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Biomedical subjects

G Molnar

Publications and source records attributed to G Molnar.

At least 73 records · Page 4Linked to original sources
PubMed1981

Adolescents on a general hospital psychiatric unit: problems and remedies.

The care and treatment of adolescents on an adult acute psychiatric unit in a general hospital can pose serious problems for unit staff. Adolescents with behavior or character problems who prove violent or manipulative can disrupt treatment of both the adolescent and adult patients on the unit. Yet the demand for immediate treatment for many adolescents and the accessibility of general hospital psychiatric units often mean that adolescents may placed there inappropriately. This paper describes how an adult acute unit in a general hospital solved the problems caused by acting-out, manipulative adolescents on the unit. A committee found problems in inappropriate admissions, unworkable treatment plans, management of acting-out behaviors, case disposition, and staff attitudes. Remedies came in the form of more specific admission and discharge guidelines, strict enforcement of those guidelines, staff discussion of treatment plans, an inservice education program, and improved liaison with community facilities for adolescents.

Acting Out↗
PubMed1981

The influence of age, height, and body weight on cerebrospinal fluid amine metabolites and tryptophan in women.

Cerebrospinal fluid 5-hydroxyindoleacetic acid (CSF 5HIAA), homovanillic acid, and tryptophan were measured in 33 depressed, 36 alcoholic, and 32 neurological control female patients selected by strict operational criteria and investigated under controlled circumstances. Plasma total tryptophan was also measured in blood samples taken simultaneously with lumbar punctures. A multivariate regression analysis was done to discover the effect of age, height, and body weight on these four biochemical measures. Only CSF 5HIAA was significantly dependent on the nonspecific patient variables: height, but neither age nor weight, accounted for more than 10% of the variance of 5HIAA. The same analysis was carried out in all three separate patient groups: the relationship between height and CSF 5HIAA was present throughout, and only 2 of 12 correlations proved to be non-homogeneous. To demonstrate the significantly of these clinical parameters a multivariate analysis of covariance was done to eliminate their effect on the four biochemical variables. As a result significant differences emerged in CSF 5HIAA and total plasma tryptophan for some of the patient groups which were not demonstrable without this correction.

Adult↗
PubMed1979

"Dislocation of expectations" (management of violence on a general hospital psychiatric unit).

An approach to the management of potential violence on a General Hospital Psychiatric Unit is described as it evolved following analysis of the successful handling of a series of problem patients. The importance of an attitude of acceptance towards potentially violent persons is emphasized as is an orientation towards prevention. An approach of consistency and directness with enhancement of the patient's positive personality features is favoured. The initial assessment is considered important and clues to the prediction of violence are highlighted, as are aspects of the supervision plan. A specific technique for prevention of violence based on the principle of Dislocation of Expectations, or doing differently than the subject expects, is introduced.

Adult↗
PubMed1977

Maprotiline-a double-blind study of a new tetracyclic antidepressant in severe depression.

A double-blind study was carried out comparing the antidepressant properties of maptotiline (a new tetracyclic antidepressant) and amitriptyline. Twenty-one hospitalized severely depressed patients, selected on the basis of clinical and psychometric criteria, completed the trial period of 28 days. The new drug was found to have an order of effectiveness similar to that of amitriptyline and both drugs were effective in agitated as well as retarded forms of depression. For both, the "day of effect", intended as the timing of sharp clinical improvement, tended to occur during the second week of treatment. Both drugs were well tolerated by most patients but one of the maprotiline patients presented a generalized rash which resolved after discontinuation of the drug. In conclusion, maprotiline is seen as an interesting addition to the group of major antidepressant drugs.

Adult↗
PubMed1977

Estimation of maprotiline in serum by gas-chromatography, with use of a nitrogen-specific detector.

We describe a gas-chromatographic procedure for estimating therapeutic concentrations of maprotiline, a new tetracyclic antidepressant, in serum by use of a nitrogen-specific detector. Desmethyldoxepin, a secondary amine similar in structure to maprotiline, is added as a mass internal standard to the specimen before extraction, to obviate the need for accurate measurements of volumes during extraction and analysis. Both maprotiline and the internal standard are converted to acetyl derivatives, to avoid the adsorption of secondary amines on the column. A highly selective liquid phase is used, which allows a very good separation of desmethyldoxepin, maprotiline, desmethylmaprotiline, and the interferences from serum and reagents.

Anthracenes↗
PubMed1976

Estimation of amitriptyline and its metabolites in serum and urine by GLC using nitrogen-specific detector.

1. A gas-chromatographic procedure for the estimation of amitriptyline and its metabolites in serum and urine using a nitrogen-specific detector is described. Specially cleaned glassware and purified solvents are used for the extraction of serum to further minimize extraneous peaks. Trimethylamine is added to serum before extraction to improve the recovery of drugs. Urine is refluxed at pH approximately 1 to hydrolyze the conjugates and to convert hydroxymetabolites to corresponding dehydro compounds. Serum is not hydrolyzed. 2. Two internal standards, one a tertiary amine similar in structure to amitriptyline and the other a secondary amine similar in structure to nortriptyline, are added to the specimen prior to extraction to obviate the need for accurate measurements of volumes during extraction and analysis. Urine and serum are washed with organic solvents at acidic pH to remove neutral and acidic impurities. Secondary bases are converted to their acetyl derivatives. 3. In the serum of a patient who is on amitriptyline therapy or who has ingested an overdose of amitriptyline, nortriptyline, a pharmacologically active metabolite is also measured. However, detection or estimation of hydroxymetabolites in serum is not clinically relevant. Hydroxylation index of an individual patient is determined by measuring the ratio of nortriptyline to its hydroxymetabolite in urine. 4. Amitriptyline and nortriptyline can be estimated in serum at a lower level of 10 and 20 ng/ml respectively. The procedure is linear over a wide range of amitriptyline and its metabolites. The use of an electronic integrator allows the estimation of different compounds with 100 fold difference in their concentration from the same chromatogram.

Amitriptyline↗