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Biomedical subjects

A Levin

Publications and source records attributed to A Levin.

At least 163 records · Page 9Linked to original sources
PubMed1987

Discontinuation of alprazolam treatment in panic patients.

Alprazolam treatment was tapered in 17 panic patients at a rate of 10% of the starting dose every 3 days. Only four subjects completed withdrawal on schedule (4-5 weeks); four additional subjects discontinued treatment in 7-13 weeks. During withdrawal 15 patients had recurrent or increased panic attacks and nine had significant new withdrawal symptoms. Most common among the latter were malaise, weakness, insomnia, tachycardia, lightheadedness, and dizziness. None had seizures, psychosis, or significant neurological or EEG abnormalities. Results indicate that relapse and withdrawal are important considerations in the choice of alprazolam treatment for panic attacks.

Acute Disease↗
PubMed1986

Evidence for heterosexual transmission and clinical manifestations of human immunodeficiency virus infection and related conditions in Lusaka, Zambia.

In a hospital-based survey in Lusaka, Zambia, 189 (17.5%) of 1078 subjects had antibodies against the human immunodeficiency virus (HIV). The prevalence of antibodies was low in subjects aged less than 20 or greater than 60 years; in men the peak prevalence (32.9%) occurred in those aged 30-35 years, and in women (24.4%) it occurred in the 20-25 year age-group. There was no significant difference in prevalence by sex after adjusting for age. High educational level was independently associated with HIV seropositivity; the antibody against HIV was found in 18.4% of blood donors and in 19.0% of hospital workers. Among patients the antibody prevalence ranged from 8.7% in antenatal women and 9.3% in orthopaedic patients to 29.2% in those attending sexually transmitted disease (STD) clinics (the prevalence being 37.3% in previous attenders and 22.8% in first-time attenders). Seropositivity rates were higher in patients with an infectious problem (23.4%) than in those without (11.4%, p = 0.0002). Herpes zoster, oral thrush, diarrhoea, tuberculosis, and weight loss were independently correlated with seropositivity. The data strongly suggest that HIV infection is prevalent in Africa and is transmitted heterosexually. The restricted distribution of seropositivity to the sexually active age-groups indicates that the epidemic, at least in this part of Africa, is newly introduced; this has substantial implications for prevention.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Alprazolam in the treatment of panic disorders.

An open clinical trial of alprazolam therapy of patients with panic disorder or agoraphobia with panic attacks was undertaken to clarify certain issues not resolved by previous studies. These included the proportion of patients who significantly improve with alprazolam; the relative time courses for improvement in panic attacks, anticipatory anxiety, and phobic avoidance; whether successful alprazolam treatment alters vulnerability to panic with sodium lactate infusion; and what factors predict response to alprazolam in panic patients. Thirty patients meeting DSM-III criteria for panic disorder or agoraphobia with panic attacks completed a 12-week open clinical trial, and 22 were considered responders. In responders, panic attacks showed rapid improvement, whereas improvement of anticipatory anxiety and phobic avoidance was more variable. Successful alprazolam therapy appeared to block lactate vulnerability. High pretreatment Hamilton Anxiety Scale scores were associated with poor treatment response. The data suggest that alprazolam is an effective treatment for panic disorder and agoraphobia with panic attacks, and acts by directly blocking panic attacks.

Adult↗
PubMed1986

Phenelzine in social phobia.

Phenelzine was administered to 11 patients meeting DSM-III criteria for social phobia in open clinical trials. Seven of 11 showed marked improvement, while the remaining four experienced moderate benefit. These findings, which require replication in controlled trials, suggest that in addition to other actions, phenelzine has a direct effect in reducing interpersonal hypersensitivity.

Adolescent↗
PubMed1985

Mianserin is better tolerated and more effective in depression than a nomifensine-clobazam combination: a double-blind study.

Patients suffering from depression (mostly depressive neurosis) were admitted to a double-blind study which compared the efficacy of a combination of nomifensine and clobazam with mianserin. Therapeutic efficacy was evaluated on the Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Clinical Global Impression Scale, physician's assessments, Global Improvement and Treatment Emergent Symptom Scale for side-effects. Assessments were made before admission to the trial and on days 3, 7, 14 and 21. Forty patients were randomly allocated to two treatment groups. A case is made against polypharmacy and in particular against the use of benzodiazepine combinations in depression. Nineteen patients on nomifensine-clobazam and 14 on mianserin completed the three-week trial. At 7, 14 and 21 days, the Hamilton Depression Rating Scale (HDRS) total scores were significantly improved for mianserin when compared with nomifensine-clobazam. Similarly, at 7 and 14 days the Hamilton Anxiety Rating Scale (HARS) total scores were significantly better for mianserin than for the nomifensine-clobazam combination. There were also significant improvements for mianserin on the HDRS sub-scales of anxiety somatization, cognitive disturbance and sleep disturbance. There were no significant differences for HDRS somatic symptoms between treatment groups. Drowsiness was the most common side-effect in both groups. The incidence of total side-effects was 74% for nomifensine-clobazam and 71% for the mianserin group.

Adolescent↗
PubMed1985

Cardiac digital angiography: applications in ventriculography and coronary arteriography.

Clearly, computer-based digital subtraction offers several advantages over conventional approaches to contrast angiography. Using the newer method, in many situations contrast loads can be beneficially reduced, radiation exposure can be markedly diminished, and right ventricle evaluations can be simplified. In addition, storage of data on magnetic tape is less space consuming, and less costly, than storage on film. Over the 5- to 10-year life expectancy of a digitally equipped laboratory, these advantages probably justify the 30-50% increase in the initial monetary outlay for equipment in excess of that required for a conventionally equipped laboratory. However, the greatest promise of digital angiography is in the area of coronary arteriography. If three-dimensional reconstruction of coronary lesions and determination of regional flow can be effected, important advances in diagnosis and in prognostication theoretically might be expected, leading to more appropriate selection of therapy for individual patients than now can be achieved. However, currently available information does not yet indicate the extent to which such potential advantages will be realized. Thus, it will be several years before we will know whether the exciting potential of digital angiography in this area can be reached.

Angiography↗
PubMed1984

The effects of cimetidine and ranitidine on psychomotor function in healthy volunteers.

Single oral doses of cimetidine (400 mg), ranitidine (150 mg), promethazine (25 mg) or placebo were administered to 8 healthy volunteers in a double-blind study. Cimetidine and ranitidine did not cause any significant change in critical flicker frequency (c.f.f.), reaction time, pursuit rotor of the visual analogue scale scores for sedation. Promethazine significantly lowered c.f.f., prolonged reaction time and increased sedation when compared with placebo. It is concluded that in this study cimetidine and ranitidine had little, if any, effect on psychomotor function.

Adult↗
PubMed1983

A psychological profile of women selected for augmentation mammaplasty.

Augmentation mammaplasty (AM) is a cosmetic surgical procedure increasingly being sought by women preoccupied with the size of their breasts. There is a divergence of opinion as to the reasons for and the morbidity associated with this. The present study attempts to clarify the reasons for requests for AM and to determine the presence of psychopathology in patients selected for this procedure compared with hospital controls. It was found that these patients generally experienced low self-esteem, depression, self-consciousness and anxiety, and had a poor body-image and psychosexual problems. AM was often sought to alleviate marital, psychosexual and interpersonal problems.

Adult↗
PubMed1982

Mianserin and clomipramine in the treatment of depression.

Forty-two patients aged between 19 and 70 years (30 women and 12 men) suffering from primary unipolar depression were randomly selected and treated under double-blind conditions with either mianserin (Lantanon; Organon) or clomipramine (Anafranil; Ciba-Geigy) after an initial wash-out period. Patients on all other medication, including benzodiazepines, were excluded from the study. The severity of depression was assessed on day 0 and after 1, 2, 3, 4 and 5 weeks' treatment. There were no significant pretrial differences between the groups in respect of severity of depression, age, sex or previous psychiatric history. During the 1st week of treatment all subjects received either mianserin 30 mg or clomipramine 75 mg once daily. From the 2nd week onwards the dose was doubled. Thirty patients completed the trial, 16 on mianserin and 14 on clomipramine. The improvement on both treatments was marked, favouring mianserin but only reaching significance in the 5th week. Side-effects, especially tremor, tachycardia, dystonia, dizziness, excitement, nasal congestion and dry mouth, were significantly more common in the group using clomipramine. This study confirms reports that mianserin is an effective antidepressant which is better tolerated and produces fewer side-effects (especially anticholinergic) than comparable tricyclic antidepressants such as clomipramine.

Adult↗
PubMed1982

Psychotherapeutic management of good and poor compliance in patients on haemodialysis.

Numerous studies have been published on the psychobiological factors which either facilitate or impede a patient's adaptation to haemodialysis. These studies have tended to group all dialysands together, and the psychological heterogeneity of dialysands has not always been adequately recognized. Recent research has assisted in identifying certain homogeneous subgroups. With this information it appears possible to formulate a more rational approach to psychotherapeutic intervention and management. This paper deals with some of the psychological factors involved in the differential management of stress in in-centre patients on ongoing haemodialysis, i.e. differentiation between those who comply and those who do not and the reflection of this in psychotherapeutic management.

Adolescent↗
PubMed1982

Nomifensine and maprotiline in endogenous depression: comparative efficacy and side effects.

50 patients suffering from endogenous depression were admitted to a double-blind study comparing the efficacy of nomifensine and maprotiline and the side effects associated with treatment. A total of 28 patients, 14 on nomifensine and 14 on maprotiline completed the study. Therapeutic efficacy was evaluated by means of the Hamilton Rating Scale for Depression before administering the drugs and on days 7, 14, 21 and 28. Also noted if present was the day on which marked improvement was reported. At each assessment period incidence and severity of side effects were registered. On the basis of this study, nomifensine and maprotiline were both found clinically to have marked antidepressant action. The difference in response did not reach statistical significance, although there was a trend towards better improvement on nomifensine at the end of the 1st and 4th weeks. There was a rapid onset of action with both compounds. Significantly more severe side effects developed in those patients treated with maprotiline compared to those treated with nomifensine.

Adolescent↗
PubMed1982

Rebound phenomenon.

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Administration, Oral↗