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Biomedical subjects

L E Arnold

Publications and source records attributed to L E Arnold.

At least 19 recordsLinked to original sources
PubMed1992

Quantifying the value of human life for cost accounting of safeguards: clarifying formulas applied to the clozapine controversy.

Using CPMS as an example, this article has developed mathematical formulations to compare the value of lives saved against the cost of medical safeguards. By a logical comparison of benefit and cost converted to the same units of currency, the article explores three important questions relating to the CPMS example. These mathematical formulations serve to quantify the decision-making process in a logical manner, and might serve as a useful example for clinical and public policy decisions.

Clozapine↗
PubMed1990

Is the 20th century increase in human height entirely nongenetic?

The twentieth-century increase in human height in affluent nations may not be entirely due only to such nurturant considerations as food supply and electric lights. A possible genetic role might be found in interactions of food supply, maternal pelvic size, and height-survival/vulnerability links, and in mate selection. Humans seem to be following the paleontological principle that most species tend to evolve larger sizes over time.

Biological Evolution↗
PubMed1990

Does hair zinc predict amphetamine improvement of ADD/hyperactivity?

In 18 boys with ADHD (ages 6-12) in a balanced crossover design, parent and teacher hyperactivity rating differences between one month of dextroamphetamine and one month of placebo correlated significantly (p less than .05, 2 tailed) on Pearson's r with baseline hair zinc levels and nonsignificantly with 24-hour urinary zinc excretion. The signs of the correlations were such that a higher baseline zinc predicted a better placebo-controlled response to amphetamine. Patient baseline urinary zinc was significantly (p less than .02) lower than 7 normal controls. These findings are compatible with the possibility that some ADHD children may be mildly deficient in zinc and constitute poorer stimulant responders. Correlations of zinc levels with 24-hour urinary MHPG were in the expected direction but nonsignificantly by 2-tailed test.

Attention Deficit Disorder with Hyperactivity↗
PubMed1989

Gamma-linolenic acid for attention-deficit hyperactivity disorder: placebo-controlled comparison to D-amphetamine.

In a Latin-square double-crossover with random assignment to sequence, 18 boys, aged 6-12 years, with attention-deficit hyperactivity disorder received 1 month each of placebo, D-amphetamine, and Efamol (evening primrose oil containing gamma-linolenic acid, with vitamin E as preservative). Parents' ratings were noncontributory. Teachers' ratings showed a trend of Efamol effect between placebo and D-amphetamine. The trend reached significance (p less than 0.05) only on Conners Hyperactivity Factor. Dosage may be crucial; 8 Efamol capsules per day were used in this study. Heuristic data scrutiny suggested possible interaction (sequence effect). Further study with a different design and dose is suggested. This study does not establish Efamol as an effective treatment.

Attention Deficit Disorder with Hyperactivity↗
PubMed1978

Megavitamins for minimal brain dysfunction. A placebo-controlled study.

Preliminary to a stimulant comparison study, 31 children with minimal brain dysfunction randomly received either placebo or a megavitamin combination. During a two-week trial, only two children responded so well that stiumlants were not considered necessary; both were in the placebo group. Change scores from pretest to posttest on four blind ratings by teachers and parents did not show a significant difference between the placebo and vitamin groups.

Ascorbic Acid↗
PubMed1978

A survey study of the use of electropupillogram in predicting response to psychostimulants.

To confirm the conclusions from a previous study supporting the usefullness of electropupillogram (E.P.G.) in predicting clinical response, data from three separate studies with hyperkinetic and learning disabled (L.D.) children treated with stimulants were surveyed. Change in extent of pupillary contraction (E.C.) after a test dose of stimulant as measured by E.P.G. did not correlate significantly with actual clinical rating change (with one exception out of 14 correlations calculated). These negative results are reported with a reservation regarding their validity because of technical difficulties in data collection.

Adolescent↗
PubMed1978

Methylphenidate vs dextroamphetamine vs caffeine in minimal brain dysfunction: controlled comparison by placebo washout design with Bayes' analysis.

Double-blind crossover comparison of methylphenidate hydrochloride, dextroamphetamine sulfate, and caffeine after placebo washout in 29 children with minimal brain dysfunction (MBD) showed on six ratings that methylphenidate and dextroamphetamine were significantly (P less than .05 to P less than .001) better than placebo and caffeine, but not significantly (P less than .05) different from each other. Placebo, caffeine, and ratings before drug did not differ significantly. Of 26 drug responders, 12 responded best to dextroamphetamine, ten to methylphenidate, and one to caffeine. The latter child showed no improvement at all with either prescription stimulant. Methylphenidate and dextroamphetamine were each efficacious for six children who did not respond to the other stimulant. All three drugs showed significant (P less than .05) weight loss and cardiovascular side effects, the latter possibly spurious. Dextroamphetamine showed a significant (P less than .05) decrease from placebo in "tummyaches."

Attention Deficit Disorder with Hyperactivity↗
PubMed1978

Father-son incest: underreported psychiatric problem?

Six families are described in which 10 sons were involved incestuously with a natural father (N=4) or step-father (N=2). Father-son incest as a part of the spectrum of child abuse appears to be a more frequent clinical entity than was thought previously.

Adolescent↗
PubMed1977

Prevention by specific perceptual remediation for vulnerable first-graders. Controlled study and follow-up of lasting effects.

In a pretest-posttest design with two matched control groups, 86 first-graders screened as vulnerable to academic failure and behavioral decompensation were each assigned to one of three groups: (1) channel-specific perceptual stimulation, (2) regular academic tutoring (contact controls), or (3) no contact. On most measures, including perceptual and achievement tests and behavior ratings by teachers, group 1 showed more improvement than either of the control groups. Several of these differences were significant (P less than .05, two-tailed). In general, the two control groups came closer to each other than to group 1. With no further intervention, follow-up one year later showed more dramatic significance. On every measure, group 1's improvement surpassed that of the control groups, and diverged from them even more than at posttest; this divergence was significant on most measures. Group 1 improved significantly (P less than .05 to P less than .01) in reading, IQ, and three behavior scales, while both control groups showed only deterioration on these measures. Group 1 gained five IQ points on the Wechsler Intelligence Scale for Children, while the controls lost five. On the Davids Scale, group 1 improved significantly (P less than .01) to "probably not hyperkinetic," while both control groups deteriorated to "probably hyperkinetic." The hypothesized mechanism of group 1's behavioral superiority at follow-up was its significant (P less than 0.1) reading improvement, with secondary emotional benefits.

Adolescent↗
PubMed1976

Levoamphetamine vs dextroamphetamine in minimal brain dysfunction. Replication, time response, and differential effect by diagnostic group and family rating.

Double-blind crossover randomized Latin square comparison of placebo, dextroamphetamine, and levoamphetamine in 31 consecutively diagnosed children with minimal brain dysfunction (MBD) replicated a smaller nonrandom study. Both isomers showed significantly more benefit than placebo but were not significantly different from each other. Dextroamphetamine showed a nonsignificant trend of superiority over levoamphetamine. Of 25 subjects who responded well to drugs, three responded only to levoamphetamine, five only to dextroamphetamine, and 17 to both. This study seems to confirm the efficacy of levoamphetamine in MBD. An unsocialized aggressive subgroup (308.4) showed a nonsignificant trend for levoamphetamine superiority, in contrast to the hyperkinetic (308.0) and overanxious (308.2) subgroups. Those who responded best to levoamphetamine tended (not significantly) to be from poorer functioning families. Parents' ratings, but not teachers' or psychiatrists' ratings, showed significant placebo effect.

Amphetamine↗
PubMed1976

Minimal brain dysfunction: a hydraulic parfait model.

A Venn diagram shows the overlap of MBD, behavior disorders, and learning disorders. A hydraulic parfait model illustrates a concept of symptom production by additive accumulation of pathology from various etiologies. This implies a psychophysiologic disorder. It also implies a multidimensional spectrum of etiologies which could be important for treatment plans in individual cases. A similar hydraulic parfait illustrates a concept of diagnosis-triggering by cumulative pressure from various symptoms. Diagnosticians form a spectrum of "trigger pulls", from "hair trigger" to "on safety." A useful research effort might be to find a convenient means of developing etiological profiles for individual patients, perhaps by correlation with symptom spectra.

Attention Deficit Disorder with Hyperactivity↗
PubMed1975

Caffeine versus methylphenidate and d-amphetamine in minimal brain dysfunction: a double-blind comparison.

The authors compared the efficacy of caffeine, methylphenidate, and d-amphetamine in children with minimal brain dysfunction using a double-blind crossover design. The slight improvement with caffeine was not significantly better than placebo. Both prescription drugs resulted in significant improvement and were significantly superior to caffeine. The authors suggest that the discrepancy between these results and an earlier, more optimistic report mat stem from the use in this study of pure caffeine rather than whole coffee.

Amphetamine↗