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Biomedical subjects

T L Thompson

Publications and source records attributed to T L Thompson.

At least 73 records · Page 4Linked to original sources
PubMed1986

Depression: medical interface with psychiatry and treatment advances.

A number of advances, primarily pharmacologic, have occurred in recent years in the treatment of depression. Some of the recent advances relating to neurotransmitters and other neuropsychiatric factors believed to be related to depression are discussed, including how antidepressants may affect these systems. Some more recently recognized or often overlooked side effects of antidepressants are also discussed, as well as differential side effect profiles. The second generation antidepressants are critiqued and are generally believed to be no better than many of the first generation antidepressants. The usefulness of and indications for tricyclic serum levels and standard neuroendocrine tests for depression are summarized. Recent findings regarding lithium, including augmentation, and monoamine oxidase inhibitors, especially for atypical depressions with panic symptoms, are included, as is the use of psychostimulants, especially for medically ill patients who cannot take other antidepressants.

Adult↗
PubMed1985

Organophosphate-mediated inhibition of choline acetyltransferase activity in rat brain tissue.

Administration of the organophosphate compound soman in rats resulted in an inhibition of choline acetyltransferase activity in almost all brain regions examined. Enzyme activity was inhibited by 20-50% in various brain regions 30 min after soman injection (94-120 micrograms/kg). Enzyme activity in two regions decreased with time to a near zero level by 3 h after injection.

Animals↗
PubMed1985

Some methodological issues in consultation-liaison psychiatry research.

This is a research methodologic design model that may be useful to consultation-liaison psychiatrists. It is intended to facilitate such researchers in setting up and executing carefully controlled studies of the effectiveness (in psychiatric, medical, surgical, functional, cost, or other areas) of consultation-liaison interventions. The specific variables discussed are areas of particular interest to the authors, but many other variables may be readily substituted into this basic model. The design may be expanded or contracted relatively easily as would be appropriate for particular projects. The overall purpose of this paper is, hopefully, to serve as a catalyst for consultation-liaison psychiatrists to consider such research in their academic settings and to foster increased discussion and critical thinking regarding such research. The authors consider such research efforts important for the future regarding the scientific basis, proven effectiveness, and funding of consultation-liaison and general hospital psychiatry.

Ethics, Medical↗
PubMed1985

Update on some of the older and newer antidepressants.

This is an edited transcription of a presentation made to a group of primary care physicians, medical students, and consultation-liaison psychiatrists. Primary care physicians frequently prescribe antidepressant medications to their patients. These medications are frequently misprescribed, often in dosages that are too low to have an optimal effect. In part this is due to generally exaggerated fears that primary care physicians have regarding these medications, especially the anticholinegic effects of recommended dosage levels and sudden cardiac death. This is rarely a problem except in overdosage or those with dangerous preexisting cardiac arrhythmias. The author reviews his thoughts about some of the more recently introduced agents, including the usual, positive, psychologic responses (placebo effects) to any new drug. The newer agents are not more efficacious than older agents but have different side-effect profiles. The common side effects, and have these may be minimized or in some cases used to the patient's advantages, are discussed for the older and newer agents.

Aged↗
PubMed1985

Research problems for consultation-liaison psychiatry in the DRG era.

Psychiatry needs to conduct more rigorously designed empirical research studies to demonstrate its cost-effectiveness, especially since the DRG era is becoming more firmly established. The effectiveness of psychiatric intervention can be evaluated on its abilities to improve physical functioning as well as its improvement of psychosocial symptoms and cost savings. Some of the problems in consultation-liaison research are discussed, including the potentially confounding influences of demographic variables, type and severity of somatic disease, time since diagnosis, level of psychosocial stress, and initial level of physical functioning. Several types of research measures used in assessing physical and psychosocial functioning are discussed, and some of the dilemmas for psychiatry in utilizing individual versus standardized research interventions are explored.

Activities of Daily Living↗
PubMed1985

The effect of thioridazine on prolactinoma growth in a schizophrenic man: case report.

Thioridazine was found to increase the serum prolactin level as well as the tumor size of a prolactin--secreting pituitary chromophobe adenoma in a schizophrenic man. He was then successfully treated with clonidine, an antinoradrenergic compound without antidopaminergic properties, which had no effect on serum prolactin or tumor growth. This case report highlights the importance of careful neuroleptic usage in patients in whom elevated prolactin levels are of concern and discusses alternative methods of treating psychosis when antidopaminergic medications are contraindicated.

Adenoma, Chromophobe↗
PubMed1985

Teaching psychiatry to primary care internists.

Many patients who seek the care of primary care physicians are suffering from a wide variety of psychiatric disorders. Primary care physicians should become skilled in interviewing techniques and basic psychiatric differential diagnosis, management, and treatment approaches for some types of psychiatric disorders and learn to regularly consult with and make referrals to psychiatrists when appropriate. Psychiatrists should play a very active role in the education of primary care specialists. This should include observation of the physician interviewing patients with different types of psychiatric disorders in addition to didactic teaching and supervision on topics such as psychopharmacology. With mutual collaboration between primary care interests and psychiatrists the patients of both groups of physicians should receive better care and continuing education of both may occur through an ongoing dialogue.

Humans↗
PubMed1985

Reintroducing the internship: reactions of three departments of psychiatry.

The reintroduction of the internship requirement has caused a number of changes in psychiatric education in the past decade. Many psychiatric educators and departments of psychiatry have been faced with the challenges of organizing internships and establishing an internship curriculum. This has been especially challenging because the psychiatrists involved have seldom had full postgraduate training in the fields being organized and have not previously administrated clinical services in those areas. The authors discuss the goals of the internship for future psychiatrists and the pros and cons of university versus community general hospital based internships for future psychiatrists, and find several potential advantages to the latter. Also discussed are their consistent observations of internship programs for future psychiatrists over the past decade in three geographically separate regions and in state and private institutions. They and most other faculty members in their respective departments believe that the reinstitution of the internship has had largely beneficial effects on future psychiatrists.

Hospitals, Community↗
PubMed1985

Improving recognition of psychiatric disorders in a primary care practice.

Primary care physicians can increase their recognition of psychiatric disorders in several ways. The first and most important is to maintain a high index of suspicion for these disorders, which are prevalent in primary care patients, and to know the frequent symptom presentations, both overt and covert, of the most common disorders. A variety of psychiatric screening questionnaires can be useful and may be given routinely or when a psychiatric disorder is suspected. Alternatively, psychiatric screening questions can be incorporated into the usual patient interview. Establishment of a good working relationship with a psychiatrist knowledgeable in current psychiatric diagnosis and therapy, including psychopharmacology, is advisable. Psychiatric consultation may be sought when diagnostic questions arise, and referral to a psychiatrist or coordinated treatment is often useful for patients with severe or persistent symptoms.

Diagnosis, Differential↗
PubMed1985

Psychiatric aspects of asthma in adults.

Asthma is a complex and multifactorial illness. Early theories focused on the psychosomatic aspects of this disease and more work has been done through the years to explore these theories and to further elucidate the variety of psychiatric conflicts, personality traits, and stressors, and the role they play in asthma. More recently, mechanisms have been postulated whereby these conflicts can influence the pathologic process in the lungs causing symptoms of asthma. These seem to act at the level of the limbic system and hypothalamus, the autonomic nervous system, and the immunologic system. Many psychiatric factors play a strong role in maintenance of the asthma. Family interactions, anxiety, depression, panic-fear, and many others can facilitate or impede compliance with an appropriate medical regimen. Although all these variables have yet to be sorted out definitively, asthma is certainly an area where psychiatrists can have a major therapeutic impact.

Adult↗
PubMed1984

Interactions between thioridazine and bromocriptine in a patient with a prolactin-secreting pituitary adenoma.

Reported herein is the possible interaction between two drugs used to treat a man with a large prolactin-secreting pituitary adenoma. The patient had a long history of schizophrenia that was treated with many different medications, including phenothiazines. Evaluation of progressive lethargy led to the discovery of a large parasellar tumor and a prolactin level of 7,981 ng/ml. His serum prolactin level fell to the 400 ng/ml range during bromocriptine therapy but rose whenever the antipsychotic thioridazine was added to his regimen. A marked deterioration of his visual fields was noted after 3 months' therapy with both drugs, and this abnormality resolved five days after the thioridazine was stopped. The use of dopamine antagonists such as thioridazine in patients with prolactinoma may interfere with bromocriptine's action, resulting in potentially serious complications.

Adenoma↗
PubMed1984

RecA-independent recombination at gamma delta termini and at IS3 producing inverted repetition in F' plasmids.

Two F' plasmids isolated independently from a recA- strain of Escherichia coli and containing identical deletion end points and identical associated inverted duplications are described. In these plasmids, DNA of F plasmid from the IS3 element alpha 1 beta 1 up to the transposon gamma delta is duplicated in inverted orientation, and a 63-kilobase-pair segment from the chromosomal DNA of the plasmid is deleted. One deletion terminus is the chromosomal IS3 alpha 4 beta 3 carried by the parental plasmid, ORF203. It is proposed that these structures resulted from interduplex strand exchanges that occurred at the ends of the movable element gamma delta and at IS3. This indicates that the 35-base-pair gamma delta termini can participate in genome rearrangements by mechanisms that are distinct from complete transposition mechanisms.

Base Sequence↗