Diagnosis and treating the depressed hemodialysis patient.
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Biomedical subjects
Publications and source records attributed to M Zetin.
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Sixteen chronic hemodialysis patients were enrolled in a double blind 13 week study of amitriptyline vs. placebo in non-crossover design. Patients receiving active drug reached therapeutic serum concentrations at doses of 50 to 200 mg/day, but antidepressant effect was not demonstrable. Patients receiving active drug had slightly greater fluctuation in weight pre- vs. Post-dialysis and had slightly greater postural hypotension post-dialysis than control patients. The trend in post-dialysis weight indicated gain in the active drug group and loss in the placebo group; this difference was highly statistically significant. Weight gain in depression and anorexia nervosa patients treated with amitriptyline is reviewed and it is suggested that amitriptyline may be a useful agent in stimulating appetite in other diseases also.
N. A. has been amnesic since 1960 when he sustained a penetrating stab wound to the region of the left dorsomedial thalamus. The amnesia occurs as a strikingly circumscribed disorder in an intelligent (IQ = 124) individual without other cognitive dysfunction. Here, we attempt to characterize the nature of this amnesic disorder as revealed in daily activities, conversations, and personality. These observations are considered in the context of current views about the nature of normal memory and its neurological foundations.
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The authors studied the effects of different sample handling techniques on 17 tricyclic plasma samples. They found that the samples were stable at room temperature for up to 3 days when kept in a glass tube sealed with Parafilm, but the samples were not stable when stored in a Vacutainer tube with the stopper in contact with the plasma.
The Rotter Inventory was used to assess external vs. internal locus of control in chronic hemodialysis patients. This measure of personality was correlated to psychological and physiologic measures of adaptation to hemodialysis. Patients with high external locus of control had poorer overall compliance with higher interdialytic weight gain, but did not show more psychological distress. Nurses Observation Scale for Inpatient Evaluation correlated negatively with mean K, mean P, Beck Depression rating, and duration of dialysis.
Medication compliance, knowledge of the disease process, attitudes toward treatment, and lifestyle adjustment were assessed in fifteen maintenance hemodialysis patients. Treatment implications are discussed.
Characteristics of the hyperactive child syndrome have been described extensively. More recently, reports have indicated that manifestation of the hyperactive child syndrome may persist into adulthood, both as a continuation of childhood symptoms and as psychopathologic entities. This study evaluated 100 adult psychiatric inpatient Veterans for self-report of symptoms of childhood and adulthood hyperactivity, attentional deficit, and impulsivity. Psychotic and non-psychotic psychiatric patients reported a significantly higher incidence of childhood hyperactive syndrome symptoms than did age and sex matched controls. In both childhood and adulthood, character disorder patients reported the highest incidence of target symptoms.
Ten male patients requiring maintenance hemodialysis were given zinc in the dialysate (400 micrograms/liter) or placebo in a double-blind crossover experiment. Sexual activity, depression ratings, and hematocrit were unchanged while subjective appreciation of food taste and smell was significantly less during zinc than placebo condition. No patients who were sexually inactive while receiving placebo became sexually active while receiving zinc.
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