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Biomedical subjects

R N Golden

Publications and source records attributed to R N Golden.

104 records · Page 6Linked to original sources
PubMed1984

Second-generation antidepressants.

The host of newly developed antidepressant drugs offer important clinical advantages to some patients, although their promises of improved therapeutic efficacy and reduced adverse effects compared with conventional treatments are not fully realized. Increased biochemical specificity and unique mechanistic or clinical profiles render these compounds valuable in research into the pathophysiology of affective disorders and mode of action of antidepressant agents.

Alprazolam↗
PubMed1983

New developments in pediatric psychopharmacology.

This is a report on recent developments in pediatric psychopharmacology: new drugs and new applications for established drugs. The drugs reviewed include imipramine, amitryptiline, lithium, piracetam, propranolol, tryptophan, clonidine, pyridoxine and fenfluramine. Putative indications include prepubertal depression, school phobia, anorexia nervosa, explosive-aggressive behavior, learning disabilities, attention deficit disorder (hyperactivity), Tourette's syndrome, autism, and the Lesch-Nyhan syndrome. Some of the information presented in this report must be regarded as "preliminary," and caution is advised in its interpretation and application.

Adolescent↗
PubMed1983

Doxepin and tinnitus.

A 66-year-old woman had tinnitus while receiving a conventional dose of doxepin. The tinnitus disappeared when the doxepin was discontinued, and returned when the patient was rechallenged with the drug.

Aged↗
PubMed1983

Organic psychosis without anemia or spinal cord symptoms in patients with vitamin B12 deficiency.

The authors describe two patients with organic psychosis who had vitamin B12 deficiency and no hematologic or spinal cord abnormalities. They review the literature that supports a causal relationship between B12 deficiency and cerebral dysfunction, as measured by the EEG, and consequent organic mental changes. The authors cite evidence that these EEG and organic mental changes are reversible with B12 replacement. They emphasize that psychiatric manifestations may be the first symptoms of vitamin B12 deficiency and thus antedate anemia and spinal cord disease. They recommend consideration of B12 deficiency and serum B12 determinations in all patients with organic mental symptoms.

Anemia, Pernicious↗
PubMedDate not supplied

Depression in the medically ill: management considerations.

This article reviews the management of depression in three medical conditions associated with a high frequency of depression: coronary artery disease (CAD), cancer, and human immunodeficiency virus (HIV) infection. Major depression significantly increases mortality in patients with CAD. This effect of depression may be mediated by a decrease in heart rate variability. Tricyclic antidepressants (TCAs) possess Type 1A antiarrhythmic activity, which may increase the risk of sudden death. Initial data suggest that tricyclic antidepressants also may decrease heart rate variability. Antidepressant therapy is effective and can improve quality of life for patients with cancer or HIV infection. Strong social support or psychosocial interventions that improve coping skills may positively affect outcome in HIV infection and cancer. Selective serotonin reuptake inhibitors (SSRIs) and new agents may be well suited for use in depressed patients with medical illnesses because they lack the significant adverse anticholinergic and cardiovascular effects of TCAs and other classes of antidepressants.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Treatment of depression in cancer patients is associated with better life adaptation: a pilot study.

Major depression occurs in a significant number of cancer patients, and there is evidence that cancer patients with depression do not receive adequate antidepressant treatment. In an uncontrolled pilot study, the authors assess the degree of depression and the quality of life after the initiation of antidepressant medication treatment in 12 depressed cancer patients who received adequate antidepressant drugs and in 10 depressed cancer patients who received inadequate antidepressant treatment. These preliminary findings suggest that cancer patients with major depression benefit from antidepressant medication treatment and may experience an improved psychosocial adjustment to cancer. Controlled clinical trials will be necessary to verify these preliminary findings.

Adaptation, Psychological↗
PubMedDate not supplied

Heart rate variability in patients with coronary artery disease: differences in patients with higher and lower depression scores.

OBJECTIVE: This study tested the hypothesis that coronary artery disease patients with higher depression scores have lower heart rate variability during daily life. METHOD: Thirty-three men and nine women, ranging in age from 46 to 79, with coronary artery disease and exercise-induced ischemia were studied. The standard deviation of normal R-R intervals (SDNN) and average heart rate were obtained from 24-hour ambulatory electrocardiographic monitoring. Patients were grouped by a median split of the Minnesota Multiphasic Personality Inventory (MMPI-D) score. RESULTS: SDNN was lower (p = .009) and average heart rate was higher (p = .003) in patients with higher depression scores. These relationships remained substantially unaltered after statistically adjusting for the only demographic/clinical factor that varied between the groups: gender. CONCLUSIONS: In comparison to the lower depression score group, those with higher depression scores had lower heart rate variability during daily life. These findings may be related to the reported relationship between depression and survival risk in patients with coronary artery disease.

Arousal↗
PubMedDate not supplied

Progression to AIDS: the effects of stress, depressive symptoms, and social support.

OBJECTIVE: We examined the effects of stress, depressive symptoms, and social support on the progression of HIV infection. METHODS: Eighty-two HIV-infected gay men without symptoms or AIDS at baseline were followed up every 6 months for up to 5.5 years. Men were recruited from rural and urban areas in North Carolina as part of the Coping in Health and Illness Project. Disease progression was defined using criteria for AIDS (CD4+ lymphocyte count of <200/microl and/or an AIDS-indicator condition). RESULTS: We used Cox regression models with time-dependent covariates, adjusting for age, education, race, baseline CD4+ count, tobacco use, and number of antiretroviral medications. Faster progression to AIDS was associated with more cumulative stressful life events (p = .002), more cumulative depressive symptoms (p = .008), and less cumulative social support (p = .0002). When all three variables were analyzed together, stress and social support remained significant in the model. At 5.5 years, the probability of getting AIDS was about two to three times as high among those above the median on stress or below the median on social support compared with those below the median on stress or above the median on support, respectively. CONCLUSIONS: These data are among the first to demonstrate that more stress and less social support may accelerate the course of HIV disease progression. Additional study will be necessary to elucidate the mechanisms that underlie these relationships and to determine whether interventions that address stress and social support can alter the course of HIV infection.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

Peripherally inserted central catheter placement in swine using magnet detection.

Positioning a PICC in the lower half of the superior vena cava is a crucial aspect of its safety and efficacy. A magnet detection system evaluated in this animal study presents a method that allows PICC placements to be performed without fluoroscopy. Forty-four localizations were studied in six pigs. The detection system located magnet-tagged PICCs with an average error of 0.40 cm and a standard deviation of 0.29 cm. The system provided real-time information about the path and orientation of the PICC tip during difficult insertions. This study demonstrates the accuracy of this magnet location system.

Animals↗
PubMedDate not supplied

Magnetic detection to position human nasogastric tubes.

Placement of nasogastric tubes is one of the most commonly performed diagnostic and therapeutic medical procedures. Proper placement of the tube in the digestive tract below the diaphragm is crucial for efficacy and safety. This study evaluates a magnet detection system that allows percutaneous non-radiographic localization of the nasogastric tube tip. Each volunteer subject had the magnet detector placed over the abdomen, and was then intubated with a magnet-tagged nasogastric tube. Eighty-eight nasogastric tube placements were performed in 22 volunteers. The detection system located the nasogastric tube tip below the diaphragm in all 88 placements. Location in all attempts was confirmed by fluoroscopy. This method of correctly locating the tip of nasogastric tubes may obviate the need for radiographic imaging in most cases.

Adult↗
PubMedDate not supplied

Neuroendocrine responsivity to monoaminergic system probes in generalized social phobia.

We examined neuroendocrine correlates of central monoamine function in patients with the generalized type of social phobia compared to healthy volunteers in order to test hypotheses of dopaminergic, noradrenergic, and/or serotonergic dysregulation in patients with this disorder. A double-blind, placebo-controlled, neuropharmacological challenge study was performed using probes for the serotonergic (fenfluramine), dopaminergic (levodopa), and noradrenergic (clonidine) systems. Twenty-one patients with DSM-III-R social phobia (generalized type) and 22 "never mentally ill" volunteers participated in the study after providing informed consent. Patients with social phobia had an augmented cortisol response to fenfluramine administration compared to the volunteers. In contrast, we found that neither the prolactin response to fenfluramine, the growth hormone or norepinephrine response to clonidine, nor the prolactin or eye-blink responses to levodopa, differed between patients with social phobia and healthy volunteers. The findings suggest that patients with social phobia may exhibit selective supersensitivity of serotonergic systems, but that dopaminergic and noradrenergic function appear normal. Further challenge studies with more specific serotonin probes before and after treatment may assist in the clarification of the pathophysiology of social phobia.

Adrenergic alpha-Agonists↗