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Biomedical subjects

M T Lambert

Publications and source records attributed to M T Lambert.

13 recordsLinked to original sources
PubMed1992

The treatment of sleep disorders.

Narcolepsy is clinically associated with cataplexy, sleep paralysis and hypnagogic hallucinations. It is treated by reassurance (that there is no physical disease) and by stimulants such as ephedrine and amphetamine on an intermittent basis. The special tricyclic antidepressant clomipramine is also used, and mono-amine oxidase inhibitors (MAOIs) are useful in theory. Obstructive sleep apnoea is an important and often unrecognised cause of daytime somnolence. It is treated by weight reduction (pickwickian syndrome), hormones, or recently, with continuous positive pressure apparatus. Night terrors (pavor nocturnus) and sleepwalking typically occur during deep sleep (stage 3 and 4 throughout the episode) in children. In a night terror the child sits up with a scream, with eyes open, but inaccessible. He eventually falls asleep calmly. Sleepwalking, too, shows the features of inaccessibility and subsequent amnesia for the episode. Both conditions are normally treated with reassurance (to the parents) but may occasionally warrant benzodiazepines. Enuresis usually occurs in non-rapid eye movement (NREM) sleep, especially stages 3 and 4. The reason for the efficacy of tricyclic antidepressants is not precisely known. Delirium tremens (DT) is treated as a rebound excess of REM sleep, with benzodiazepines and other drugs. It is the withdrawal syndrome (with or without major seizures) to the barbiturate-alcohol group of drugs, which includes alcohol, chloral, paraldehyde, glutethimide, methylprylone, ethchlorvynol, meprobamate and meprobamate-diphenhydramine. Insomnia may be treated by the above drugs, by analgesics, antidepressants, major tranquillisers (neuroleptics) and miscellaneous other compounds. For the majority of patients, however, the most suitable group seems to be the benzodiazepines. The benzodiazepines are much safer than their predecessors, in both acute and chronic usage.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Pheochromocytoma presenting as exacerbation of post traumatic stress disorder symptomology.

OBJECTIVE: The following case report and discussion is intended to increase awareness of the difficulties in diagnosing pheochromocytoma when a primary psychiatric diagnosis is first suspected. METHOD: The case of a middle-aged combat veteran who was admitted with agitation and flashbacks is presented. Episodes of hypertension were initially believed to be related to agitation or alcohol withdrawal. When the hypertensive episodes persisted, further evaluation revealed a pheochromocytoma. In three years' follow-up since removal of the tumor, the patient has shown considerable improvement in the symptoms of Post Traumatic Stress Disorder (PTSD). CONCLUSIONS: Pheochromocytoma should be considered in patients with psychiatric disorders if a pattern of hypertensive episodes persists or worsens. The case highlights the importance of medical evaluation in patients presenting with psychiatric complaints.

Adrenal Gland Neoplasms↗
PubMed1991

A comparison of the hypnotic effects of temazepam capsules and temazepam elixir.

The effect of temazepam as a hypnotic was assessed with two different formulations, the solution-filled soft gelatin capsule and the more recently introduced elixir. Sixty psychiatric in-patients were included in the trial and 59 completed it. The study followed a double-blind crossover design for two consecutive nights. Patients took a capsule and elixir each night, but only one would contain the active ingredient (in a dose of 20 mg temazepam). In contrast to earlier work with volunteers, the elixir failed to reveal more of the characteristics of an ideal hypnotic. In fact, in those measures that were statistically significant, the balance favoured the capsule. We conclude that although there are many situations where an elixir is clearly clinically preferable, the essential hypnotic effect of the elixir is not conspicuously different to that of the capsule.

Adolescent↗
PubMed1990

Insight.

Explore the source record for details and available documents.

Cognition↗
PubMed1990

Combination tricyclic antidepressant and lithium maintenance medication in unipolar and bipolar depressed patients.

In a small study of up to 3 years' duration comparison of the value of amitriptyline alone versus amitriptyline + lithium in unipolar cases (27 patients) and of that of lithium alone versus amitriptyline + lithium in bipolar cases (13 patients) showed no advantage for the combination treatments in terms of efficacy in reducing depressive relapses. There was no effect of treatment, developing depression or developing hypothyroidism upon the psychological tests which were conducted during this prolonged study. Observer and self ratings detected an increase in depression before relapse was clearly present, but of the various psychological assessments conducted only arousal showed changes in association with developing and definite relapse. The prescription of lithium but not amitriptyline + lithium or amitriptyline alone was associated with significant increases in blood pressure.

Adult↗
PubMed1990

Evaluation of the treatment of intestinal helminthiases with albendazole in Djohong (North Cameroon).

246 inhabitants of Djohong, a township located in North-east Cameroon, presented with single or mixed nematode infections. They were treated by 400 mg albendazole in a single dose. The results were evaluated either with the Kato thick-smear technique and the Ritchie technique on stools and/or the Graham test: albendazole has proved to be 100% efficacious in pinworm and roundworm treatment, 63% to 84% in hookworm treatment (difference due to the type of technique used). Albendazole showed a mean efficacy in whipworm treatment (about 50% cure rate). In case of residual worm infection, the egg count is reduced from 80% to 90% which is of the utmost importance. The relative treatment failures occurring with large worm load. This systematic treatment of a whole population considerably reduces the spread of nematode eggs over the soil (18-fold for Nector americanus, 10-fold for Trichuris trichiura). This broad spectrum anthelmintic is strongly recommended in mass treatments for its efficacy and excellent tolerance, as its ovicide action reduces the probability of fecal pollution of the environment by treated patients who have residual parasites.

Adolescent↗
PubMed1989

Small intestine permeability in schizophrenia.

Gastrointestinal permeability was assessed by means of absorption of 51Cr-labelled EDTA in 24 patients with schizophrenia (12 in relapse and 12 in remission). The results were compared with those for patients with coeliac disease and those for normal controls. Significant differences between the schizophrenic patients and the normal controls were not established. The results for the schizophrenic patients in remission were no different from those for the patients in relapse, and there was no evidence from the study of an effect on gastrointestinal permeability of either anticholinergic or antidepressant medication. It is concluded that schizophrenia is, at least in the majority of cases, unrelated to coeliac disease.

Adolescent↗
PubMed1989

Pitfalls in assessing efficacy and side-effects of antidepressants.

Pitfalls in designing studies to test efficacy of new antidepressants occur in a number of different areas, including the criteria used for selecting patients, the choice of rating instruments for the assessment of severity, the length of treatment and the size of the study. Similarly there are pitfalls in the assessment of the side-effects of a compound. The paper considers each of these pitfalls and also the assessment of risk of adverse drug reactions.

Antidepressive Agents↗
PubMed1989

[Halofantrine in the treatment of malaria. Clinical trial in a semi-rural zone of Cameroon].

Twelve children, 2 to 15 years of age, with falciparum malaria (parasitaemia 4,500 to 170,000/mm3) have taken 24 mg/kg body weight of halofantrine hydrochloride (Halfan) per os in three divided doses given within 12 hours. The symptomatology improved after 24 to 48 hours, with no more fever 5 to 90 hours after treatment and with a decrease of splenomegaly in 80% of the cases. The parasitic clearance was obtained after 24 to 60 hours. The haematocrit started raising again in 58% of the cases. Halofantrine hydrochloride is an efficient antimalarial drug in semi-immune patients. It is well tolerated and well accepted, thus representing an alternative for the cure of chloroquine-resistant falciparum malaria.

Adolescent↗
PubMed1987

Paranoid psychoses after abuse of proprietary cold remedies.

It is well established that psychosis may arise in the context of the abuse of certain prescribed or illicit drugs. Two cases of paranoid psychosis are described in which proprietary preparations containing amphetamine-like drugs were abused. The role of these drugs is discussed with reference to previous case reports, and it is emphasised that initial clinical assessment and urinary screening for drugs may fail to reveal the relevant history with respect to proprietary medicines.

Ephedrine↗