: Having observed new onset psychosis in a patient on methadone taper, the authors identified three other such patients by chart review. All met DSM-III-R criteria for opioid dependence. Distinctive features of their clinical presentation, pharmacotherapy received, and follow-up were recorded. RESULTS: Two patients had no history of psychosis, one patient had a psychotic episode 21 years prior to admission, and one patient was diagnosed with schizophrenia but remained asymptomatic for at least 1 year while treated with only methadone. Psychosis resolved spontaneously in one case, whereas the other cases required neuroleptic treatment. In one case, methadone resumption was required. None of the patients developed typical methadone withdrawal syndrome. CONCLUSION: The above results suggest that opioid taper may be a period of high risk for development of psychosis. This risk is probably higher in patients with preexisting CNS illness. Clinicians caring for patients in opioid withdrawal should be aware of this risk. Further research is required to evaluate whether methadone withdrawal psychosis represents a clinical manifestation of opioid agonist modulation of dopaminergic neurotransmission in the human brain.
Adult↗
Renal function after nephrectomy for donor organs.
Thirty-three living related kidney donors were investigated at a mean of 5.8 years after donor nephrectomy (range 3-18 years) to detect late adverse effects. They were evaluated for hypertension, the presence of proteinuria and renal dysfunction as assessed by serum creatinine value and creatinine clearance. There was a significant rise in both diastolic blood pressure and serum creatinine levels and a trend towards significance in the decline in creatinine clearance. Eleven individuals had diastolic blood pressure greater than or equal to 90 mmHg but only 1 required treatment. Although the rise in serum creatinine reached significance the mean serum creatinine (104.91 mumol/l) remained within the normal range. Two patients showed a minimal rise in proteinuria. The overall results confirm that kidney donation is safe and indicate that there are no significant late sequelae.
Adult↗
[Value of echocardiography in the diagnosis of myxoma of the left auricle].
We have been able to differentiate the right pre-operatory diagnosis of mixoma in the left auricle versus "tumor" caused by hypertrophy and fusion of the papillary muscles of the left ventricle in a severe mitral stenosis. In the mixoma we find the echoes only in the ventricular diastole and not in the sistole; there is a place without echoes in the protodiastole--which has a diagnosis value, and sometimes in the telediastole. When it is a "tumor" in the fusioned papillary muscles of the left ventricle, echoes can be found in ventricular diastole and sistole and there are not spaces without echoes in the protodiastole as it is usual in the pedicled tumors of the left auricle. We have found a new sign to predict the existence of a tumor in the left auricle instead of a mitral stenosis; if we find echoes in the left auricle during the ventricular sistole, we will observe that the front edges of the waves form a capital W, and the back ones form a small w. In the central portions of both ws, the waves go forward as it should happen in the mitral valve when existing a real mitral stenosis. Nevertheless, as this central portion is surrounded by a space without echoes, it means that the tumor is a pedicled one, constitutes an obstruction and is causing similar signs to those pertaining to the mitral stenosis.
Adult↗