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Biomedical subjects

K White

Publications and source records attributed to K White.

At least 253 records · Page 14Linked to original sources
PubMed1981

Combined MAOI-tricyclic antidepressant treatment: a reevaluation.

Recent studies have shown that monoamine oxidase inhibitors (MAOIs), in appropriate patients and with proper precautions, are not as dangerous as once thought, especially in comparison to alternative antidepressants. We review the literature regarding the combined use of MAOIs and tricyclic antidepressants, which has been reported to be both highly toxic and highly effective. A large number of reports of adverse effects and their management, uncontrolled clinical trials, and animal studies are summarized. We also discuss the three controlled studies of combined MAOI-tricyclic therapy that have been undertaken. We conclude that the hazards of combination therapy have been exaggerated and that MAOI-tricyclic therapy is a reasonable approach in patients found resistant to standard antidepressant treatment if certain precautions are observed.

Animals↗
PubMed1981

Dysphoric response to neuroleptics as a predictor of treatment outcome with schizophrenics. A comparative study of haloperidol versus mesoridazine.

In a double-blind comparison of haloperidol and mesoridazine in the treatment of 39 recently hospitalized schizophrenic patients, the two drug treatment groups showed comparable antipsychotic effects, though they did differ in side effects in expected manners. Analysis of the Brief Psychiatric Rating Scale to calculate an index of dysphoric response previously found predictive of poor ultimate outcome failed to predict outcome in this 4-week trial though patients with a dysphoric response to neuroleptics did prove to include a higher proportion of process schizophrenics, who might ultimately show poorer outcome, than did nondysphoric responders.

Adult↗
PubMed1980

Appraisal of a new rapid enzyme strip.

The accuracy and reliability of new blood glucose measurement strips, BM Test-Glycemie 20-800, were assessed in 99 consecutive patients attending the diabetic clinic and seven subjects at home. The BM Test-Glycemie 20-800 strip technique was compared with the automated hexokinase method and the Reflotest-Glucose test strip technique employing the Boehringer Reflomat. The mean of the blood glucose values was 12.6 +/- 0.6 mmol/L for the hexokinase method and 12.9 +/- 0.6 mmol/L for the 20-800 strip technique, with a mean difference between the hexokinase and the 20-800 strip methods of 1.9 +/- 0.2 mmol/L. In the range 4 mmol/L to 12 mmol/L, the 20-800 strips were found to be extremely accurate, but for blood glucose levels less than 3.5 mmol/L and greater than 12 mmol/L, they were less reliable. Importantly, the strips were often misleading in indicating hypoglycaemia. It is concluded that the BM Test-Glycemie 20-800 strips have a practical and valuable role when used by suitably instructed staff members, or by patients in the management of diabetes, and represent a major advance over urine testing on previously available direct reading enzyme strip methods.

Blood Glucose↗
PubMed1980

Behavioral and biochemical defects in temperature-sensitive acetylcholinesterase mutants of Drosophila melanogaster.

Temperature-sensitive (ts) mutants of the Ace gene, which codes for acetylcholinesterase (AChE) in Drosophila melanogaster, were analyzed for defects in viability, behavior and function of the enzyme. The use of heat-sensitive and cold-sensitive mutations permitted the function of AChE in the nervous system to be analyzed temporally. All ts mutations were lethal, or nearly so, when animals expressing them were subjected to restrictive temperatures during late embryonic and very early larval stages. Heat treatments to Ace-ts mid- and late larvae had little effect on the behavior of these animals or on the viability or behavior of the eventual adults. Heat-sensitive mutants exposed to nonpermissive temperatures as pupae, by contrast, had severe defects in phototaxis and locomotor activity as adults. AChE extracted from adult ts mutants that had developed at a permissive temperature were abnormally heat labile, and they had reduced substrate affinity when assayed at restrictive temperatures. However, enzyme activity did not decline during exposure of heat-sensitive adults to high temperatures even though such treatments caused decrements in phototaxis (29 degrees) and, eventually, cessation of movement (31 degrees). The cold-sensitive mutant also produced readily detectable levels of AChE when exposed to a restrictive temperature during the early developmental stage when this mutation causes almost complete lethality. We suggest that the relationship among the genetic, biochemical and neurobiological defects in these mutants may involve more than merely temperature-sensitive catalytic functions.

Acetylcholinesterase↗
PubMed1980

An unusual movement disorder associated with neuroleptic treatment: tardive dyskinesia?

This case report describes a chronically psychotic man presenting signs of a movement disorder exacerbated by neuroleptic treatment and repeatedly diagnosed as tardive dyskinesia. However, this movement disorder differed from classical tardive dyskinesia both in the nature of specific symptoms and in their relationship to neuroleptic treatment. Closer examination revealed evidence of neurolgical disorder preceding the earliest neuroleptic treatment. Although the nature of this disorder remains unclear, serious doubt exists whether it properly deserved a diagnosis of tardive dyskinesia, which opened the way for medicolegal dispute. The numerous ramifications of tardive dyskinesia speak for restrictive use of this diagnosis and for clear diagnostic criteria.

Adult↗
PubMed1980

Combined monoamine oxidase inhibitor-tricyclic antidepressant treatment: a pilot study.

Thirty newly hospitalized patients with RDC major or minor depressive disorder were randomly assigned to open treatment according to fixed dosage steps with 1) amitriptyline alone, up to a maximum dose of 300 mg/day; 2) tranylcypromine alone, up to a maximum dose of 40 mg/day; or 3) the combination of amitriptyline, up to 150 mg/day, and tranylcypromine, up to 20 mg/day. For 28 patients this protocol continued for 4 weeks or until discharge. As measured by the Hamilton and Zung depression scales, patients in all three treatment groups improved equally. The combination treatment produced a nonsignificantly higher frequency of minor side effects, none of which required discontinuation of treatment. The results indicate the feasibility and safety of further controlled clinical research with combined treatment, although caution is advised.

Adult↗
PubMed1980

Nurse recruitment and retention in long-term care.

The administrator and director of nursing are responsible for initiating and implementing a facility and nursing philosophy that will attract nurses to a career in the long-term care facility. Much of the "crisis" character of recruitment can be eliminated by a systematic, well-defined nurse recruitment program. A working atmosphere that allows an individual to make use of her intellectual and creative abilities and permits use of more of her total personality can attract and hold employees.

Long-Term Care↗
PubMed1979

Hemispheric dysfunction in schizophrenia: assessment by visual perception tasks.

Before and after a double-blind trial of haloperidol vs. mesoridazine, 24 hospitalized schizophrenics performed visual perception tasks designed to assess function of the cerebral hemispheres. Tasks involved identifying as "same" or "different" two images (either letters, digits, or unfamiliar shapes) projected tachistoscopically to the right or left visual field or to both together. Multivariate analysis of variance related response latency and accuracy to task type, hemisphere stimulated, and pre- vs. posttreatment testing. Both before and after treatment, subjects responded most slowly and least accurately to letter-matching. Bilateral presentation of stimuli resulted in faster and more accurate responses, except on shape-matching. Neuroleptic treatment improved speed and accuracy overall, though not under certain task conditions. Results accorded more with an impairment in verbal processing and interhemispheric coordination than with a specific left-hemispheric deficit in schizophrenia.

Acute Disease↗
PubMed1979

Lithium effects on normal subjects. Relationships to plasma and RBC lithium levels.

15 normal subjects took lithium carbonate for 10 days in dosage sufficient to attain plasma lithium concentrations in the range of 0.7-1.4 mEg/l. Periodic blood specimens were analyzed for both plasma and RBC lithium. Subjects completed Profile of Mood States questionnaires every other day, and listed side effects. Just prior to beginning and ending the lithium trial, 10 subjects completed three tests of psychomotor function. Results indicate that such a course of lithium in normals induces dysphoric mood change and psychomotor slowing, without significant relationship to either plasma or RBC lithium concentrations.

Choice Behavior↗
PubMed1979

Relationship between plasma, RBC, and CSF lithium concentrations in human subjects.

Simultaneous measurement of plasma, RBC, and plasma lithium concentrations took place with 17 inpatients chronically treated with lithium, at various times after the last lithium dose. RBC lithium levels were significantly higher than CSF lithium levels. Specimens drawn 10 or more hours after the last dose showed higher RBC and CSF lithium and lower plasma lithium than specimens drawn 4 or less hours after the last lithium dose. None of the lithium measurements differentiated manic-depressives from schizophrenics or schizoaffectives. Plasma, RBC, and CSF lithium all intercorrelated highly and equally.

Adult↗