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Biomedical subjects

B Waters

Publications and source records attributed to B Waters.

51 records · Page 3Linked to original sources

Affective disorder, paranatal and educational factors in the offspring of bipolar manic-depressives.

Fifty-five of the 58 adult offspring of 17 bipolar manic-depressives were studied. Fifty-three were interviewed and some data were available on the two who had committed suicide. A detailed educational history and pregnancy and birth (paranatal) history were obtained and were corroborated by records where available. Thirty-two percent of the offspring met RDC criteria for major affective disorder, and 13 percent for minor affective disorder. Paranatal and educational problems, separately and together, were not associated with an enhanced risk to affective disorder, however they were significantly associated with an earlier onset to affective disorder. This association may be partly due to a relatively lower IQ among the early onset subjects.

Adolescent↗

A review and controlled study of cutaneous conditions associated with lithium carbonate.

This study compares the incidence of a variety of cutaneous conditions among 91 patients treated with lithium carbonate with the incidence of such conditions among 44 patients treated with other non-neuroleptic, maintenance medications. Data on cutaneous conditions and allergies were obtained using structured interviews, demographic data, medication histories and personal and family histories. A significantly greater proportion of the lithium-treated patients than the comparison patients reported a cutaneous condition which may have been secondary to treatment in that it developed for the first time after the medication or appeared to have been exacerbated by the medication. Among the lithium-treated patients, females were found to be significantly more likely to report a secondary cutaneous condition. This effect was found across the whole range of cutaneous conditions. Male lithium-treated patients on the other hand reported approximately the same rate of secondary cutaneous conditions as both male and female comparison patients. Possible reasons for this sexual effect on incidence are discussed. The literature on cutaneous conditions which have been associated with lithium therapy is also reviewed.

Acne Vulgaris↗

A review of research relevant to custody and access disputes.

With the high rate of marriage breakdown, increasing numbers of children are becoming the subjects of custody and access disputes. The Courts are looking to the services of psychiatrists in these matters. They value our expert opinion on the least detrimental available alternative for the child. This paper reviews available research data which are relevant to psychiatric testimony on the determination of exclusive custody, joint custody and access. It is concluded that there is emerging an objective body of data which can buttress psychiatric opinion in these matters, but that a number of the principles which have guided the Courts to date, have not been thoroughly researched.

Adaptation, Psychological↗

Comparative trial of cefonicid and cefamandole in the therapy of community-acquired pneumonia.

Cefonicid (Smith Kline & French Laboratories; D-75073) is a new parenteral cephalosporin with a markedly long half-life, high serum levels, and good in vitro activity against Haemophilus influenzae. Patients with community-acquired pneumonia were randomized 2:1 to receive cefonicid, 1 g daily (21 cases) or cefamandole, 1 g every 6 h (12 cases). The two groups were similar, except that the cefonicid patients were older (mean 42 versus 31 years). Peak serum levels of cefonicid averaged 133 microgram/ml after intravenous and 83 microgram/ml after intramuscular administration compared with 55 microgram/ml with intravenous cefamandole. All 9 patients on intramuscular cefonicid and 8 or 12 patients on intravenous cefonicid had trough serum levels of greater than 2.0 microgram/ml at 24 h. Sputum levels of cefonicid were usually between 2.0 and 4.0 microgram/ml and did not correlate with serum levels. Cefonicid was well tolerated, and all cefonicid patients responded clinically. Sputum cultures for H. influenzae or Streptococcus pneumoniae became negative in 6 of 7 cefamandole patients and 13 or 15 cefonicid patients. In in vitro studies, cefonicid inhibited 90% of beta-lactamase-negative h. influenzae at 0.5 microgram/ml and beta-lactamase-positive strains at 2.0 microgram/ml. Cefonicid inhibited 50% of S. pneumoniae at 1.6 microgram/ml, but required 6.4 microgram/ml to inhibit 90%. Cefonicid once a day appears to be as safe and as effective as cefamandole four times a day for therapy of community-acquired pneumonia.

Adult↗

Determination of the optimal concentration of lithium for the prophylaxis of manic-depressive disorder.

A group of 29 bipolar manic-depressives completed a 12-month double-blind cross-over trial of low-dose and high-dose lithium prophylaxis. Twelve patients relapsed, and significantly more of the relapses occurred during the low-dose 6-month phase of the trial. There was a trend for relapse to occur within 2 months of an abrupt drop in plasma lithium level, and to occur more often in women than in men. The efficacy of low-dose lithium prophylaxis and the significance of rebound relapse are discussed.

Adolescent↗

Absent pulmonary valve with tricuspid atresia or severe tricuspid stenosis: report of three cases and review of the literature.

Absence of the pulmonary valve occurs usually in association with tetralogy of Fallot and occasionally with an atrial septal defect or as an isolated lesion. Very rarely it occurs with tricuspid atresia, intact ventricular septum, and dysplasia of the right ventricular free wall and of the ventricular septum. We present the clinical, anatomic, and histologic findings of a new case, and for the first time, the data from two patients with absent pulmonary valve and severe tricuspid stenosis, who exhibited similar histologic findings. We also reviewed the clinical and anatomic data of 24 previously published cases and compared them with the new cases. In all three new cases, the myocardium of the right ventricle was very abnormal. In the two cases with tricuspid stenosis, large segments of myocardium were replaced with sinusoids and fibrous tissue. In the case with tricuspid atresia, the right ventricular free wall contained only fibroelastic tissue. The ventricular septum in all three patients showed asymmetric hypertrophy and in two of the three patients, multiple sinusoids had replaced large segments of myocardial cells. The left ventricular free wall myocardium and the walls of the great arteries were unremarkable. Our data indicate that myocardial depletion involving the right ventricular free wall and the ventricular septum and its replacement by sinusoids and fibroelastic tissue occur not only in cases of absent pulmonary valve with tricuspid atresia but also in cases of absent pulmonary valve with tricuspid stenosis. The degree of myocardial depletion varies and is more severe when the tricuspid valve is atretic.

Fatal Outcome↗