Long-term downregulation of central adrenoceptor function by desipramine treatment: a clonidine study in normal subjects.
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Adult↗
Biomedical subjects
G Charles
Publications and source records attributed to G Charles.
Growth hormone response to clonidine and cortisol secretion pattern predict changes in peripheral blood lymphocyte subsets in major depressive patients.
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Adult↗
How strictly do dialysis patients want their advance directives followed?
OBJECTIVE: The Cruzan case and the Patient Self-Determination Act will encourage patients to specify in advance which life-sustaining treatments they would want if they become mentally incompetent. However, strictly following such advance directives may not always be in a patient's best interests. We sought to determine whether patients differ in how strictly they want advance directives followed. DESIGN: Interview study. SETTING: Seven outpatient chronic dialysis centers. PARTICIPANTS: One hundred fifty mentally competent dialysis patients. INTERVENTION: Using a structured questionnaire, we asked the subjects whether they would want dialysis continued or stopped if they developed advanced Alzheimer's disease. We then asked how much leeway their physician and surrogate should have to override that advance directive if overriding were in their best interests. Subjects granting leeway were also asked what factors should be considered in making decisions for them. RESULTS: Subjects varied greatly in how much leeway they would give surrogates to override their advance directives: "no leeway" (39%), "a little leeway" (19%), "a lot of leeway" (11%), and "complete leeway" (31%). Subjects also varied in how much they wanted various factors considered in making decisions, such as pain or suffering, quality of life, possibility of a new treatment, indignity caused by continued treatment, financial impact of treatment on family members, and religious beliefs. CONCLUSIONS: Strictly following all advance directives may not truly reflect patients' preferences. To improve advance directives, we recommend that physicians explicitly ask patients how strictly they want their advance directives followed and what factors they want considered in making decisions.
Adolescent↗
Reduced clonidine rapid eye movement sleep suppression in patients with primary major affective illness.
Clonidine hydrochloride, administered intravenously (2 micrograms/kg) during the second non-rapid eye movement period, was significantly less suppressant of rapid eye movement sleep in 10 depressed patients with primary major affective illness, according to Research Diagnostic Criteria, than in three groups of matched subjects (10 normal controls, 10 patients with minor depression, and 10 patients with generalized anxiety). These results suggest that depressed patients with major primary affective illness have down-regulated alpha 2-adrenergic receptors. These findings are consistent with the cholinergic-aminergic balance hypothesis of depression and support the aminergic side of the concept. Finally, the rapid eye movement sleep response to clonidine could provide a new biological marker of affective illness.
Adult↗
Growth hormone response to clonidine in male patients with panic disorder untreated by antidepressants.
We report a non-significantly higher growth hormone (GH) response to intravenous clonidine administration (150 micrograms) in 10 male patients with panic disorder who had never received antidepressant therapy than in 10 matched controls. These results are consistent with data suggesting a normal or increased adrenergic receptor sensitivity in panic disorder patients.
Adult↗
Lymphocyte subsets in major depressive patients. Influence of anxiety and corticoadrenal overdrive.
We studied 26 inpatients (17 females; mean age +/- SD: 41.2 +/- 14.3 years) who met the DSM III criteria for a major depressive episode and had a mean (+/- SD) Hamilton Depression Score of 19.3 +/- 8.0. All patients were drug free and medically healthy at the time of experimentation. We found a significant correlation between the CD4/CD8 ratio and the Hamilton Anxiety Score (r = 0.57, p less than 0.005). When splitting our sample in dexamethasone suppression test suppressors (DST-S) and nonsuppressors (DST-NS), this relationship appeared only in DST-NS (DST-NS: r = 0.81, p less than 0.005; DST-S: r = 0.20, p = NS). These results are discussed in terms of heterogeneity among major depressive disorders and possible relationships between catecholaminergic activity and the immune system.
Adrenal Cortex Diseases↗
[Surgical care of the multiple trauma patient].
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Bandages↗
Use of traditional and modern health services by Laotian refugees.
Although refugee health care emerged as a special interest in the United States following the influx of almost a million Southeast Asians since 1975, few studies have been done of the influence of refugee traditions on the use of Western medical services. The illness patterns, medical beliefs, and health care behavior of a Southeast Asian refugee group, the Mien from Laos are described in this study. A cohort of 119 Mien refugees living in Richmond, California, was observed for a 6-month period. In-home interviews were undertaken about all episodes of ill health, including treatment and health care decisions. This study shows that the Mien integrate traditional healing beliefs and practices with the use of American health services. Such findings are important because the increasing cultural diversity in the United States, particularly in Western states, necessitates that health care professionals understand the importance of cultural factors for access to and the use of health care by all patients including refugees and other immigrant groups.
Adolescent↗
[Diagnostic criteria for research in psychiatry (RDC) and guide for the diagnosis of affective disorders and schizophrenia (SADS)].
The Research Diagnostic Criteria (RCD) and the Schedule for Affective Disorders and Schizophrenia (SADS) were developed in the mid-1970s by researchers at the New York State Psychiatric Institute and at Columbia University. This article shows their clinical and research interests. The authors of the french translations, compare them to the recent DSM-III. These criteria represent a widely used nosologic system for clinical research in psychiatry. The SADS was developed in an effort to provide research investigators with a clinical procedure which reduce information variance in both diagnostic and descriptive evaluations of subjects.
Depressive Disorder↗
A physician extender training program based on clinical algorithms.
The ability of physician extenders to provide patient care in a variety of settings has been reported widely. Less attention has been paid to training programs, especially those of short duration, for physician extenders. A three-month training program for physician extenders at a large teaching hospital was based on teaching the skills needed to run 39 clinical algorithms. The course content and the methods used to test the students during the three months may prove of value to those preparing similar programs.
California↗
[A rare case of cavernous haemangioma of the bladder (author's transl)].
The authors report a case of haemangioma of the bladder treated by partial cystectomy in a young man aged 17 years and review the world literature. Less than 70 cases have been published up to the present time. In 30 per cent of cases, the presence of signs of vascular dysplasia of the limbs is also noted.
Adolescent↗
[P 300 slow potential. Clinical interest in 3 mental diseases and neurobiology: a review].
P300 is a late component of evoked potential which meet special relevance to the study of cognitive processes. P300 indexes categorization processes and the context updating of memory. Its latency reflects the stimulus evaluation time, and P300 amplitude is related to some psychological variables such as expectancy, attention and stimulus significance. In this review, clinical correlation between P300 components and mental diseases are reported, especially dementia, schizophrenia and depression. Delayed P300 latency has been found in Alzheimer disease and in other forms of dementia. Reduced P300 amplitude as well as altered topography has been reported in schizophrenia. In depression, reduced P300 amplitude has been related with longer reaction time. Unfortunately, the diagnosis utility of P300 seems limited. The authors also propose an overview of the actual knowledge on neurobiological findings in the generation of the P300 wave. Anatomical data point out the importance of the limbic system, more specifically, of the hippocampus and the locus coeruleus, in generating and modulating P300 wave. Data from the literature on the psychopharmacological modifications induced by cholinergic, catecholaminergic and other agents, are reviewed. Although the dopaminergic and noradrenergic systems are of some importance, these data emphasise the importance of the cholinergic system for the generation and modulation of P300 amplitude and latency. The value and interpretation of these neurobiological and clinical findings are discussed.
Adolescent↗
[Comparative statistics of cancers in Sahara (author's transl)].
Statistics of 204 cases of cancer observed in Saharian populations from 1969 to 1976 and a comparison with studies previously made in this area and statistics from other countries. Skin cancer have a special frequence which may be related to climatic and atmospheric environment.
Adolescent↗