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Biomedical subjects

S R Hirsch

Publications and source records attributed to S R Hirsch.

At least 91 records · Page 5Linked to original sources
PubMed1981

"Revealed" Depression and drug treatment for schizophrenia.

Symptoms of depression are common in patients who have been treated for schizophrenia. Various concepts have been proposed to explain the relationship between depression and schizophrenia. Data for schizophrenic patients in prospective studies and a comparison group of depressives show that depressive symptoms are more prevalent during the acute phase of the illness and they decrease (rather than increase) in severity with effective neuroleptic treatment.

Antipsychotic Agents↗
PubMed1981

Rinkel injection therapy: a multicenter controlled study.

The American Academy of Allergy sponsored a 2-yr "double blind" multicenter study of the effect of Rinkel injection therapy (RIT) compared with a histamine placebo in subjects with atopic rhinitis. Accumulated data included the symptom, medication, and physical examination scores and specific IgE antibody levels measured by the radioallergosorbent test (RAST). A total of 155 subjects (81 treated, 74 placebo) entered the project from six centers during their respective ragweed, grass, and mountain cedar pollen (from one center) seasons for a total of 11 pollen seasons. The total mean cumulative dose of extract was 18.6 PNU, which is much lower than recommended for standard immunotherapy. With one exception, none of the centers reported a consistent significant difference between the pollen extract-treated and placebo-treated groups in any of the weekly mean scores or the RAST before, during, and after the pollen seasons. For 4 wk after the height of the mountain cedar season the group treated with pollen extract showed a significant decrease in weekly mean symptom and medication scores as compared with the placebo group. The overall comparison of the mean seasonal scores for the entire study, however, showed no significant difference between the treated and placebo groups. We conclude the RIT is no more effective than a histamine placebo in influencing the weekly mean symptom, medication, and physical examination scores or IgE antibody levels.

Adolescent↗
PubMed1981

DL-propranolol and chlorpromazine following admission for schizophrenia. A controlled comparison.

Similar improvement followed when propranolol and chlorpromazine were randomly used as the first drug after admission. Forty-six patients with florid symptoms of schizophrenia were assigned at random to have either racemic propranolol (24) or chlorpromazine (22). Each individual's drug was adjusted to an optimal dose, and the progress of the groups was followed for 12 weeks. Thirty-five patients remained in the study for 6 weeks, and 27 for 12 weeks. By weeks 6 and 12 the total schizophrenia scores on a modified Brief Psychiatric Rating Scale had improved significantly when the results from both groups were combined. The numbers leaving the study, and the amount and rate of improvement, were similar for both groups, but with a possible advantage to chlorpromazine. Side-effects, which usually were mild, were commoner in the chlorpromazine group.

Adult↗
PubMed1981

Effects of brief hospitalization on psychiatric patients' behaviour and social functioning.

224 newly admitted inpatients were randomly allocated to two treatment groups: standard care (length of stay determined by the clinical team) and brief care (acute treatment aimed at effecting the patient's discharge after about a week). Using a new research instrument (the Patient Behaviour Assessment Schedule), information was gathered from the patient's closest relative or friend on a subsample of 99 patients (the "target group"), which actually showed shortened length of hospitalization for brief care patients. There were no significant differences between groups at the two follow-up evaluations on measures of behavioural disturbances and limited social functioning. Results for the whole "target" group reveal that although there was significant improvement in both behaviour and social functioning 2 weeks after admission, there was little subsequent change thereafter. Overall, individual patients demonstrated more improvement in behavioural disturbance than in social functioning at the follow-up interview.

Adult↗
PubMed1980

Intact antibody response to pneumococcal capsular polysaccharides in uremia and diabetes.

To test their immune responsiveness to pneumococcal polysaccharide antigens, eight azotemic patients, ten dialysis patients, and five insulin-dependent diabetics were vaccinated with a 14-valent vaccine. When compared with nonazotemic, nondiabetic control subjects, both diabetics and uremic patients responded with normal antibody titers to each antigen type. Therefore, we are advising immunization with commercially available vaccine in our patients with diabetes, renal failure, or both, although long-term efficacy has yet to be proved.

Adult↗
PubMed1980

Existence of basophil chemotaxis in subjects with hay fever.

From an earlier study we proposed that the relative peripheral basophilia of subjects with symptomatic hay fever might be associated with a basophil chemotactic factor in the serum. Six subjects with symptomatic hay fever and six nonallergic subjects were tested for basophil chemotaxis (BC) weekly during and after the hay fever season. Cells of the allergic subjects with autologous serum showed significantly more BC than with control serum during the symptomatic weeks. After they hay fever season there was no difference in BC between the allergic and nonallergic groups. We conclude that there is a BC factor(s) in the serum of symptomatic subjects with hay fever which requires basophils from symptomatic subjects to be demonstrable.

Basophils↗
PubMed1980

Caution and conservatism in the use of a psychiatric day hospital: evidence from a research project that failed.

A randomized trial to evaluate day hospital care as an alternative to inpatient treatment in the acute phase of psychiatric illness was abandoned when too few patients were admitted to the trial to enable any valid generalization to be made concerning the total at-risk population. In accounting for the failure of the experimental design, attention is drawn to the inability of the research team to influence either the organization of the unit, whereby junior staff had no contact with the day hospital, or the prevailing belief among senior staff that the two treatment settings serve distinctive, not alternative, functions. The implications of our failure for the feasibility of conducting a successful and externally valid controlled trial in this research setting are explored.

Clinical Trials as Topic↗
PubMed1980

EEG spectral analysis in schizophrenia.

Four channels of EEG (T4-T6, P4-02, T3-T5, P3-01) were recorded from several groups of control subjects and schizophrenia patients on analogue tape. They were later digitized and analysed by computer; power spectra were computed for 30 second epochs of EEG per channel; eyes closed, eyes open. No difference between normal controls and neurotic in-patients was apparent. An acute schizophrenic group had less alpha power, this change being confined largely to the temporal areas. A chronic outpatient sample showed less alpha and beta power, while chronic long-stay schizophrenic patients had an excess of delta power. The changes in both chronic patient groups were diffuse rather than local.

Acute Disease↗
PubMed1980

Clinical change as a function of brief admission to hospital in a controlled study using the present state examination.

A randomized controlled trial of brief hospital admission failed to show any difference on clinical measures when compared with standard admission for all psychiatric patients admitted from a catchment area over one year. Psychotic and neurotic symptoms were examined separately and together, using the Present State Examination (PSE) a week after admission and three months later. Clinical outcome was not related to length of stay in hospital or psychiatric diagnosis. This study shows how the PSE can be used to measure change in clinical state for a heterogenous group of psychiatric patients.

Clinical Trials as Topic↗
PubMed1979

Shortening hospital stay for psychiatric care: effect on patients and their families.

A one-year cohort of patients from a defined catchment area with acute functional disorders were allocated at random to brief care (experimental group) or standard care (control group) in hospital to examine the effect of shortening hospital stay on the clinical and social functioning of patients and the distress abnormal functioning caused to others. A total of 127 patients were interviewed on entry to the study, and 106 were followed up. The brief care group had significantly shorter mean and median lengths of stay than the control group, but there was no difference between the groups in the number of days spent in hospital during subsequent admissions. The groups were well matched for clinical and social variables. Rates of improvement over 13 weeks were essentially the same by all measures of outcome, including the Present State Examination and Patient's Behaviour Assessment Scale, which was developed for the study to measure deterioration in behaviour and social functioning and adverse effects and distress on others. There was no difference between the two groups in burden to the community supporting services, social security requirements, or GP attendances. Improvement rates were nearly identical on all measures within and across diagnostic subgroups. Brief care resulted in a 33% reduction in average length of stay compared with the year before but was associated with a corresponding increase in day hospital use. The short-stay policy continued the year after the study finished.The findings confirm the value of shortening hospital stay and improving day care facilities for most localities.

Attitude↗
PubMed1979

Psychiatric symptoms in self-poisoning patients.

Self-poisoning patients admitted to hospital were studied for persistence of psychiatric symptoms over a 3-month period and evaluated at 3 points in time with the General Health Questionnaire and the Present State Examination. Symptoms were identified which had a high or low prevalence at 3-month follow-up. GHQ and PSE scores correlated at 0.8. The implications of the study are discussed, particularly the earlier need for out-patient help in those who had a moderate or high number of symptoms at initial interview.

Adult↗