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Biomedical subjects

B Spittle

Publications and source records attributed to B Spittle.

11 recordsLinked to original sources
PubMed1996

Risperidone appears safe in patients with antipsychotic-induced blood dyscrasias.

Two cases are reported who developed blood dyscrasias, involving neutropenia and thrombocytopenia respectively, after treatment with phenothiazine and butyrophenone antipsychotics. A subsequent good therapeutic response was obtained with risperidone. It is suggested that risperidone may be considered as an alternative when blood dyscrasias occur with classic antipsychotics.

Adult↗
PubMed1994

Psychopharmacology of fluoride: a review.

Although the blood-brain barrier is relatively impermeable to fluoride, it does not pose an absolute barrier and fluoride has the ability to enter the brain. The literature was examined to assess the quality of the evidence for cerebral impairment occurring due to exposure to fluoride from therapeutic or environmental sources. Several surveys of persons chronically exposed to industrial fluoride pollution reported symptoms related to impaired central nervous system functioning with impaired cognition and memory. Examination of individual case reports showed the evidence for aetiological relationships between symptoms and fluoride exposure to be of variable quality. The evidence was seen as being suggestive of a relationship rather than being definitive. The difficulties with concentration and memory described in relation to exposure to fluoride did not occur in isolation but were accompanied by other symptoms of which general malaise and fatigue were central. Possible mechanisms whereby fluoride could affect brain function include influencing calcium currents, altering enzyme configuration by forming strong hydrogen bonds with amide groups, inhibiting cortical adenylyl cyclase activity and increasing phosphoinositide hydrolysis.

Animals↗
PubMed1993

Wernicke's encephalopathy complicating schizophrenia.

Wernicke's encephalopathy producing an altered mental state may occur in malnourished psychiatric patients even in the absence of alcohol abuse. A case is reported of a woman, aged 61 years, with schizophrenia who refused her medication for four months, had the delusion she was dying from a tumour, and withdrew to her bed with a neglect of her nutrition. She was committed to hospital in a mute unresponsive state and after taking some food and fluids for four days lapsed into coma. She responded within three hours to the administration of thiamine. Clinicians need to remain vigilant to the possibility that an altered mental state in malnourished patients may be due to thiamine deficiency rather than to the primary psychiatric disorder. If doubt exists as to the presence of Wernicke's encephalopathy, then parenteral thiamine should be administered.

Activities of Daily Living↗
PubMed1992

Paternalistic interventions with the gravely disabled.

Interfering in the affairs of the gravely disabled has received attention in areas such as philosophy, theology, law, politics, and sociology. For such persons to be declared incompetent and have guardians appointed to care for them, a balancing is required of the right to personal freedom against the right to care. When consideration is given to the underlying principles of autonomy and beneficence, a case can be made for weak paternalistic interventions with persons of diminished capacity who are clearly endangered and in whom the conduct involved is substantially nonvoluntary. Examples are given of beneficial results occurring in persons with alcohol dependence or alcohol-related brain damage on whom a paternalistic intervention involving financial management was imposed with the aim of seeing that basic needs were met and that spending on alcohol was not excessive.

Alcoholism↗
PubMed1991

The effect of financial management on alcohol-related hospitalization.

OBJECTIVE: Treatment-unresponsive alcoholics in New Zealand who are unable to care for themselves tend to be hospitalized for lengthy periods of time. The author examined the effect of adding financial management to the therapeutic management of such patients. The null hypothesis was that this would have no effect on the duration of alcohol-related hospitalization. METHOD: All 61 alcoholic patients registered with an alcohol outpatient clinic who received financial management over a period of 6 years were included in the study. Their alcohol-related disabilities were so severe that they had resulted or were likely to result in lengthy or frequent periods of hospitalization. The financial management involved putting each patient's income into a checking account for which a budget advisory officer was cosignatory for withdrawals. The advisor saw to it that patients' basic living requirements were being met and that expenditure on alcohol was not having a detrimental effect. Participation was voluntary for voluntary patients and involuntary for committed patients. The durations of each patient's alcohol-related hospitalizations were compared for two equal periods of time before and after financial management was instituted. RESULTS: The null hypothesis was not supported. The duration of alcohol-related hospitalizations after financial management was instituted was 86% less than it was before such management. CONCLUSIONS: For the patient who is struggling in the face of excessive drinking to cope with the tasks of daily living, including the provision of adequate shelter and nutrition, the benefits of adding financial management to other therapeutic strategies should be considered.

Activities of Daily Living↗
PubMed1977

Psychosocial factors and myocardial infarction.

Two questionnaires totalling 370 questions were used to compare 61 male patients who had survived a first myocardial infarction with a group controlled for age and social status who had not had an infarction. The questionnaires included the Edwards Personal Preference Schedule, providing a measure of 15 personality variables, the Anxiety and Depression Sub-Scales of the MMPI, and the Cochrane and Robertson Life Events Inventory, as well as originally-designed questions based on known risk factors. Significant differences were found in several dimensions of personality as well as in the family histories of myocardial infarction and in certain life styles. The patient group showed a greater sense of independence, greater difficulty in relaxing, and a sence of personal inferiority. Suggestions are offered for the modification of life styles in susceptible individuals as a possible aid to prevention.

Aggression↗
PubMed1976

Risk-taking propensity, depression and parasuicide.

One hundred patients admitted consecutively to an inpatient psychiatric unit were given questionnaires to measure risk-taking propensity and depression. The purpose was to study the relationship between risk-taking, depression, and recent suicide attempts. It was found that depressed patients showed a bimodal clustering towards the extremes of risk-taking. There was a history of suicide attempts only when a certain threshold of risk-taking was exceeded. These findings are discussed with relation to defensive styles of psychological adaptation and to arousal thresholds.

Adaptation, Psychological↗