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Biomedical subjects

L Lewis

Publications and source records attributed to L Lewis.

At least 37 records · Page 2Linked to original sources

Serotonin syndrome.

We describe a patient treated with trazodone, isocarboxazid, and methylphenidate hydrochloride who developed confusion, agitation, poor concentration, rigidity, myoclonus, involuntary movements, orthostatic hypotension, and hyperreflexia. CK was normal, and the syndrome resolved spontaneously over 12 hours. The serotonin syndrome occurs following the use of serotomimetic agents (serotonin reuptake inhibitors, tricyclic and tetracyclic antidepressants, tryptophan, 3,4-methylenedioxy-methamphetamine, dextromethorphan, meperidine, S-adenosylmethionine) alone or in combination with monoamine oxidase inhibitors. It is characterized by various combinations of myoclonus, rigidity, hyperreflexia, shivering, confusion, agitation, restlessness, coma, autonomic instability, low-grade fever, nausea, diarrhea, diaphoresis, flushing, and rarely, rhabdomyolysis and death.

Depressive Disorder

Caring for the carers.

The author reports a small-scale study of stress in the labour ward. 25 labour ward staff were asked about stress at work. 80% felt stressed at work, citing overwork as the main cause, and talking to others as the main way of coping. Existing counselling facilities were found to be underused Stress did not appear to spread over into private lives. Only half of those questioned felt adequately supported at work. Participants were offered a 20-minute massage, and all felt this helped reduce stress. The average pulse rate of participants dropped by 12 beats per minute during massage.

Burnout, Professional

Symbolization in psychotherapy with patients who are disabled.

Symbols created during the process of psychotherapy serve psychological functions of giving form and substance to previously murky experiences, making what is private something shared, and forging meaningful linkages among thoughts, emotions, and perceptions. Symbols can also enable therapist and patient together to gain insight into transference themes, transformations in identity, and feelings about life changes, as well as serve as guides to articulating treatment goals. Clinical vignettes are used to illustrate the process.

Adult

Tubular fluid concentrations and kidney contents of angiotensins I and II in anesthetized rats.

Previous micropuncture studies have reported nanomolar concentrations of angiotensin II in proximal tubular fluid and have indicated that angiotensin II or a precursor may be secreted into the tubular lumen. Further experiments were performed to determine if proximal tubular fluid angiotensin I concentrations are also greater than plasma and kidney levels and to estimate the degree of intrarenal compartmentalization of the angiotensin peptides. Free-flow proximal tubular fluid samples were collected in micropipets and were pooled for each animal. At the end of each experiment, a blood sample was collected and the micropunctured left kidney was harvested and homogenized in methanol. The angiotensin I concentration in proximal tubular fluid samples averaged 6.1 +/- 1.2 pmol/mL, whereas the angiotensin II concentration averaged 8.1 +/- 1.6 pmol/mL (N = 13). HPLC analysis of a separate sample pooled from collections in five rats indicated that the immunoreactive angiotensin I and angiotensin II primarily represented authentic angiotensin I and II. Plasma concentrations of angiotensin I and angiotensin II averaged 0.39 +/- 0.09 and 0.15 +/- 0.03 pmol/mL, respectively. The kidney contents of angiotensin I and angiotensin II were 1.28 +/- 0.24 and 0.97 +/- 0.17 pmol/g of kidney, respectively. These findings indicate that proximal tubular fluid contains nanomolar concentrations of angiotensin I as well as angiotensin II. These high tubular fluid concentrations, which greatly exceed the plasma and kidney levels, likely reflect net secretion of the angiotensin peptides by proximal tubule cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Angiotensin I

Behavioral Intensive Care Unit (BICU): a new concept in the management of acute agitated behavior in elderly demented patients.

Intensive care units were developed in response to the perceived need for increased monitoring in critically ill medical patients. The same principle applies to elderly patients with severe agitated behaviors. These patients can be served by the Geriatric Behavioral Intensive Care Unit (BICU). The uniqueness of the program results from the application of a behavioral and environmental approach to the treatment of agitated behavior. The underlying strategy in the treatment process is to enhance the patient's ability to adapt to his or her home environment. Preliminary results have been encouraging, showing positive outcomes in diverse areas such as low level of institutional placement, patient quality of life, and caregiver symptoms of burden and depression.

Aged

Antibodies to platelet glycoprotein V in polytransfused patients with haematological disease.

Polytransfused patients often develop platelet-reactive antibodies (PRAb). These give positive reactions in the platelet immunofluorescence test (PIFT) and may be either lymphocytotoxic (LCTAb) or platelet-specific antibodies (PSAb). The latter may be detected in the PIFT using chloroquine-treated platelets (Chl-PIFT) or by immunoblotting. Serial samples from 106 multiply transfused patients with bone marrow failure were screened by PIFT using a microplate method and flow-cytometric analysis. PSAb activity was confirmed by Chl-PIFT. In 45 (42%) of the patients studied PSAb were detected; 37 (35%) formed LCTAb and 19 (51%) had co-existent PSAb. Sera from 25 of 27 patients with a positive Chl-PIFT, retested by immunoblotting, recognised determinants of Mr 82-160 kD on whole platelets. A large group became sensitised to a component of Mr 105-115 kD reduced (99 kD non-reduced) with similar electrophoretic mobility to GPIIIa using a monoclonal anti-GPIIIa and two human polyclonal anti-HPA-1a sera; some also produced anti-GPIIb. The largest group recognised a determinant of Mr 80-83 kD, probably glycoprotein V (GPV). Three sera were immunoblotted against thrombin-treated platelets and the results confirmed GPV specificity.

Adolescent

Evaluation of a supplementary retention program for black allied health sciences students.

The Medical College of Georgia's (MCG's) Minority Academic Advising Program (MAAP), which began in 1984, is a supplementary retention program for Black students. This paper describes an evaluation study of the effectiveness of MAAP within the MCG School of Allied Health Sciences (SAHS). The study sample consisted of 89 Black students who enrolled in the SAHS from fall 1978 to fall 1982 (preMAAP period) plus 129 Black students who entered the SAHS from fall 1984 through fall 1988 (MAAP period). The comparison group consisted of all other students who entered the SAHS (n = 1,884) within those same time periods. Using an evaluation design produced by merging a quasi-experimental and a time-series design, the authors found that the MAAP succeeded in increasing both the Black student retention-to-graduation rate and the time-persisted-in-program, to the extent that Black students achieved parity with other SAHS students.

Black or African American

Anti-sulfatide antibodies in neurological disease: binding to rat dorsal root ganglia neurons.

Increased titers of anti-sulfatide antibodies were detected by ELISA in 5 of 200 patients and control subjects. All 5 patients had sensory impairment; 4 had neuropathy, and one had multiple sclerosis. Of the patients with neuropathy, 2 had a clinical syndrome of small fiber sensory neuropathy with normal electrophysiological or nerve biopsy studies, 1 had a sensorimotor axonal neuropathy associated with IgM monoclonal gammopathy, and 1 had sensorimotor neuropathy with multifocal motor conduction block and anti-GM1 antibodies. The anti-sulfatide antibodies bound to the surface of unfixed rat dorsal root ganglia neurons and human neuroblastoma cells, and to fixed sections of central and peripheral myelin. No binding was detected following intraneural injection into rat sciatic nerves. Pre-absorption with sulfatide but not with galactocerebroside eliminated the tissue binding activity. These findings indicate that increased titers of anti-sulfatide antibodies are found in patients with sensory impairment but are not restricted to a particular neurological syndrome or type of neuropathy. The significance of anti-sulfatide antibodies is uncertain although sulfatide on dorsal root ganglia neurons may be a target antigen.

Aged

Evaluation of a summer prematriculation program for black and other nontraditional students.

This study evaluated the effectiveness of the Medical College of Georgia School of Medicine's Summer Prematriculation Program in facilitating participants' first-year achievement and retention from 1980 to 1989. The four-week curriculum included biochemistry, anatomy, immunology, learning skills, medical or anatomy terminology, and clinical forums. Of 101 black and 96 other nontraditional, at-risk students who had been invited to attend the program, the 115 attendees were compared with the 82 nonattendees on a variety of demographic and academic measures. For all measures examined, no statistically significant difference was found between the two groups. Several factors may have obscured the results. However, there were indications that the program had a favorable effect, including the evaluation by over 90% of the attendees that the program had contributed positively to their adjustment to medical school.

Black or African American

Prematriculation program grades as predictors of black and other nontraditional students' first-year academic performances.

This study explored the relative strengths of select background variables, including grades in a summer prematriculation program (SPP), as predictors of students' first-year academic performances. During the years 1980-1989, 115 black and other nontraditional prematriculants at the Medical College of Georgia School of Medicine attended a four-week SPP featuring courses in biochemistry, anatomy, and immunology. Canonical correlation analysis revealed that the combination of undergraduate grade-point average (GPA) and SPP grades in biochemistry and anatomy was the best predictor of the students' academic performances based upon their first-year grades in biochemistry, anatomy, and microbiology, and upon their GPAs for all first-year basic science courses. The authors conclude that SPP grades can be used to identify the specific academic weaknesses of nontraditional students at highest risk of falling into academic jeopardy.

Black or African American

Two neuropsychological models and their psychotherapeutic implications.

Two neuropsychological models of normal brain functioning--cerebral laterality and hierarchical brain organization--are reviewed and their implications for psychotherapy are discussed. The purpose is not to reduce or translate complex psychological phenomena into neural terms or to suggest that psychopathology will ultimately be viewed as neuropathology. Rather, the effort is to point out convergences in findings of the two disciplines and to discuss the possible neurophysiological mechanisms underlying the resolution of psychopathology through psychotherapeutic interventions.

Brain

High-moisture diet for laboratory rats: nutrient analysis, growth, and organ weights.

A diet (KSC-25) to be sterilized by irradiation was formulated to contain 66% moisture and to provide the required nutrients for growing rats. Analyses of the irradiated dry diet provided data to evaluate its nutrient content. The diet was evaluated for its ability to supply all nutrients, including water, required by immature rats. Sixteen Sprague-Dawley rats were fed the high-moisture diet with or without access to a water bottle. Rats (n = 16) fed an irradiated purified diet in a meal form with access to a water bottle were the control animals. Feed efficiency, food and water consumption, and growth rate data were collected during the 28-day study. Organ weights were collected on day 28. The test diet met or exceeded the National Research Council (NRC) estimated nutritional requirements for immature laboratory rats. The 66% moisture KSC-25 diet provided all nutrients, including water, required by weanling male Sprague-Dawley rats for growth equivalent to the established purified diet.

Animal Feed

High-moisture diet for laboratory rats: complete blood counts, serum biochemical values, and intestinal enzyme activity.

Rats were fed an irradiated high-moisture diet (KSC-25) with or without access to a water bottle. Physiologic values were compared between these two groups and a group of rats fed a purified diet. Hematologic and serum biochemical values, urine specific gravity, and intestinal enzyme activities were determined from samples collected from the three groups of rats. Sprague Dawley rats (n = 32) fed the irradiated high-moisture diet with or without a water bottle were the test animals. Rats (n = 16) fed an irradiated purified diet and water provided via a water bottle were the control group. The purified diet formulation modified AIN-76A, is a commonly used purified diet for laboratory rodents. All rats remained alert and healthy throughout the study. A comparison of the physiologic values of rats in this study with reported normal values indicated that all of the rats in the study were in good health. Significant differences (P less than 0.05) of the physiologic values from each rat group are reported.

Animal Feed

Psychoanalytic psychotherapy with brain-injured adult psychiatric patients.

Scant attention has been paid to psychotherapy with patients who have acquired neurological conditions. In this paper the authors describe the common psychological problems and repetitive themes that emerge in the therapeutic process with these patients, as well as the salient attitudes toward therapy and the therapist that these patients manifest. Case vignettes illustrate the theoretical and technical considerations.

Affect