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Biomedical subjects

J C Dean

Publications and source records attributed to J C Dean.

86 records · Page 5Linked to original sources
PubMed1985

Drug and alcohol use by disabled and nondisabled persons: a comparative study.

The study is an initial attempt to provide comparative alcohol and drug use data on disabled and nondisabled persons. The lack of useful information on disabled persons is described in the literature review. Sixty-six disabled students and 115 nondisabled students returned questionnaires which examined their alcohol and drug use. The two groups were compared using tests of significance. The data provided in this report tend to confirm the notion that the disabled and nondisabled students use alcohol and drugs in similar ways. Caution is urged against generalization, and the need for additional studies is emphasized.

Adolescent↗
PubMed1984

The drug addict and the stigma of addiction.

Two hundred and fifty-six respondents from a small, upper-midwestern college town answered a questionnaire designed to assess their first impression images of the term "drug addict." The results indicated that the overwhelming image was of a disoriented, unhealthy, thin, low-class, male "hippie" with behavioral and skin problems who suffered from a disease. Only 11% of the responses described the condition as a crime. This study is compared with a previous, similar study of the first impression of the term "alcoholic," and suggestions are provided to explain the categorization of the conditions as disease states.

Adolescent↗
PubMed1983

Scalp hypothermia: a comparison of ice packs and the Kold Kap in the prevention of doxorubicin-induced alopecia.

Two methods of scalp hypothermia were compared in preventing alopecia, a side effect of doxorubicin chemotherapy that has a significant psychologic impact on the patient. Thirty-three patients received scalp ice packs consisting of crushed ice in plastic bags. Twenty-nine patients received Kold Kap, a device that produces chilling via an endothermic reaction. Scalp hypothermia was applied for 5-10 min before the doxorubicin bolus and left in place for 30-40 min afterward. The percent of hair loss was rated at each visit and photographs were used to further quantitate any hair loss. Sixty-three percent of Kold Kap and 56% of ice pack patients had good or better protection and did not require wigs. Excellent protection (less than 25% loss) was provided for 51% of Kold Kap and 33% of ice pack patients. Similar protection was provided to Kold Kap patients regardless of dose, while ice pack patients received significantly better protection if their doxorubicin doses were less than 50 mg. Scalp hypothermia is an effective method of preventing doxorubicin-induced alopecia.

Alopecia↗
PubMed1983

Dialectics as an alcohol treatment intervention.

It has been reported repeatedly in the literature that treatment outcome is not related to the form of treatment. These research data do not, therefore, provide the clinician with specific treatment approaches for specific forms of alcohol use problems. It would be helpful to have an effective intervention conceptual model which can be used in a variety of settings and with a variety of clients. This article presents a model developed within clinical practice which employs a dialectical intervention process. The goal of the model is a decision by the client to do something about his/her condition. The decision is seen as the sine qua non of recovery. The model is presented as a clinically useful tool which should be tested within a variety of clinical settings.

Alcoholism↗
PubMed1983

The alcoholic stigma and the disease concept.

Acceptance by the client of the label "alcoholic" is viewed by many practitioners as a prerequisite to alcohol abuse recovery. This study demonstrates, however, that the label is a highly stigmatized term associated with the skid row habitué. The 1956 American Medical Association acceptance of alcoholism as within the "purview of medical practice" was an important step for those who believed alcoholism could be destigmatized under the disease label. This study demonstrates that although the disease concept is widely held, the image of the term "alcoholic" remains highly stigmatized. These findings have implications for clinicians in the areas of labeling and the phenomenon of client denial.

Adolescent↗
PubMed1982

The treatment facility as coalcoholic.

An institution or group has a personality which is different from the individuals who make up the institution or group. An institution functions as a person. It is not just the total of its members. It is a distinct entity. The alcohol treatment facility has the capacity to interact with clients. The relationship can lead to alcoholic "game playing" between the institution and its clients. This can occur regardless of the administrative structure of the facility. the notion of the "game" adopted for this paper comes from Transactional Analysis. According to this theory, the potential game roles include: persecutor, rescuer, victim, patsy, and connection. The roles may be played by the institution as well as the clients. It can perpetuate the alcoholic behavior of the clients. Examples of this process come from clinical observation. Ultimately the potential for change of this situation rests with the self-awareness of the administration and treatment staff as a collective personality. The game can be ended when the players recognize the role playing and refuse to continue to play. The staff and administration are key elements in this recognition and refusal.

Alcoholism↗
PubMed1979

Superiority of nabilone over prochlorperazine as an antiemetic in patients receiving cancer chemotherapy.

Two double-blind, crossover trials comparing the antiemetic effectiveness of nabilone, a new synthetic cannabinoid, with that of prochlorperazine were conducted in patients with severe nausea and vomiting associated with anticancer chemotherapy. Of 113 patients evaluated, 90 (80 per cent) responded to nabilone therapy, whereas only 36 (32 per cent) responded to prochlorperazine (P less than 0.001). Complete relief of symptoms was infrequent, occurring only in nine patients (8 per cent) given nabilone. When both drugs were compared, both nausea (P less than 0.01) and vomiting episodes (P less than 0.001) were significantly lower in patients given nabilone. Moreover, patients clearly favored nabilone for continued use (P less than 0.001). Predominant side effects noted by patients were similar for both agents and included somnolence, dry mouth and dizziness but were about twice as frequent and more often severe in patients receiving nabilone. In addition, four patients (3 per cent) taking nabilone had side effects (hallucinations in three, hypotension in one) that required medical attention. Euphoria associated with nabilone was infrequent (16 per cent) and mild.

Adolescent↗
PubMed1979

Patterns of relapse in patients with small cell carcinoma of the lung treated with adriamycin-cyclophosphamide chemotherapy and radiation therapy.

Twenty-seven patients with small cell carcinoma of the lung were treated sequentially with induction chemotherapy (adriamycin and cyclophosphamide), radiation therapy (chest and whole-brain), and then maintenance chemotherapy for 2 years. Twenty responding patients were followed to relapse and patterns of recurrence were observed. This combined treatment resulted in a complete remission rate of 80% and a median survival of 565 days in limited-disease patients. Relapse overwhelmingly occurred in the chest, but patients receiving higher-dose radiation (4000-4500 rads in split-course) had a significant prolongation of time to recurrence compared to patients receiving 3000 rads in a single course of radiation (540 versus 270 days). Despite a long mean survival, only one limited-disease patient relapsed outside of the brain or chest, suggesting that chemotherapy had a good protective effect against micrometastatic disease. Three patients relapsed in the brain at 330, 450, and 520 days, suggesting that in future studies the prophylactic whole-brain radiation (3000 rads) should be intensified.

Carcinoma, Small Cell↗
PubMedDate not supplied

Valproate monotherapy in 30 patients with partial seizures.

This retrospective pilot study describes 30 patients diagnosed and treated for complex partial seizures (CPS) and simple partial seizures (SPS) with and without generalization who received valproate (VPA) monotherapy after lack of response or allergic reaction for carbamazepine (CBZ), phenytoin (PHT), or phenobarbital (PB). Seizures were tabulated daily on seizure calendars by the patients. Three time periods were examined for seizure frequency, 90 days before VPA treatment and 90 and 180 days after VPA treatment. Twenty-two were "controlled" or "improved" (reduction of seizure activity by greater than or equal to 51%) 6 months following the initiation of VPA. VPA was particularly effective in 17 patients who had secondarily generalized tonic-clonic seizures (GTCS) as a subtype of partial seizures. Failure of response to VPA in eight patients appears to be related to their type of partial seizure (SPS or CPS alone, without GTCS) and duration of uncontrolled recurrent seizures. Etiology and compliance were not related to treatment failure. This study supports the need for a double-blind controlled trial with VPA in patients with partial seizures.

Adolescent↗
PubMedDate not supplied

The safety, tolerability, and pharmacokinetics of fosphenytoin after intramuscular and intravenous administration in neurosurgery patients.

STUDY OBJECTIVE: To evaluate the safety, tolerability, and pharmacokinetic profile of fosphenytoin, a water-soluble phenytoin prodrug, after intramuscular and intravenous administration. DESIGN: Open-label study of intramuscular administration, and double-blind, randomized study of intravenous administration. SETTING: Six and ten hospitals throughout the United States for the intramuscular and intravenous multicenter studies, respectively. PATIENTS: Neurosurgical patients who required anticonvulsant prophylaxis or treatment. INTERVENTIONS: In the intramuscular study, 118 patients received loading doses ranging from 480-1500 mg phenytoin equivalents (PE) and daily maintenance doses ranging from 130-1250 mg PE for 3-14 days. In the intravenous study, 88 patients received fosphenytoin and 28 received phenytoin sodium for 3-14 days. Mean +/- SD loading doses and maintenance doses of intravenous fosphenytoin and phenytoin were 1082 +/- 299 mg PE and 411 +/- 221 mg PE, and 1082 +/- 299 mg and 422 +/- 197 mg, respectively. Trough phenytoin concentrations were measured daily in all patients. MEASUREMENTS AND MAIN RESULTS: Intramuscular fosphenytoin was safe and well tolerated, with no irritation found for 99% of all injection site evaluations. Adverse events associated with the drug occurred in 9% of patients, commonly those typical of the parent drug. For intravenous treatment, the frequency of mild irritation at the infusion site was significantly lower in the fosphenytoin group (6%) than in the phenytoin group (25%, p < 0.05). Reductions in infusion rates were required in 17% and 36% of fosphenytoin and phenytoin recipients, respectively. No significant difference was observed relative to adverse events or seizure frequency between the groups. Trough plasma phenytoin concentrations were approximately 10 micrograms/ml or greater in patients receiving at least 3 days of intramuscular and intravenous fosphenytoin. Trough phenytoin concentrations were similar between patients receiving intravenous phenytoin and fosphenytoin on all study days. CONCLUSION: Fosphenytoin can be administered intramuscularly and intravenously in neurosurgical patients to achieve and maintain therapeutic phenytoin concentrations for up to 14 days. Both routes are safe and well tolerated. Intravenous fosphenytoin is significantly better tolerated than intravenous phenytoin sodium in this patient subset.

Adolescent↗