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Biomedical subjects

I Modai

Publications and source records attributed to I Modai.

At least 19 recordsLinked to original sources
PubMed1999

Mouse strains differ in their sensitivity to alprazolam effect in the staircase test.

The behavioral responses of five mouse strains (inbred: C57 and BALB/c; outbred: Swiss, ICR and HS/Ibg) to alprazolam was examined in the staircase test, an animal model sensitive to benzodiazepines (BZs). Alprazolam administration resulted in a dose-dependent suppression of rearing behavior, but to a different extent among the strains. By contrast, the number of stairs ascended was not suppressed by alprazolam at doses of 0.25 and 0.5 mg/kg, except in the C57 mice. The addition of flumazenil antagonized the alprazolam effect on rearing and climbing in all strains. There was a consistency within strains in sensitivity to alprazolam, with some strains being highly sensitive (C57 and HS) or less sensitive (Swiss, ICR and BALB/c) with regard to both rearing and climbing behaviors. Serum alprazolam levels did not differ significantly among the strains. This strain-dependent pattern of response to alprazolam seems to indicate a genetic component, rather than pharmacokinetic, in the behavior sensitivity to the BZ, with a spectrum of degree of responsivity among strains.

Alprazolam↗
PubMed1999

Homicide by schizophrenic patients in Israel.

Thirty-three schizophrenic inpatients aged 45.3 +/- 13.5 years who had been found not guilty of homicide by reason of insanity were compared with 28 schizophrenic patients matched for age, sex and duration of disease who had not committed any crime. Statistical analysis revealed a high rate in the study group of individual factors associated with aggression, such as alcohol abuse, previous contact with the police, aggressive behavior and threats (P < 0.05). Significantly more of them were also immigrants (P < 0.05). There was no between-group difference in familial factors. These findings support earlier studies indicating that schizophrenic patients with the profile of alcoholism, aggressiveness and foreign country of origin are at high risk of homicidal behavior.

Adolescent↗
PubMed1999

Association of unipolar major depressive disorder with genes of the serotonergic and dopaminergic pathways.

Major depressive disorder (MDD) is a severe psychiatric disorder with a lifetime prevalence of about 15%.1 The importance of the genetic component is well accepted,2 but the mode of inheritance is complex and non-Mendelian. A line of evidence suggests the involvement of serotonin and dopamine neurotransmitters in the pathophysiology of depression. In the present study, 102 unipolar MDD patients and 172 healthy controls were genotyped for polymorphisms in four serotonergic and three dopaminergic candidate genes [tryptophan hydroxylase (TPH), serotonin receptor 2A (HTR2A), serotonin receptor 2C (HTR2C), serotonin transporter promoter region (5-HTTLPR), dopamine receptor D4 (DRD4), dopamine transporter (DAT1) and catechol-O-methyl transferase (COMT)]. There were no statistical differences between MDD patients and healthy controls in the genotypic and allelic distribution of all polymorphisms investigated. Thus, our study does not support a major role for these polymorphisms in contributing to susceptibility to MDD, although it does not preclude minor effects.

Alleles↗
PubMed1999

Suicidal ideation and suicide attempts among immigrant adolescents from the former Soviet Union to Israel.

OBJECTIVE: A community survey was conducted to examine suicidal ideation and suicide attempts, behavior problems, psychological distress, social support, and adjustment difficulties in a sample of adolescents. METHOD: Four hundred six Russian-born Jewish immigrants to Israel, aged 11 to 18 years, were selected to match the age and sex distribution of the total immigrant adolescent population. Two indigenous samples of Jewish adolescents in Russia (n = 203) and in Israel (n = 104) were matched with immigrants for comparison. Parameters of interest were measured with self-administered questionnaires. RESULTS: The 6-month prevalence rate of suicidal ideation in the immigrant sample (10.9%) was significantly higher than that for Russian controls (3.5%) but not for Israeli natives (8.7%). There were few gender differences in suicidal ideation and suicide attempts. Older adolescents reported suicidal ideation 2 times more frequently than their younger counterparts. Suicide ideators scored significantly higher than nonideators on all scales of psychological distress and behavior problems. They rated higher sources of immigration difficulties concerning language, physical health, personality characteristics, and family problems but had less socioeconomic and intercultural problems of migration and lower social support from the family but not from other sources. CONCLUSIONS: Results clearly support the migration-convergence hypothesis of suicide risk among adolescents.

Adolescent↗
PubMed1999

Fluvoxamine treatment of obsessive-compulsive symptoms in schizophrenic patients: an add-on open study.

Obsessive-Compulsive (OC) symptoms are observed in a substantial proportion of schizophrenic patients and pose a significant therapeutic challenge. Based on findings of the benefit of the anti-obsessive agent clomipramine, we designed an open-label study to examine the effect of adding the serotonin-selective reuptake inhibitor (SSRI) fluvoxamine to the ongoing antipsychotic regimen of schizo-obsessive patients. The study population consisted of ten neuroleptic-stabilized chronic schizophrenic patients with OC symptoms. Fluvoxamine (up to 150 mg/day) was added to the ongoing antipsychotic treatment, which remained unchanged for the entire 12-week trial period. The patients were evaluated before the trial and at weeks 1, 2, 4, 6, 8 and 12 (end point) with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Schedule for Assessment of Positive Symptoms and the Schedule for Assessment of Negative Symptoms. The results showed a significant improvement in obsessions (P < 0.02) (but not compulsions) and both positive (P < 0.01) and negative (P < 0.05) schizophrenic symptoms. By the end of the trial, three patients showed a more than 50% reduction in the Y-BOCS score, with complete amelioration of the OC symptoms in one of them. Three patients were dropped from the study during the first 4 weeks, two because of aggressiveness and one because of psychotic exacerbation. No exacerbation or new onset of extrapyramidal side-effects (EPS), as measured by the Barnes Akathisia Scale (BARS) and the Simpson-Angus Scale (SAS), was noted during the course of the trial and there were no other significant clinical side-effects of fluvoxamine addition. We conclude that fluvoxamine may be an effective adjunctive agent in some schizo-obsessive patients.

Adult↗
PubMed1998

Elevated adhesiveness/aggregation of peripheral blood leukocytes in patients with major depression.

A simple slide test was used to determine the effects of major depression (MD) and heterocyclic antidepressants on leukocyte adhesiveness/aggregation (LAA) in the peripheral blood. Eighty subjects were categorized into four equal groups: untreated-MD patients, treated-MD patients, nondepressed patients treated with antidepressants and healthy controls. Significantly higher LAA values were observed both in untreated- and treated-MD patients, 13.8+/-1.7% and 13.5+/-1.9% respectively, compared to nondepressed-treated patients and healthy controls, 5.4+/-0.9% and 6.4+/-0.7% respectively (P < 0.0001). Increased LAA was associated with the depressive episode, was not affected by antidepressants and may potentially serve as a useful laboratory state marker for MD.

Adult↗
PubMed1997

Sulpiride augmentation in people with schizophrenia partially responsive to clozapine. A double-blind, placebo-controlled study.

BACKGROUND: We hypothesised that a combined regimen of clozapine, a relatively weak D2-dopaminergic antagonist, and sulpiride, a selective D2 blocker, would demonstrate a greater antipsychotic efficacy by enhancing the D2 blockade of clozapine. METHOD: Twenty-eight people with schizophrenia, previously unresponsive to typical antipsychotics and only partially responsive to current treatment with clozapine, received, double-blind, 600 mg/day sulpiride or placebo, in addition to an ongoing clozapine treatment. The clinical status was evaluated before, during, and at the end of 10 weeks of sulpiride addition using the Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms, and Hamilton Rating Scale for Depression. RESULTS: The clozapine-sulpiride group exhibited substantially greater and significant improvements in positive and negative psychotic symptoms. About half of them, characterised by a younger age and lower baseline SAPS scores, had a mean reduction of 42.4 and 50.4% in their BPRS and SAPS scores, respectively. CONCLUSIONS: A subgroup of patients with chronic schizophrenia may substantially benefit from sulpiride addition to clozapine.

Adult↗
PubMed1996

Neural network based on adaptive resonance theory as compared to experts in suggesting treatment for schizophrenic and unipolar depressed in-patients.

A modified neural network based on adaptive resonance theory (ART) was trained with the records of 211 psychiatric inpatients (74 schizophrenic, 50 unipolar depressed, 34 bipolar depressed, 20 bipolar manic, 33 other) who improved by at least 40 points on the GAFS during 8 weeks of treatment. Thereafter, a comparison was made between the clinical response of another 26 schizophrenic patients and 28 unipolar depressed inpatients, to treatment suggested by the trained ART (N = 21) and by the consensus of two senior psychiatrists (N = 33). The patients were allocated blindly and randomly to the two treatment groups. The BPRS (for the schizophrenic patients) or the HDRS (for the unipolar depressed patients) was completed weekly for 5 weeks. Results showed no difference between decisions regarding treatment by the ART network and by the experts. Length of hospital stay was also similar. All ART suggestions included supportive psychotherapy. High potency antipsychotics were suggested for 7 schizophrenic inpatients, clozapine for one and the addition of community therapy for another. Depressed patients got a variety of treatment suggestions. No contraindicated treatment was suggested by ART; however, two incomplete treatment suggestions were dropped from the study. In conclusion, in a prospective study ART was successful in learning treatment strategies and performed under supervision similar to experts.

Adolescent↗
PubMed1996

Spreadsheet evaluation of computerized medical records: the impact on quality, time, and money.

Information and communication technologies are presumed to play a critical role in improving effectiveness and efficiency of clinical care. Although the most promising directions of technological development are microcomputer-generated computerized medical record systems, documenting their value has been a major challenge for health care providers. This paper proposes a 15-item spreadsheet instrument for evaluating computerized medical records, and demonstrates how it was experimentally applied to a 6-year long experience at three sites. In conclusion, preliminary implications and guidelines are drawn with regard to practice and research in this area.

Cost-Benefit Analysis↗
PubMed1996

Trihexyphenidyl as a possible therapeutic option in clozapine-induced nocturnal enuresis.

Enuresis is an adverse event of clozapine treatment. The occurrence of nocturnal functional enuresis in two schizophrenic patients during the initial phase of clozapine therapy is reported. Beneficial effect of trihexyphenidyl administration (5 mg at 21.00 h) on clozapine-induced enuresis is clearly demonstrated in one patient. Trihexyphenidyl discontinuation and subsequent readministration in this patient led to corresponding recurrence and then disappearance of enuresis. Involvement of the cholinergic system has been proposed as one of the possible pathophysiological mechanisms of clozapine-induced enuresis.

Adult↗
PubMed1996

A combined clinical approach to treating and understanding prolonged combat stress reaction.

Over the last decade combat stress reaction (CSR) has received increasing attention in Israel and abroad. The treatment of prolonged CSR is known to be complicated and unrewarding, and the majority of cases became chronic. The authors describe the difficulties of diagnosing delayed and prolonged CSR and present a model of combined treatment approach through a case study.

Adult↗
PubMed1995

Cytokine production in drug-free and neuroleptic-treated schizophrenic patients.

A line of evidence indicates changes of the immune system in schizophrenic patients. We investigated the production of cytokines by peripheral blood mononuclear cells (PBMCs) in drug-free and neuroleptic-treated schizophrenic patients compared to healthy, normal controls. A significant reduction in interleukin (IL)-2 production was detected in untreated schizophrenic patients (-59.6%; p < .05) as well as in IL-3-like activity (IL-3-LA) production (-27.4%; p < .05) in treated patients compared to controls. No alteration was observed in IL-1 beta production. It seems that schizophrenia is associated with diminished IL-2 production, while neuroleptic treatment interferes with the capacity of immunocompetent cells to synthesize and/or release Il-3-LA. The alteration in cytokine production did not correlate with either the severity of the disorder or the serum prolactin levels.

Adult↗
PubMed1995

Effect of melatonin on active transport of serotonin into blood platelets.

Previous research has demonstrated that the circadian rhythm of melatonin negatively correlates with that of the sensitivity of platelet serotonin uptake sites. Moreover, serotonin has been found to be a competitive inhibitor of melatonin binding to platelets. The goal of the present study was to investigate whether melatonin directly affects platelet serotonin transport. Blood samples from 12 healthy subjects were assayed for both serotonin transport into platelets. Active transport of serotonin (at a concentration of 10(-6) M) into blood platelets was measured in the presence of melatonin at physiological concentrations (10(-12) M to 2 x 10(-9) M) and high nonphysiological concentrations (2 x 10(-8) M to 2 x 10(-3) M). Melatonin inhibited serotonin uptake by blood platelets at the high concentrations only ( > 10(-5) M with IC50 value of 1.1 x 10(-3) M) and had no effect at physiological concentrations.

Adult↗
PubMed1995

Lithium-induced akathisia responds to low-dose mianserin: case report.

A case of acute akathisia induced by lithium treatment is described. Since lithium administration leads to activation of serotonergic neurotransmission, the 5-HT2A/2C and 5-HT3 antagonist mianserin was added as a possible anti-akathitic agent. Mianserin treatment (15 mg/day at 21.00 h) resulted in amelioration of the lithium-induced akathisia.

Adult↗
PubMed1995

Mood and hormonal changes during late pregnancy and puerperium.

The present study was designed to assess the relationship between puerperal hormonal changes and mood. Twenty-five postpartum physically and mentally healthy, drug-free women were included in the study; seven later dropped out. Blood samples 'were drawn between 8 and 9 a.m. just prior to delivery, and again three days after delivery, before discharge. Blood levels of LH TSH, FSH, estrogen and prolactin were determined. Three days after delivery, a psychiatric interview was conducted during which psychometric rating scales (Brief Psychiatric Rating Scale, Hamilton Depression and Hamilton Anxiety Rating Scales, and Beck Depression Inventory) were completed. The rate of change in hormonal blood levels was analyzed in relation to the scores on the rating scales. Results showed that the rise in prolactin plasma levels had a negative and significant correlation with the scores on the Hamilton anxiety scale. This may indicate that high prolactin plasma levels, associated with milk production, may lead to lower anxiety levels in lactating women.

Adult↗