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Biomedical subjects

R C Hall

Publications and source records attributed to R C Hall.

At least 145 records · Page 8Linked to original sources
PubMed1978

Single case study. A novel psychiatric adjunct to cancer therapy.

Confronted with the hazards of a patient unable to cooperate predictably with a 3-day radium implantation procedure as a part of cancer therapy, the authors describe in a case report their solution to an unusual clinical dilemma. The patient displayed adverse responses to psychotropics and nursing care was markedly restricted by radiation exposure limits. Behavioral management of the patient through the interval of radium therapy was successfully effected by the use of closed-circuit television monitoring combined with brief nursing interventions. This novel psychiatric adjunct to cancer therapy averted the threat posed by displacement of the radium implants.

Aged↗
PubMed1978

Covert outpatient drug abuse. Incidence and therapist recognition.

One hundred ninety-five consecutive psychiatric outpatients were surveyed for covert drug abuse by a standardized technique for determining opiates, cocaine, barbiturates, and amphetamines in urine samples. On the basis of demographic variables, diagnostic information, and treatment course, patterns of abuse were defined for the 13.3 per cent with positive test results. Covert abusers demonstrated a higher incidence of adverse drug reactions and a less favorable therapy course than controls. Covert abuse was meaningfuly related to misdiagnosis, management problems, and therapist's response. Demographic variables and patient reports of previous abuse were not found to be reliable predicators of covert drug abuse. Urine screening for drug use is recommended as an aid to proper diagnosis of psychiatric outpatients that present diagnostic questions.

Adolescent↗
PubMed1978

Experimental and clinical trials of new 99mTc-labeled hepatobiliary agents.

Several new derivatives of lidocaine were synthesized and used to examine the intra- and extrahepatic bile ducts and gallbladder. Diisopropyl-IDA exhibited approximately twice the bile concentration of 131I-rose bengal during the first hour after injection. P-butyl-IDA also concentrates moderately well in the bile and has the added advantage of very low excretion into the urine (2%). It seems more effective than the other IDA derivatives at high bilirubin levels.

Bile Ducts↗
PubMed1978

Drug use by the polysurgical patient.

The authors compared the drug use of 23 patients with 5 or more major surgeries (mean number of surgeries = 9.8) with that of a matched control group (mean number of surgeries = 1). Total drug use of the polysurgical patients was 3.7 times greater than that of the controls and involved narcotics, analgesics, barbiturates, and minor tranquilizers. The authors describe the characteristics of polysurgical patients, one of which is chronic pain, and propose a treatment plan that involves psychological intervention for the patient and his or her family.

Adult↗
PubMed1978

The benzodiazepines.

The benzodiazepines are remarkably effective anxiolytic drugs. However, they are prone to misuse by both physicians and patients. They should be used in clearly defined clinical situations for short periods, at the lowest possible dosages. Although rare, toxicity can be severe. These agents should be used with caution in persons likely to abuse medication, in the elderly, in patients with glaucoma and in patiens with known hepatic impairment. Sudden cessation may be followed by a withdrawal state.

Anti-Anxiety Agents↗
PubMed1978

Amobarbital treatment of multiple personality. Use of structured video tape interviews as a basis for intensive psychotherapy.

The case of a 30-year-old woman with five distinct personalities is presented. The patient was treated, using a system of structured video taped sodium amobarbital interviews, in which areas to be explored were developed in psychotherapy. Tapes were played for the patient after each session. The taped material was used as the basis for psychotherapeutic investigation. The patient evidenced many of the features previously reported in cases of multiple personality, specifically: being the product of an unwanted pregnancy in a repressively rigid family; emotional distancing by one parent; strong sibling rivalry with an adopted sib; family history of mental illness; a traumatic first sexual experience (rape); a marriage to a maladjusted individual in an attempt to escape the parental home; a high internalized standard of performance and an inability to display anger or negative feelings toward the parents. In the course of treatment, the patient's personalties fused and she was able to accept each component as part of herself. No further fragmentation has occurred during the year following discharge. The therapy technique minimized dependency, and the possiblity of addiction to amobarbital interviews permitted more active patient therapy involvement, and set clear-cut goals and expectations for improvement before further amobarbital interviews could be conducted.

Adult↗
PubMed1977

The effect of acetylcholine and dopamine on the caudate spindle in cats.

Electrocortical activity was reacorded in cats whose caudate nuclei were perfused and electrically stimulated using a push-pull cannula. Electric stimulation invariably induced spindles (10-14 Hz) in the ipsilateral frontal cortex. Perfusions of acetylcholine together with physostigmine reduced the number of spontaneous spindles, the response to electric stimulation and induced behavioural arousal. This effect was atropine-sensitive. Perfusions of dopamine with or without tranylcypromine had no significant effect on the number of spontaneous spindles or the response to electric stimulation. Injections of both acetylcholine and dopamine into the cuadate nucleus invariably induced spontaneous spindles and slow waves. The significance of acetylcholine and dopamine in the caudate nucleus intiating caudate spindles and their significance in controlling arousal is discussed.

Acetylcholine↗
PubMed1977

Angel's Trumpet psychosis: a central nervous system anticholinergic syndrome.

The authors warn physicians that intoxication by Angel's Trumpet (Datura sauveolens) is becoming more frequent due to its use by adolescents and young adults as a legal, readily available hallucinogen. Ingestion of Angel's Trumpet flowers or a tea brewed from them results in an alkaloid-induced central nervous system anticholinergic syndrome characterized by symptoms such as fever, delirium, hallucinations, agitation, and persistent memory disturbances. Severe intoxication may cause flaccid paralysis, convulsions, and death. Treatment with intravenous physostigmine reverses the toxic effects of Angel's Trumpet.

Acetylcholine↗
PubMed1977

The effect of unrecognized drug abuse on diagnosis and therapeutic outcome.

One-hundred and ninety-five consecutive psychiatric outpatients had urine sampled for the presence of opiates, cocaine, barbiturates, and amphetamines. All patients had demographic variables, diagnostic information, and treatment course analyzed in a blind fashion using preselected criteria. Patterns of abuse were defined for the 13.3% of the total sample who were covert abusers. An analysis of diagnostic accuracy for abusing and nonabusing populations indicated that covert abuse markedly distorted diagnosis and management. The study indicates that demographic variables and previous history were not reliable predicators of covert abuse. Drug abuse was a major factor in distorting the accuracy of diagnosis. Drug abusers were significantly less likely to improve with therapy than were nonabusers. Barbiturate abusers were most likely to suffer from adverse drug reactions. Urine screening for drugs was the single most valuable diagnostic tool and was felt to be indicated in all cases where diagnostic confusion was present. Therapists saw the covert abuser as sick out of proportion to their social behavior, were perplexed and frightened by these patients' dependency, and perceived them as too brittle for therapy. Therapists behaved very differently with these patients than with diagnostically matched controls. They misdiagnosed them four times more often, missed appointments with them seven times more often, and were ten times more likely to refer them to another therapist or agency. Therapist anxiety and "flight from therapy" with covertly abusing patients are discussed.

Adolescent↗
PubMed1977

An evaluation of 99mTc-labeled hepatobiliary agents.

Scintigraphic imaging of the hepatobiliary system has been significantly improved with the development of 99mTc-labeled compounds. Two of the most promising agents, pyridoxylideneglutamate and HIDA, each formed the basis for the development of a group of structural analogs. Condensation of pyridoxal with leucine and arginine (in place of glutamate) produced pyridoxylideneleucine and pyridoxylidenearginine. Since increasing the molecular weight and the lipid solubility of compounds tends to enhance their biliary excretion, several new IDA derivatives were synthesized by altering the lipophilic substituents on the ring of HIDA. The substitutions included ethyl and ethoxy groups as well as iodine. All compounds were compared with 131I-rose bengal using a baboon model that allowed blood, bile, and urine collection.

Acetanilides↗