Prostacyclin levels during orthotopic liver transplantation.
Explore the source record for details and available documents.
Biomarkers↗
Biomedical subjects
R Katz
Publications and source records attributed to R Katz.
Clinical predictors of treatment response in obsessive compulsive disorder: exploratory analyses from multicenter trials of clomipramine.
Two multicenter, double-blind trials were conducted in adults with DSM-III (American Psychiatric Association 1980) defined Obsessive Compulsive Disorder (OCD), comparing clomipramine (Anafranil, CMI) up to 300 mg daily with placebo. Of 519 patients evaluated, 260 received CMI for up to 10 weeks. More than half of the CMI treated patients were significantly improved, approximately 30 percent were minimally improved, and 15 percent showed no improvement after CMI treatment. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was used to assess treatment effects and attempts were made to correlate change in Y-BOCS score from baseline with a number of baseline characteristics, including age, sex, duration of OCD, baseline Y-BOCS score, baseline Hamilton Rating Scale for Depression (HAM-D) score, presence or absence of secondary depression, and predominance of obsessions or compulsions. Pearson and/or Spearman correlations failed to reveal any statistically significant correlations between outcome and any of the baseline characteristics studied. While the differences were not statistically significant, it did appear that male patients and patients with a longer duration of illness may be less likely to respond to CMI treatment; however, the overall conclusion from this analysis is that none of the variables studied is a reliable predictor of responses to treatment with CMI.
Adult↗
Safety of frequent high dose nebulized terbutaline in children with acute severe asthma.
Forty-four Pediatric Intensive Care Unit (PICU) admissions for acute severe asthma in 27 children between 8/80 and 10/86 were reviewed to determine the safety of prolonged administration of frequently nebulized terbutaline. The mean dose of nebulized terbutaline was 0.2 mg/kg/dose (range = 0.1 to 0.4 mg/kg/dose) given at a mean frequency of 2.4 +/- 1.2 hours. Seven patients received continuous nebulization at a dose of 0.4 +/- 0.2 mg/kg/h. All patients were placed on continuous cardiorespiratory monitoring. Emergency room therapy was determined by the primary emergency room physicians. Upon admission to the PICU, the mean +/- SD heart rate was 150 +/- 21 bpm and the respiratory rate was 44 +/- 16 bpm. After institution of therapy, these parameters decreased to a similar degree in parallel. The maximum decrease after 36 hours was 28% and 37% for heart rate and respiratory rate, respectively. No cardiac arrhythmias were noted. The initial PaCO2 upon admission to the PICU was 32 mm Hg (range = 24 to 44 mm Hg), the maximum decrease in PaCO2 generally occurred during the 6-hour to 12-hour time interval following admission. We conclude that frequent administration of high doses of nebulized terbutaline is safe in the management of acute severe childhood asthma even in the setting of prolonged administration to the hospitalized child.
Acute Disease↗
Pattern of projections of group I afferents from forearm muscles to motoneurones supplying biceps and triceps muscles in man.
1) Two independent methods were used, in man, to assess the modifications of the excitability of biceps and triceps brachii motoneurone pools following the stimulation of group I afferents coming from muscles acting at the wrist: a) the modifications of the excitability of a motoneuronal population were studied using a reflex technique, b) the modifications of the excitability of an isolated motor unit were estimated using a post-stimulus time histogram (p.s.t.h.) method. 2) The activation of group I afferents contained in the median nerve, originating from wrist flexors and pronators, resulted in a strong, short-latency facilitation of the biceps brachii motoneurones. A similar effect was also evoked by stimulation of group I afferents in the radial nerve, distally to the branch supplying the brachio-radialis muscle. The latency of both median and radial-induced facilitations is compatible with a monosynaptic linkage. 3) The stimulation of group I afferents in the median or the radial nerves produced inhibition of triceps motoneurones, with a latency compatible with a disynaptic linkage. 4) The prolonged vibration of the tendon of the flexor carpi radialis (FCR) or of the extensor carpi radialis (ECR) raised the threshold for both the facilitation of biceps and the inhibition of triceps motoneurones. The same pattern of excitatory and inhibitory convergence could also be obtained when the electrical conditioning stimulus to the median or radial nerves was replaced by a tap applied to the tendons of FCR or ECR respectively. Both results suggest that the conditioning fibres were Ia fibres. 5) The pattern of distribution of Ia afferents from muscles acting at the wrist onto motoneurones of muscles acting at the elbow has been compared to that described in the cat and monkey. A comparison has also been made between Ia connections of muscles acting at different joints in the upper and lower limb in man. The differences are discussed in relation to the manipulating capacity of the hand.
Action Potentials↗
Duodenal duplication cyst with enteroliths: computed tomography and ultrasound diagnosis.
A duodenal duplication cyst containing enteroliths in an adult patient is presented. The preoperative diagnosis was established by computed tomographic (CT) and ultrasound (US) examinations. To the best of our knowledge this is the first description of enteroliths in a duodenal duplication cyst.
Calculi↗
Short- and long-acting angiotensin-converting enzyme inhibitors: a randomized trial of lisinopril versus captopril in the treatment of congestive heart failure. The Multicenter Lisinopril-Captopril Congestive Heart Failure Study Group.
A randomized, parallel, double-blind study was performed with lisinopril, a long-acting angiotensin-converting enzyme inhibitor, versus captopril, a shorter-acting angiotensin-converting enzyme inhibitor, in the treatment of congestive heart failure. All patients were in New York Heart Association class II, III or IV and had remained symptomatic despite therapy with digoxin and diuretics. After a 4 to 14 day placebo baseline period, patients were randomized to receive either lisinopril, 5 mg orally once per day (n = 94), or captopril, 12.5 mg orally three times per day (n = 95), in addition to continuation of digoxin and diuretics. The dose of study drug could be doubled at 4 week intervals for a total of 12 weeks of double-blind therapy. The maximal dose was 20 mg once per day of lisinopril or 50 mg three times per day of captopril. The addition of either lisinopril or captopril to a regimen of diuretics or digoxin, or both, caused an increase in exercise duration as assessed on a motorized treadmill. When protocol violators were excluded, patients receiving lisinopril had a statistically greater increase in exercise duration than that of patients receiving captopril. In patients with renal impairment (serum creatinine greater than 1.6 mg/dl at baseline), lisinopril was superior to captopril in improving exercise duration. Lisinopril, but not captopril, increased left ventricular ejection fraction in patients with moderately to severely (less than 35%) decreased function (p less than 0.05). Improvement in functional capacity and quality of life, as assessed by the Yale Scale dyspnea/fatigue index, was significantly greater for the lisinopril group.(ABSTRACT TRUNCATED AT 250 WORDS)
Angiotensin-Converting Enzyme Inhibitors↗
The risk of minor depression before age 65: results from a community survey.
Data from a general population survey of psychiatric disorder in Camberwell were used to calculate the risk of a CATEGO-defined depressive episode before the age of 65, using a modification of Strömgren's method. Current depression was defined as cases within the relevant categories of the CATEGO program and at threshold level or above on the Index of Definition (Wing et al. 1978). A past history of depression was elicited using key symptoms such as persistent tearfulness and depressed mood, already enquired after in the course of the PSE, to identify potential episodes, followed by questions to determine accessory symptoms, duration, and degree of social impairment. Clinical judgement was then used to decide whether the disturbance constituted a significant depressive episode. Risk under one set of assumptions was 46% for men and 72% for women. Using another method based on (untenably) conservative assumptions, it became 16% and 30% respectively. The status and implications of these high values are discussed, particularly for genetic studies.
Adjustment Disorders↗
Oxiracetam in the treatment of multi-infarct dementia and primary degenerative dementia.
Oxiracetam is a recently synthesized nootropic that was tested as a potential treatment for cognitive decline in patients with multi-infarct dementia (MID) and primary degenerative dementia (PDD). Subjects were 34 MID patients and 39 PDD patients who met entrance criteria for the study. A repeated measures ANOVA showed significant improvement in both patients with MID and patients with PDD for word fluency. The total score on the Relatives' Assessment of Global Symptomatology-Elderly showed significant improvement for patients with PDD. The average score on the Instrumental Activities of Daily Living Scale, however, showed a significant decline for patients with PDD.
Activities of Daily Living↗
Maternal depression and the emotional development of the child.
Ninety-two women and their first-born children took part in a longitudinal survey of maternal mental health. When the children were four years old, their mothers were interviewed by means of the Behavioural Screening Questionnaire, and the children's problems were rated by a psychiatrist, who was unaware of the mothers' psychiatric histories or of assessments of their current health. As expected, mothers who were concurrently depressed reported significantly more behavioural difficulties in their children. Marital disharmony during pregnancy and a history of paternal psychiatric problems were also associated with later childhood behavioural difficulties. Children who scored below average on the McCarthy scales of cognitive abilities were also reported by their mothers to have more behavioural problems, but the children's behavioural difficulties at four showed no clear links with post-natal depression.
Adult↗
The genetics of depression and manic-depressive disorder.
Depressive disorders are more common in the relatives of depressed probands than in the population at large, and there is compelling evidence that the familial aggregation of bipolar disorder and severe unipolar depression is at least partly due to genetic factors. However, the evidence concerning 'non-endogenous' depression is less clear, and family environment probably plays a stronger role. Much current research is focused on two areas: firstly, the mode of inheritance of manic-depressive illness, with the use of molecular biological techniques to detect and localise major genes; and secondly, the ways in which familial predisposition and environmental insults combine to produce depressive disorder.
Adoption↗
Pyogenic thyroiditis due to branchial pouch sinus.
Suppurative thyroiditis due to branchial pouch sinus is a rare disease, affecting children and young adults. It presents as an abscess in the lower lateral neck, usually on the left side. Suppurative thyroiditis can be suggested by ultrasound, radionuclide scintigraphy or CT scan, but the diagnosis can only be established by barium swallow showing the sinus from the apex of the pyriform sinus to the perithyroid region. Complete surgical excision of the sinus is essential. Two patients are presented and the role of the various imaging modalities in the diagnosis is discussed.
Abscess↗
Antigen stimulated IgM secretion by circulating B lymphocytes in patients with benign and malignant IgG gammopathy. Relationship to stage of disease.
In the present investigation antigen-driven (sheep red blood cells, SRBC) IgM antibody secretion by B lymphocytes of 22 MM (IgG kappa) patients and 15 patients with IgG kappa monoclonal gammopathy of undetermined significance (MGUS) was studied and compared to that of 20 age-matched healthy controls and five patients with Waldenstrum (IgM) macroglobulinemia (WM). Antibody production by cultured lymphocytes of MM and WM patients was significantly decreased, whereas in MGUS patients it fell within normal limits. We could divide MM patients into three subsets: those who secrete normal amounts of IgM in vitro (patients with the stable type); a second subset of patients whose B lymphocytes secreted low amounts of IgM (MM patients in remission); and a third subset of patients who manifested an intrinsic block of B cell differentiation into IgM-secreting cells (patients with the progressive stage). Sephadex G-10 adherent suppressor cells had no effect on antibody production in the stable and progressive types of disease, whereas in the remission stage they markedly inhibited IgM secretion. Measurement of antigen-driven IgM antibody secretion might help in the differentiation of MGUS and stable (smouldering) MM from frank (progressive) MM at diagnosis. It may also provide a tool for monitoring progression of disease and response to therapy.
Aged↗
Humoral and cellular immune dysfunction in a patient with Bloom's syndrome and recurrent infections.
Immunological evaluation of a patient with Bloom's syndrome (BS) who suffered from recurrent bacterial and fungal infections, revealed low serum levels of IgG and high levels of IgM accompanied by an elevated proportion of surface membrane IgM positive B-lymphocytes and a decreased proportion of IgG positive B-cells. In vitro IgG secretion was also reduced whereas IgM production was normal. Although proportions of T-cell subsets were normal and proliferative responses to T-cell mitogens were adequate, a defective regulatory T-cell function for the generation of IgG was observed. Natural killer (NK) cell activity against K562 tumor cells was also decreased in this patient. The findings in this patient may suggest a maturation arrest of lymphocytes at an early developmental stage, and this may explain in part the increased susceptibility to infections.
Adolescent↗
Double-blind assessment of the value of magnetic resonance imaging in the diagnosis of anterior cruciate and meniscal lesions.
A prospective double-blind study was undertaken to evaluate the usefulness of magnetic resonance imaging in the accurate interpretation of pathological intra-articular changes in the knee. Forty-seven patients who were scheduled to have arthroscopy and three patients who wer to have arthrotomy volunteered for magnetic resonance imaging preoperatively. The radiologists had no clinical or roentgenographic information about the patients before the evaluation of the magnetic resonance images, and the radiologists' interpretations were unknown to the surgeon before the arthroscopy or arthrotomy was done. Our important observations were limited to the findings in the menisci and in the anterior cruciate ligament. Magnetic resonance imaging had a positive predictive value of 75 per cent, a negative predictive value of 90 per cent, a sensitivity of 83 per cent, and a specificity of 84 per cent for pathological findings in the menisci. For complete tears of the anterior cruciate ligament, the positive predictive value was 74 per cent; the negative predictive value, 70 per cent; the sensitivity, 61 per cent; and the specificity, 82 per cent. We believe that magnetic resonance imaging, when combined with clinical and roentgenographic examination, provides the most accurate non-invasive source of information that is currently available for pathological findings in the menisci and in the anterior cruciate ligament.
Adolescent↗
Preliminary results from a multicenter trial of clomipramine in obsessive-compulsive disorder.
Two multicenter, double-blind, placebo-controlled clinical trials were conducted to evaluate the effectiveness of 10 weeks of treatment with up to 300 mg daily of clomipramine in nondepressed patients with OCD. There were 575 patients enrolled in these clinical trials, and preliminary analyses of data from 384 of these patients demonstrate a virtual absence of placebo response, a very low rate of premature discontinuation, and for patients receiving clomipramine, a statistically and clinically significant improvement in OCD symptoms (40%-45% mean improvement with clomipramine vs. 4%-5% mean improvement with placebo). In general, clomipramine was well tolerated in doses of up to 300 mg daily.
Clinical Trials as Topic↗
Rebound withdrawal reactions due to clomipramine.
Explore the source record for details and available documents.
Adult↗
The genetics of depression: current approaches.
It is widely accepted that depression shows a tendency to run in families. This is partly due to genetic influences--and the subject has been covered in recent reviews. This article, therefore, does not aim to recapitulate the genetic evidence but rather aims to elucidate the mode of transmission, to achieve an understanding of relevant gene-environment co-actions and interactions, and to describe attempts to identify and localise major genes.
Bipolar Disorder↗