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Biomedical subjects

A B McEachran

Publications and source records attributed to A B McEachran.

29 records · Page 2Linked to original sources
PubMed1985

Comparison of effects of desipramine and amitriptyline on EEG sleep of depressed patients.

Despite their widespread use, there are few data concerning the effects of tricyclic antidepressants on EEG sleep in depression. The present study documented the effects of desipramine (DMI, n = 17) and amitriptyline (AT, n = 16) upon EEG sleep in hospitalized depressed patients as part of a double-blind protocol involving 28 days of active treatment. Compared to placebo, patients receiving DMI showed somewhat worsened sleep continuity, particularly after 1 week of administration when the dose was 150 mg/day. On the other hand, sleep architecture and REM measures showed a rapid suppression of REM sleep, and then partial tolerance for this effect was observed with continued administration of DMI for 3 weeks. DMI was a more potent suppressor of REM sleep, while AT was more sedative. Based on these differences in effects upon EEG sleep, a discriminant function was derived and resulted in a correct classification of 87.5% of AT cases and 76.5% of DMI cases. These results are discussed in terms of the differences in pharmacological profiles for uptake blockade and anticholinergic potency for these two compounds.

Adult↗
PubMed1984

Renal function after acute and chronic spinal cord injury.

Computer-assisted renal scintigraphy was performed on 160 acute and 240 chronic spinal cord injury patients, and 287 noninjured controls. Concurrently, measurements of global and individual kidney effective renal plasma flow, time of maximum activity in each kidney, ratio of maximum counts to the counts at 27 minutes after injection over each kidney and number of counts in each kidney at 1 to 2 minutes after injection were made. The time of peak activity over the kidney and differential function at 1 to 2 minutes after injection were not affected significantly by age, sex or spinal cord status. Global and individual effective renal plasma flows were significantly affected by all of these factors. Both plasma flow measures generally were higher for male than for female patients. Effective renal plasma flow decreased steadily after early adulthood and, except for the youngest and oldest patients, values were lower for spinal cord injury patients than for normal controls. The ratio of peak to 27-minute counts was affected significantly by age and spinal cord injury but not by sex. In patients without obvious pathological conditions followup scintigrams 1 to 3 years after injury showed no significant changes owing to interval since injury on any parameter studied. Lower limits of basal scintigraphic parameters are given for evaluation of renal status in neurologically intact or spinal cord injury persons.

Adolescent↗
PubMed1984

Differential effects of amitriptyline and of zimelidine on the sleep electroencephalogram of depressed patients.

The effects of amitriptyline (n = 14) or zimelidine (n = 13) on the sleep electroencephalogram of hospitalized depressed patients were assessed in a double-blind protocol involving 28 days of active dosing. Zimelidine induced no immediate improvement in sleep continuity, and even after 3 wk on zimelidine subjects tended to have longer sleep latency, more awakenings, and lighter non-rapid eye movement (REM) sleep than before taking the drug. Zimelidine did, however, induce a rapid and persistent alteration of sleep architecture and selected REM measures. REM sleep, which was suppressed over the first two nights on zimelidine, was maximally suppressed after 1 wk, but by 3 wk there was some tolerance for selected REM measures. While zimelidine induced none of the sedative effects of amitriptyline, both were equivalent in their REM-suppressant effects. These findings are discussed in terms of the differences in uptake blockade and anticholinergic potency in these two drugs.

Adult↗
PubMed1984

Serum creatinine as an indicator of renal function after spinal cord injury.

This study was conducted to determine (1) if serum creatinine levels (SCL) in spinal cord injury (SCI) patients are influenced by neurologic level of lesion, sex, age, or time since injury, and (2) if SC values are a sensitive indicator of renal function (as reflected by renal plasma flow [RPF]) in these patients. The overall SC mean and SD were 0.9 +/- 0.2mg/dl (n = 141). There was no difference in SC values between patients with higher injuries (T-6 or above) and patients with lower injuries (T-7 or below), nor was there any difference between patients with lesions less than 3 months, 10-14, 22-26, 34-38, 46-50, or 58-62 months in duration. Age and gender each accounted for less than 5% of the variation in SC. There was no significant correlation between RPF and SC (unless the patient also had moderate or severe pyelocaliectasis) nor between change in serum RPF (from the previous examination, usually 12 months earlier) and change in SC, suggesting that SCL does not reflect the functional status of the kidney in these patients.

Adolescent↗
PubMed1984

REM latency distribution in major depression: clinical characteristics associated with sleep onset REM periods.

In a sample of 92 inpatients with major depression, REM latency showed a unimodal, rather than bimodal, distribution, with peak frequency between 50-59 min (on each of 4 consecutive nights). A total of 20 patients (21.6%) exhibited a sleep onset REM period (SOREMP-10) i.e., REM latency less than or equal to 10 min, during at least 1 of the 4 nights; an additional 11 patients (12%) showed REM latencies of 11-20 min on at least one night. SOREMP-10 positive patients were older both at the time of study (p less than 0.01) and at the age of onset of depressive illness (p less than .01) than the rest of the sample. They also showed greater sleep continuity disturbances, while patients with at least one SOREMP-20, i.e., REM latency less than or equal to 20 min, exhibited higher REM percentage (p less than or equal to 0.05) and a higher first-period density (p less than 0.05) than the remaining patients. No other clinical or polysomnographic correlates of SOREMP positivity were noted with regard to gender, RDC subtypes, severity of illness, or clinical response to tricyclic antidepressants. The unimodal distribution of REM latency, as well as the absence of a relationship between SOREMP positivity and severity of depression or therapeutic outcome, may result from the low representation of psychotic depressives in this sample (n = 6), who might constitute a qualitatively different subgroup.

Adolescent↗
PubMed1984

Depressive psychopathology in male sleep apneics.

Depression has been reported to be frequent in sleep apnea syndromes. In a sample of 25 consecutive male sleep apneics, 40% met Research Diagnostic Criteria for an affective disorder or for alcohol abuse. A multiple regression analysis indicated that 61% of the variance in depression ratings could be explained by four variables: age, REM activity, REM latency (square root), and presence or absence of antihypertensive medications (multiple R = 0.78). The use of these variables in a discriminant function analysis correctly predicted the membership of 68% of the sample in either a low or high depression group (kappa = 0.44; p less than .01). These findings are reviewed in relation to other research on age-related sleep changes and vulnerability to depression.

Adult↗
PubMed1983

Prescriptive arm ergometry to optimize muscular endurance in acutely injured paraplegic patients.

This study compared the effect of (1) continuous, (2) intermittent, and (3) graded exercise on the cardiopulmonary responses of 12 acutely injured paraplegic individuals having neurologically complete spinal lesions, between T7 and T12, and seven able-bodied control subjects. Continuous exercise consisted of cranking an arm ergometer at a constant rate of 30W. Intermittent exercise consisted of arm ergometry at 60W for 30-second periods interspersed with 30-second rest periods. In graded exercise, subjects worked for consecutive two-minute periods at rates of 10, 20, 30, 40, and 50W with no rest periods between work periods. Subjects exercised for 10 minutes or until they reached subjective fatigue. Heart rate (HR) and oxygen consumption (VO2) were measured during rest and work. Paraplegic subjects performed 4.93, 4.89, and 4.95 watt-hours of continuous, intermittent, and graded exercise respectively. Comparable figures for control subjects were 4.98, 4.91, and 4.96 watt-hours. There was a high degree of correlation between HR and VO2 in both paraplegic (r = 0.80) and normal (r = 0.85) subjects. Both VO2 and HR were highly correlated with work load in each group. Paraplegic subjects had significantly higher HRs (p less than 0.001), respiratory quotients (p less than 0.05), and ventilatory volumes (p less than 0.05) than control subjects. Graded exercise produced a significantly higher HR than continuous or intermittent exercise (p less than 0.001) during the final data collection period. Oxygen consumption during graded exercise was higher than VO2 for continuous or intermittent exercise (p less than 0.01) during the final data collection period.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

Cardiopulmonary response in spinal cord injury patients: effect of pneumatic compressive devices.

The purpose of this study was to determine the effects of an inflatable abdominal corset and bilateral pneumatic leg splints on certain physiologic parameters during and after postural change in 27 quadriplegic patients. Data reflecting respiratory rate, tidal volume, heart rate, systolic and diastolic blood pressure were collected and analyzed. Measurements were acquired with patients in supine, 20 degrees head-up, 45 degrees head-up, and 20 degrees head-down positions. The study population was divided into 2 groups of cervical spinal cord injured patients: group I included 13 patients with C6 or C7 lesions; group II included 14 patients with C4 or C5 lesions. The mean time between injury and data collection was 47 days. Several trends were identified: (1) the neurologic level of lesion in quadriplegics appears relatively unimportant in determining cardiopulmonary response to postural change; (2) the use of assistive compressive devices does not improve pulmonary ventilatory parameters during postural change, although such devices do help maintain cardiovascular parameters; and (3) the abdominal corset appears more effective than pneumatic leg splints in maintaining blood pressure at pretilt levels. A tidal volume of 350ml to 400ml is most easily maintained by placing patients in a supine position and eschewing assistive compressive devices. Because the pneumatic devices proved successful in helping quadriplegic patients maintain cardiovascular stability during postural changes, therapeutic modalities, such as tilt table treatments, may be initiated at an earlier stage in the rehabilitation process.

Adolescent↗