Search PubMed⌕ Search

Biomedical subjects

J E Mitchell

Publications and source records attributed to J E Mitchell.

At least 127 records · Page 7Linked to original sources
PubMed1987

Medical complications and medical management of bulimia.

The syndrome of bulimia is a common disorder and can be associated with serious psychological and physical morbidity. Unfortunately, many patients are reluctant to discuss their symptoms with their physicians and few clues can be found on physical examination to aid in the diagnosis. Possible physical signs include ulceration or scarring of the dorsum of the hand, salivary gland hypertrophy, and dental enamel erosion. In laboratory testing it is fairly common for patients with active bulimia to have fluid and electrolyte abnormalities, particularly hypokalemic alkalosis, and some also have elevated serum amylase levels. Rare complications include myopathies from misuse of ipecac, ruptured esophagus and pneumomediastinum associated with vomiting, and subtle abnormalities in neuroendocrine regulatory systems. Medical management including monitoring of fluid and electrolyte balance is essential during treatment.

Bulimia↗
PubMed1986

Impact of vascular surgery on community mortality from ruptured aortic aneurysms.

The workload of aortic surgery in a district increased fourfold over 10 years as the incidence of aneurysm rupture rose from 7 to 17/100,000. Of 260 patients with ruptured aneurysms 101 reached hospital alive (38 per cent) of which 52 (52 per cent) survived, an overall survival rate of 19.8 per cent. Despite increasing experience, mortality after emergency surgery did not improve, suggesting outcome was largely determined by the patient's condition and age. Only 5 of 90 patients aged over 75 survived aortic rupture at home. In consequence overall community mortality did not improve in the period studied. Survival after elective surgery was 95 per cent, suggesting that efforts to improve survival should be directed towards identifying and treating the disease before rupture occurs. The commonly stated figure of 50 per cent survival for ruptured aortic aneurysms is an overestimate, due to neglect of patients dying at home.

Age Factors↗
PubMed1986

Effect of naltrexone on mood and cognitive functioning among overweight men.

The effects of naltrexone on both mood and cognition were examined in overweight male subjects. Subjects were randomly prescribed, in a double-blind fashion, either placebo or naltrexone for 8 weeks. The results of the study showed that a chronic administration of a high dose of naltrexone (300 mg/day) does not significantly change mood or cognitive functioning among overweight adult men.

Adolescent↗
PubMed1986

Naloxone but not CCK-8 may attenuate binge-eating behavior in patients with the bulimia syndrome.

We undertook a study to see if putative anorectic agents could attenuate binge eating episodes in bulimic patients. Bolus intravenous administration, followed by continuous intravenous infusion of naloxone, resulted in a significant decrease in the amount of food consumed during binge-eating episodes, whereas bolus followed by continuous intravenous infusion of CCK-8 failed to significantly suppress binge eating behavior. These results suggest that the endogenous opioid system is involved in the maintenance of binge eating behavior in patients with bulimia.

Adult↗
PubMed1986

Characteristics of patients with bulimia only, bulimia with affective disorder, and bulimia with substance abuse problems.

Characteristics of patients with a diagnosis of bulimia only (N = 46), bulimia with a history of affective disorder (N = 34), and bulimia with a history of substance abuse (N = 34) were compared. Results showed that compared to patients with bulimia only or with bulimia and affective disorders, patients with bulimia and substance abuse experienced a higher rate of diuretic use to control weight, financial and work problems, stealing before and after the onset of the eating disorder, previous psychiatric inpatient treatment, and greater amount of alcohol use after the onset of the eating disorder. Both the substance abuse group and affective disorder group showed a higher incidence of attempted suicide, more social problems, and greater overall treatment rate than the bulimia only group. There were no significant differences among groups in their family histories.

Alcoholism↗
PubMed1986

Laxative abuse as a variant of bulimia.

Two groups of bulimic patients, one group characterized by a pattern of laxative abuse for purposes of weight control and the other group characterized by no history of laxative abuse, were compared on several behavioral variables associated with bulimia. Relative to the nonabusers, the laxative abusers were more likely to abuse diuretics; to use diet pills; to chew and spit out food; and to report a history of suicide attempts, self-injurious behavior, and prior inpatient treatment for depression.

Adult↗
PubMed1986

The need for psychiatric-dental liaison in the treatment of bulimia.

During dental examinations 38% of 66 outpatients with bulimia were found to have evidence of significant enamel erosion, and chronicity of vomiting was significantly associated with erosion. Liaison with colleagues in dentistry is necessary when working with bulimic patients.

Adolescent↗
PubMed1986

Prevalence of smoking among psychiatric outpatients.

The prevalence of smoking among psychiatric outpatients (N = 277) was significantly higher than among either local or national population-based samples (N = 1,440 and 17,000) (52% versus 30% and 33%). The higher prevalence was not associated with the age, sex, marital status, socioeconomic status, alcohol use, coffee use, or institutionalization of the psychiatric patients. Smoking was especially prevalent among patients with schizophrenia (88%) or mania (70%) and among the more severely ill patients. Hypotheses about why psychiatric patients are more likely to smoke and why they do not have a high rate of smoking-induced illnesses are presented.

Adult↗
PubMed1986

Naltrexone hydrochloride (Trexan): a review of serum transaminase elevations at high dosage.

In summary, evidence is presented associating typically asymptomatic and reversible elevations of serum transaminase values with high daily dosages of naltrexone. Statistical significance was found only between placebo and the 300 mg dosage. Subjects aged 40 years and over were significantly more likely to develop this finding than younger subjects. All subjects with significant elevations of transaminase values in these studies took daily naltrexone dosages higher than recommended for opioid addiction. The daily dosage of naltrexone recommended for opioid addiction did not cause abnormalities of serum transaminase values in these studies.

Adult↗
PubMed1986

Subjective evaluation of treatment methods by patients treated for bulimia.

The authors present data obtained from telephone interviews with 35 patients who were considered recovered 12 to 15 months following treatment for bulimia. Subjects were asked to rate treatment approaches and treatment components as to their helpfulness. The results show that activities within the domain of dietitians can play an important part in the treatment of bulimia.

Adult↗
PubMed1985

Bulimia and depression.

Fifty-six adult females with DSM-III bulimia were evaluated for personal and family histories of other psychopathologies. Forty-three subjects (77%) evidenced mild depression of which 13 (23%) reported moderate-severe symptoms by the Beck Depression Inventory--a finding confirmed with Hamilton Rating Scale for Depression and the SCL-90-D scale. A personal history of affective disorder was found in 52%, while 59% reported first degree relative(s) with affective disorder. Subjects with first-degree relatives with drug dependence, alcoholism, or depression had an earlier onset of bulimia than those without such relatives. Bulimia may be symptomatically or pathophysiologically related to depression.

Adult↗