PubMed Health⌕ Search

Biomedical subjects

J L Crammer

Publications and source records attributed to J L Crammer.

At least 19 recordsLinked to original sources
PubMed2002

Subjective experience of a confusional state.

BACKGROUND: Confusional states associated with medical and surgical conditions require more study and biochemical explanation. AIMS: To understand impairment of consciousness, cognition and memory. METHOD: A psychiatrist reports experience of his changing mental state over 5 days from notes made immediately on recovery. RESULTS: A prodromal phase of declining consciousness, understanding and memory registration over perhaps 48 h was difficult to detect. During unconsciousness there were four brief partial reversals with arousal, and some mental functioning (memory, formation of beliefs) occurred. CONCLUSIONS; Self-report can be a useful addition in clinical study, and patients with renal failure require psychological and psychiatric study. Comparison with the mental effects of benzodiazepine or of an anaesthetic such as nitrous oxide might throw light on the pathology.

Acute Kidney Injury↗
PubMed1991

Drinking, thirst and water intoxication.

Drinking is an activity determined partly by oropharyngeal stimulation and gastrointestinal sensations as well as biochemical changes, and thirst need not be involved. It is sometimes disturbed in mania or depression. Overdrinking (polydipsia) is common in long-stay in-patients, but only gives rise to water intoxication when there is a variable functional renal abnormality such as SIADH causing water retention. In contrast, in affective disorders, disturbance of sodium retention may be seen, possibly representing failure of nervous vascular control as part of the mental illness.

Bipolar Disorder↗
PubMed1990

Leucocyte arylsulphatase A activity and subtypes of chronic schizophrenia.

Previous studies have suggested that arylsulphatase A (ASA - the biochemical marker of metachromatic leucodystrophy) deficiency may be present in a sizeable proportion of patients with chronic psychosis. This study surveyed leucocyte ASA activity in a group of chronic psychotic patients and compared ASA activity in 3 subgroups fulfilling Research Diagnostic Criteria for schizophrenia (undifferentiated), paranoid schizophrenia and schizoaffective psychosis. Three of 45 patients had significantly reduced ASA activity but none had metachromatic leucodystrophy. Although ASA levels did not differ significantly between the groups, schizophrenics without a family history of schizophrenia had significantly lower ASA levels than those with. The implications of these findings are discussed.

Adult↗
PubMed1990

Vasopressin in chronic psychiatric patients with primary polydipsia.

Twelve chronic in-patients with primary polydipsia were studied, during free drinking and after fasting, by concurrent measurements of plasma AVP, serum sodium and osmolality, and urine volume, AVP, osmolality, and creatinine. A majority of the patients showed inappropriately high levels of AVP: plasma AVP estimations demonstrated that seven had Type I SIADH and two had Type II SIADH. Urinary AVP estimations confirmed inappropriately raised AVP in seven of the subjects tested, and there was a significant agreement between the plasma and urine diagnoses. Although able to concentrate their urine in response to fluid deprivation, the patients showed a decreased renal sensitivity to AVP. Despite the mitigating effect of decreased renal sensitivity to AVP, the SIADH seen in these patients appears to contribute to the development of water intoxication caused by polydipsia.

Adult↗
PubMed1989

Osteopenia, pathological fractures, and increased urinary calcium excretion in schizophrenic patients with polydipsia.

Ten male chronic schizophrenic patients with polydipsia and 10 nonpolydipsic controls, matched for gender, diagnosis, duration of illness, age, and race, were studied by dual- and single-photon absorptiometry to estimate bone density of the lumbar spine and radius and by 24-hr urine collections to estimate urinary electrolyte excretion. Bone density was normal in the control group, but was abnormally low in the polydipsic group, which had a markedly increased incidence of fractures. Electrolyte excretion was normal in the control group and in the polydipsic group when water intake was restricted to normal amounts; increased urinary sodium and calcium excretion occurred in proportion to polydipsia. As polydipsia is associated with a number of physiological changes, the cause of the osteopenia is unclear; we suggest that a negative calcium balance caused by increased urinary calcium excretion induced by extracellular space expansion may play an important role in the causation of the skeletal changes.

Adult↗
PubMed1988

Polydipsia in chronic psychiatric patients. Body weight and plasma sodium.

Eight chronic psychiatric in-patients with polydipsia, and polyuria, up to 22 litres per 24 hours, were studied by frequent timed body weight and urine volume measurements, and episodic plasma electrolyte estimations. During the day they all showed irregular water retention, with hyponatremia in proportion to the weight gain. During the night they always lost water and weight, returning to their individual lowest weights and to normal plasma sodium. Measurement of weight in chronic psychiatric patients can be used to identify patients with significant polydipsia, to monitor those with the disorder and permit targeted fluid restriction, and to assess the efficacy of treatment procedures such as medication.

Adult↗
PubMed1986

Premenstrual depression, cortisol and oestradiol treatment.

A woman with a 5-year history of frequently recurrent depressions responded poorly to the usual antidepressants. She had a raised plasma cortisol and was made worse by progesterone or by ACTH. An oestradiol/testosterone implant every 4 months abolished all symptoms for at least 8 years, and plasma cortisol returned to normal. This case is relevant to an understanding of premenstrual syndromes and the genesis of depressive illness.

Adrenocorticotropic Hormone↗
PubMed1986

Disturbance of water and sodium in a manic-depressive illness.

Specific questioning and frequent observation of a 69 year-old woman with cyclic bipolar manic-depressive illness showed that she had disturbances of thirst, appetite, bowel and bladder function and dramatic changes in body weight, in association with different phases of her mental illness. Examination of one manic phase under constant diet and inpatient control showed cardiovascular changes, sodium retention, body weight gain, with raised aldosterone secretion but steady vasopressin. There appears to be a sub-group of manic-depressive patients with evidence of disturbed hypothalamic functions as part of their mental illness, as shown particularly by changes in water and electrolyte metabolism.

Aged↗
PubMed1986

A case of resistant schizophrenia.

In an era when it is generally believed that the acute symptoms of schizophrenia can be controlled pharmacologically, the case of a young man who has remained almost continuously floridly psychotic for 13 years, despite treatment, is disquieting. Conventional psychiatric treatment appears to be rendered impotent. It is in this context that it may be of interest to report a summary of the proceedings of a Special Problems Conference held at the Institute of Psychiatry on 18 February 1985 to discuss such a case.

Adult↗
PubMed1986

Sulphoxide metabolites of thioridazine in man.

Chromatograms of urine extracts from patients taking thioridazine contain several different sulphoxide metabolites. Some of these have not hitherto been described or identified. Two of the unknown metabolites appear, from chemical tests and mass spectrometry, to be isomers of the already known thioridazine ring-sulphoxide and sulphoridazine ring-sulphoxide from which they can be produced by treatment with trifluoroacetic anhydride. Two others appear, by similar identification tests and i.r. analysis, to be lactams of mesoridazine ring-sulphoxide and of sulphoridazine ring-sulphoxide.

Chemical Phenomena↗