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Biomedical subjects

R A Sweet

Publications and source records attributed to R A Sweet.

62 records · Page 4Linked to original sources
PubMed1978

Fluorescent thyroid scanning. A method based on stable iodine measurements.

Analysis by x-ray fluorescence allows in vitro determination of iodine content of the thyroid gland and a mapping of the regional distribution of iodine in the gland. The picture produced is similar to that of the conventional radioisotope thyroid scan. In 5 normal subjects and 70 patients with thyroid disease, the thyroid concentration of iodine varied between undetectable and 28 mg. With the exception of hypothyroid patients, who showed low thyroid levels of iodine, all patients showed iodine values overlapping the normal range. The fluorescent scan gave results similar to those of the isotope scan in most cases. Exceptions were noted in some hypothyroid patients, patients with flooded iodine pool, and patients receiving suppressive doses of exogenous thyroid hormone. Small cold nodules were best detected by the radionuclide scintigram. The value of the fluorescent scan is in its low radiation dose and in the possibility it affords of studying patients whose thyroid glands have reduced uptake of the radioactive tracer.

Americium↗
PubMedDate not supplied

Dyskinesia and neuroleptic exposure in elderly psychiatric inpatients.

A wide variation in prevalence rates of tardive dyskinesia and spontaneous orofacial dyskinesia has been reported in the elderly. To clarify these discrepancies, we studied 45 patients over the age of 60 years admitted to a short-term psychiatric unit. Standardized criteria for the diagnosis of dyskinesia were used. We found a rate of tardive dyskinesia of only 21% (7/33) in our patients having a history of neuroleptic exposure. We found no cases (0/12) of spontaneous orofacial dyskinesia. There was a significant association between tardive dyskinesia and psychiatric diagnosis, with the highest rate of tardive dyskinesia in those patients with schizophrenic disorders, followed by those with organic disorders and mood disorders, respectively. There was also a significant association between the presence of tardive dyskinesia and radiographic evidence of cortical atrophy, and a trend towards an association with leukoencephalopathy. Our results suggest that published rates of tardive and spontaneous dyskinesia in the elderly may overestimate the prevalence of these disorders, especially among geriatric patients with acute psychiatric presentations.

Aged↗
PubMedDate not supplied

Early detection of neuroleptic-induced parkinsonism in elderly patients with dementia.

The recently promulgated Health Care Finance Administration guidelines regarding the use of neuroleptic medications for nursing home residents do not offer criteria for the frequency or nature of the required assessments of neuroleptic-induced parkinsonism (NIP). NIP has been poorly characterized in the elderly and empirical evidence on which to base guidelines for monitoring NIP is sparse. We examined the onset of NIP in 12 closely monitored, elderly psychiatric inpatients diagnosed with dementia being treated with perphenazine. Significant increases in the Simpson Extrapyramidal Side Effect Scale total score were detected by day 4 of treatment with perphenazine at a mean dose of 8.0 mg. This increase was highly correlated with the final NIP severity. This is the first report to demonstrate that routine screening of elderly patients can detect NIP within days of the initiation of neuroleptic treatment. Early detection of NIP may allow for effective intervention to reduce the ultimate severity and associated morbidity of NIP.

Age Factors↗
PubMedDate not supplied

Neuroleptics in the elderly: guidelines for monitoring.

The Nursing Home Reform Amendments of the Omnibus Reconciliation Act of 1987 provided guidelines for the use of neuroleptic medications in nursing home patients. Although the guidelines have been successful in reducing the inappropriate use of such drugs in this population, neuroleptics remain indicated in the treatment of many elderly patients. For these patients the new regulations also specified maximum daily neuroleptic doses, and they mandated monitoring for neuroleptic-induced movement disorders, although they did not provide guidelines for such monitoring. We review the existing empirical data base in an effort to refine the recommendations for neuroleptic dosage limits and to derive standards for the monitoring of neuroleptic-induced movement disorders in the elderly.

Aged↗