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Biomedical subjects

R C Smith

Publications and source records attributed to R C Smith.

At least 343 records · Page 19Linked to original sources
PubMed1980

Controlled trial of intravenous hyperalimentation and total bowel rest as an adjunct to the routine therapy of acute colitis.

Thirty-six patients (27 with ulcerative colitis and 9 with Crohn's disease) completed a prospective controlled therapeutic trial of intravenous hyperalimentation (IVH) and total bowel rest in acute colitis. All patients received prednisone 40 mg/day which was reduced every 3 days or more depending on the response to treatment. The trial was completed either when the prednisone was reduced to 10 mg/day or when the patient came to colectomy. In the control group (5 males, 12 females; mean age 44.7 yr), 6 came to surgery and 11 responded medically in a mean time of 23.7 days. In the IVH group (8 males, 11 females; mean age 37.4 yr) 9 came to surgery and 10 responded medically in a mean time of 21.2 days. The results of this trial show that IVH with total bowel rest has no primary therapeutic effect in acute colitis.

Acute Disease↗
PubMed1980

Cardiovascular effects of therapeutic doses of tricyclic antidepressants: importance of blood level monitoring.

The cardiovascular effects of therapeutic doses of tricyclic antidepressants are reviewed and their clinical significance discussed. At standard therapeutic doses these antidepressant drugs produced small changes in heart rate and several intervals of the EKG in some patients, but clinically significant effects on the EKG are usually seen only in patients with high blood levels of the drugs; these high plasma levels are often above those needed for therapeutic antidepressant effects. In contrast, the orthostatic hypotension induced by antidepressants usually occurs at dosages and blood levels within the therapeutic range, and, therefore, this side-effect may be of greater clinical significance in standard clinical treatment with antidepressants. A review of recent studies suggest that adequate doses of antidepressants may be used safely in geriatric depressed patients and in many patients with stable preexisting cardiac disease. However, more frequent monitoring of plasma levels of antidepressants and EKGs may be particularly important in these groups of patients.

Adult↗
PubMed1979

Behavioral evidence for supersensitivity after chronic bromocriptine administration.

Behavioral evidence for tolerance and supersensitivity during and after chronic (30 day) administration of bromocriptine (BRC) or bromocriptine + L-dopa in mice was assessed by measuring wheel running (WR) behavior during and after chronic drug administration, and apomorphine- and methylphenidate-(MP-)induced stereotyped gnawing after termination of chronic injections. In both BRC and BRC + L-dopa groups, tolerance developed fairly quickly to the depressing effect of BRC on WR seen on day 1 of drug administration. Mice receiving BRC showed significant increases in WR by week 2 of chronic drug administration, which persisted for at least two days after the termination of chronic injections. During the first week after termination of chronic injections, low doses of both apomorphine and MP induced significantly more stereotyped gnawing in BRC and BRC + L-dopa mice than in the control mice or the mice treated with L-dopa alone. This behavioral evidence for dopaminergic supersensitivity after chronic BRC administration may have relevance for the clinical use of BRC in combination with L-dopa or other dopamine agonists.

Animals↗
PubMed1979

Suspending sutures in blepharoplasty.

Lateral canthopexy using permanent suspending sutures to shorten the lateral canthal tendon helps prevent scleral show, increased sloping of the upper lid, and inferomedial displacement of the lateral canthus following lower lid blepharoplasty. While these complications usually are prevented by flap suspension techniques, in which more skin is excised above and lateral to the commissure than below it, sutures running from the inferomedial part of the lateral canthal tendon to its superolateral aspect and to periosteum just inside the orbit still further reduce the tendency toward the complications mentioned. We report technical aspects and results. After several years of clinical experience, we have the impression that the technique is a useful adjunct, even though it may produce more swelling and inflammation and a longer recuperative period.

Eyelids↗
PubMed1979

Blood levels of neuroleptic drugs in nonresponding chronic schizophrenic patients.

Blood levels of butaperazine were measured in schizophrenic patients who were chronic nonresponders to their psychotropic medication. The blood levels were compared with those in patients who had shown a better clinical response to this neuroleptic. Nonresponders had two to seven times lower levels of butaperazine in plasma and RBCs after a single dose or chronic dosing. Some of the patients later treated with thioridazine or haloperidol had lower plasma levels of these neuroleptics also. No significant differences were found between nonresponders and relative responders in either the alpha- or beta-phase half-life of butaperazine in plasma and RBCs after administration of a single dose of the drug. Butaperazine and thioridazine levels were not related to previously administered amounts of neuroleptic drugs. These findings do not support the hypothesis that low blood levels are the result of faster systemic metabolism of the drug after it reaches the central circulation. Our results suggest that low blood levels of neuroleptics may be one important factor in the poor clinical response of some chronic schizophrenic patients.

Adult↗
PubMed1979

Multi-element analysis of the living body by neutron activation analysis-application to critically ill patients receiving intravenous nutrition.

Neutron activation analysis has been used to determine the total content in the body of N, K, Na, Cl, P and Ca in 25 critically ill surgical patients before and after a 14-day course of intravenous nutrition. Muscle elemental composition was also determined in these patients at the same time as the total body analysis. Over the 14-day period of intravenous feeding the total body contents of all the measured elements increased (2-9.7 per cent) but only the increase in K was statistically significant. Muscle chemistry suggested an intracellular K depletion which was corrected over the study period. The results of the total body multi-element analysis were interpreted to show a mean gain of 1.25 l of extracellular fluid and 0.51 l of intracellular fluid and direct measurement of total body water suggested that this interpretation was probably valid. The first application of the technique to patients with nutritional and metabolic problems has quantified the weight gained by two body compartments during a 2-week period of intravenous nutrition. Its further application should help to solve a number of nutritional and metabolic problems in clinical surgery.

Adult↗
PubMed1979

Plastic surgical education for the otolaryngologist.

Otolaryngology shares responsibility for provision of plastic surgical services involving facial and cervical structures, but many training programs have been weak in this part of the specialty. Some still are. Beginning in 1963 when a national organization was formed, leading facial plastic surgeons and the senior author analyzed the weaknesses and embarked on a program to correct these educational deficits. There was widespread lack of surgical background, woefully inadequate knowledge of soft tissue techniques, and poor understanding of dynamics involved in cosmetic procedures. Annual meetings, international symposia, numerous courses, and extensive videotape and microfiche production, as well as political and academic recognition, have all helped plastic surgical teaching endeavors at both residency and postgraduate levels. However, much remains to be done. Program directors are the "key" people here. Suggestions for future action are presented.

Humans↗
PubMed1979

Relationship of butaperazine blood levels to plasma prolactin in chronic schizophrenic patients.

The relationship of plasma prolactin to plasma or red blood cell butaperazine levels was investigated in chronic schizophrenic patients treated with clinical doses of butaperazine, both after a single acute dose of the drug and during regular, twice daily butaperazine administration. Although there was a significant curvilinear relationship between peak plasma butaperazine levels after an acute single oral dose of butaperazine and the maximum prolactin response that we measured, steady-state levels of plasma or red cell butaperazine and plasma prolactin were not related. We conclude that plasma prolactin cannot be used as a substitute for or even as a rough indicator of butaperazine blood levels in chronic schizophrenic patients being treated with clinical doses of butaperazine.

Adult↗