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Biomedical subjects

M Sandler

Publications and source records attributed to M Sandler.

At least 73 records · Page 4Linked to original sources
PubMed1991

Platelet [3H]imipramine binding in migraine and tension headache in relation to depression.

Platelet [3H]imipramine binding was measured in 40 migrainous (7 classical and 33 common) and 17 tension headache patients and in 28 normal controls. A significant reduction in Bmax was found in migraine compared with controls (p less than 0.05) but not in tension headache. In migraine, there was no significant relationship between Bmax and depression or anxiety score on the self-rating Hospital Anxiety and Depression (HAD) Scale, suggesting that the reduction in Bmax is a concomitant of migraine itself rather than a manifestation of associated depression. Preliminary evaluation using the Schedule of Affective Disorders and Schizophrenia-Lifetime Version (SADS-L) tended to confirm this conclusion.

Adult↗
PubMed1991

Release of (14C)5-hydroxytryptamine from human platelets by red wine.

Red wine, at a final dilution of 1/50, caused release of [14C]5-hydroxytryptamine (5-HT) from preloaded platelets, an effect which was not observed with any white wines or beers tested. Since 5-HT, is probably released from body stores during migraine attacks and red wine is known to provoke migraine episodes in susceptible individuals, release of 5-HT, possibly from central stores, could represent a plausible mechanism for its mode of action.

Beer↗
PubMed1991

Chocolate is a migraine-provoking agent.

Patients with migraine who believed that chocolate could provoke their attacks were challenged with either chocolate or a closely matching placebo. In a double-blind parallel group study, chocolate ingestion was followed by a typical migraine episode in 5 out of 12 patients, while none of the 8 patients challenged with placebo had an attack (p = 0.051). The median time to the onset of the attack was 22 h. This brief study provides some objective evidence that chocolate is able to provoke a migraine attack in certain patients who believe themselves sensitive to it.

Adult↗
PubMed1991

Kinetics of platelet 5-hydroxytryptamine uptake in headache patients.

Platelet 5-hydroxytryptamine (5-HT) uptake was measured in asymptomatic headache patients attending a specialist migraine clinic, and in hospital staff who did not suffer from regular or severe headache. Current levels of anxiety and depression were assessed in all subjects using the Hospital Anxiety and Depression (HAD) scale and their possible influence on the uptake kinetics taken into account during the analysis of results. The Michaelis-Menten constant (Km) was significantly raised in common migraine and tension headache compared with controls (p less than 0.001 and p less than 0.01, respectively), but not in classical migraine or cluster headache. The increase remained significant after adjusting for differences in age, sex, presence of anxiety or depression (HAD sub-scale score greater than or equal to 8), drug intake during the week before testing, time elapsed since last attack and time of assay (am or pm). No differences were observed between patients and controls in the maximal rate of uptake (Vmax) or platelet count, and previous reports of a reduction in Vmax in patients experiencing attack within 5 days prior to testing could not be confirmed. The cause and significance of an increased Km are not clear, but plasma factors acting as competitive inhibitors for the uptake site or an alteration in the configuration of the uptake site are possible explanations. If confirmed, the shared biochemical abnormality may suggest that common migraine and tension headache have a common pathogenesis.

Analysis of Variance↗
PubMed1991

Urinary but not brain isatin levels are reduced in germ-free rats.

Germ-free rats excreted considerably smaller amounts of the monoamine oxidase-inhibiting compound isatin than the substantially larger output by conventional animals of the same strain, although concentrations in brain and other tissues were similar in the two groups. Thus, isatin is likely to be elaborated both endogenously in rat tissues and "exogenously" by flora inhabiting the lumen of the alimentary tract.

Animals↗
PubMed1991

Effects of captopril on glucose tolerance in elderly patients with congestive cardiac failure.

A prospective study was carried out to investigate the effects of the ACE inhibitor captopril on glucose tolerance in 14 elderly patients, aged 76 to 89 years, who had co-incident cardiac failure and stable Type II diabetes mellitus. Patients were maintained on their diet and diabetic therapy and were given 12.5 mg captopril twice daily. Clinical findings, including signs of cardiac failure, body weight and blood pressure, biochemical profile and chest X-ray appearance were documented at each visit. Blood glucose tolerance testing was carried out immediately before starting captopril and again 28 days later. A reduction in symptoms of heart failure occurred in all patients and 5 of them reduced their New York Heart Association grade of heart failure. Significant improvement in glucose tolerance occurred in all patients. Four were able to reduce hypoglycaemic therapy and 1 was able to stop his hypoglycaemic agents. This potentially valuable additional benefit of captopril in improving glucose tolerance has not yet been shown to occur with other ACE inhibitors.

Aged↗
PubMed1991

Anticholinergic antiparkinsonian drugs in psychiatry.

In this article the treatment of drug-induced extrapyramidal disorders is briefly reviewed. Anticholinergic antiparkinsonian drugs are discussed with emphasis on the extent of their usage; the potential for abuse, causing confusion, and impairing cognition; and their effect on neuroleptic drug levels and on tardive dyskinesia. Practical guidance for their use is included.

Antiparkinson Agents↗
PubMed1991

Senior registrar training in geriatric medicine 1977-1990.

Higher medical training in geriatric medicine was assessed in 1977, 1983 and 1990 by a questionnaire distributed to members of the British Geriatrics Society Senior Registrar Group. Comparisons over this 14 year span show consistent concern about training programmes, particularly in relation to research, health service management and psychiatry of the elderly.

Education, Medical, Graduate↗
PubMed1990

Can we predict and/or prevent type I diabetes?

The highest risk for the development of type I diabetes resides with first-degree relatives of the diabetic proband, this risk being in the order of 2.9%, 6.6% and 4.9% for parents, siblings and children of the proband, respectively. The major genetic markers associated with the development of insulin-dependent diabetes mellitus (IDDM) is the possession of the HLA alleles DR3/DR4 and more recently the absence of aspartate in the 57th position on the beta-chain of the HLA DQ gene (HLA DQ beta Asp 57 negative). The most important auto-immune marker for predicting preclinical IDDM is the presence of high titres (greater than 40 Juvenile Diabetes Foundation units) of islet cell antibodies (ICA), while the finding of insulin auto-antibodies (IAA) is a good predictive marker in children less than 5 years of age. The presence in a susceptible individual of ICA plus IAA is a better predictor of impending IDDM than the presence of either of these two markers alone. Antibodies which precipitate an islet membrane protein (MW 64K) are highly sensitive and specific markers of preclinical IDDM. The presence of 64K antibodies may well be the most important predictive marker of impending IDDM in the future. The progressive decline of the first phase of insulin secretion in response to an intravenous glucose challenge is associated with the onset of IDDM within 18 months. Of the immunotherapeutic agents at present used in clinically manifest IDDM, azathioprine has been shown to be ineffective in increasing the remission phase, while the value of nicotinamide is controversial.(ABSTRACT TRUNCATED AT 250 WORDS)

Autoantibodies↗
PubMed1990

High incidence of endogenous depression in migraine: confirmation by tyramine test.

Forty patients with migraine who were attending a specialist clinic were interviewed with the Schedule for Affective Disorders and Schizophrenia--Lifetime version. Sixteen (40%) had a history of major depression which was of endogenous type in 15, according to Research Diagnostic Criteria. The tyramine test, a previously established trait marker for endogenous depression, showed that the migraine group as a whole had significantly low values compared with 14 normal controls, due almost entirely to low values in the endogenous depressive subgroup; there were no differences between diet-sensitive and non-diet-sensitive migraine patients. Thus depression in patients with migraine seems unlikely to be secondary to migraine per se. A substantial subgroup of patients with migraine may possess an inherent predisposition to endogenous depression.

Adult↗
PubMed1990

Is the lung a 'target organ' in diabetes mellitus?

Histopathologic evidence of lung involvement in subjects with diabetes mellitus has included thickened alveolar epithelial and pulmonary capillary basal laminae, the latter being suggestive of existing pulmonary microangiopathy. Abnormal pulmonary function has been detected in some diabetic patients; the most consistent abnormalities are reduced lung volumes in young (aged less than 25 years) insulin-dependent diabetic subjects, reduced pulmonary elastic recoil in both young and adult (aged greater than 25 years) diabetic subjects, and impaired diffusion due to a reduced pulmonary capillary blood volume in the adult group. Nonenzymatic glycosylation-induced alteration of lung connective tissue is the most likely pathogenetic mechanism underlying mechanical pulmonary dysfunction in diabetic subjects, while the most tenable explanation for impaired pulmonary microangiopathy. these patients is the presence of underlying pulmonary microangiopathy. The finding of abnormal lung function in some diabetic subjects suggests that the lung should be considered a "target organ" in diabetes mellitus; however, the clinical implications of these findings in terms of respiratory disease are at present unknown.

Aging↗
PubMed1989

Isatin and tribulin concentrations are increased in rabbit brain but not liver following pentylenetetrazole administration.

Isatin has recently been identified in rat tissues and normal human urine where it constitutes the major part of the endogenous monoamine oxidase inhibitor, tribulin. In this study, we have measured both isatin (by gas chromatography/mass spectrometry) and tribulin (inhibition of a standard rat liver monoamine oxidase preparation) in extracts of rabbit brains and livers after intravenous administration of the anxiogenic, proconvulsant agent pentylenetetrazole. There were increased levels of both isatin and tribulin in rabbit brains, but not in livers, after pentylenetetrazole, compared with saline treated controls. This finding supports the hypothesis that isatin is a component of tribulin activity and may have a role in anxiety or epilepsy.

Anxiety↗
PubMed1989

Stress reduces in vivo inhibition of monoamine oxidase by phenelzine in rat brain.

The level of inhibition of rat whole brain monoamine oxidase activity produced by the irreversible monoamine oxidase inhibitor phenelzine has been studied with or without concurrent cold restraint stress. We have found that phenelzine caused significantly less enzyme inhibition when given during a period of stress than during a control period. Thus, stress can reduce the in vivo potency of MAO inhibitors. This would be compatible with an increased production of the reversible, endogenous monoamine oxidase inhibitor, tribulin, competing for the active site of the enzyme.

Animals↗
PubMed1989

Cutaneous reaction to zinc--a rare complication of insulin treatment. A case report.

A diabetic patient presented with furunculoid lesions at the sites of insulin injections. These lesions were diagnosed as representing a manifestation of a cutaneous reaction to the zinc component of an intermediate-acting insulin. The differential diagnosis of furunculoid lesions in insulin-dependent diabetic subjects is discussed.

Female↗
PubMed1989

Acute febrile neutrophilic dermatosis (Sweet's syndrome). A report of 2 cases.

Two cases of Sweet's syndrome are described. The diagnostic criteria, clinical spectrum, complications, pertinent differential diagnoses and treatment modalities of this relatively rare clinical condition are described. The association of Sweet's syndrome with underlying haematological malignant disease is stressed.

Adult↗