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Biomedical subjects

E Shur

Publications and source records attributed to E Shur.

At least 19 recordsLinked to original sources

The relationship between onsets of depression and sudden drops in solar irradiation.

In a retrospective single-case study of a patient (L.S., the first author), who suffers from recurrent depression, we compared the onsets of his depression with meteorological data on light intensity, independently obtained, for the years 1975-1988. During those years there were 24 onsets or worsening of an existing depressive episode. Eleven of these occurred in the months September-December. Seven of these 11 autumn/winter onsets and 12 of the remaining 13 non-autumn/winter onsets coincided with a period of unusually low natural light intensity. Thus, 19 of 24 onsets (79%) were associated with falling light intensity, regardless of season. Some episodes that were not related to falling light intensity were associated with life events. For the years prior to the patient's use of light therapy, there was a statistically significant relationship between falling light and onset of depression. This supports the suggestion that depressive episodes (in certain individuals) may be triggered by unusually dull weather, regardless of season.

Aged

Physical complications in anorexia nervosa. Haematological and neuromuscular changes in 12 patients.

Of twelve patients consecutively admitted to the Maudsley Hospital Eating Disorders Unit, four had neuromuscular abnormality, eight haematological abnormality, and four no abnormality. All those having neuromuscular signs had concomitant haematological dysfunction. Vomiting, and food restriction with vegetarianism, appeared more likely to lead to complications than either food restriction alone or laxative abuse. The physical status of severely underweight patients admitted for refeeding needs to be carefully monitored.

Adolescent

The epidemiology of schizophrenia.

Epidemiology studies the factors affecting the frequency and distribution of diseases in populations. Surveys of the rates of schizophrenia, by studying the distribution of the disorder in populations, assist in the planning of services and provide clues about the aetiology. This article reviews the rates of schizophrenia in various countries, and the factors affecting its distribution.

Adult

Characterization of platelet alpha 2 adrenoceptors and measurement in control and depressed subjects.

The alpha-adrenoceptor on platelets has been characterized using 3H-yohimbine, 3H-dihydroergocriptine, and 3H-clonidine. The receptor, which exhibits the characteristics of an alpha 2-type, has a Bmax for dihydroergocriptine of 330 fmoles/mg protein, for yohimbine of 178 fmoles/mg protein, and for clonidine of 38 fmoles/mg protein. Clonidine, but not yohimbine binding, is decreased by the presence of K+, Na+, or Li+. Adenosine triphosphate (ATP) and the guanosine triphosphate (GTP) analogue, Gpp(NH)p, reduce the affinity of clonidine for its binding site. Acute exercise, such as playing squash, does not apparently alter the Bmax or Kd of 3H-yohimbine binding to platelet membranes, and in vitro studies, with intact platelets or platelet membranes, show that incubation with adrenalin (10 microM) does not induce alterations in Bmax or Kd. In the present study, no correlation was found between age and alpha 2-adrenoceptor numbers. There was no significant difference in the Bmax for 3H-yohimbine binding to platelet membranes from control and depressed subjects, although the mean value for the depressed group was some 10% lower than that for the corresponding control group. There were no overall significant and consistent effects of desipramine (DMI) treatment. After 2-3 days of treatment, the Bmax was reduced by 20%, after 7 days by 14%, and after 21 days it was 8% above the control value. When an additional group of patients on DMI (7 days of treatment) was analyzed using one supramaximal concentration of 3H-yohimbine, there was a significant decrease (25%) in binding.

Adult

Sex concordance for schizophrenia in proband-relative pairs.

Some hypotheses about the cause of schizophrenia are based on the puzzling tendency for mental illness to affect the same sex when two close relatives become psychiatrically ill. Sex-concordance rates were examined in 71 schizophrenic probands, who had at least one first-degree relative suffering from the same disorder, in order to test this tendency in a population of recently admitted patients. No unusual concordance rates were found when unaffected sibs were taken into account and relatives were stratified to take account of possible confounding factors. It would seem premature to construct hypotheses about the aetiology of schizophrenia based on evidence of this type.

Adult

Long-term benzodiazepine administration blunts growth hormone response to diazepam.

Growth hormone and prolactin responses to diazepam were measured in eight male patients who had been receiving long-term treatment with benzodiazepines and eight age-matched drug-free controls. The growth hormone response was significantly attenuated during benzodiazepine administration, but increased significantly after benzodiazepine treatment was discontinued. Growth hormone responses four days after the drug therapy withdrawal in patients, however, were still significantly less than in drug-free controls. Prolactin levels were unaltered after diazepam challenge, both in patients and in controls. The results clearly demonstrate tolerance to the growth hormone-releasing effect of diazepam, but do not suggest receptor supersensitivity after withdrawal of benzodiazepine therapy. It is possible that pituitary mammotropes lack benzodiazepine receptors.

Adult

Failure of mianserin to affect autonomic function in the pupils of depressed patients.

The autonomic effects of mianserin were tested in seven depressed patients by comparing pupillary responses to adrenergic and cholinergic agonists before and after treatment. Mianserin failed to affect pilocarpine-evoked miosis and tyramine- or phenylephrine-evoked mydriasis, despite adequate plasma levels of the drug. There was, however, a significant reduction in resting pupillary size after 1 and 3 weeks of treatment: this could result either from a central action, or from interactions at receptors other than cholinergic or adrenergic ones in the pupil of the eye. It is concluded that in clinical dosage mianserin is devoid of effects upon muscarinic receptors, alpha 1 adrenoceptors and noradrenaline uptake in the pupil.

Adult

Family history and schizophrenia: characteristics of groups with and without positive family histories.

Social and demographic characteristics were examined retrospectively in a sample of 475 hospitalized schizophrenics to test the hypothesis that they can be meaningfully distinguished by the presence or absence of psychiatric disorders in their relatives. Cases with a positive family history of psychiatric disorders (FHP cases) were significantly more likely to have been born in the United Kingdom and to have had older mothers. Those who had relatives with psychiatric disorders other than schizophrenia were significantly more likely to have been diagnosed as schizo-affective. The findings are thought to reflect a constitutional trait in parents of FHP cases leading to delayed child bearing. They also support the 'environmental stress' theory of immigrant psychosis and the hypothesized genetic link between schizo-affective and affective disorders.

Adult

Pupil studies in depressed patients: an investigation of the mechanism of action of desipramine.

Six depressed patients were treated routinely with desipramine, a relatively selective noradrenergic uptake blocking drug. After 0, 1 and 3 weeks' treatment, pupillary responses to tyramine, phenylephrine and pilocarpine were measured using a photographic techniques. Both 1 and 3 weeks' treatment significantly inhibited tyramine and phenylephrine-induced mydriasis, but did not inhibit pilocarpine-induced miosis; in fact the longer treatment enhanced miosis due to pilocarpine. Resting pupil size was significantly increased after 1 and 3 weeks' treatment. The findings can be explained by the known ability of desipramine to block noradrenaline uptake and alpha adrenoceptors: they provide no evidence of muscarinic receptor blockade or of a slowly developing adaptation at alpha adrenoceptors.

Adult

Season of birth in high and low genetic risk schizophrenics.

Hypotheses which have been proposed to account for the unusual seasonal birth pattern observed in schizophrenic populations are discussed. These competing hypotheses were tested by retrospectively studying season of birth in 975 schizophrenics divided according to family history of psychiatric illness. Information was obtained from case notes, item sheets, and questionnaires sent to general practitioners. The results were inconclusive, but there was a trend for high genetic risk cases to be born less often in the first quarter of the year. Although no clear support could be provided for one or other season of birth hypothesis, it is tentatively suggested that a seasonal constitutional damage factor may be responsible for the excess of births described in schizophrenic populations in the early months of the year.

England

The effect of desipramine upon central adrenergic function in depressed patients.

Eleven drug free patients meeting Research Diagnostic Criteria for Major Depressive Disorder have been treated with desipramine and given a clonidine infusion after 0, 1 and 3 weeks of treatment. The sedative and hypotensive effects of clonidine were significantly inhibited after three weeks of treatment with desipramine: a similar interaction was seen after one week of treatment although this just failed to reach statistical significance. The growth hormone (GH) response to clonidine was initially impaired, but increased significantly after one week of treatment. A significant reduction in the GH response occurred during the second and third weeks of treatment with desipramine. This last finding is interpreted as evidence of adaptive change of alpha 2 adrenoceptors: the other changes can be explained by the known ability of desipramine to block the re-uptake of noradrenaline.

Adult

Growth hormone and other responses to clonidine in patients with endogenous depression.

The growth hormone response to clonidine was significantly less in 10 drug-free patients with endogenous depression than in 10 normal subjects who were individually matched with the patients for age and sex. The hypotensive and sedative effects of clonidine in the two groups were similar. The findings may indicate a defect at central alpha adrenoceptors at least in neuro-endocrine systems.

Adult

A pilot study of the mechanism of action of desipramine.

To test the hypothesis the desipramine alters alpha adrenoceptor function in depressed patients, the effects of clonidine upon growth hormone sedation and blood pressure have been measured in depressed patients before and after treatment with desipramine. After three weeks of treatment the hypotensive and sedative effects of clonidine were inhibited in all patients even though plasma desipramine concentrations at this time varied from 42 to 560 micrograms/l. Growth hormone responses to clonidine were enhanced in five of the six patients but this effect was not statistically significant. These findings are consistent with the hypothesis that in these patients desipramine altered alpha adrenoceptor function: other explanation are discussed.

Adult