Aeromonas associated diarrhoea in an otherwise healthy 70-year-old man.
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Biomedical subjects
Publications and source records attributed to M Garvey.
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Fourteen panic disorder patients with low 3-methoxy-4-hydroxyphenylglycol (MHPG) were compared to 14 patients with high MHPG. Patients with low MHPG were more likely during the preceding month to have experienced spontaneous panic attacks (P less than 0.008) than were patients with high MHPG. Patients with high MHPG had increased severity ratings on several individual symptoms of anxiety.
Levels of N-acetyl-beta-glucosaminidase (NAG) were examined in 575 patients with various psychiatric diagnoses and 38 non-ill controls. Ten percent of affectively disordered patients and 19% of chemically dependent patients had abnormal NAG levels, whereas none of the 38 controls did (P less than 0.05 and P less than 0.003 respectively). Other psychiatric diagnostic groups were not associated with abnormal levels of this enzyme.
The ability of pretreatment 3-methoxy-4-hydroxyphenylglycol (MHPG) to predict response to various antidepressants is reviewed. MHPG appears to be a modest predictor of treatment response to imipramine but does not appear to be a reliable predictor for other antidepressants.
Thirty depressed patients collected 24-h urine samples for a 3-methoxy-4-hydroxyphenylglycol (MHPG) determination prior to imipramine treatment. Patients responding to treatment had lower levels of MHPG than did non-responders.
A semistructured interview that evaluates 70 clinical variables, including constipation, was administered to 170 patients with major depression. Twenty-seven percent of the patients had depression-associated constipation. Constipation was not associated with any other clinical variable.
Symptoms of gastrointestinal distress, including those of irritable bowel syndrome, were reported more frequently by patients with panic disorder than by nonanxious controls. Five of 30 subjects with panic disorder met criteria for irritable bowel syndrome, the onset of which coincided with the onset of panic disorder. Effective treatment for the anxiety disorder was accompanied by a reduction in gastrointestinal symptoms in all subjects.
The central nervous and immune systems share a number of common properties, e.g. neurotransmitter receptors. In contrast to age matched healthy and/or hypertensive controls, the total lymphocyte count in 25 carefully diagnosed and staged patients with primary degenerative dementia were significantly reduced and also correlated with the severity of their dementia. Subjects' age, age of dementia onset, or duration of illness were unrelated. Total leukocyte counts were similar between groups. Nutritional status, ACTH, or plasma cortisol in dementia cohort were also not explanatory of their lymphopenia. These results are potentially significant in light of an immune hypothesis for primary degenerative dementia: Alzheimer's type and/or that population's high concomitant risk of infection.
Levels of 24-hour urinary 3-methoxy-4-hydroxyphenylglycol (MHPG) were not markedly elevated in a group of 35 panic disorder patients when compared to healthy controls (mean = 2,430 micrograms/day vs. 2,130 micrograms/day). There was a weak association between elevated pretreatment levels of MHPG and a positive treatment response to alprazolam or diazepam. Alprazolam and diazepam may differ in their effects on MHPG.
The family physician occupies a critical place in the detection and management of mental health problems. Optimal case management requires an awareness of individual limitations and effective use of a psychiatric consultant. The consultant must understand the unique relationship between the patient and the family physician. Several historical biases may impede the physician's use of psychiatric consultation and the patient's acceptance of psychiatric treatment options.
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The cardiovascular and renal effects of intravenous (i.v.) and intra-arterial (i.a.) infusions of isoproterenol (ISP, 0.1-0.2 micrograms/kg/min) were evaluated in 17 two-week-old swine anesthetized with pentobarbital. The glomerular filtration rate (GFR) of each kidney and blood flow and vascular resistance (RVR) of the left kidney were determined in all animals. In the 8 animals given ISP i.v., right ventricular pressure and dP/dtmax were also determined via a thoracotomy. In 9 animals, ISP was given i.a. after stabilization of constant-flow perfusion of the left kidney in situ. During i.v. infusion of ISP, the positive inotropic and chronotropic effects and the decrease in arterial pressure were maintained; renal blood flow and GFR increased and RVR decreased. During i.a. infusion of ISP in the constant-flow perfused kidney, similar changes in RVR and GFR were observed despite the higher effective concentrations of drug reaching the kidney. We conclude that, at this stage of postnatal renal development, the infusion of cardiotonic doses of ISP lowers RVR and produces a small increase in GFR.
An elderly woman developed a high serum digoxin concentration resulting in toxicity when alprazolam was added to her digoxin therapy. The reduced renal clearance of digoxin is postulated as the mechanism for this interaction.
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Newly admitted paranoid schizophrenic patients (N = 68) were treated with either loxapine or chlorpromazine for up to 4 weeks. Mean maximum dosages were 84 mg/day of loxapine and 820 mg/day of chlorpromazine. Loxapine showed efficacy superior to that of chlorpromazine, confirming earlier retrospective findings. Adverse reactions were also less troublesome with loxapine.
The endocrinologic methods used in the dexamethasone suppression test (DST) for depression were examined, by employing two different doses of dexamethasone (0.5 or 1.0 mg) at 11 p.m. Nonsuppression to the 1.0 mg DST (plasma cortisol criterion value of 5 micrograms/dl) was seen in 33% of major depressives and in 15% of schizophrenics. A similar result was obtained with the 0.5 mg DST when 12 micrograms/dl was employed as the plasma cortisol criterion value. Plasma cortisol levels 33 hours postdexamethasone did not distinguish between major depressives and schizophrenics.
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