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Biomedical subjects

I B Glass

Publications and source records attributed to I B Glass.

17 recordsLinked to original sources
PubMed1990

Diploma in addiction behaviour: update.

The Diploma in Addiction Behaviour, offered by the Institute of Psychiatry of the University of London, began in 1986. We are now recruiting for the fourth year, 1989/90. Although its primary objective remains to 'train the trainers', this 'experiment in action' has in itself catalysed changes in the structure and goals of the programme. These include balancing the academic and clinical training, in which placements will be both hospital-based and community-orientated. Student participation will be maximised, and the experience of their own country emphasised. Training for leadership emerges as an important module, as does the process of learning about research skills.

Adult↗
PubMed1989

Alcoholic hallucinosis: a psychiatric enigma--1. The development of an idea.

This paper outlines the evolution of ideas on the topic of alcoholic hallucinosis. From 1847 to 1987 numerous descriptive case-histories appeared in the literature. Analysis of these demonstrates that there were some phenomenological features of the illness about which authors were agreed. These were the acute onset of the illness, the predominance of auditory hallucinations and a history of heavy drinking. Protagonists of the delirium tremens school of though drew attention to the slight clouding of consciousness, the presence of the physical symptoms which may accompany an acute confusional state and the possibility of other kinds of hallucinations. Those who favoured the idea that it was a schizophrenic-like illness emphasized the chronicity, the predominance of auditory hallucinations and clear consciousness. Enlightening as these case-histories were, it was impossible to conclude the debate on these unsystematic observations alone.

Alcohol Withdrawal Delirium↗
PubMed1989

Alcoholic hallucinosis: a psychiatric enigma--2. Follow-up studies.

This paper reviews the contribution of natural history and genetic studies to the understanding of the syndrome called alcoholic hallucinosis. Critical analysis of research methodology demonstrates that the diversity of fundamental definitions and assessment techniques challenge the interpretations derived from the data. Important questions for future research are outlined.

Follow-Up Studies↗
PubMed1989

Undergraduate training in substance abuse in the United Kingdom.

During 1987 thirteen departments in each of 28 medical schools were surveyed about the training their undergraduate medical students received in substance abuse. There was a 70% response rate, and of the departments that responded, 54% provided formal teaching (lectures, seminars, symposia), on average 14 hours over the 5 year training. Forty-three per cent of the major clinical specialities provided clinical exposure to addiction problems, but only 21% of clinical and non-clinical departments ensured that students were examined on the topic. There is a need to focus teaching in addiction behaviour either by co-ordinated effort over all departments, or by integration within departments. It is pressing to review and revise the medical curriculum because of the escalation of substance abuse, the need for resources, the pivotal role of the medical profession and the relation of drug abuse to the acquired immunodeficiency syndrome. The development of a 'core' curriculum which demarcates key topics, and which encompasses and links pre-clinical and clinical training in addiction behaviour would be valuable.

Curriculum↗
PubMed1989

Increased plasma carnitine in severe alcohol dependence.

Carnitine plays a central role in lipid metabolism. There have been several suggestions that carnitine metabolism is affected in alcoholism. In the present study plasma carnitine levels in severely dependent alcoholic patients were investigated. The results show that total and free plasma carnitine in 11 out of 14 patients were raised above those found in normal control subjects. This may be indicative of changes central to the disease process. We suggest that plasma free carnitine represents a useful test which can be added to those currently used to assess alcohol dependence.

Adult↗
PubMed1988

Diploma in addiction behaviour.

The first international full-time one-year course in Addiction Behaviour was offered by the Institute of Psychiatry, University of London in October 1986. It has a strong multidisciplinary focus and integrates teaching on basic sciences, clinical aspects, service organisation and development of national policy. Clinical teaching takes place in specialised treatment facilities, and visits are arranged to a wide range of community organisations. Personal tutorials, seminars closely linked to clinical experience and research workshops complement the clinical basis of the course. Although there is a final written, oral and clinical examination, weight is given to continuous assessment. A general consensus emerged as to the value of the course contents, despite widely differing cultural, educational and professional backgrounds of the six students. Four of the six students who enrolled were awarded a Diploma, one of whom received a distinction for work of exceptional calibre.

Adult↗
PubMed1986

Neuroendocrine and other studies of the mechanism of antidepressant action of desipramine.

It is not known whether in depressed patients antidepressant treatment increases or reduces monoaminergic neurotransmission. Clinical studies are therefore reviewed that investigate adaptive changes at adrenoceptors in depressed patients treated with desipramine, and the net effect of these changes upon neurotransmission. Although in animals chronic desipramine treatment enhances the responsiveness of alpha 1-adrenoceptors to phenylephrine, no such effect could be demonstrated in patients upon the responsiveness of pupil diameter to phenylephrine. However, in keeping with animal studies, clinical evidence of altered responsiveness of alpha 2-adrenoceptors could be demonstrated after chronic desipramine treatment. The alpha 2-mediated growth hormone response to clonidine was increased after one week's treatment with desipramine and then reduced during the second and third weeks of treatment. No clinical measure of the responsiveness of central beta-adrenoceptors is available. However, the secretion of melatonin is a measure of neurotransmission at noradrenergic terminals in the pineal with alpha 1-, alpha 2- and beta 1-adrenoceptors. In normal volunteers the secretion of melatonin was increased by the noradrenaline uptake inhibitors desipramine and (+)-oxaprotiline; (-)-oxaprotiline had no effect. In depressed patients melatonin secretion was increased after three weeks' treatment with desipramine. These and other clinical studies suggest that antidepressant treatments increase noradrenergic neurotransmission in depressed patients.

Animals↗
PubMed1985

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↗
PubMed1984

Measurement of the GH and other responses to clonidine at different times of the day in normal subjects.

The growth hormone response to clonidine may be impaired in some patients with endogenous depression. To determine whether or not this change is due to a circadian variation in the GH response to clonidine, this measure has been studied in normal subjects at 0900, 1800 and 2100 hr. Similar responses were obtained at 0900 and 1800 hr. The responses at 2100 hr could not be interpreted, as the baseline plasma GH was raised. At no time of day were there impaired GH responses similar to those found in endogenous depression. The effects of clonidine upon blood pressure and alertness were similar at the three times studied, providing no support for any circadian rhythm in the function of the alpha 2-adrenoceptors that mediate these effects of clonidine.

Adult↗
PubMed1984

The GH response to clonidine in endogenous as compared with reactive depression.

The growth hormone (GH) response to clonidine was measured in 10 patients meeting standardized criteria for 'endogenous' depression and in 10 patients individually matched for age and sex but meeting the corresponding criteria for 'reactive' depression. In a paired comparison of patients with reactive and endogenous depression (matched for age and sex), the GH response to clonidine was less in the endogenous member of the pair in 8 out of 10 cases. These findings are interpreted as evidence of a defect at alpha 2 adrenoceptors in neuroendocrine systems in endogenous as compared with reactive depression.

Adjustment Disorders↗
PubMed1982

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↗
PubMed1978

Recovery from ECT in elderly patients.

Nine elderly depressed patients were given ECT in courses which alternated unilateral and bilateral electrode placement; recovery times were measured. When compared with similar times for younger patients, recovery took on average five times as long from unilateral treatment and nine times as long from bilateral. Within the group, bilateral treatment took significantly longer for recovery than unilateral treatment and was significantly more sensitive to cumulative effect and interval effect.

Age Factors↗