Biomedical subjects
Publications and source records attributed to W E Thornton.
Gastrin release was studied in 5 hypergastrinemic patients, both during calcium infusion and EDTA infusion. In each patient, gastrin decreased in conjunction with the fall in plasma calcium, and increased during calcium infusion. Plasma gastrin and calcium levels were strongly correlated.
The combination of biochemical theory, case studies, and patient population surveys suggests that the water soluble vitamin, folic acid, is relevant to mental functions. Several studies demonstrate a clinical correlation between folate deficiency and psychiatric hospitalization. The role of dietary deficiency to these observations has needed further examination. After reviewing the serum folate values of 269 psychiatric hospital admissions, the incidence of serum folates below 5.9 ng./ml. was found to be greater than a control group. A dietary rating for all admissions revealed a high frequency of deficiency in all patients with no greater prevalence among the low folate group. These observations agree that psychiatric patients are more likely to have low serum folate values, and suggest that poor diet does not explain the increased likelihood.
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A review of the growing body of information regarding folic acid biochemistry indicates a relationship between folate metabolism and mental disturbance. Clinical correlations between altered mental functions associated with aging and lowered serum folate values are found to suggest that further studies are warranted. The fasting serum folate levels of two groups of subjects 65 years of age and older are compared after excluding the influence of drugs, alcohol, and gastrointestinal disease. The results show that those elderly persons with good dietary habits and mental acuity had no lowered serum folate levels. Thus, the suggestion that serum folate level normally falls with age is not confirmed. Additionally, it was found that 35% of similarly aged subjects with combined mental dysfunction and poor dietary habits had lowered serum folate values.
Phencyclidine appears to be unique in action compared with other psychedelic drugs, and its effects are less dependent upon the individual's personality than are the effects of LSD or mescaline. The authors discuss the sensory, psychological, and behavioral symptoms of phencyclidine intoxication. Most cases are of short duration and the only treatment necessary may be observation together with minimal stimulation and diazepam. However, prolonged and severe behavioral disturbances, exaggeration of preexisting thought disorder, and serious medical complications commonly occur and must be considered in the treatment plan.
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Proprietary sleep aids and sedatives can cause delirium, coma and occasionally death in children and adults. The constituents in sleep aids that significantly effect central nervous system activity are bromides, methapyrilene, pyrilamine and scopolamine (hyoscine). Constituent proportions and mixtures vary greatly at different times since manufacturers make frequent adjustments. The effects of toxicity resulting from the misuse of ethylenediamines include nausea, vomiting, blurred vision, incoordination, tremors, dry mouth, constipation and an acute poisoning syndrome. Management of adverse reactions produced by either methapyrilene or pyrilamine consists of dosage reduction or discontinuation. The acute poisoning syndrome requires implementation of general symptomatic and supportive principles.
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The frequency with which a psychotropic agent is used in combination with another drug preparation is emphasized. The authors present an update of the clinical and theoretical knowledge bearing on combination drug therapy in psychopharmacology. Drug combination interactions that enhance clinical efficacy and those that either diminish it or even endanger the patient are described. The authors hope to create an awareness on the part of physicians of the importance of being knowledgeable in the area of combination drug therapy. Any unexpected or unusual drug action should be examined for the possibility of a drug combination interaction.
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Two cases of toxic reaction to lithium carbonate are reported. The first patient displayed symptoms resembling those of organic brain syndrome which was not associated with a high serum lithium level. The influence of diuretic therapy in combination with lithium is felt to enhance the risk of intoxication. The second case depicts acute CNS toxicity with known fatal potential. Conservative lithium administration is recommended for acute manic psychosis and reference is made to the beneficial effects of urea and aminophylline on renal lithium elimination in the active treatment of lithium poisoning.
A portrait is presented of an impulsive, violent and paranoid young murderer. A review of the psychiatric literature for indicators which address themselves to predicting murderous behavior yields a broad spectrum of theories and observations. The portrait presented includes a composite of many of the indicators which the various authors have described. The patient presented is felt to represent a discernable stereotype, and the predisposing factors which are viewed as contributiing to his murderous behavior are offered and given priorities.