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Biomedical subjects

G Holme

Publications and source records attributed to G Holme.

At least 19 recordsLinked to original sources
PubMed1997

The brief admission unit in emergency psychiatry.

The study evaluates a Brief Admission Unit for clients of an emergency service located within a comprehensive community psychiatric program. Eighty-five clients completed the Brief Symptom inventory and a structured interview. Substance abuse disorder (n = 29) and major depression (n = 24) were the most common Axis I diagnoses, of which 30 subjects had two or more. Sixty subjects had an Axis II diagnosis. Mean duration of admission was 3.9 days, compared with the average in other acute units of 11.5 days. At discharge, half the subjects were rated as moderately to greatly improved and client satisfaction was high. The unit was crucial to the psychiatric emergency service and had a key role in relieving pressure on beds elsewhere within the system.

Adolescent↗
PubMed1996

The influence of a therapeutic community on psychiatric disorder.

Forty-eight residents of a therapeutic community took part in a prospective study aimed at assessing overall outcome and which components of the program were most helpful. All subjects had a DSM-III-R axis II diagnosis, usually borderline personality disorder (N = 34). As well, subjects had a mean of 1.3 axis I diagnoses, underlining the severity of their psychiatric disorders. Significant symptom reduction on the Brief Symptom Inventory occurred at discharge after a mean stay of 64 days, with further significant falls at three month follow-up. These changes were paralleled in the Hostility and Direction of Hostility Questionnaire, a measure of personality. Hospital admission rates fell significantly in the year after discharge. Clients rated group therapy as the most helpful component of the program.

Adult↗
PubMed1995

Behavioral disturbance in dementia.

Fifty-seven subjects with moderate to severe dementia (49 with Alzheimer's disease) were rated twice, 8 weeks apart, using the Mini-Mental State Examination (MMSE), the Blessed Information-Memory-Concentration Test (BIMC), and the Stockton Geriatric Rating Scale (SGRC). Only three subjects lived at home; the rest were in long-stay hospital beds or nursing homes. For 29 subjects, the first rating coincided with their referral to a comprehensive geriatric psychiatry service. The main hypothesis, that the level of behavioral disturbance would correlate positively with the level of cognitive impairment, was strongly confirmed. This finding may reflect the severity of dementia in the study sample. The correlations between MMSE and BIMC scores were .87 at entry and .92 at exit, suggesting that the two measures were broadly equivalent, although both had marked floor effects. Test-retest reliability was high for all three measures. Overall, medication was of limited effectiveness in managing severe behavioral disturbance, highlighting the need for introducing effective behavioral programs.

Aged↗
PubMed1995

Borderline personality disorder: a challenge for mental health services.

OBJECTIVE: This study had two main aims: to determine the stability over time of the diagnosis borderline personality disorder (BPD) in a psychiatric hospital population; and to assess the quality and effectiveness of treatment offered within state mental health service. METHOD: The case notes of 47 psychiatric hospital patients followed up for 3 years after the index admission were analysed. RESULTS: The mean number of previous psychiatric hospital admissions was 9.0, and at least 74% of the sample had further admissions (mean 3.7) during the 3 year follow-up. Comorbidity with schizophrenia and schizoaffective disorder was rare, and was only 13% with major depression. Longitudinal stability of diagnosis was very high. CONCLUSIONS: The study firmly supported BPD as a valid diagnosis. Its treatment within the state mental health system was generally haphazard and ineffective. Post-discharge plans were implemented for only 3 subjects. Current moves toward community psychiatric treatment represent a unique opportunity for improving treatment of BPD by using existing resources more effectively.

Activities of Daily Living↗
PubMed1995

Self reports of the interaction between substance abuse and schizophrenia.

Fifty-three psychiatric hospital inpatients with a dual diagnosis of substance abuse and schizophrenia were given the Brief Symptom Inventory and the Schizophrenia/Substance Abuse Interview Schedule. Mean age was 29; 49 were men. Only 11% were employed. Forty percent abused mainly alcohol, 40% cannabis and 8% amphetamines; 20% abused more than one substance. Mean onset age of drug abuse was 16 years; schizophrenia was diagnosed a mean of 5 years later, and subjects had been admitted to hospital an average of 7 times since then. Most believed that drug abuse initiated or exacerbated their schizophrenia; 80% took drugs primarily to relieve dysphoria and anxiety. Amphetamines improved subjective well-being significantly more than alcohol, but choice of drugs was determined mainly by price and availability. Only cannabis increased positive symptoms of schizophrenia and only amphetamines reduced negative ones. Effectively treating this population requires an integration of psychiatric and drug treatment services, ideally in a community context.

Adolescent↗
PubMed1994

Electroconvulsive therapy in a psychiatric intensive care unit.

This study reviewed all patients (N = 37) treated with ECT in a psychiatric intensive care unit during 1989-91. Diagnoses were: psychotic depression (8); bipolar disorder, manic phase (13); schizoaffective disorder (14); and schizophrenia (2). All patients were very severely disturbed and had failed to respond to medication given at highest levels judged to be safe, usually over 3-4 weeks. Response to ECT was generally rapid and marked, allowing substantial reductions in medication. To achieve the same clinical outcome for each course of ECT, 50% more unilateral than bilateral treatments were required, suggesting that bilateral ECT has a more rapid effect in this highly disturbed population.

Adolescent↗
PubMed1994

Depression and somatic symptoms: a cross-cultural study.

The study was carried out by the same research team in two metropolitan hospitals, one in Greece (N = 60) and one in Australia (N = 56). Subjects comprised patients consecutively admitted with a DSM-III-R diagnosis of depressive disorder, all of whom completed questionnaire measures of depression, anxiety and somatic symptoms. Clinical concepts and practices in the two hospitals were very similar. Overall levels of depression, anxiety and somatic symptoms in the two samples were almost identical, but there were differences in the pattern of somatic complaints: Greeks scored significantly higher on dizziness, paraesthesiae and masticatory spasms, and Australians scored significantly higher on drowsiness, hypersomnia and non-refreshing sleep, with the latter two items being the best discriminators of the two samples using discriminant function analysis. These findings, combined with factor analysis, suggested that symptoms associated with hyperventilation in the Greek sample, and with sleep disturbance in the Australian sample, explained most of the differences between them.

Adult↗
PubMed1992

Assaults by patients: the experience and attitudes of psychiatric hospital nurses.

Four hundred and twenty-five nurses working in a 420 bed metropolitan psychiatric hospital were asked to complete a questionnaire about their experience of physical assault by patients and their attitude toward the problem. 61% returned the questionnaire. The overall mean annual rate of assault per nurse was 2.0, with student psychiatric nurses (mean 6.7) significantly more at risk than any other group. Nurses working in the psychogeriatric area reported more than double the rate of assaults reported by nurses working in rehabilitation services. 60% of respondents were female; there were very few sex differences in attitudes to assault. Overall, nurses reported a high tolerance for assault, although they recognised it as an experience that was often very traumatic psychologically. Views about managing assaultiveness differed widely, and this lack of consensus probably hinders the development of optimal strategies to deal with what is a major problem in many psychiatric units.

Adaptation, Psychological↗
PubMed1989

[Prerequisites for bacterial invasion of the periodontal tissues].

Bacterial invasion of the periodontium has recently been described by several authors. The conditions necessary for this to occur in vivo are being discussed. The anatomical relations of the periodontal pocket are described macroscopically and microscopically as well as the postulated mechanisms for colonization, adhesion and penetration. It is necessary for the microorganisms to colonize and adhere in order to be able to invade tissues. The possibility of establishment of microorganisms in the tissues and the importance of the immune system are also being described. The conclusion is that there is a possibility of bacterial invasion of the periodontal connective tissue. However, the human body with help from the immune system will in most cases be able to neutralize and get rid of these microorganisms.

Humans↗
PubMed1983

Respiratory responses to leukotrienes and biogenic amines in normal and hyperreactive rats.

The effects of leukotriene D4, serotonin, and methacholine were studied on respiratory smooth muscle in vitro and respiratory responses in vivo in three strains of rats. These were an inbred strain of hyperresponsive rats, Sprague Dawley rats, and Fischer rats. Trachea from inbred rats responded in vitro to serotonin and methacholine but not to leukotrienes or histamine. Parenchyma from inbred rats responded to serotonin, methacholine, and leukotrienes. In vivo respiratory responses in inbred rats were observed after aerosol administration of histamine and serotonin, methacholine, and leukotriene D4. When these in vitro and in vivo experiments were repeated in Sprague Dawley and Fischer rats, a clear correlation was observed between the responses of strains of rats to aerosolized antigen and responses to spasmogenic mediators. It is concluded that inbred rats have a nonspecific bronchial hyperreactivity that contributes to their sensitivity to aerosolized antigen and that they may be a useful model for human asthmatic conditions.

Animals↗
PubMed1982

Biological activity of leukotriene sulfones on respiratory tissues.

The biological activity of synthetic leukotriene C4, D4 and E4 sulfone has been determined in respiratory smooth muscle in vitro and in vivo. The sulfones of LTC4, LTD4 and LTE4 were potent contractile agonists on indomethacin-treated guinea pig tracheal chains with respective pD2-values of 8.2, 8.0 and 7.9. Contractions were submaximal (75-85% of the cholinergic maximum), slow in onset, prolonged in duration, slowly reversed by washing (compared to acetylcholine or histamine) and were partially reversed by 2 muM FPL-55712. The sulfones of LTC4, LTD4 and LTE4 also contracted indomethacin-treated guinea pig parenchyma (respective pD2's of 7.9 8.2 and 7.8) and rat parenchyma (respective pD2's of 7.1, 7.2 and 7.2) but were inactive on rat trachea (0.01-2.0 muM). When administered intravenously to anaesthetized guinea pigs, the sulfones of LTD4, LTE4 and to a lesser degree LTC4 (respective ED50's - 0.5; 2.0 and 4.6 microgram/kg) elicited dose-dependent increases in inflation pressure which were antagonized by FPL-55712 and indomethacin. Leukotriene C4, D4 and E4 sulfones display a qualitatively similar profile of biological activity to that of their corresponding sulfides.

Animals↗
PubMed1982

Analysis of antigen-induced changes in pulmonary mechanics in sensitized inbred rats.

An inbred line of rats was derived which develop marked and consistent dyspnea following sensitization and then exposure to aerosolized antigen. This pulmonary response was investigated in detail by determining forced pulmonary mechanics to derive respiratory rate, peak expiratory flow rate (PEFR), forced vital capacity (FVC), forced expiratory volume in 0.1 s (FEV0.1), and maximal midexpiratory flow rate (MMFR). Challenging anesthetized rats for 5 min with an aerosol of 3% egg albumin produced minimal change in respiratory rate, a 20% fall in PEFR, a 50% fall in FVC, and a 30% decrease in FEV0.1 and MMFR. The response could be inhibited or reversed by salbutamol (0.5 mg/kg, i.v.) and aminophylline (25 mg/kg, i.v.) administered either before or after challenge. The pulmonary changes are consistent with antigen-induced asthma in the rats. The response shows similarities to human asthma and may provide a relevant experimental model.

Albuterol↗
PubMed1981

The derivation of an inbred line of rats which develop asthma-like symptoms following challenge with aerosolized antigen.

Sensitized Sprague-Dawley rats developed respiratory impairment after challenge with aerosolized antigen. The response to challenge was heterogeneous. A proportion of each group of rats developed dyspnea and other symptoms similar to asthma; the remainder developed apnea but no other symptoms. Selective breeding from rats which developed dyspnea increased the incidence from 44% in F0 to 55% in F1 and greater than 90% in F2 and F3. Inbreeding also produced a significant increase in the duration of antigen-induced dyspnea. The results from the selective inbreeding suggest antigen-induced dyspnea is controlled genetically, possibly by multiple gene loci. These inbred rats constitute a population which have a predictable response to aerosolized antigen challenge. They should have utility in investigating allergic asthma and evaluating potential new drugs.

Aerosols↗
PubMed1980

The activity of synthetic leukotriene C-1 on guinea pig trachea and ileum.

The effects of synthetic leukotriene C-1 (LTC-1) on isolated guinea pig trachea and ileum have been determined and compared to histamine. LTC-1 produced a slow contraction of the trachea and the ileum with pD2 values of 8.7 +/- 0.1 (n = 14) and 8.5 +/- 0.1 (n = 13), respectively. In comparison, the pD2 values for histamine were 5.6 +/- 0.1 (n = 6) and 6.2 +/- 0.1 (n = 6), indicating LTC-1 was 2-3 orders of magnitude more potent. LTC-1 was antagonised by FPL 55712 with pA2 values of 6.9 +/- 0.1 (n = 5) and 6.4 +/- 0.1 (n = 7) on the trachea and ileum, respectively. Incubation with lipoxidase produced a time and enzyme dependent loss of biological activity and a concurrent shift in U.V. absorption spectrum.

Animals↗
PubMed1980

Evaluation of pulmonary mechanics in guinea pigs during respiratory anaphylaxis.

Guinea pigs sensitized to ovalbumin exhibit signs of respiratory impairment when exposed to an aerosol of the antigen. This response was investigated in anesthetized guinea pigs by determining forced pulmonary mechanics to derive peak expiratory flow rate, forced vital capacity, forced expiratory volume in 0.1 sec, maximal mid-expiratory flow rate and respiratory rate. Measurement of these parameters allows qualitative comparisons to be made with changes that are routinely determined during investigations of human asthma. Exposure of anesthetized guinea pigs to a 3% ovalbumin aerosol for 2 min produced an increase in respiratory rate, a 20% fall in peak expiratory flow rate and maximal mid-expiratory flow rate, a 50% fall in forced vital capacity and a 40% fall in forced expiratory volume in 0.1 sec. This response was reversed by aminophylline. In these respects the response appears to be similar to the acute asthmatic response in humans.

Aminophylline↗
PubMed1979

The respiratory response of sensitized rats to challenge with antigen aerosols.

An experimental procedure was developed to evaluate the effects of challenging sensitized conscious rats with antigen aerosols. The challenge resulted in changes in the respiratory patterns which were antigen specific and mediated by IgE antibodies. The response was inducible in non-sensitized rats by passive administration of IgE-rich serum. Sprague-Dawley rats were heterogeneous with respect to the respiratory response. A proportion (20--70%) of each group had continuous dyspnoea and other symptoms similar to asthma; the other had only episodes of apnoea. Wistar and Long-Evans rats resembled Sprague-Dawley rats; Fischer 344 rats had apnoea only, even though they produced IgE antibodies. The type of response did not correlate with serum IgE levels. The respiratory responses were reduced by dexamethasone, disodium cromoglycate, epinephrine and theophylline. Rats that respond with dyspnoea may provide a useful experimental model of allergic asthma.

Aerosols↗