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Biomedical subjects

J L Boyd

Publications and source records attributed to J L Boyd.

At least 37 records · Page 2Linked to original sources
PubMed1989

The pharmacotherapy of septic shock.

Septic shock is a common clinical problem in the intensive care setting. The high mortality rate associated with septic shock, regardless of age, reflects the inadequacy of available therapeutic approaches. The purpose of this article is to review the current pharmacologic approaches to the treatment of septic shock with an emphasis on the pathophysiologic correlations of these treatments.

Adrenergic Agonists↗
PubMed1987

Family management in the prevention of morbidity of schizophrenia: social outcome of a two-year longitudinal study.

Effective community treatment of schizophrenia involves not merely the removal of florid symptoms, but restoration of effective social role functioning. The efficacy of a family management approach is compared with an individual approach of similar intensity in terms of its impact on the patient's social adjustment after a florid episode of schizophrenia. Clinical reports, patient self-reports, and interviews with the family members of 36 patients, who were randomly assigned to family or individual management, demonstrated a consistent superiority for family management. The advantages for the family approach were sustained over a two-year period. The potential mechanisms through which the family approach may have achieved its greater efficacy are discussed from a multi-determined perspective.

Adolescent↗
PubMed1985

Family management in the prevention of morbidity of schizophrenia. Clinical outcome of a two-year longitudinal study.

Environmental stress may contribute to the clinical morbidity of established cases of schizophrenia treated with optimal neuroleptic drugs. A family-based approach that aimed to enhance the problem-solving capacity of the index patient and his family caregivers was compared with a patient-oriented approach of similar intensity over a two-year period. Thirty-six patients who returned to stressful parental households after florid episodes of schizophrenia (CATEGO and DSM-III) were stabilized with optimal neuroleptics before being randomly assigned to family or individual therapy in a comprehensive community management program. After nine months, family-managed patients had fewer exacerbations of schizophrenia, lower ratings of schizophrenic psychopathology, fewer hospital admissions, and a trend toward lower deficit symptoms and reduced neuroleptic dosage. This reduced clinical morbidity was sustained throughout the second year of less intensive follow-up. The relative efficacy of the family approach in this clinical management study did not appear to be due to prognostic factors, rater bias, stressful life events, or the effectiveness of pharmacotherapy. Definitive tests of these findings with respect to efficacy require further well-designed studies.

Adolescent↗
PubMed1983

Relationship between plasma desipramine levels and clinical outcome for RDC major depressive inpatients.

Depressed patients (N = 31), who met Research Diagnostic Criteria for major affective disorder-depressed, were severely ill and maintained drug-free for a 1-week period on inpatient status. They received a fixed dose (150 mg/day) of desipramine for a 4-week period with drug plasma level determination and clinical ratings performed at fixed time intervals throughout the study. Despite these rigid criteria for entrance and clinical outcome measures, no obvious relationship between plasma desipramine level and clinical outcome was found. The clinical implications of this finding are discussed.

Adult↗
PubMed1983

Consecutive-night reliability of portable nocturnal penile tumescence monitor.

Consecutive-night reliability of nocturnal penile tumescence (NPT) was determined in 77 patients, including 47 normal controls (NC), 16 patients with end stage renal disease on maintenance hemodialysis (ESRD), and 14 patients with chronic illnesses but normal renal functioning (CI). A portable NPT monitor was used in a clinical research ward setting. Since there is not yet widespread agreement as to the clinically most relevant NPT response criteria, three were examined: the proportion of sleep time during which an erection of a given penile circumference change was maintained, the maximum penile circumference change obtained, and the number of erections per night of a given penile circumference change. For all three response criteria in each of the three populations the consecutive-night correlation of results was statistically significant, suggesting that portable NPT has consecutive-night reliability.

Erectile Dysfunction↗
PubMed1983

Family educational intervention in the treatment of schizophrenia.

In the aftermath of deinstitutionalization, when current public policy dictates greater community management of schizophrenia, patients and their families play an increasing role in the treatment of the illness. Since mental health professionals often neglect to educate them on the causes, symptoms, and treatment of schizophrenia, patients and their families are often misinformed, fearful, and ill-equipped to aid in treatment. The authors describe a brief family educational intervention and the questionnaire that was used to compare the knowledge of patients and their families who received the intervention with the knowledge of those who did not. The findings suggest that patients and their families in family treatment programs can acquire and retain information about schizophrenia more readily than patients and families involved in individual treatment. This knowledge enables them to become more effective participants in aftercare and helps surmount the problems associated with posthospital adjustment.

Adolescent↗
PubMed1982

Family management in the prevention of exacerbations of schizophrenia: a controlled study.

Environmental stress has been implicated as an important factor in the relapse of schizophrenic patients receiving optimal drug therapy. In a randomized controlled study, we compared at-home family therapy with clinic-based individual supportive care in the community management of schizophrenia in 36 patients taking neuroleptic maintenance medications. The family-treatment approach sought to enhance the stress-reducing capacity of the patient and his or her family through improved understanding of the illness and training in behavioral methods of problem solving. The results at the end of nine months revealed the superiority of this approach in preventing major symptomatic exacerbations. Only one family-treated patient (6 per cent of all patients) was judged to have had a clinical relapse, as compared with eight patients (44 per cent) treated individually. Family-treated patients averaged 0.83 days in the hospital, as compared with 8.39 days for the comparison group. Significantly lower levels of schizophrenic symptomatology on blind rating-scale assessments supported these clinical observations of the superiority of family management.

Adolescent↗
PubMed1981

Family participation in the community rehabilitation of schizophrenics.

Families of schizophrenic patients frequently are ill equipped to handle the primary caretaking responsibilities that have fallen to them due to deinstitutionalization. The authors describe a program begun at a medical center in Southern California in 1978 to assist schizophrenic patients living at home and their families. The program, which consists of family therapy sessions in the home, focuses on education about schizophrenia, development of communication skills, and acquisition of structured problem-solving and other behavioral strategies. Preliminary findings of a controlled study of program participants suggest that the family interventions are both cost-effective and highly successful in reducing the incidence of relapse and hospitalization.

Behavior Therapy↗
PubMed1980

Combined monoamine oxidase inhibitor-tricyclic antidepressant treatment: a pilot study.

Thirty newly hospitalized patients with RDC major or minor depressive disorder were randomly assigned to open treatment according to fixed dosage steps with 1) amitriptyline alone, up to a maximum dose of 300 mg/day; 2) tranylcypromine alone, up to a maximum dose of 40 mg/day; or 3) the combination of amitriptyline, up to 150 mg/day, and tranylcypromine, up to 20 mg/day. For 28 patients this protocol continued for 4 weeks or until discharge. As measured by the Hamilton and Zung depression scales, patients in all three treatment groups improved equally. The combination treatment produced a nonsignificantly higher frequency of minor side effects, none of which required discontinuation of treatment. The results indicate the feasibility and safety of further controlled clinical research with combined treatment, although caution is advised.

Adult↗
PubMed1980

Breast-feeding reduces incidence of hospital admissions for infection in infants.

The prevalence of exclusive breast-feeding among infants 0 to 3 months of age in a community was contrasted with the prevalence of breast-feeding among infants hospitalized for the presence of presumed or established infections. During a one-year period, 136 infants, 0 to 3 months of age, were admitted to the hospital. Among the hospitalized group, only 11.0% were being exclusively breast-fed as contrasted with an expected frequency of 25.2% based on community feeding patterns. No bacterial infections were documented among the breast-fed group while 27 bacterial infections were documented among 121 non-breast-fed infants. This survey indicates that exclusively breast-feeding during the first three months of life significantly reduces the incidence of infections that ultimately require hospitalization of infants.

Bacterial Infections↗
PubMedDate not supplied

Cost-benefit comparison: holmium laser versus electrocautery in arthroscopic acromioplasty.

This prospective study was designed to measure the costs and benefits of using a laser rather than electrocautery for soft tissue resection during arthroscopic shoulder decompression. Forty-nine shoulders with refractory Neer stage II impingement (persistent fibrosis and tendinitis) were divided into 2 groups. The composition of the 2 groups was similar with regard to sex, worker's compensation status, dominant arm involvement, duration of symptoms, and length of conservative treatment. In one group, electrocautery was used to ablate the bursa and periosteum, release the coracoacromial ligament, and maintain hemostasis. In the other group, a laser was used in place of electrocautery. Patients had been evaluated preoperatively with 2 functional scoring systems. The patients were reexamined at 1 week and at 1, 2, 3, 6, and 12 months after surgery. There were no differences between the groups with regard to functional outcome or satisfaction. There was also no difference in terms of estimated blood loss or operative time. However, there was a statistically significant difference in total hospital charges between groups, with the laser group having a 23% higher hospital bill. On the basis of these results, it is concluded that there was no medical benefit to laser-assisted arthroscopic subacromial decompression but there was an increased monetary cost.

Adult↗