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Biomedical subjects

K R Krishnan

Publications and source records attributed to K R Krishnan.

At least 235 records · Page 13Linked to original sources
PubMed1979

Testicular endocrine function in paraplegic men.

The responses of FSH and LH to the injection of LHRH were studied in fifteen paraplegic men and ten normal controls. The basal FSH levels in the paraplegic men were elevated in eight cases, basal LH being raised in nine cases. The responses of FSH were exaggerated in fourteen patients, and LH responses were exaggerated in nine patients. Only one patient was normal in respect of both hormones. Subnormal plasma testosterone was found in three patients. This depressed testicular function could not be explained as being due to spread of urinary tract infection and a direct neurological effect is the probable explanation.

Adolescent↗
PubMed1976

Diffuse myelitis associated with rubella vaccination.

Two patients who had received live rubella vaccine developed diffuse myelitis shortly afterwards. Neither patient fully recovered her motor function. In one patients the time between vaccination and development of neurological signs was rather too short to indicate definitely a causal relation. Nevertheless, the chronological association is suggestive, and other observations of such an association may strengthen the suspicion that rubella vaccination may occasionally cause severe neurological damage.

Adolescent↗
PubMedDate not supplied

Decision model for the acute treatment of mania.

Decision making in psychiatric diagnosis and treatment has not been evaluated systematically. The authors present a model for treatment of an acute manic episode using a decision analysis software program. Six treatment options were put into the model: lithium, valproate, carbamezepine, electroconvulsive therapy, clonazepam, and neuroleptics. Each treatment was evaluated on three factors, efficacy, tolerability, and cost, using data from the literature and pharmacy and billing information. Output from the computer program identified three top choices among the six options: valproate, carbamazepine, and lithium, with valproate emerging as the first choice using the data we inputted.

Antimanic Agents↗
PubMedDate not supplied

Assessment of posterior fossa structures with midsagittal MRI: the effects of age.

Midsagittal magnetic resonance (MR) images of 36 normal volunteers, ranging in age from 26 to 79 years, were used to evaluate the effects of age on the size of posterior fossa structures (cerebellar vermis, midbrain, pons, medulla and fourth ventricle). Our results demonstrate a highly statistically significant age-related decline in the cross-sectional area of the midbrain (r = -.44, p less than 0.007), a less prominent decline in the area of the anterior cerebellar vermis (r = -.33, p less than 0.05) and striking intercorrelations between the dimensions of the pons, medulla and cerebellar vermis. To the best of our knowledge, this is the first MRI demonstration of midbrain atrophy during aging in normal adults.

Adult↗
PubMedDate not supplied

Subcortical hyperintensities on brain magnetic resonance imaging: a comparison between late age onset and early onset elderly depressed subjects.

Subcortical structural changes have been reported to occur in some elderly subjects with late age onset depression. Given the association between diseases affecting subcortical structures and affective disorders, this suggests that these structural changes may be involved in the etiology of late age onset depression in some patients. With the advent of Brain Magnetic Resonance Imaging (MRI), "in vivo" analysis of these subcortical structures is now possible. The authors report a higher occurrence of caudate (60% vs. 11%) and large deep white matter hyperintensities (60% vs. 11%) in late age onset elderly depressed subjects compared with early onset elderly depressed subjects. These results suggest that late age onset depression may be mediated by caudate and white matter structural changes in some patients.

Aged↗
PubMedDate not supplied

Religious coping and cognitive symptoms of depression in elderly medical patients.

The investigators examined associations between depressive symptom type and religious coping in 832 consecutively admitted older medical inpatients. Cognitive symptoms of depression, but not somatic symptoms, were related to religious coping. Boredom, loss of interest, social withdrawal, feeling downhearted and blue, restlessness, feeling like a failure, feeling hopeless, or feeling that other people were better off were all significantly less common among religious copers. Difficulty initiating new activities was the only somatic symptom related to this coping behavior. Religious coping, a strategy heavily dependent on cognitive processes, is associated with fewer cognitive but not somatic symptoms of depression in medically ill older patients

Adaptation, Psychological↗
PubMedDate not supplied

Exercise treatment for major depression: maintenance of therapeutic benefit at 10 months.

OBJECTIVE: The purpose of this study was to assess the status of 156 adult volunteers with major depressive disorder (MDD) 6 months after completion of a study in which they were randomly assigned to a 4-month course of aerobic exercise, sertraline therapy, or a combination of exercise and sertraline. METHODS: The presence and severity of depression were assessed by clinical interview using the Diagnostic Interview Schedule and the Hamilton Rating Scale for Depression (HRSD) and by self-report using the Beck Depression Inventory. Assessments were performed at baseline, after 4 months of treatment, and 6 months after treatment was concluded (ie, after 10 months). RESULTS: After 4 months patients in all three groups exhibited significant improvement; the proportion of remitted participants (ie, those who no longer met diagnostic criteria for MDD and had an HRSD score <8) was comparable across the three treatment conditions. After 10 months, however, remitted subjects in the exercise group had significantly lower relapse rates (p = .01) than subjects in the medication group. Exercising on one's own during the follow-up period was associated with a reduced probability of depression diagnosis at the end of that period (odds ratio = 0.49, p = .0009). CONCLUSIONS: Among individuals with MDD, exercise therapy is feasible and is associated with significant therapeutic benefit, especially if exercise is continued over time.

Antidepressive Agents↗
PubMedDate not supplied

Neuroanatomic substrates of depression in the elderly.

The causes of depression in the elderly are poorly understood. The concept that psychological and social factors are the primary contributors to the occurrence of depression in later life, though intuitively appealing, is not supported by available evidence. In addition, genetic factors are less significant in patients presenting with depression for the first time in later life. In this article, the following hypotheses are examined: (1) the aging process facilitates emergence of depression in later life; (2) cerebrovascular pathology plays a role in the etiology of depression in the elderly; and (3) the site and location of changes in the brain provide a basis for understanding neuroanatomic substrates of depression in the elderly. The role of the basal ganglia and different basal ganglia circuits in the pathophysiology of depression is discussed. The clinical significance of the findings of structural changes in the brain are also discussed.

Aged↗
PubMedDate not supplied

Subcortical structural changes in ECT-induced delirium.

A prolonged (interictal) delirium was induced by electroconvulsive therapy (ECT) in 6/36 (17%) elderly depressed patients. Brain magnetic resonance imaging or brain computerized axial tomography revealed structural changes in the basal ganglia and white matter in all six patients who developed delirium. These findings are consistent with our previous work and with several lines of data that have implicated the basal ganglia and subcortical white matter in the development of delirium from other causes. These result suggest that lesions in these areas may predispose one to developing an interictal delirium during a course of ECT.

Age Factors↗
PubMedDate not supplied

Caudate hyperintensities in elderly depressed patients with neuroleptic-induced parkinsonism.

Elderly patients are particularly sensitive to the neurologic side effects of psychotropic medications. This increased sensitivity may be related to brain structural changes associated with aging. In this pilot study, the authors report on the occurrence of caudate hyperintensities, using brain magnetic resonance imaging, in seven elderly depressed subjects who developed neuroleptic-induced parkinsonism. Caudate hyperintensities were not observed in any of the seven healthy elderly controls examined. These results suggest that caudate hyperintensities may render some elderly depressed patients susceptible to neuroleptic-induced parkinsonism.

Aged↗