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Biomedical subjects

J McGrath

Publications and source records attributed to J McGrath.

At least 109 records · Page 6Linked to original sources
PubMed1991

The phenotypic heterogenicity of bullous ichthyosis--a case report of three family members.

We present a family with an inherited disorder of cornification. The clinical features are much less severe and developed much later in life than is usual in bullous ichthyosis. Skin biopsy demonstrated epidermolytic hyperkeratosis, a feature typical of bullous ichthyosis. The family is reported both to highlight the wide interfamilial variation that may occur in this condition and the value of histology in classifying this form of ichthyosis.

Adult↗
PubMed1991

Split skin grafting and bullous pemphigoid.

We present a case of a 73-year-old Caucasian female with known recent mild generalized bullous pemphigoid who underwent a forearm-to-palm split skin graft as part of a fasciectomy for Dupuytren's contracture. Histologically confirmed bullous pemphigoid blistering occurred extensively around the donor site 5 weeks post-operatively and required systemic corticosteroids for adequate control.

Aged↗
PubMed1991

Ordering thoughts on thought disorder.

A common denominator can be found permeating thought disorder at various levels--the lack of executive planning and editing. With data available from aphasiology and neuropsychology, certain features of thought disorder can be reinterpreted as being consistent with dysfunction of the frontal lobe. It is hypothesised that thought disorder may reflect a dysfunction of the cortical-subcortical loops that project into the pre-frontal cortex. The hypothesis predicts that thought-disordered patients will have impaired performance on tests of frontal lobe function, regardless of diagnosis.

Attention↗
PubMed1991

The control of seborrhoeic dermatitis and dandruff by antipityrosporal drugs.

For many years the exact nature of the pathophysiology of seborrhoeic dermatitis and dandruff was in doubt. Different schools of thought debated whether Pityrosporum yeasts were of primary pathogenic significance or a secondary phenomenon, with epidermal hyperproliferation as the primary pathology. Although effective therapy in seborrhoeic dermatitis and dandruff has for a long time been based on compounds whose only common link was antipityrosporal activity, proof of this relevance was lacking until the introduction of effective antifungal drugs, in particular ketoconazole. This article charts the swing of opinion towards the primary pityrosporal aetiology of seborrhoeic dermatitis and dandruff, reviews the evidence that antipityrosporal activity is the common link to various compounds which benefit these conditions, and compares the efficacy of these substances in treatment.

Antifungal Agents↗
PubMed1990

Schizophrenia: age at onset, gender and familial risk.

In a family history study of 366 schizophrenic probands and their 1851 first-degree relatives, we found a relationship between age at onset of psychosis in the male probands and the risk for schizophrenia in their relatives. The relatives of male schizophrenic probands whose onset of psychosis occurred when they were younger than 17 years of age had an increased risk of schizophrenia when compared with the relatives of male probands with an age at onset greater than 17. We did not find an association between age at onset of psychosis in the female probands and familial risk. Cox proportional hazards models permitted us to examine the relationship between age at onset of psychosis in the probands and familial risk while controlling for possible confounding effects.

Adolescent↗
PubMed1990

A select psychiatric mother and baby unit in Britain: implications for care in the United States.

Severe psychiatric disturbances that arise during the postpartum period have serious implications for the optimal development of the mother-infant relationship. The treatment approach of psychiatric admission in the postpartum period raises the issue of whether to admit the mother together with her infant or to separate the two. This article describes the nursing care on a select Psychiatric Mother and Baby Unit in Britain utilizing the nursing process. Implications for inpatient management of postpartum disorders in the United States are presented giving special consideration to the significance of the mother-infant dyad.

Female↗
PubMed1989

Pulmonary microvascular cytology in the diagnosis of lymphangitic carcinomatosis.

The diagnosis of lymphangitic spread of carcinoma in the lungs is sometimes difficult. We studied the cytologic characteristics of blood drawn through a wedged pulmonary-artery catheter from eight patients in whom lymphangitic carcinomatosis was confirmed by subsequent autopsy, lung biopsy, or clinical evaluation. The sites of the primary tumors were the prostate, breast, esophagus, and lung. Malignant cells were found in seven of the eight patients. Cytologic findings were normal in 16 of 17 patients with cancer but without pulmonary metastases and in 22 of 23 patients with nonmalignant pulmonary disorders. In a patient with cancer with tumor embolism to the lungs, the findings were positive, probably because of extensive intravascular tumor in large hepatic veins. One false positive finding occurred in a patient with extensive pulmonary infarction. Megakaryocytes, which are present in large numbers in the pulmonary capillary bed, are the hallmark of a satisfactory pulmonary vascular blood sample for pulmonary microvascular cytologic study. Familiarity with the cytologic characteristics of these cells in Papanicolaou preparations is essential to avoid mistakenly identifying them as malignant. Although transbronchial lung biopsy remains the diagnostic procedure of choice in this disorder, our findings suggest that the presence of malignant cells in pulmonary microvascular-cytology preparations in patients with cancer and unexplained dyspnea constitutes presumptive evidence of lymphangitic carcinomatosis. Pulmonary microvascular cytology may be particularly valuable when lung biopsy is refused or is thought to be too hazardous.

Aged↗
PubMed1989

Cure of experimental human malignant mesothelioma in athymic mice by diphtheria toxin.

A single ip or iv dose of 1-3 micrograms of diphtheria toxin consistently cured athymic mice of an advanced stage experimental human malignant mesothelioma. All cancer cells were killed within 18 hours and the profuse ip ascites plus large solid tumor masses associated with this model of neoplastic disease were subsequently eliminated. Treated mice appeared normal in 3 days and lived for greater than 300 days with no signs of recurrence, while control animals did not survive greater than 32 days. The complete tumoricidal effect implies that toxin readily reached, entered, and preferentially killed each human cancer cell. This outcome exemplifies the true therapeutic potential of highly selective, site-directed toxins, and offers a frame of reference for judging the performance of current as well as prospective toxin-based agents.

Animals↗
PubMed1989

A survey of deliberate self-poisoning.

Over a 12-month period in 1985-1986, 325 cases of deliberate self-poisoning were admitted to the Princess Alexandra Hospital in Brisbane. This survey confirms that deliberate self-poisoning remains common, accounting for 19.6% of all admissions to the intensive-care unit, and 5.4% of all medical-ward admissions. In 232 (71.4%) cases formal psychiatric consultation occurred, and some form of follow-up was organized in 227 (69.8%) cases. In the total group, the female-to-male ratio was 1.5 to one. In the 325 cases, a total of 489 substances was consumed. Benzodiazepine agents were consumed the most often (39.5% of all substances), followed by antidepressant drugs (11.7% of substances) and paracetamol (7.2% of substances). Barbiturate drugs, which previously have been shown to be prominent in deliberate self-poisoning, accounted for only 1.6% of the substances that were used in this survey. Alcohol was consumed in almost one-third (31.1%) of cases. The diagnosis of adjustment disorder with depressed mood was the most-frequent primary diagnosis (64.8% of diagnosed cases), followed by personality disorder (16.7% of diagnosed cases), schizophrenia (5.5% of diagnosed cases) and major depression (3.7% of diagnosed cases). Nearly one-half (46.8%) of all cases involved a past history of deliberate self-poisoning. Comparison of the results of this survey with those of past surveys shows that the profile of deliberate self-poisoning is changing. Barbiturate usage has declined markedly with a reciprocal increase in benzodiazepine usage. A review of the prescribing pattern of antidepressant agents in groups of individuals who are at high risk of deliberate self-poisoning is suggested in the light of the frequency of this phenomenon.

Adjustment Disorders↗
PubMed1989

The incidence and notification of measles in Australia.

The incidence of measles in Australia in 1986 was estimated as 43 per 100,000 population, high by the standards of countries where immunization levels are high, low by the standards of countries where immunization levels are low. It is estimated that only 5 per cent of cases are notified in New South Wales, one of only 2 States which require notification. The reasons for this, its significance and a possible remedy are discussed.

Australia↗
PubMed1989

Psychiatry, molecular genetics and ethics: the new discoveries and the new issues.

Recent developments in molecular genetics are examined with particular reference to psychiatry. The new technologies available have allowed significant advances in the understanding of certain illnesses such as familial Alzheimer's disease and Huntington's chorea, and will provide powerful tools to explore many other important psychiatric illnesses. The area of genetic counselling is already characterized by complex ethical issues. We can expect that as the new technologies provide the prospect of positive germ line genetic engineering, these ethical issues will become more complex. It is important that psychiatrists prepare themselves for these future developments and take an active role in leading the debate.

Ethics, Medical↗
PubMed1989

General pharmacology of nizatidine in animals.

Nizatidine (N-[2-[[[2-[(dimethylamino)methyl-4-thiazolyl]- methyl]thio]ethyl]-N'-methyl-2-nitro-1,1-ethenediamine, LY139037, Axid) is a novel, potent, and selective H2-antagonist. The potential secondary pharmacologic effects of this agent on the cardiovascular, respiratory, gastrointestinal, renal, hepatic, autonomic, and central nervous systems as well as effects on circulating blood glucose and the acute inflammatory response were examined. Nizatidine was generally inactive in the tests conducted in mice, rats, guinea pigs, rabbits, and dogs. Nizatidine and the reference H2-antagonist, cimetidine, both produced effects upon the cardiovascular and respiratory systems by intravenous administration in anesthetized dogs at doses in excess of the intended clinical exposure. In summary, these studies confirm the selective pharmacologic activity of nizatidine and indicate a low potential for secondary pharmacologic side effects to be encountered clinically.

Animals↗
PubMed1988

Flumazenil: US clinical pharmacology studies.

Flumazenil, a benzodiazepine antagonist, blocks the central effects of benzodiazepines by competitive interaction at the receptor site. Two double-blind, placebo-controlled, randomized studies in healthy volunteers (110/study) were performed to determine the minimal effective dose of flumazenil required to reverse the sedative, psychomotor and amnesic effects of benzodiazepines used to produce conscious sedation. Conscious sedation was produced by i.v. diazepam (12-30 mg) in one study and i.v. lorazepam (0.045 mg kg-1) in the other. Intravenous flumazenil (0.001, 0.003, 0.007 or 0.014 mg kg-1) or placebo was administered after diazepam or lorazepam. Assessment of sedation, psychomotor performance and recall/recognition were made both before and after the benzodiazepine as well as serially after flumazenil or placebo. Doses as low as 0.007 and 0.014 mg kg-1 flumazenil consistently reversed diazepam- and lorazepam-induced effects, respectively. The duration of reversal produced by varying doses of flumazenil (0.2, 0.6, 1.0 or 3 mg) was evaluated in 50 volunteers in a double-blind, placebo-controlled, parallel group study. A constant level of conscious sedation was produced by a continuous infusion of midazolam. Assessments of sedation and psychomotor performance were assessed both before and at varying times after the administration of flumazenil or placebo. Preliminary results indicate that the duration of reversal produced by 3.0 mg flumazenil was longer than that produced by any of the lower doses. While the mean duration of reversal produced by the lower doses was comparable, the 0.2 mg dose resulted in the greatest between subject variability and only partial rather than complete reversal. Two further double-blind, placebo-controlled studies were done in healthy volunteers (45/study) to evaluate the safety of flumazenil 1.0 mg or placebo given i.v. to reverse midazolam-induced sedation in subjects who had been treated for up to 14 days with either oral diazepam or triazolam. No clinically significant changes were noted in laboratory test values, electrocardiograms or vital signs monitored for up to 36 h after flumazenil or placebo in any pre-treatment group.

Adult↗