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Biomedical subjects

David B Menkes

Publications and source records attributed to David B Menkes.

7 recordsLinked to original sources
PubMed2006

The silent expert.

Following a telephonic deposition, the author discovered that a psychiatrist expert witness for the other side had electronically eavesdropped on the entire six-hour proceedings. Under cross-examination the expert admitted eavesdropping on instruction of state's attorneys, and directing their deposition of the author, but denied wrongdoing. The ethical implications of such deceptive behavior and its rationalization are discussed.

Expert Testimony↗
PubMed2005

Stereotactic radiosurgery: the patient's experience.

Stereotactic radiosurgery (SRS), a highly technical treatment for life-threatening brain tumors and vascular malformations, is provided at one site (Dunedin Hospital) for all New Zealand. The full-day procedure begins with the surgical attachment by bone screws of a metal helmet, followed by computerized tomography with or without angiography, and concludes with focused irradiation of the lesion. Previous SRS research has focused on therapeutic indications and outcomes; we report here patients' experiences of this procedure using both qualitative and quantitative methods. Participants (n = 12) uniformly described SRS as unusual and highly significant, a pivotal event shaping the future. For most, the procedure symbolized relief of symptoms, hope, reduction of risk, and recovery. Descriptions of the disruption produced by the onset of symptoms, diagnostic procedures and SRS, followed by a period of uncertain prognosis, also signaled experiences of liminality. Although patients experienced anxiolysis and described status changes following SRS, their lives are not returned to normal; they continue to inhabit a liminal state between health and normality on one hand, illness and disability on the other. Our findings indicate aspects of the experience of SRS for patients and their families that could assist in technically informing and emotionally supporting patients through this unusual treatment.

Adolescent↗
PubMed2002

Cardiotoxicity and prescription of thioridazine in New Zealand.

OBJECTIVE: To review the production of cardiac arrhythmia by thioridazine, and consider the role of government regulation in light of antipsychotic prescribing trends in New Zealand. METHODS: We conducted a focused literature review on psychotropic-induced cardiotoxicity, including mechanisms and incidence. In addition, we considered trends in antipsychotic prescription in New Zealand and decisions made by regulatory bodies in Australia, North America and the United Kingdom regarding restrictions on the prescription of thioridazine. RESULTS: In general, the cardiotoxicity of antipsychotics, including thioridazine, relates to the ability of these drugs to antagonize voltage-sensitive potassium channels, and thereby prolong the QT interval. This action can lead to malignant arrhythmias in a very small proportion (< < 1%) of patients; the risk may be increased by other drugs or factors which prolong QT or inhibit the metabolism of thioridazine. A review of prescription doses and volumes in New Zealand indicates that thioridazine is prescribed mainly in low doses by non-specialists, and its use has been waning significantly over the past 2 years. These trends predate recent publicity regarding cardiotoxicity. CONCLUSION: Recommendations regarding thioridazine use are presented. Although new patients should not receive this drug, existing patients benefiting from modest doses should not be denied access unless clear-cut risk factors for cardiotoxicity are evident.

Antipsychotic Agents↗