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Biomedical subjects

M A Raskind

Publications and source records attributed to M A Raskind.

At least 127 records · Page 7Linked to original sources
PubMed1983

Polycystic ovary disease in two patients with Briquet's disorder.

Luteinizing hormone, testosterone, and follicle-stimulating hormone were evaluated by radioimmunoassay in two patients with Briquet's disorder, secondary depression, and menstrual irregularity. In both patients a hormonal pattern consistent with polycystic ovary disease was documented. The ovaries of both patients showed the classic pathologic findings of this disease. These results suggest that the hormonal and ovarian pathologic abnormalities of polycystic ovary disease may be common in patients with menstrual irregularity and Briquet's disorder.

Adult↗
PubMed1982

Cardiovascular effects of tricyclic antidepressants in depressed patients with chronic heart disease.

Twenty-four depressed patients with heart disease were treated for four weeks in a double-blind trial of imipramine, doxepin, or placebo to assess the effects of tricyclic antidepressants on ventricular function and rhythm. The tricyclic antidepressants had no effect on left ventricular ejection fraction at rest or during maximal exercise, as measured by radionuclide ventriculograms obtained before and after treatment. Premature ventricular contractions were reduced by imipramine but were not consistently changed by doxepin or placebo. Treatment with imipramine and doxepin, but not placebo, was associated with significant improvement (P less than 0.001) in standard ratings of depression. Our findings underscore the need for a reappraisal of the cardiovascular risks of tricyclic antidepressants and suggest that in the absence of severe impairment of myocardial performance, depressed patients with preexisting heart disease can be effectively treated with these agents without an adverse effect on ventricular rhythm or hemodynamic function.

Adult↗
PubMed1982

Changes in the sleep and waking EEGs of nondemented and demented elderly subjects.

Sleep and waking EEGs from 11 healthy nondemented elderly men and from ten inpatients for whom the diagnosis was probable senile dementia of Alzheimer's type (SDAT), were monitored in the subjects' typical home or ward environments or in the sleep laboratory, according to their customary sleep schedules. Aged normal subjects (age range, 56-85 years) had less Stage 3 and Stage 4 sleep, less REM sleep, and more wakefulness than normally observed in young adults. Patients with SDAT (age range, 56-88 years) had even less Stage 3 sleep, no Stage 4 sleep, and very little REM sleep, and experienced fragmentation of their sleep, with frequent awakenings. These sleep variables were significantly different in the SDAT and control groups (MANOVA). Examination of the 24-hour plots of sleep/waking patterns revealed prominent fragmentation of the diurnal sleep/waking rhythm in SDAT patients, with frequent daytime napping and nighttime periods of wakefulness. In addition, significant group differences were observed for the EEG variable, dominant occipital frequency. More qualitative EEG variables (diffuse slowing, spindle activity, and paroxysmal discharges) also differed between groups. It is suggested that correlative neuropathologic data might provide an understanding of the basis for the sleep, EEG, and mental-function factors that undergo change in SDAT.

Aged↗
PubMed1982

Screening for depression in hospitalized geriatric medical patients.

As part of an effort to improve the detection of depression in geriatric hospitalized medical patients, the validity of two self-rating depression scales, the Zung Self-rating Depression Scale (SDS) and the Popoff Index of Depression (ID), was evaluated. These two scales were completed by 42 medical inpatients whose mean age was 68 years. A psychiatrist who was "blind" to scale results interviewed each patient and diagnosed the presence or absence of depression according to the Diagnostic and Statistical Manual-III (DSM-III) criteria for Major Depressive Episode. On both the SDS and the ID, there was significant agreement between the scale results and the interview diagnosis. Compared with the interview diagnosis, the SDS had a sensitivity of 58 per cent and a specificity of 87 per cent, and it correctly identified 74 per cent of the patients as being either depressed or nondepressed. The ID had a sensitivity of 88 per cent and a specificity of 52 per cent, and it correctly identified 66 per cent of the patients. Although performance on both scales is reduced compared with that of younger depressed patients, these self-rating scales appear to be useful aids for the detection of depression in geriatric medical patients.

Aged↗
PubMed1982

Screening for depression in geriatric medical patients.

Depression, a common and treatable psychiatric disorder in later life, is often overlooked in geriatric medical patients. The authors evaluated the validity of two self-rating depression scales, the Zung Self-Rating Depression Scale and the Popoff Index of Depression, for 55 elderly patients. They compared these ratings with the diagnosis assigned by a psychiatrist who was blind to scale results and who interviewed these patients using DSM-III criteria. The two scales correctly classified 80% and 69% of the subjects, respectively. The authors identify six items from the two scales that may serve as a simple screening instrument for the detection of depression in geriatric medical patients.

Aged↗
PubMed1981

DSM-III criteria and the clinical diagnosis of dementia: a nursing home study.

Examinations were given to 64 elderly nursing home patients who met DSM III criteria for dementia to determine if a specific diagnosis for their dementing disorder could be established through clinical evaluation. Pre-established diagnostic criteria were followed in diagnosing the cause of a patient's dementia. The diagnostic criteria for primary degenerative dementia, multi-infarct dementia, or alcoholic dementia were the same as those in the DSM-III. All but four of the patients evaluated could be given a specific, criteria based diagnosis for the cause of their dementia. The two most common diagnoses were primary degenerative dementia (56%) and multi-infarct dementia (27%). Existing chart diagnoses for these 64 patients did not appear to be adequate as 39% had only a nonspecific diagnosis such as "organic brain syndrome," 30% had no diagnosis of any kind related to an organic mental disorder, and 8% had an inaccurate arteriosclerotic cerebro-vascular diagnosis. These results suggest that demented nursing home patients have discrete clinical syndromes which can be assigned a specific diagnosis and that the current clinical diagnosis of these disorders can be greatly improved.

Aged↗
PubMed1981

Problems of families caring for Alzheimer patients: use of a support group.

An eight-week support group program was conducted for 15 members of the families of Alzheimer patients still living at home. It became clear that caring for an Alzheimer patient at home created tremendous practical, psychologic and social problems for family members. Frequently discussed problems included lack of support and information from physicians, poor understanding of the disease, depression, a trapped feeling, anger and fear about the patient's behavioral problems, isolation, and the caretaker's loss of self-identity. Group participation was especially beneficial for spouses who functioned as primary care providers. It increased their understanding of the disease, made them feel more supported and less isolated, and helped them resolve some of the feelings created by the illness. It also helped spouses to become more aware of their own needs and to regain some self-identity in relation to the patient. Such family support programs offer a way to strengthen the emotional well-being and treatment skills of the care-providing family and are an important aid to treatment in Alzheimer's disease.

Aged↗
PubMed1981

Depression in older persons: diagnosis and management.

Depression is a common psychiatric disturbance of late life that is frequently not recognized by nonpsychiatric physicians. Confusion in psychiatric nosology, variability in clinical presentation, increased frequency of medical disease and medication use and cultural biases toward older persons complicate the diagnosis. Detection of depression is important because often this disorder can be successfully treated.

Adult↗
PubMed1978

Bromide intoxication in the elderly.

Four patients with dysfunction of the central nervous system secondary to bromide intoxication are reported. Three of them were referred because of symptoms of "senility," which appeared to preclude further independent living. After diagnosis and treatment of the bromism, they were able to continue living at home. The development of bromide toxicity with relatively low serum bromide levels in the elderly is discussed. The importance of a home visit to establish the diagnosis of drug-induced cognitive dysfunction is emphasized.

Aged↗
PubMed1978

Is antidiuretic hormone elevated in psychosis? A pilot study.

Plasma antidiuretic hormone (ADH) measured by radioimmunoassay was higher in acutely psychotic subjects than in acutely anxious nonpsychotic subjects or normal subjects. ADH was not elevated in acutely anxious nonpsychotic subjects. ADH was positively correlated with degree of psychosis. Normal osmolar and volume regulatory mechanisms did not seem responsible for the ADH elevations in the psychotic subjects. Because ADH is both produced in the hypothalamus and can be accurately measured in blood, this substance may prove particularly valuable in the study of psychiatric disorders.

Anxiety↗
PubMed1976

Screening for syphilis in an aged psychiatrically impaired population.

A serum Venereal Disease Research Laboratories (VDRL) test was carried out in 216 elderly patients with dementia or "functional" psychiatric illness, or both, as part of a community based screening program. The VDRL test was positive in 13 patients, 11 of whom (5.1 percent) had an actual past or present syphilitic infection as confirmed by the fluorescent treponemal antibody absorption test (FTA-Abs). In six patients (2.8 percent) syphilis was newly detected, and in another two patients previously detected syphilis had been inadequately treated. Only two (0.9 percent) biologic false positive reactors were detected. These results question the belief that aging per se is a common cause of the biologic false positive reaction; and indicate a relatively high incidence of past or present syphilitic infection in geriatric patients with psychiatric illness in the community who have been referred for crisis intervention.

Aged↗
PubMed1975

Acute psychosis, increased water ingestion, and inappropriate antidiuretic hormone secretion.

The authors describe three postmenopausal women with agitated psychotic depression, increased water ingestion, and electrolyte values consistent with the syndrome of inappropriate antidiuretic hormone (ADH) secretion. They hypothesize that this clinical triad represents a syndrome reflecting underlying dysfunction of the hypothalamus and limbic system of the brain. The diagnosis of inappropriate ADH in one of the patients was directly confirmed by a recently developed serum radioimmunoassay.

Acute Disease↗
PubMedDate not supplied

Depression and physical illness among elderly general medical clinic patients.

In this study we conducted a resurvey at 33 months of elderly general medical clinic outpatients previously classified as depressed or not using the Zung Self-Rating Depression Scale. Resurvey results and review of medical records permitted characterization of the point prevalences of depression at the time of the initial and follow-up surveys, and identification of physical illness factors associated with depression. The point prevalences of depression were approximately equal (20%), although only about 10% were depressed at both occasions. Among the initially nondepressed, the number of new physical diagnoses during follow-up was the best predictor of depression at retest. Other factors associated with depression at one or both occasions were: alcohol abuse, obstructive pulmonary disease, and a relatively greater number of medical diagnoses. Thus, among elderly outpatients, depression appears common with roughly equal rates of remission and incidence; also, new medical illness may precipitate depression.

Adjustment Disorders↗
PubMedDate not supplied

Age-related decline of vasopressin mRNA in the bed nucleus of the stria terminalis.

To determine whether aging influences arginine vasopressin (AVP) biosynthesis in the extrahypothalamic neurons of the bed nucleus of the stria terminalis (BNST), we used in situ hybridization and quantitative autoradiography to compare AVP mRNA in 3-month-old, 14-month-old, and 24-month-old male Fischer 344 rats. As AVP synthesis in the BNST has previously been shown to be steroid-dependent, plasma testosterone (T) was measured by radioimmunoassay. The 24-month-old animals had significantly fewer AVP-labelled cells than either the 3-month-old (p less than 0.01) or 14-month-old (p less than 0.05) animals. The cells that were present in the 24-month animals were less intensely labelled than in the other groups, as indicated by a significantly reduced number of grains per cell (p less than 0.01). Plasma T was also significantly lower in 24-month-old animals when compared with 3-month (p less than 0.01) or 14-month (p less than 0.05) groups. The results indicate that there is a marked age-related decline in vasopressin biosynthetic activity in neurons of the BNST.

Aging↗
PubMedDate not supplied

Cerebrospinal fluid S100B is elevated in the earlier stages of Alzheimer's disease.

Postmortem demonstration of increased expression of biologically active S100B in Alzheimer's disease (AD) and its relation to progression of neuropathological changes across the cortical regions suggests involvement of this astrocytic cytokine in the pathophysiology of AD. The hypothesis that the overexpression of S100B in Alzheimer brain is related to the progression of clinical symptoms was addressed in living persons by measuring S100B concentrations in cerebrospinal fluid (CSF) from AD patients with a broad range of clinical dementia severity and from healthy older persons. The effect of normal aging on CSF S100B concentrations also was estimated. CSF S100B did not differ between all 68 AD subjects (0.98+/-0.09 ng/ml (mean+/-S.E.M.)) and 25 healthy older subjects (0.81+/-0.13 ng/ml). When AD subjects were divided into mild/moderate stage and advanced stage clinical dementia severity by the established Clinical Dementia Rating Scale (CDR) criteria, S100B was significantly higher in the 46 mild/moderate stage AD subjects (1.17+/-0.11 ng/ml) than in either the 22 advanced stage AD subjects (0.60+/-0.12 ng/ml) or the healthy older subjects. Consistent with higher CSF S100B in mild to moderate AD, there was a significant correlation among all AD subjects between CSF S100B and cognitive status as measured by the Mini Mental State Exam (MMSE) score. CSF S100B did not differ between healthy older subjects and healthy young subjects. These results suggest increased CNS expression of S100B in the earlier stages of AD, and are consistent with a role for S100B in the initiation and/or facilitation of neuritic plaque formation in AD brain.

Adult↗
PubMedDate not supplied

Increased alpha 2-adrenergic receptor binding in locus coeruleus projection areas in dementia with Lewy bodies.

Clinical studies suggest involvement of brain noradrenergic systems in the pathophysiology of disruptive agitation in Alzheimer's disease (AD). This behavioral problem is even more prevalent in dementia with Lewy bodies (DLB). Here we used receptor autoradiography with [(125)I]para-iodoclonidine to estimate alpha-2 adrenergic receptor (A2R) density in locus coeruleus (LC) projection areas in postmortem brain tissue from age and gender comparable groups of DLB (n = 6), AD (n = 5) and normal (n = 7) subjects. LC neuronal loss was substantial and equivalent in DLB and AD. A2R density was greater in DLB than in normals in the deep layers of the frontal cortex. A2R density was greater in DLB than in AD in hippocampus (CA-1, CA-3 and dentate hilus) and in the granule layer of the cerebellum. Increased A2R binding in DLB is consistent with expression of presynaptic A2R on fibers from surviving LC neurons involved in reinnervation of LC projection areas. These areas develop compensatory noradrenergic hyperinnervation in a rat model of partial LC ablation. It is also consistent with upregulation of post-synaptic A2R in response to loss of LC noradrenergic innervation. Either mechanism could lower the threshold for increased agitation in response to noradrenergic outflow in these dementing disorders.

Adrenergic alpha-Agonists↗