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Biomedical subjects

F J Letemendia

Publications and source records attributed to F J Letemendia.

At least 19 recordsLinked to original sources
PubMed1993

Therapeutic advantage of bifrontal electrode placement in ECT.

Fifty-nine patients suffering from a major depressive episode, for whom electroconvulsive therapy (ECT) was clinically indicated, were randomly assigned to one of three electrode placement groups for treatment with brief pulse, threshold-level ECT: bitemporal (BT), right unilateral (RU) or bifrontal (BF). Comparison of these groups in terms of number of treatments, duration of treatment, or incidence of treatment failure, showed that the bilateral placements were superior to the unilateral; comparison of Hamilton, Montgomery-Asberg, and visual analogue scale scores showed that the bifrontal placement was superior to both bitemporal and unilateral treatment. Bitemporal treatment showed therapeutic results intermediate between BF and RU. Because BF ECT causes fewer cognitive side effects than either RU or BT, and is independently more effective, it should be considered as the first choice of electrode position in ECT.

Adult↗
PubMed1990

Sleep deprivation in depression: pattern of relapse and characteristics of preceding sleep.

The pattern of relapse following therapeutic response to 40-hr sleep deprivation (SD) was examined in nine depressed patients. On the night ending SD patients were awakened from polygraphically recorded sleep on one or more occasions, in order to assess the clinical state. All subjects were found to demonstrate a precipitous and full relapse over this night, the timing of the relapse varying considerably between individuals. No association was found between deterioration in the clinical state and characteristics of preceding sleep. These results are consistent with the notion that, in predisposed individuals, some process associated with sleep has a depressogenic effect. However, they necessitate revision of theories of SD and depression that emphasize the infrastructure of sleep.

Adult↗
PubMed1990

Electrode placement in ECT: cognitive effects.

Forty patients suffering from a major depressive disorder, for whom electroconvulsive therapy (ECT) was clinically indicated, were assigned to one of three electrode placement groups: bitemporal (BT), right unilateral (RU) or bifrontal (BF). Comparisons of these groups in terms of cognitive status showed that the BF placement, which avoided both temporal regions, spared both verbal and nonverbal functions. These differential effects, which were independent of the degree of clinical depression, were not, however, evident three months after the last ECT.

Adult↗
PubMed1989

Capillary gas chromatography of trihexyphenidyl, procyclidine and cycrimine in biological fluids.

A sensitive (50-100 pg/ml) method is described for the analysis of the anticholinergic drugs cycrimine, procyclidine and trihexyphenidyl by capillary gas chromatography with flame thermionic detection. Since these anticholinergic drugs are frequently administered in combination with antipsychotic medication for the treatment of mental illness, the potential interference by antipsychotic drugs in this assay was examined. No interference was observed from a series of antipsychotic drugs in the quantitation of cycrimine, procyclidine or trihexyphenidyl. The use of this technique to study trihexyphenidyl pharmacokinetics in man is described.

Antipsychotic Agents↗
PubMed1986

The sleep of remitted bipolar depressives: comparison with sex and age-matched controls.

The sleep of 10 bipolar patients was recorded for five consecutive nights following their recovery from a depressive episode. In all respects except the number of arousals, their sleep did not differ reliably from that of 10 sex and age-matched control subjects. We conclude that sleep measures are unlikely to be useful as trait markers of a depressive diathesis in bipolar disorder.

Adult↗
PubMed1986

Diagnostic applications of sleep deprivation.

Four cases are described in which observation of the response to forty hour sleep deprivation was used in resolving the differential diagnosis between depression and dementia. In each case it was possible to conduct psychometric assessment of cognitive ability during the period of improvement of the clinical state. The utility of this approach and some of the difficulties associated with its use are discussed.

Aged↗
PubMed1984

Neuropsychological function in diabetic patients with neuropathy.

Psychometric examination of a group of diabetic patients and a group of age-matched controls failed to provide evidence of impaired intellectual functioning in the diabetic group. The cognitive status of the diabetics was not related to the duration of the illness, the age at diagnosis, or clinical ratings of peripheral or autonomic neuropathy.

Adolescent↗
PubMed1984

Psychiatric aspects of diabetes mellitus.

A descriptive study of the psychiatric findings in 50 insulin--dependent diabetics is presented. Among the symptoms found were a marked reduction in energy level, increased fatigue and irritability, depression, and delayed psychosexual maturation. Diabetes mellitus is commonly considered to be a disease that, if properly controlled, allows the patient to lead a relatively normal life. We found, however, that these symptoms often made the patients' lives uncomfortable, reduced their functional capacity, disrupted their family life, and disturbed the adolescence of those who were affected at an early age.

Adolescent↗
PubMed1984

Functional correlates of reduced central conduction velocity in diabetic subjects.

In a previous publication, we presented evidence of slowed conduction speed in the central nervous systems of insulin-dependent diabetic subjects, manifest in a delay in the latency of the brainstem auditory-evoked response (BAER). In this article, we present the results of a multivariate study conducted on a larger sample of 50 insulin-dependent, adult diabetic subjects. The purpose of the study was to determine some of the functional correlates of the BAER delay; each patient received an assessment of the BAER, the late auditory-evoked potential (EP), the conduction velocities of the sural, median, and common peroneal nerves, and intellectual and emotional function, in addition to neurologic and audiologic examinations. A nondiabetic control group was matched with the diabetic group as to age and sex. The results indicated a delay in the latency of wave V, and in interpeak latencies I-III and I-V, of the BAER. The most reliable effect was on interpeak latency I-V; this suggested that the locus of the delay was in the central auditory projections, rather than in the acoustic nerve. In addition, BAER waves I, II, III, IV, and V were reduced in amplitude, as was the N1 component of the late auditory EP; the most reliable reduction in amplitude was in wave V. The effect was similar in magnitude for males and females, relative to their counterparts in the control group. The slowed BAER response appeared early in the disease and was not related to the duration of insulin treatment. It was correlated with a chronic loss of energy and the presence of sexual dysfunction.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1983

Symposium on the teaching of psychiatry. Canada: Queen's University, Kingston, Ontario.

The medical school at Queen's University offers a 4-year M.D. degree course. Because the majority of graduating students consistently choose family medicine as a career, it was decided that the overall objective of the undergraduate course should be to provide the students with the skills and knowledge required to deal with the psychiatric disorders commonly found in general medical practice. The teaching of psychiatry is limited to the second, third and fourth medical years, and teachers are clinicians rather than nonpractising experts in particular fields related to medicine.

Clinical Clerkship↗
PubMed1981

Delayed auditory brainstem responses in diabetes mellitus.

Diabetic patients have longer interpeak latencies in the brainstem auditory evoked responses than age-matched controls. The delay is not related to clinical hearing loss or blood glucose level at time of testing. Since waves I and II are normal in latency, the conduction velocity of the eighth nerve is not involved. The delay occurs between waves II and V, which would reflect altered transmission times in auditory brainstem and midbrain structures, and suggests the presence of a central neuropathy in patients with diabetes.

Adult↗
PubMed1981

Sleep deprivation: outcome of controlled single case studies of depressed patients.

Six drug-free depressed patients, each of whom acted as their own control, were studied for eleven consecutive days during which they were twice deprived of sleep for either 36 or 40 hours. The sequence of events was baseline (3 days), SD, recovery (3 days), SD, recovery (3 days). Blind ratings of clinical state were made on the basis of four-hourly interviews (standardized for each case), which were videotaped; sleep was monitored by conventional electrophysiological methods. Sleep deprivation had a beneficial, but transient, effect on four of the six patients studied. Changes in sleep were unrelated to changes in clinical state.

Aged↗
PubMed1979

Five variations of sleep deprivation in a depressed woman.

Systematic variation in aspects of the sleep-wakefulness cycle of a depressed woman showed that recovery occurred reliably after 19 to 20 hours sustained wakefulness, unrelated to diurnal rhythm. Depression returned during as little as 15 minutes sleep. The effect of sleep deprivation was a specific response, probably unrelated to REM sleep.

Aged↗
PubMed1976

A survey of social inadequacy among psychiatric outpatients.

An investigation into the extent and nature of social inadequacy among outpatients diagnosed as neuroses and personality disorders was undertaken on patients aged 18-49 attending one clinic over a six-month period. A feature of this survey was that each patient took part in a standard social interaction test, and their performance was assessed by two psychologists. A relatively high proportion of patients, one in six on the most conservative estimate, and probably over one in four, were judged by psychologists and psychiatrists to be socially inadequate, and the results showed a clear pattern of behavioural, social and personality factors associated with these judgements. Implications for assessment and treatment are discussed.

Adolescent↗