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Biomedical subjects

J Razani

Publications and source records attributed to J Razani.

At least 19 recordsLinked to original sources

Neuropsychological profiles of adults with Klinefelter syndrome.

Children and adolescents with Klinefelter syndrome (XXY) have been reported to show deficits in language processing including VIQ < PIQ and a learning disability in reading and spelling. However, whether this is characteristic of adults with Klinefelter syndrome has not been established. Thirty-five men with Klinefelter syndrome, aged 16 to 61, and 22 controls were evaluated with a comprehensive neuropsychological battery. The Klinefelter patients scored significantly below controls in language skills, verbal processing speed, verbal and nonverbal executive abilities, and motor dexterity. Within the Klinefelter sample, three cognitive subgroups were identified: VIQ 7 or more points below PIQ (n = 10), VIQ within 6 points of PIQ (n = 12), and PIQ 7 or more points below VIQ (n = 12). The deficits detected in language, verbal processing speed, and verbal executive skills were found to be isolated to the VIQ < PIQ subgroup, while the abnormalities in motor dexterity and nonverbal executive skills were confined to the PIQ < VIQ subgroup. Older age was significantly correlated with increases in VIQ relative to PIQ in the patient group, which suggests the intriguing possibility that the PIQ < VIQ subgroup primarily emerges in young adulthood, perhaps in response to the reported hormonal abnormalities detected in Klinefelter syndrome patients during puberty.

Adolescent↗

Neuropsychological performance of right- and left-frontotemporal dementia compared to Alzheimer's disease.

The performance of 16 patients with Alzheimer's disease (AD) was compared to 11 patients with right-frontotemporal dementia (FTD) and 11 patients with left-FTD on a comprehensive neuropsychological battery. Standardized scores (i.e., z scores based on normal control data) were analyzed for 5 cognitive domains. The results revealed that the AD group displayed significant impairment in visual-constructional ability relative to the two FTD groups; however, no significant difference was found between the groups on memory scores (verbal and nonverbal). Patients with left-FTD scored significantly below patients with AD on the language measures (e.g., word retrieval, verbal semantic memory), and verbal executive ability (phonemic fluency); AD patients did not differ from patients with right-FTD on these measures. Patients with right-FTD exhibited significantly more perseverative behavior than AD patients; AD patients did not differ from left-FTD patients on this parameter. These results indicate that the pattern of neuropsychological performance of AD patients is distinguishable from patients with left and right frontal frontotemporal dementia.

Alzheimer Disease↗

Abnormality of semantic network in patients with Alzheimer's disease. Evidence from verbal, perceptual, and olfactory domains.

A series of studies was initiated to model the organization of semantic memory in Alzheimer's disease (AD) patients using multidimensional scaling (MDS) and Pathfinder analyses. The resulting models (cognitive maps or semantic networks) embed studied stimuli in a coordinate space or network where distances between points are assumed to reflect psychological proximity between items. The organization of semantic networks in verbal and sensory domains were modeled based upon the frequency of the subject's choice of two concepts as most alike. Results suggested that while the organization of concepts in the semantic networks of AD patients was primarily based upon a concrete perceptual dimension in both verbal and olfactory domains, those of normal controls subjects were predominantly organized by an abstract conceptual attribute. Also, networks of AD patients were more complex and chaotic than normal, that is, they consisted of more unnecessary connections and of atypical strengths of association between concepts.

Alzheimer Disease↗

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↗

Tranylcypromine vs nortriptyline vs placebo in depressed outpatients: a controlled trial.

This study was designed to compare the therapeutic and adverse effects of tranylcypromine (a monoamine oxidase inhibitor), nortriptyline (a tricyclic antidepressant), and placebo. A total of 122 depressed outpatients randomly assigned to double-blind treatment with one of these agents completed the 4-week protocol. Treatment groups were balanced for proportions of endogenous versus nonendogenous depressions, defined according to the Research Diagnostic Criteria; however, nonendogenous depressions outnumbered endogenous depressions by such a large proportion (4:1) that meaningful statistical comparisons were limited to the nonendogenous group. In this group, both active drugs proved more effective than placebo, with little differences between the two active drugs except in the areas of side effects and of differential sensitivity of the outcome scales to a given drug. It was concluded that tranylcypromine, a drug which has received relatively little use and study in recent years, represents an effective and reasonably safe treatment for nonendogenous depression, although significant advantages over tricyclics with this disorder remain to be demonstrated.

Adolescent↗

Effects of endogenicity and severity on consistency of standard depression rating scales.

Agreement between the clinician-rated Hamilton Depression Rating Scale and the patient-rated Zung Self-Rating Depression Scale was examined in 36 inpatients with major depression during the course of a 4-week antidepressant treatment protocol. Clinician-patient agreement was low when depression was rated as most severe by the clinician. An endogenicity factor extracted from the Zung scale also predicted disagreement, which was greatest for patients with more nonendogenous symptom patterns. Clinicians and researchers should remain aware of the limitations of such standard assessment procedures in the context of changing criteria for the diagnosis of depression.

Adult↗

The safety and efficacy of combined amitriptyline and tranylcypromine antidepressant treatment. A controlled trial.

Sixty patients meeting DSM-III criteria for major depression were assigned randomly to double-blind treatment for four weeks according to fixed-dosage steps with (1) amitriptyline hydrochloride alone, up to a maximum dosage of 300 mg/day; (2) tranylcypromine alone, up to 40 mg/day; or (3) the combination of amitriptyline hydrochloride, up to 150 mg/day, and tranylcypromine, up to 20 mg/day. The conditions of patients in all three treatment groups improved equally. The combined treatment did not produce a higher frequency of side effects, and no side effects, such as hypertensive or hyperthermic crises, occurred in any patient. Both amitriptyline alone and combined treatment produced substantially more anticholinergic side effects than did tranylcypromine. These results support the safety and efficacy of the combined treatment, although claims for superior efficacy over single-antidepressant treatments in this heterogenous population were not supported.

Adult↗

Electrocardiographic effects of tranylcypromine vs. amitriptyline.

The authors compared ECG changes during the course of treatment with a tricyclic antidepressant (amitriptyline) or a monoamine oxidase inhibitor (tranylcypromine) in 22 adult psychiatric patients. Amitriptyline-treated patients showed increased heart rate, PR, QRS, and QTc intervals. Tranylcypromine-treated patients showed no significant changes in ECG parameters. The clinical significance of the differing pattern of ECG effects for tricyclic antidepressants and monoamine oxidase inhibitors is discussed.

Adult↗

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↗

Dysphoric response to neuroleptics as a predictor of treatment outcome with schizophrenics. A comparative study of haloperidol versus mesoridazine.

In a double-blind comparison of haloperidol and mesoridazine in the treatment of 39 recently hospitalized schizophrenic patients, the two drug treatment groups showed comparable antipsychotic effects, though they did differ in side effects in expected manners. Analysis of the Brief Psychiatric Rating Scale to calculate an index of dysphoric response previously found predictive of poor ultimate outcome failed to predict outcome in this 4-week trial though patients with a dysphoric response to neuroleptics did prove to include a higher proportion of process schizophrenics, who might ultimately show poorer outcome, than did nondysphoric responders.

Adult↗

Self-regulated methadone detoxification of heroin addicts. An improved technique in an inpatient setting.

We used a method of detoxifying heroin addicts involving a self-regulated schedule of methadone hydrochloride detoxification in an inpatient setting. This method allows the addict to receive methadone on an "as needed" basis within specified guidelines, thus permitting him to regulate his own detoxification. For this study, 30 chronic heroin addicts were detoxified using this self-regulated detoxification procedure. Measures of length of stay, amount of methadone required, and degree of patient satisfaction indicate that this is a practical means of withdrawing chronic heroin addicts that may have advantages over fixed withdrawal schedules.

Adult↗