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Biomedical subjects

J Merola

Publications and source records attributed to J Merola.

7 recordsLinked to original sources
PubMed1988

Hypotension in severe tricyclic antidepressant overdose.

Sixty four patients who presented to the emergency department following severe acute tricyclic antidepressant (TCA) overdose (defined as an antidepressant ingestion associated with a QRS interval greater than or equal to 0.10 seconds, TCA level greater than or equal to 500 ng/mL, or grade IV coma) were prospectively evaluated to determine the incidence of hypotension and the factors associated with its development. Among these patients, the mean antidepressant level was 1,094 ng/mL. The overall frequency of admission hypotension (systolic BP less than 95 mmHg) was 34% (22 of 64 patients). Using regression analysis, systolic BP showed poor correlation with TCA level (r = -.37) and maximal QRS interval (r = -.17) following severe TCA overdose. Using multivariate analysis with a logistic regression model, the influence of BP (as well as TCA level, QRS interval, and coingestion of another drug) was evaluated on four clinical outcomes: seizures, arrhythmias, aspiration pneumonia, and pulmonary edema. The occurrence of arrhythmias and pulmonary edema was significantly associated (inversely) with hypotension (P less than .01). Seizures and aspiration pneumonia were unrelated to admission BP. These results suggest that hypotension is common after severe TCA overdose and occurs independently of TCA level and prolongation of the QRS interval. Hypotension is strongly associated with the development of arrhythmias and pulmonary edema. Seizures and aspiration pneumonia may occur regardless of initial BP.

Adult↗
PubMed1987

Adolescents' compliance with the use of oral contraceptives.

To elucidate the factors that might influence compliance with oral contraceptive use among sexually active adolescents, we undertook a study of 209 unmarried adolescents initiating use of oral contraceptives in three different settings: an inner-city adolescent clinic, a birth control clinic in a midsized industrial city, and a suburban private practice. At the three-month follow-up visit, factors associated with compliance included older age, suburban residence, white race, health care in the suburban private practice, payment status, prior use of contraception, mother's unawareness of oral contraceptives, married parents, older boyfriend, lack of worry about being pregnant, and satisfaction with pill use. Compliance at long-term follow-up (13.5 +/- 3.7 months) was additionally associated with educational goals, father's education level, and absence of side effects. Ten pregnancies occurred during the study period among noncompliant site I patients. Inner-city clinic patients were at high risk of noncompliance and unplanned pregnancy.

Adolescent↗
PubMed1985

Interhemispheric collaboration in response to simultaneous bilateral input.

Two experiments tested whether processing is speeded when inputs are divided between the hemispheres rather than projected to a single hemisphere. Bilateral (bihemispheric) vs unilateral (single hemisphere) word pairs were tachistoscopically presented. Subjects responded when the words semantically matched. Irrespective of distance, visual angle and compatibility with reading biases, bilateral/bihemispheric performance was as fast as the better of the two individual unilateral/single hemisphere conditions and faster than their average. This pattern occurred only at the beginning of each experiment. With practice, performance significantly improved in the single but not the bihemispheric conditions. The excellent initial performance during the bihemispheric condition and its lack of improvement with practice are discussed with reference to models of interhemispheric collaboration.

Adolescent↗
PubMed1985

Motor overflow and attentional processes in normal school-age children.

Two groups of 28 school-age children (divided equally by sex) who were equivalent in terms of chronological age and IQ but differed in the prevalence of motor overflow were given a concept identification task designed to measure relative attentiveness to central, task-related cues and incidental, social environmental ones. Children with a high level of overflow were relatively more responsive to social cues than to task-related ones, while children with a low level were more equally responsive to the two types of cues. The results are interpreted in terms of a relationship between motor overflow and attentional processes.

Attention↗
PubMed1984

SES-related aspects of neuropsychological performance.

Children from different socioeconomic backgrounds have been observed to employ different cognitive styles in problem-solving situations. These cognitive styles have in turn been linked to the functional specialization of the cerebral hemispheres. It was hypothesized, therefore, that performance asymmetries would also be SES-related, high-SES children processing stimuli presented to the right visual field-left hemisphere (RVF-LH) more efficiently than those presented to the left visual field-right hemisphere (LVF-RH) and low-SES children showing the reverse pattern. A laterality task was administered tachistoscopically to 120 children, divided evenly by SES (high and low), sex, and grade (fifth and seventh). A marked RVF-LH advantage emerged among the high-SES group and a weak LVF-RH advantage among the low-SES group. Thus, the results provided general support for the central hypothesis. The findings are reviewed in the context of current models of human information processing in the cerebral hemispheres, and their broader implications for understanding SES-related differences in cognitive function are discussed.

Child↗