Biomedical subjects
Publications and source records attributed to J Marcus.
A case of death associated with chlorpromazine agranulocytosis and the pertinent literature is reviewed. The authors conclude that the condition is cumulative dose related. Elderly, sickly Caucasian females are the population at high risk. Daily evaluation of the need for medication, the cumulative dose, and signs of infection and fever can reduce the incidence.
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In summary, the Mental Health Nurse Consultant is committed to the belief that nursing staff are competent to implement appropriate mental health care. Because of this the consultant utilizes both resource and process consultation to assist staff in determining care plans and to support a realistic method for delivery. The Mental Health Nurse Consultant interviews clients in order to assess dynamics of behavior and uses this information for care plan development. The direct interview also enables the consultant to investigate client perceptions of Psychiatric Mental Health Intervention and support the utilization of direct involvement by a member of the Consultation and Liaison Team. The Mental Health Nurse Consultant acts as a facilitator for ongoing utilization of existing resources through resource and process consultation to members of the Department of Nursing. Thus, consultation as a clinical specialty offers an additional opportunity for nurses to utilize individual skills and refocus the tasks of nursing within the general hospital.
Sixty-nine diabetic children were studied with respect to the motor nerve conduction velocities, duration of illness and adequacy of control.As a group there was a trend for children with diabetes to have slower MNCV than non-diabetic children, and for the slowing to become progressive as the duration of their disease increased. Poorer quality of diabetes control was also associated with progressive slowing of conduction but the exact relationship is uncertain, since no patient who had diabetes for more than four years was well controlled.Theories of causation of peripheral neuropathy in diabetic patients are reviewed; metabolic changes, rather than other factors, are thought most likely in children.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A sample of 29 psychiatrically ill women and a non-ill comparison group were recruited during pregnancy. Twelve of the ill mothers were receiving antipsychotic and anti-anxiety medication during the final trimester of pregnancy. The behavior of their infants was assessed at 3 and 14 days of age using the Brazelton Neonatal Behavioral Assessment Scale. Compared to infants of non-ill mothers and infants of ill nonmedicated mothers, infants whose mothers received antipsychotic drugs--particularly those in the phenothiazine family--showed a stable pattern of poor neonatal motor functioning that included tremulousness, hypertonicity, and poor motor maturity. It was speculated that this behavior was symptomatic of a neonatal abstinence or withdrawal syndrome.
Motor and state functioning of 20 infants born to methadone-maintained women and 25 born to controls was assessed at 1 day and 1 month of age using Brazelton Neonatal Behavioral Assessment Scale with Kansas Supplements (NBAS-K). The infants were of mothers who were Black, of low SES, between the ages of 18 and 35 years, and who had good prenatal care. Motor behaviors were scored on NBAS-K items: General Tonus, Motor Maturity, and Tremulousness. State behaviors were scored on 2 items: Alertness and General Irritability. Guttman's Multidimensional Scalogram Analysis (MSA) of individual profiles revealed an orthogonal relationship between motor and state functioning, with motor functioning being a much clearer discriminator between methadone and non-methadone infants than state functioning. With age, both groups generally improved, but non-methadone infants maintained some of their advantage in motor functioning. Both groups showed a variety of behavior patterns during the neonatal period. The results suggest that methadone acts differentially on CNS functioning, with strong effects on neuro-motor functioning.
Motor functioning of 38 infants, 15 exposed in utero to methadone, was assessed on Brazelton Neonatal Behavioral Assessment Scale with Kansas Supplements (NBAS-K) (Items: General Tonus, Motor Maturity, Activity, and Tremulousness) at 1 day, and at 4 months on Bayley Infant Behavior Record (IBR) (Items: Tension, Activity, Interest in Body Motion, Gross Coordination, and Fine Coordination). At 4 months, methadone infants generally showed a profile of poorer motor coordination, greater tenseness and interest in body motion, and higher activity level than did non-methadone infants. Guttman's Multidimensional Scalogram Analysis (MSA) of the 5 IBR motor-item profiles showed that a line can be drawn that almost perfectly discriminates the methadone and non-methadone infants by their joint performance on these 5 variables. A scatterplot of each infant's sum scores of the Brazelton versus IBR motor items revealed a significant correlation between 1-day and 4-month motor functioning. Methadone infants showed poorer motor functioning at both ages. This analysis of behavioral continuity again revealed an almost perfect discrimination between the two groups.
Human research on the effects of drugs, medications, pollutants, and other toxins on fetal and child development requires longitudinal studies. Such studies must recognize the heterogeneity of populations and individuals, the multiplicity of variables, and the dynamic interactional character of development. This requires the construction of an a priori theoretical model, selection of research tools to fit the model, and the use of appropriate multidimensional data analysis techniques that can identify profiles of variables in individuals and subgroups, and can trace development over time. A model, based upon the facet theory of Louis Guttman, is presented with examples from a study of infant offspring of methadone-maintained women. An introductory explanation of one non-metric multidimensional data analysis technique. Guttman's Multidimensional Scalogram Analysis (MSA), is presented. Examples of its use and its relation to the theoretical model are given in subsequent papers.