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Biomedical subjects

C Kahn

Publications and source records attributed to C Kahn.

At least 19 recordsLinked to original sources

In search of predictors of dropout from inpatient treatment for anorexia nervosa.

OBJECTIVE: The purpose of the present study was to investigate risk factors associated with premature dropout in the treatment of anorexia nervosa (AN). METHOD: Eighty-one women who received free inpatient treatment for AN on a clinical research unit at a university-based psychiatric facility participated in this study. Demographic, lifetime, and baseline clinical characteristics as well as self-report measures of eating disorder symptomatology and associated psychopathology were assessed upon admission. RESULTS: Results indicated that AN subtype was [corrected] modestly predictive of treatment dropout. DISCUSSION: With the exception of AN subtype [corrected], successful completion of inpatient treatment may be unrelated to the severity of eating disorder symptomatology and associated psychopathology. Continued empirical research into factors that influence treatment dropout is clearly needed.

Adolescent↗

How the media influences women's perceptions of health care.

To better understand the effectiveness of media sources that marketers use to channel direct-to-consumer (DTC) campaigns to women, researchers devised a study that segmented the female participants according to their degree of involvement in health care decisions, marital status, age, employment, income, and education. The findings show that women in certain population segments reacted far differently to health care information depending on whether it was presented through the Internet, magazines, newspapers, radio, or TV.

Attitude to Health↗

Fluoxetine for bulimia nervosa following poor response to psychotherapy.

OBJECTIVE: This was an investigation of whether treatment with fluoxetine is useful for individuals with bulimia nervosa who do not respond to psychotherapy or relapse afterward. METHOD: Twenty-two patients with bulimia nervosa who had not responded to, or had relapsed following, a course of cognitive behavior therapy or interpersonal psychotherapy were randomly assigned to receive placebo (N=9) or fluoxetine (60 mg/day, N=13) for 8 weeks. RESULTS: The median frequency of binge eating in the previous 28 days declined from 22 to four episodes in the fluoxetine group but increased from 15 to 18 episodes in the placebo group. Similarly, purging frequency in the previous 28 days declined from 30 to six episodes in the fluoxetine group but increased from 15 to 38 episodes in the placebo group. CONCLUSIONS: Fluoxetine may be a useful intervention for patients with bulimia nervosa who have not responded adequately to psychological treatment.

Adult↗

Health care for all: comparing proposals for reform. A roundtable discussion: Part 2.

Part 1 of this roundtable discussion [Geriatrics 1992; 47(Sept):34-48] examined the flaws in our current healthcare system and factors that are interfering with our nation's ability to achieve reforms. This month, the panelists discuss the benefits and drawbacks of the major healthcare reform proposals, including managed care, single-payer systems, and so-called "play or pay." The practical aspects of any redistribution of healthcare resources are considered as each panelist outlines a favored approach. The influence of special interests, such as the insurance industry, is also discussed.

Health Policy↗

Health care for all: long-term care, the missing piece. A roundtable discussion: Part 3.

Long-term care has been described as the "missing piece" in many healthcare reform proposals. Yet the cost of nursing home care often exceeds that of acute care, especially for the elderly with Alzheimer's disease. In this final installment of a three-part roundtable discussion, panelists discuss the options for providing long-term care, such as social insurance, a single-payer system, play or pay, or private insurance models. Alternatives to nursing home care, such as community service centers and home care, are discussed. The panelists conclude with an examination of how these proposed reforms might affect the practices of physicians and the U.S. economy.

Community Health Services↗

Suppression of pentylenetetrazol-elicited seizure activity by intraosseous propranolol in pigs.

The intraosseous (IO) route provides a rapid and effective alternative venous access in the pediatric population when the conventional intravenous (IV) route cannot be easily obtained. DL-propranolol, a beta-adrenoceptor antagonist, exhibits antiepileptic activity in various animal seizure models. This study assessed the efficacy of IO propranolol in suppressing pentylenetetrazol (PTZ)-induced seizure activity in pigs. Domestic swine (13-20 kg) were prepared for recordings of arterial blood pressure, ECG and electrocortical activity. Seizure activity was induced by pentylenetetrazol (PTZ; 100 mg/kg; IV). Sixty seconds after the onset of seizure activity, the animals either received no drug (control) or propranolol (IV or IO via an 18-gauge spinal needle placed in the right proximal tibia). A transient increase (16.3-50.0%) in the mean arterial blood pressure (MAP) was observed following PTZ administration. Both IO and IV propranolol significantly suppressed the seizure duration (SD) (sec/min interval) at 1 min following drug administration; SD control, 36.3 +/- 4.8; IV propranolol, 12.3 +/- 5.1; IO propranolol, 18.3 +/- 6.0. In addition, both IV and IO propranolol produced a maximal decrease of 32-38% in the basal heart rate; and reduced the transient increase in MAP elicited by PTZ, with no significant effect on the basal MAP. The data demonstrate that 1) propranolol possesses anticonvulsant activity against PTZ-induced seizure in the pig, and 2) the intraosseous route is a rapid and effective alternative venous access for propranolol administration in swine.

Animals↗

Environmental factors affecting paracetamol metabolism in London factory and office workers.

A Paracetamol elimination was measured, using serial saliva samples, in 114 London factory and office workers, 76 Whites and 38 Asian immigrants. 2. Use of social drugs such as alcohol, tobacco and the oral contraceptive varied considerably within the sample, being appreciably greater in White subjects. 3. Paracetamol clearance was 21% slower in Asians than in Whites and half-life 18% longer. The total range of clearance was 1.86--6.78 ml min-1 kg-1. 4. Clearance was slower in women than in men, increased with increasing alcohol intake and cigarett consumption, and was more rapid in those women using the oral contraceptive. The effects of alcohol and the oral contraceptive were also found in White subjects alone. 5 The variables found to correlate independently with paracetamol clearance accounted for only 27% of the total sample variance, however, and are unlikely to be the major determinants of paracetamol elimination in man.

Acetaminophen↗

The pharmacokinetics of metoclopramide in man with observations in the dog.

1 The pharmacokinetics of metoclopramide have been studied in eight normal male volunteers. 2 The mean plasma beta half-life was 156.7 min after i.v. administration of 10 mg metoclopramide. 3 After oral dosing of 10 mg the mean half-life was 196.6 min and after 20 mg 317.5 min (P less than 0.05). 4 Bioavailability of a 10 mg oral dose of metoclopramide varied between 32 and 97%. 5 A major urinary metabolite was metoclopramide-N-4-sulphate and the amounts of conjugates appearing in urine to 24 h correlated significantly with the bioavailability. 6 In the dog the metabolic fate of metoclopramide is different to man with conjugation being a minor metabolic pathway. The half-life in the dog does not appear to be dose dependent. 7 The wide differences in bioavailability of metoclopramide in man may contribute to the unpredictable occurrence of side effects.

Adult↗

Environmental factors affecting antipyrine metabolism in London factory and office workers.

1 Measurements of antipyrine clearance in saliva have been made in 128 London factory and office workers. 2 Mean antipyrine clearance in 56 Asian immigrants was 40% slower than in 72 White subjects. 3 Although dietary differences existed between the two groups, analysis of their effect independently of race was impossible since all but one of the vegetarians were Asian and the non-vegetarians were nearly all White. 4 In the White subjects, use of the oral contraceptive reduced clearance by 38% in women, while cigarette smoking increase clearance by 38% in men.

Adolescent↗