Biomedical subjects

J Dickens

Publications and source records attributed to J Dickens.

3 recordsLinked to original sources

PubMed1993

Diagnostic dilemmas in psychiatric consultation/liaison: the problem of depression.

We use the case of a 62-year-old retired widow, referred for psychiatric evaluation by the internal medicine house staff, to illustrate the complexities of diagnosing depressive syndromes in medically ill patients. The patient's presenting symptoms included diarrhea, severe weight loss, and abdominal pain. She appeared cachectic, but diagnostic findings did not account sufficiently for the degree of weight loss observed. When symptoms failed to resolve, the psychiatric consultation was requested. Chronic cognitive symptoms, including feelings of guilt, anhedonia, and hopelessness, were noted. These symptoms had been present since the death of the patient's sister 2 years earlier. This case shows the importance of processing clinical data carefully to include both medical and psychiatric symptoms. It also reveals the need for an ongoing evaluation to gather significant information so the diagnosis can be solidified, allowing more specificity in planning treatment.

Bereavement↗

PubMed1993

An exercise therapy program for balance disorders.

Patients with chronic balance or disequilibrium disorders can be difficult to evaluate and treat, due to the complex integration of sensory systems which control balance function. There is a trend away from placing these patients on long-term sedative medication. In fact, long-term sedative medications may actually reduce or prevent central compensation. For patients with chronic balance disorders who have already been appropriately treated with medicine and/or surgery, we now strongly recommend an active exercise therapy program, which promotes central compensation and improves general fitness.

Exercise Therapy↗

PubMed1990

A structurally novel inhibitor of cGMP phosphodiesterase with vasodilator activity.

A novel, potent, competitive inhibitor of smooth muscle cGMP phosphodiesterase is described (Compound I, [4-[2-n-butyl-5-chloro-1-(2- chlorobenzyl)imidazolyl]methyl] acetate). The compound is highly selective for inhibiting cGMP phosphodiesterase compared with cAMP phosphodiesterase. Compound I inhibits the contraction of smooth muscle in response to a variety of agonists in the same concentration range to that which inhibits the enzyme. Compound I produced a dose-related reduction in the pressor responses to angiotensin II infusion while not inhibiting the responses to bolus doses of angiotensin II. Two structural analogues of Compound I which did not inhibit cGMP phosphodiesterase failed to inhibit smooth muscle contraction in vitro and did not affect angiotensin II pressor responses in vivo. We propose a mechanism to account for the effects of a cGMP phosphodiesterase inhibitor on smooth muscle contraction in vitro and in vivo.

3',5'-Cyclic-AMP Phosphodiesterases↗