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Biomedical subjects

J Whyte

Publications and source records attributed to J Whyte.

36 records · Page 2Linked to original sources
PubMed1989

Lithium carbonate for aggressive behavior or affective instability in ten brain-injured patients.

Lithium carbonate (LiCO3) was used to treat 10 brain-injured patients with severe, unremitting, aggressive, combative, or self destructive behavior or severe affective instability. Five patients had a dramatic response that resulted in significant improvement in their participation in a rehabilitative program. One other patient had a moderate response. A seventh patient improved dramatically, but regressed after 7 wk. Three other patients had neurotoxic side effects that precluded continued use of the medication. Two of them were simultaneously taking neuroleptic agents. These case reports provide further evidence that LiCO3 can be a useful medication in the treatment of aggressive behavior and affective instability after brain injury, but that it has significant potential for neurotoxicity in this population, particularly when used in conjunction with neuroleptic agents.

Adult↗
PubMed1989

Sleep-related laryngeal obstruction presenting as snoring or sleep apnea.

The difference between snoring (with or without sleep apnea) and laryngeal stridor resulting from laryngeal dysfunction may not be readily apparent. Two cases of Shy-Drager syndrome and one undiagnosed case in which laryngeal dysfunction was exacerbated by sleep are reported. Such dysfunction might create life-threatening situations for which emergency tracheostomy should be considered. The importance of differentiating stridor from snoring is discussed.

Aged↗
PubMed1989

Evoked potential assessment: utility in prognosis of chronic head injury.

Brainstem auditory evoked potentials (BAEP) and somatosensory evoked potentials (SSEP) were performed on 29 patients an average of 12.4 months after traumatic brain injury (TBI). The study purpose was to predict long-term outcome in chronic TBI patients by using multimodality evoked potentials (MEP), the Rancho Los Amigos Scale (RLAS), and other clinical parameters. Neither the BAEP nor SSEP correlated significantly with the cognitive level on the RLAS at the MEP study approximately one year after TBI (RLAS1). Only 11.7% of RLAS1 could be predicted by the combined study of BAEP and SSEP. BAEP and SSEP obtained about one year after TBI jointly had a 15% predictive power of the long-term follow-up RLAS score obtained 18 months after performance of the MEP (RLAS2). Stepwise regression analysis showed that the best predictive indicator of the status of long-term outcome was RLAS1 which alone can predict 60% of long-term outcome. The predictive value of combinations of RLAS1 and age improved prediction of long-term outcome to 66.8%, and the combination of RLAS1, age, and SSEP further increased the value to 72%. Perhaps the MEPs were relatively insensitive in reflecting the patient's adaptation to fixed neuronal damage since patients can perform higher cognitive function by adaptation through behavioral modification and cognitive retraining despite little structural improvement. This adaptation would result in a discrepancy between MEP and RLAS scores in the late chronic phase.

Adolescent↗
PubMed1988

Teaching safe sex.

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Acquired Immunodeficiency Syndrome↗
PubMed1988

HIV testing.

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Acquired Immunodeficiency Syndrome↗
PubMed1986

Carbamazepine-erythromycin interaction. Case studies and clinical significance.

Because of significant and seemingly haphazard fluctuations in serum carbamazepine concentrations, we decided to investigate the possible link between erythromycin administration and potential changes in serum carbamazepine concentration. We studied four cases involving this combination. In every case, serum carbamazepine concentrations either rose dramatically (doubled or tripled previous steady-state concentrations) or dropped precipitously once erythromycin therapy was discontinued. In all cases, we report serum carbamazepine concentrations obtained before, during, and after concurrent erythromycin administration. We conclude that the combination of erythromycin and carbamazepine represents a clinically significant drug interaction and should be avoided where possible.

Adult↗
PubMed1986

Subcellular fractionation and distribution of cholinergic binding sites in fetal human brain.

Conventional subcellular fractionation techniques have been applied to human fetal brain (13-15 weeks gestation) and the fractions have been characterized by assaying for marker enzymes, cholinergic binding sites and electron microscopy. Fractionation of the homogenate resulted in a nuclear pellet (P1), a crude mitochondrial pellet (P2) and a supernatant (S2). Further resolution of the P2 fraction by density gradient centrifugation resulted in two bands at the gradient interfaces and a pellet. The P2 and subsequently the P2B fraction contained intact plasma membrane profiles as judged by the predominance of adenylate cyclase activity and the presence of occluded lactate dehydrogenase which constituted over 70% of the total activity in these fractions. Morphological examination of the gradient fractions revealed that the P2B fraction contains membrane bound structures which resemble synaptosomes prepared from neonatal rat brain. These structures have a granular matrix in which mitochondria and frequently, neurofilaments were observed. Very few synaptic vesicles were present and there was no evidence for post synaptic attachments. The cholinergic markers choline acetyltransferase, acetylcholinesterase and receptor sites defined by quinuclidinyl benzilate and alpha-bungarotoxin binding were enriched in fractions P2 and P2B which contained the bulk of nerve ending particles. This enriched preparation of fetal synaptosomes may be valuable for functional studies on pre-synaptic terminals in developing brain.

Brain↗
PubMed1985

Inspection time and intelligence in dyslexic children.

Dyslexics and normal readers aged 9-11 were compared on an inspection time task. Results indicated that dyslexics required significantly longer inspection times. The findings suggested, however, that there was greater individual variation among dyslexics than among normal readers and that the dyslexics benefited from practice to a considerable extent. Inspection times were not significantly related to IQ as measured by a non-verbal test.

Attention↗
PubMed1981

Prediction of the severity of ABO haemolytic disease of the newborn by cord blood tests.

Seventy-one ABO incompatible (heterospecific) infants and 71 controls, who were free from other potential causes of jaundice, were studied to ascertain which cord blood tests reliably predict the severity of ABO haemolytic disease of the newborn (ABO HDN). The modified Direct Antiglobulin Test (spin DAGT) was positive in all infants who required treatment for haemolytic jaundice and only DAGT positive children showed evidence of impending haemolytic anaemia or compensated haemolysis in cord or capillary blood. Cord serum bilirubin concentration had some predictive value, particularly when the level exceeded 85 mumol/l, but it was a less reliable indicator and had greater value if used in association with the DAGT. The elution test, which is frequently used as a diagnostic tool in ABO HDN, had no predictive value and we felt that its putative value is due to overdiagnosis of ABO HDN in jaundiced heterospecific infants. We conclude that the spin DAGT, despite the weakness of the reaction, reliably identifies infants at risk from severe ABO HDN and is sufficiently sensitive to be used as a single screening test for the early detection of the disorder.

ABO Blood-Group System↗
PubMed1977

Drug usage and adverse drug reactions in paediatric patients.

The development of epidemiological methods for the study of adverse drug reactions is reviewed in connection with the presentation of data obtained by intensive monitoring of 1 000 admissions to a medical paediatric unit. Compared with adults and American children, the patients received fewer drugs and experienced fewer reactions while in hospital. The drug usage pattern was different from that of American paediatric practice and general practice in the United Kingdom. Fifty-one (6%) patients experienced 119 adverse drug reactions. These occurred more frequently in children suffering from serious disorders and in the majority of cases the basic therapy was continued regardless of the severity of the drug side-effects. Treatment was required for the effects of 66 (55%) adverse reactions. It appears that drug monitoring in paediatric practice may be of greater value if surveillance programmes are designed to provide a "therapeutic audit" and extended to include children receiving drugs in the community.

Child↗
PubMed1976

Pattern and quality of recording pre-admission drug treatment in paediatric patients.

The pattern and quality of recording drug use before admission was examined in children admitted to a paediatric unit over eight months. The preadmission drug intake (1-7 drugs/patient) was lower than that of adults. Antibiotics were the most frequently prescribed drugs, but mild analgesics and antihistamine preparations were commonly used, often without medical advice. The simultaneous administration of prescribed and non-prescribed drugs appeared to be as common in children as in adults. The number of drugs taken was related to the number of domicilary consultation received and the number of doctors seen as as to confirm that most doctors' visits result in the prescription of medicine. The transfer and recording of drug information was poor, owing principally to lack of communication between doctors and failure to detect self-medication, but the modern practices of self-referral to hospital and use of multiple prescribers have further reduced the information available. The use of a "current treatment card" is required if the full significance of iatrogenic disease in childhood is to be investigated.

Adolescent↗
PubMedDate not supplied

Carbamazepine replacement of phenytoin, phenobarbital and primidone in a rehabilitation setting: effects on seizure control.

Most patients who receive anticonvulsants after traumatic brain injury are treated with the sedative anticonvulsants phenytoin and/or phenobarbital, or perhaps primidone. However, there is considerable evidence demonstrating that these medications have a deleterious effect on cognitive function. Thus, in a rehabilitation setting, alternatives should be sought. Carbamazepine has been found to be relatively free of such effects, and would be an optimum alternative if seizure control were comparable. We have studied the effects of withdrawing phenytoin, phenobarbital and primidone, and using carbamazepine as the primary anticonvulsant in 27 patients at the Greenery Rehabilitation and Skilled Nursing Center for whom ongoing anticonvulsant treatment was considered to be necessary due to previous seizures or a high risk of the occurrence of seizure. We compared a 3 month baseline period (just prior to carbamazepine introduction or sedative anticonvulsant tapering), to a 3 month post-withdrawal period immediately following sedative anticonvulsant withdrawal, when carbamazepine was the sole anticonvulsant. In 20 out of 21 patients in whom carbamazepine replaced sedative anticonvulsants seizure control was essentially similar or somewhat improved. In only one patient did the substitution with carbamazepine result in a loss of seizure control. Six patients were initially receiving carbamazepine in combination with phenytoin and/or phenobarbital. The removal of phenytoin and phenobarbital, leaving carbamazepine as sole therapy, resulted in improved seizure control in three patients and no change in the other three. In the light of carbamazepine's reportedly less detrimental effects on cognitive function and behaviour in other patient populations, it should perhaps be considered as a first line anticonvulsant, especially for patients in rehabilitation settings.

Adult↗
PubMedDate not supplied

Arterial microanastomosis technique by using only one stitch.

The starting point of this work is the description of a microsurgical technique designed to carry out termino-terminal arterial anastomosis in rats. The technique is based on the intussusception of the afferent vessel of the anastomosis in the efferent vessel, both of which are fixed by a horizontal U-shaped stitch. Of the twelve cases which make up this series, haemorrhage appeared in two, and a postanastomotic aneurysm developed in one. The lack of complications both before and after operating, even in the long term, in the balance of the cases (75%), together with the simple and quick procedure of this kind of anastomosis, makes this technique a possible alternative to the classical techniques of vascular microanastomosis in experimental surgery.

Anastomosis, Surgical↗