PubMed HealthSearch

Biomedical subjects

A A Maltbie

Publications and source records attributed to A A Maltbie.

18 recordsLinked to original sources

Medical management of chronic cancer pain.

Management of the chronic pain of cancer is a common and difficult problem. In addition to a medical examination of the patient, it is necessary to perform a psychological assessment of his premorbid personality, current mental status, and coping mechanisms to devise an individualized approach to his pain. The mainstay of cancer pain control are the narcotics, which differ primarily in potency and duration of action. Nonnarcotic analgesics are equianalgesic with the less potent narcotics. Antipsychotic drugs are useful as tranquilizers, antiemetics, and analgesic potentiators. Antidepressants and hypnotics permit the patient a more normal life-style. Stimulants such as cocaine and amphetamines both potentiate narcotic analgesia and reduce narcotic-induced somnolence and respiratory depression. Tetrahydrocannabinol offers no advantage over traditional analgesics. With care and patience, the physician can render practically any cancer patient pain-free.

Analgesics, Opioid

A clinical note on hysterical psychosis.

The authors review the concept of hysterical psychosis and its reported psychodynamics. They suggest a psychodynamic issue that apparently has not been previously reported, namely, emotions engendered by an overt sexual advance or rage and disappointment over a lack of a sexual advance. This finding can be most helpful in distinguishing a case of hysterical psychosis from an acute schizophrenic episode.

Acute Disease

Analgesia and haloperidol: a hypothesis.

We have previously reported 10 patient histories involving various intractable pain syndromes where the administration of Haloperidol either eliminated the need for narcotic analgesics or resulted in a significant reduction in narcotic dosage. We are presently undertaking a controlled double-blind evaluation of Haloperidol as an adjunctive treatment for intractable cancer pain. Based upon the reported clinical observations, these findings are discussed from the following aspects: 1. The isomeric similarity of Haloperidol to Meperidine. 2. Dose response between Haloperidol and analgesic effect. 3. The clinical literature regarding the use of Haloperidol for the effective withdrawal or maintenance of narcotic addicts. 4. The analgesic property as it relates to the opiate receptor.

Analgesics

Depression simulating organic brain disease.

The authors report four cases of depression manifesting as organic brain syndrome in adult nongeriatric patients. The correct diagnoses in three cases were made by a psychiatrist's or resident's empathic response to the patient, and in the fourth by the patient's history of depression. The authors state that only by maintaining a high degree of suspicion and trusting one's empathic response to the patient will unusual presentation of depression be recognized.

Adult

Familial biochemical and clinical correlates of alcoholics with low platelet monoamine oxidase activity.

This study substantiates previous reports that low platelet MAO activity is associated with alcoholism. The results also indicate that low platelet MAO activity in alcoholic probands is associated with a higher prevalence of psychiatric hospitalization in first-degree family members as well as alcoholism and suicide attempts among alcoholics. Psychiatrically ill family members of the alcoholic probands with low platelet MAO activity also demonstrate low enzyme activity whereas the well family members have normal enzyme activity.

Adult

Capgras syndrome-a biochemical marker?

Two cased of Capgras syndrome are reported in which platelet monoamine oxidase (MAO) activity is singificantly less than that of 24 psychiatric controls and 39 nonpsychiatric controls. This is the first report of a consistent biochemical abnormality associated with the Capgras phenomenon. Additional evidence is discussed which suggests that psychiatric patients with Capgras syndrome may belong to a discrete group of behavioral disorders characterized by reduced platelet MAO activity.

Adult

Anniversary reactions presenting as physical complaints.

The literature concerning anniversary reactions is reviewed. Five cases seen by various medical specialists for physical complaints, and subsequently referred for psychiatric evaluation are presented. Each case was felt to represent an anniversary reaction. The necessity of considering the possibility of an anniversary reaction, when the genesis of a complaint is unclear, is emphasized.

Adult

Stability of low blood platelet monoamine oxidase activity in human alcoholics.

There are now several studies in the literature which document low blood platelet monoamine oxidase (MAO) activity in alcoholics. However, these reports are in disagreement as to the stability of reduced enzyme activity over time. The present study provides evidence that reduced platelet MAO activity in alcoholics is a relatively stable phenomenon, independent of ethanol consumption and proximate factors of the illness which are associated with excessive ethanol consumption.

Adult

Anniversary reactions masquerading as manic-depressive illness.

The authors suggest that many patients diagnosed as having manic-depressive illness, depressed type, may in fact be experiencing anniversary reactions--time-specific psychological and physiological reactions to a past trauma. They report three cases of cyclic depressive disorder, two of which were first diagnosed as manic-depressive illness, depressed type. Careful, complete interviewing and attention to temporal sequence led to the correct diagnosis of anniversary reaction.

Adult