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Biomedical subjects

I Modai

Publications and source records attributed to I Modai.

At least 19 recordsLinked to original sources
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↗
PubMed1994

Understanding who improves after psychiatric hospitalization.

This study attempts to identify variables associated with improved functioning after psychiatric hospitalization. The relationship between 25 clinical and demographic variables and improvements and functioning at discharge of 309 consecutive patients in an open ward over 2 years were studied using stepwise logistic regression. Measures of patients functioning at discharge were score above or below 50 on the (Global Assessment of Functioning scale) (GAF) and 3-point scale of functioning 1 week after discharge (needs constant supervision, functions independently at home, functions on the job). We created a logistic regression model of outcome based on the information available at admission and one based also on information at time of discharge (i.e., medication, therapy and length of stay etc.). Discharge models predicted 6-10% better than admission models. Discharge models correctly predicted whether GAF level was above 50 in 72% of the cases and return to preadmission functioning in 71% of the cases. We also created a model of functioning at discharge using a hierarchical logistic regression model. It correctly predicted 74% of the lowest level of functioning, 47% of the middle level and 68% of the highest level. The best predictors of improved functioning after discharge were preadmission levels of functioning, psychotherapy in hospital, absence of organic brain syndrome, attendance at occupational therapy and hospitalization less than 4 months. Diagnosis had almost no discernible effect on outcome of hospitalization.

Activities of Daily Living↗
PubMed1994

Environmental factors and admission rates in patients with major psychiatric disorders.

The aim of this study was to identify environmental factors that might correlate with the admission rate of patients with major psychiatric disorders. During the years 1988-90, 393 consecutive admissions (119 unipolar depressed patients, 211 schizophrenic patients, and 63 bipolar depressed patients) were monitored. Correlations were calculated between the mean daily admission rate for each month and monthly photoperiod, rate of change in photoperiod, mean temperature, mean relative humidity, and mean barometric pressure. It was found that the admission rate of bipolar depressed patients negatively correlated with monthly photoperiod, which means that during winter the admission rate of these patients increased.

Adult↗
PubMed1994

Psychological aspects of developmental endocrinopathies in adolescence.

Ninety-six adolescents referred to a pediatric endocrinology clinic were divided into eight groups according to degree of sexual maturity and height. Each adolescent was assessed by a psychiatric interview, a self-concept questionnaire, a human figure drawing test and a cognitive screening battery. The results showed a definite deleterious effect of growth retardation, but not sexual maturity, on self-concept. Sex of the adolescent did not affect the results. Cognitively there was no difference between groups. The psychological impact of short stature should be taken into consideration in the decision to utilize pharmacological or delay of puberty.

Adolescent↗
PubMed1994

Serum cholesterol levels and suicidal tendencies in psychiatric inpatients.

BACKGROUND: Cholesterol has been generally associated with suicide and aggression. The aim of this study was to investigate the relationship between serum cholesterol levels and suicide in psychiatric inpatients. METHOD: Data on age, sex, serum cholesterol levels, absence or presence of suicidal ideations, absence or presence of past suicide attempts, ethnicity, weight, Hamilton Rating Scale for Depression scores, and physical illnesses were collected from 584 inpatient medical records. The patients were diagnosed by the authors according to the DSM-III-R criteria. Serum cholesterol levels were evaluated 24 to 48 hours after admission. The entire group and each diagnostic group were divided as follows: patients who had attempted suicide at least once, patients who expressed a suicidal wish or plan during hospitalization or the month before hospitalization, and patients who had neither made suicidal gestures nor expressed suicidal thoughts. Statistical evaluation was done using analysis of variance and chi-square test. RESULTS: Patients who had attempted suicide had significantly lower serum cholesterol than nonsuicidal patients (F = 4.68, df = 2, p < .01). Comparison on the basis of specific diagnoses revealed similar results in age- and sex-matched depressed patients (F = 4.02, df = 2, p < .01), but not in schizophrenic or bipolar patients. These results were not influenced by age, sex, ethnicity, weight, disease severity, or physical health. CONCLUSION: Our findings may imply that an association exists between cholesterol, suicide, and depression.

Cholesterol↗
PubMed1993

Computerized patient information system in a psychiatric unit: five-year experience.

A computerized psychiatric clinical application based on CLICKS program was developed, consisting of a network of 34 personal computers, run by Novell Netware version 3.11. It includes all clinical records and covers most of the administrative needs of the department; it may be used also in the outpatient clinics. Implementation of the system followed the stages of planning, record structuring, record programming, practice and operation. The system is favorably accepted by the patients, has several important advantages over pencil and paper record keeping, and although it is slightly more time-consuming, it improves record quality and departmental efficiency.

Attitude to Computers↗