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Biomedical subjects

J Clothier

Publications and source records attributed to J Clothier.

13 recordsLinked to original sources
PubMed1999

Impact of travel distance on the disposition of patients presenting for emergency psychiatric care.

For veterans presenting for emergency psychiatric care, this research tested the hypothesis that patients with poor geographic accessibility to ambulatory mental health services would be more likely to be hospitalized. Logistic regression results indicated that distant patients (> 60 miles) were 4.8 times more likely (p < .05) to be admitted for acute psychiatric treatment than were proximal patients (< 60 miles), controlling for clinical and demographic case-mix factors. This finding suggests that the Department of Veterans Affairs might be less effective in its effort to substitute intensive outpatient care in place of expensive inpatient treatment for rural veterans with emergent mental health problems.

Adult↗
PubMed1993

Correlation of severity of psychiatric patients' delusions with right hemispatial inattention (left-turning behavior).

Studies associate psychotic disorders with various forms of subtle inattention to the right hemispace (left-turning behavior). The authors examined the correlation between this dopamine-related sign and severity of delusions (presumably dopaminergic symptoms) in 20 psychotic patients. Delusions were significantly correlated with severity of left-turning bias, and this neurological sign accounted for 33% of the variance in severity of delusions.

Adolescent↗
PubMed1992

Dysphoric mania.

Lithium remains the mainstay of therapy for most patients with bipolar disorder. Patients with syndromal variations of bipolar disorder, such as those experiencing mixed states or dysphoria have generally had a rather poor therapeutic response to lithium. Our group conducted a double-blind, parallel-group comparison of lithium and valproate for the control of mania in 27 patients with bipolar disorder. The study addressed the question of whether certain illness characteristics might be predictive of a positive response to a particular pharmacologic agent. There were significant differences in the cohort of patients who responded favorably to valproate compared with those who did not. Pretreatment depression scores were higher in the patients responding to valproate than in nonresponders. Patients with depressed mood or anxiety associated with mixed states responded equally to lithium and valproate. Studies are needed to clarify the clinical and pathophysiologic status of mixed or dysphoric manic states and to validate predictors of response to therapeutic agents.

Bipolar Disorder↗
PubMed1991

Recognition and management of poststroke depression in the elderly.

Depression occurs in 30-50% of stroke survivors and is an important determinant of functional outcome in these patients. Depression after stroke has a biological basis and can be successfully treated. Tricyclic drugs are the first line of treatment therapy but their side effects need to be considered and patients undergoing this treatment need to be carefully monitored.

Aged↗
PubMed1987

Patients with panic attacks and abnormal EEG results.

The authors describe a series of patients who presented with atypical panic attacks involving hostility, irritability, severe derealization, and social withdrawal. None had clear temporal lobe epilepsy but most had temporal EEG abnormalities. Although their response to treatment was unpredictable, some did well with carbamazepine or alprazolam.

Adult↗
PubMed1987

Light-induced colour changes by the iridophores of the Neon tetra, Paracheirodon innesi.

The iridophores of the Neon tetra Paracheirodon innesi consist of alternating layers of guanine and cytoplasm. In the dark-adapted state the reflected light from constructive interference is in the ultraviolet or blue. When exposed to light the cytoplasm layers increase in thickness and as a result the reflections shift to longer wavelengths and the iridophores appear green. The iridophores are thought to contain a rhodopsin-like molecule and we suggest that the colour-change mechanism involves the light-induced opening of sodium channels in the plasma membrane, leading osmotically to an increase in thickness of the cytoplasm layers. Experimental support for this suggestion was obtained by the substitution of choline chloride for sodium chloride in the perfusing medium, which can be done without altering the osmotic strength of the perfusing medium. This procedure almost abolished the light response and makes it seem likely that sodium ions are necessary for the light response to take place.

Animals↗
PubMed1986

Effect of chronic treatment of ethanol on benzodiazepine and picrotoxin sites on the GABA receptor complex in regions of the brain of the rat.

Ethanol has been shown to enhance gamma-aminobutyric acid (GABA)ergic transmission. In this study an examination was made of the effect of chronic treatment with ethanol and its withdrawal at 24 h on the binding of [3H]flunitrazepam and [35S]t-butylbicyclophosphorothionate (TBPS) to brain regions in rat. Rats were rendered tolerant to, and dependent on, ethanol by an intragastric intubation method. The affinity (KD) or the binding capacity (Bmax) of [3H]flunitrazepam or [35S]TBPS was not altered by chronic treatment with ethanol or during withdrawal from ethanol. Neither the enhancing effect of GABA on the binding of [3H]flunitrazepam nor its inhibitory effect on the binding of [35S]TBPS were affected by chronic treatment with ethanol or its withdrawal at 24 h. These results suggest that the sensitivity of benzodiazepine and picrotoxin sites on the oligomeric GABA receptor complex is not affected during tolerance to, or withdrawal from ethanol. It is suggested that the effects of ethanol on GABAergic transmission may be produced at the level of coupled chloride ion channels.

Animals↗
PubMed1985

Management of burns in pregnant women.

Although few women sustain thermal injuries during pregnancy, when pregnancy is complicated by thermal injury a clear management scheme plus a team approach is needed to provide optimal care to both the fetus and mother. The clinical courses of 11 pregnant women treated at the Louisiana State University Medical Center after sustaining thermal injuries were reviewed and combined with 29 other instances from the literature. Fetal survival before 28 weeks of gestation appears to be dependent upon maternal survival. After 32 weeks of gestational age, fetal survival becomes increasingly independent of maternal survival if fetal distress can be minimized. Although in general, optimal care of the fetus coincides with the care of the mother, occasionally the medical needs of the mother and fetus are different. Therefore, we have developed maternal and fetal medical care schemes to serve as general guidelines for the care of the pregnant patients with burns.

Adolescent↗
PubMed1984

Targeting therapeutic plasma levels of nortriptyline from test dose plasma concentrations.

Computer programs, based on first order pharmacokinetic equations, were developed to predict steady state plasma levels and required daily maintenance doses of nortriptyline from plasma concentrations 24 hours after a test dose. These predictions are compared to clinical findings for geriatric and nongeriatric patients with a variety of accompanying medical disorders and concurrent medications.

Computers↗
PubMed1983

Burns in the elderly: an early surgical approach.

Forty-nine consecutive burned patients over the age of 50 years treated with an early surgical protocol of wound closure were studied prospectively to determine if early surgery had a beneficial effect on total hospitalization time or mortality. Surgery was performed within the first 72 to 96 hours postburn. Twenty-six patients (Group I) had burns less than 20% of the TBSA, range, 3 to 18%, with 0 to 10% full thickness. Seventeen (66%) of these patients had surgical closure of the wound. The mean hospitalization time was 16.3 days. Twenty-three patients (Group II) had burns greater than 20% TBSA, range, 20 to 81%, with 0 to 68% full thickness. Eight (35%) of these patients died and five of the deaths were due to cardiovascular collapse during the initial resuscitative phase. Fourteen patients had 37 operative procedures performed to close the burn wound. Twelve (86%) of these 14 patients survived and the mean hospitalization time of the surviving patients was 44 days. No anesthetic complications occurred in either group. Results of this study indicate that an early surgical approach to wound closure resulted in a greater than 25% reduction in total hospitalization time, and further, that this early surgical approach was not associated with any increase in mortality, but instead, appeared to be associated with a reduction in mortality (chi 2 = 8.10; p less than 0.01).

Aged↗
PubMed1983

Hypertrophic burn scars: analysis of variables.

A major problem in patients surviving thermal injury is the development of hypertrophic burn scars. The current study was performed to determine the factors associated with an increased risk of the development of hypertrophic burn scars. Fifty-nine children (mean age, 3 years; mean TBSA, 14%) and 41 adults (mean age, 37; mean TBSA, 21%) followed from 9 to 18 months formed the study group. The location as well as time required for the burns to heal were recorded in addition to the age and race of the patients. Sixty-three (26%) of the 245 burn areas, in these 100 patients, became hypertrophic. No correlation between patient age and the development of wound problems was found. Blacks had more wound problems than others, if the burn wound took longer than 10 to 14 days to heal. The most important indicator of whether wound problems would occur, in our series, was the time required for the burn to heal. If the burn wound healed between 14 and 21 days then one third of the anatomic sites became hypertrophic; if the burn wound healed after 21 days then 78% of the burn sites developed hypertrophic scars. Based upon these results we have developed a selective, individualized protocol for the use of prophylactic pressure therapy in patients with spontaneously healing burn wounds.

Aging↗
PubMedDate not supplied

Varying rates of alcohol metabolism in relation to detoxification medication.

Fifteen patients admitted for alcohol dependency had serial blood alcohol levels drawn. The rate of metabolism was calculated a number of different ways and this was compared to the amount of Librium required for the initial period of withdrawal. It was found that the alcoholics' average metabolism was 26.6 mg%/hour. Although there was a tendency for those with high initial blood alcohol levels to have faster metabolisms, there was not a significant correlation between the two features. There was correlation between the amount of Librium used in the initial period of detoxification and the initial blood alcohol concentration.

Alcoholism↗