PubMed Health⌕ Search

Biomedical subjects

K Kuoppasalmi

Publications and source records attributed to K Kuoppasalmi.

At least 19 recordsLinked to original sources
PubMed2001

Targeted use of naltrexone without prior detoxification in the treatment of alcohol dependence: a factorial double-blind, placebo-controlled trial.

Several studies have shown the opioid antagonist naltrexone to be effective when combined with psychosocial therapies for the treatment of patients who are dependent on alcohol with fixed medication and time (12 weeks). In this study, 121 nonabstinent outpatients with alcohol dependence (DSM-IV) were treated with sessions of cognitive coping skills (N = 67) or supportive therapy (N = 54) and either naltrexone 50 mg/day (N = 63) or placebo (N = 58) daily for the first 12 weeks and thereafter for 20 weeks only when craving alcohol (i.e., targeted medication) in a prospective one-center, dual, double-blind, randomized clinical trial. The dropout rate for all subjects was 16.5% during the first 12-week period and approximately twice that level by the end of the study. There were no significant group differences in study completion and therapy participation rates. After the continuous medication (12 weeks), the coping/naltrexone group had the best outcome, and coping/placebo had the worst. This difference remained during the targeted medication period (the following 20 weeks). Naltrexone was not better than placebo in the supportive groups, but it had a significant effect in the coping groups: 27% of the coping/naltrexone patients had no relapses to heavy drinking throughout the 32 weeks, compared with only 3% of the coping/placebo patients. The authors' data confirm the original finding of the efficacy of naltrexone in conjunction with coping skills therapy. In addition, their data show that detoxification is not required and that targeted medication taken only when craving occurs is effective in maintaining the reduction in heavy drinking.

Adaptation, Psychological↗
PubMed2001

Relation between frontal 3-7 Hz MEG activity and the efficacy of ECT in major depression.

The efficacy of electroconvulsive therapy (ECT) in major depression has been linked to the accentuation of postconvulsive prefrontal electroencephalography slow-wave activity. We investigated the change in slow-wave activity (0.5-7 Hz) using whole-scalp magnetoencephalographic (MEG) recordings. The 3-7 Hz (theta) activity increased in the right frontal and occipital regions during the course of treatment. After four treatments, the increase of the theta activity in the left frontal cortex correlated with the efficacy of the ECT treatment. Moreover, the change of the ratio of left and right frontal theta activity to occipital theta activity had a positive correlation with the therapeutic effect. These findings suggest that an efficient ECT treatment increases MEG theta activity in the frontal cortex.

Adult↗
PubMed1999

Value of the initial stimulus dose in right unilateral and bifrontal electroconvulsive therapy.

BACKGROUND: The outcome of electroconvulsive therapy (ECT) is affected by the placement and dose of the stimulus. In general, the ECT dose can be selected either by the dose-titration method (on which the measured seizure threshold level is based), or the method of predetermined dose (e.g. the age-based dosing and the fixed high dose method). METHODS: Seizure thresholds were measured in 50 patients with right unilateral (RUL) and in 30 patients with experimental bifrontal (BF) ECT stimulus. The ECT dose (mC) of the age-based dosing was calculated by multiplying the age (years) by 5.0 (age method) or 2.5 (half-age method). The fixed high dose was set to 378 mC. RESULTS: The seizure thresholds had only a moderate correlation with the age of the patients. The methods based on the predetermined dose would have led us to give patients with the lowest seizure thresholds in the RUL ECT group very high stimulus doses, up to 12 (age method) or 15 (fixed high dose method) times the individual seizure threshold. In contrast, the RUL ECT patients with the highest seizure thresholds would have received low stimulus doses down to 1.5 times (half-age method) the initial seizure threshold. In the BF ECT group the-age based dose would have been similarly dependent on the initial seizure threshold level. CONCLUSION: The use of the dose-titration method is recommended, because it is the only method that allows for the individual selection of ECT stimulus dose relative to the seizure threshold.

Adult↗
PubMed1996

Suicide in non-major depressions.

We compared depressive suicides who had unipolar depression not fulfilling the diagnostic criteria of major depression (non-major depressions) with suicides who had major depression. A random sample of 229 suicides representing all suicides in Finland within a 12-month period were comprehensively examined using the psychological autopsy method and diagnosed according to DSM-III-R criteria. We included in this study all cases of current depressive disorder not otherwise specified (n = 48), adjustment disorder with depressed mood (n = 6) and dysthymia (n = 4). These 58 cases of suicide in non-major depressions were compared with the suicides with unipolar major depression (n = 71) in the same random sample. The non-major depressive victims were younger, and comprised more males, more cases with psychoactive substance use disorders, more secondary depressives, and more cases not having contact with health care, or cases not having communicated suicidal intent despite such contact. Recent life events were also reported more common among those with non-major depressions, particularly during the final week. The findings suggest that suicides in major depression and in unipolar depressions not fulfilling the criteria for major depression are likely to differ in several clinically relevant characteristics besides depressive symptomatology.

Adult↗
PubMed1994

Suicide in psychotic major depression.

A sample of unipolar DSM-III-R major depressive suicide victims representing all suicides in current unipolar major depression within 1 year in Finland was carefully examined by psychological autopsy. The sample was divided into currently psychotic (n = 24) or non-psychotic (n = 46) subgroups, the psychotic subgroup was described and the two subgroups were compared. The majority (79%) of psychotic as well as nonpsychotic (87%) major depressive suicide victims were found to be complicated, comorbid cases. No major differences between the psychotic and nonpsychotic subgroups were found in sociodemographic features, comorbidity, clinical history or communication of suicide intent. However, the psychotic victims were more likely to have used violent suicide methods (88% vs. 59%).

Adolescent↗
PubMed1993

The use of clozapine in treatment-refractory schizophrenia.

The effects of clozapine on positive and negative symptoms were studied in 103 patients with treatment-refractory schizophrenia. The evaluation of symptom profile was made before and after clozapine treatment. Overt psychopathology did not vary significantly before clozapine treatment. Significant decreases in positive and negative symptoms were noted by the third month on clozapine. No further significant progress could be observed after 6 months of treatment. No fatal cases were observed, although two patients developed agranulocytosis during clozapine treatment.

Adult↗
PubMed1992

Chronic facial pain together with severe depression is responsive to electroconvulsive therapy. A case report.

Electroconvulsive therapy (ECT) is widely accepted as a treatment for severe depression, but is seldom used in the treatment of chronic pain even though chronic pain and depression frequently occur together. This study presents a case in which ECT relieved both severe depression and chronic pain. It seems that the recognition of depressive disorders merits more attention and that ECT as a treatment for chronic pain in patients with severe depression should be taken into consideration in cases in which other treatments have failed.

Amitriptyline↗
PubMed1991

Plasma concentrations of remoxipride and haloperidol in relation to prolactin and short-term therapeutic outcome in schizophrenic patients.

Plasma concentrations of remoxipride and haloperidol as well as prolactin (PRL) were determined in 20 patients with acute symptoms of schizophrenia. Ten patients received remoxipride and ten patients haloperidol for a period of 6 weeks. A significant linear correlation was found between the plasma level of remoxipride and the dosage applied (P less than 0.02) as well as between the corresponding haloperidol dosage and plasma concentration (P less than 0.05). In both patient groups a significant reduction in psychopathology was observed during the trial period (P less than 0.001). In the haloperidol group this was associated with a clearcut elevation of plasma PRL, whereas in the remoxipride group after an initial rise for 4 weeks, the mean PRL level returned to baseline at the end of the study.

Adolescent↗
PubMed1990

Pituitary and gonadal function during physical exercise in the male rat.

The effects of training and acute exercise on serum testosterone, luteinizing hormone (LH) and corticosterone levels and on testicular endocrine function in male rats were studied. In the first part of the study, the rats were trained progressively on a treadmill, over 8 weeks. Training did not change the basal levels of serum testosterone, LH and corticosterone, or the testicular concentrations of testosterone and its precursors progesterone and androstenedione. The levels of testicular LH (30.3 +/- 2.6 ng/g wet wt, mean +/- SEM) and lactogen (150 +/- 14 pg/g) receptors were unchanged after training. However, the capacity of testicular interstitial cell suspensions to produce cAMP and testosterone increased by 20-30% during in vitro gonadotropin stimulation. In the second part, the trained and untrained control animals underwent acute exhaustive exercise. Serum testosterone levels decreased by 74 and 42% in trained and untrained rats, respectively (P less than 0.02), and corticosterone rose by 182% in trained and 146% in untrained rats (P less than 0.01), whereas the LH level was unchanged. Testicular levels of testosterone and its precursors decreased, with the exception of unchanged androstenedione, in trained rats; the cAMP concentration was unchanged. In both trained and untrained rats, acute exercise decreased the capacity of interstitial cell suspensions to produce cAMP, whereas there were no consistent effects on testosterone production. Acute exercise had no effect on LH or lactogen receptors in testis tissue. In conclusion, training had no effect on serum or testicular androgen concentrations, but increased Leydig cell capacity to produce testosterone and cAMP. Acute exercise decreased serum and testicular testosterone concentrations without affecting serum LH. A direct inhibitory effect of the increased serum corticosterone level on the hypothalamic-pituitary level and/or testis may be the explanation for this finding.

Androstenedione↗
PubMed1988

Human urinary biogenic amines and some physiological responses during situation stress.

Using a shooting competition as a model, the effect of situation stress on self-assessed mental tension, urinary metanephrine, normetanephrine, 3-methoxy-4-hydroxymandelic acid, 4-hydroxy-3-methoxyphenyl acetic acid and 5-hydroxyindole acetic acid (5-HIAA), as well as heart rate (HR), systolic and diastolic blood pressure (SBP, DBP), skin conductance level (SCL) and electromyographic (EMG) parameters were studied in 7 male and 2 female champion rifle and (rapid-fire and air-)pistol shooters. The sample collection and recordings were carried out first in the training (baseline) circumstances and then during the competition. Self-assessed mental tension was higher than suitable during the competition but good performance was the expectation. During the competition, HR, SBP, DBP, SCL and EMG were increased significantly as compared with the baseline levels. No significant correlations between the variables and between the biogenic amine metabolite excretions were observed. The competition-induced changes in self-assessed mental tension correlated positively with the corresponding changes in SCL (r = 0.63), but negatively with changes in SBP (r = -0.74). The HR of male rapid-fire pistol shooters was higher than that of male rifle shooters (P less than 0.05). All the urinary biogenic amine metabolite excretion levels were increased significantly as compared with the baseline values. Higher metabolite excretion was observed in rifle shooters than in rapid-fire shooters (P less than 0.05). The correlation between catecholamine metabolites was significant (r = 0.67-0.93), but surprisingly the correlation between 5-HIAA and catecholamine metabolites was highly significant (r = 0.80-0.91). This study indicates a marked divergence in the behaviour of various stress-responsive variables during shooting competitions.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Plasma glucagon and catecholamines during exhaustive short-term exercise.

Plasma glucagon and catecholamine levels were measured in male athletes before and after exhaustive 15 min continuous running and strenuous intermittent short-term exercise (3 X 300 m). Blood lactate levels were higher after the intermittent exercise (mean 16.7 mmol X 1(-1)) than after the continuous running (mean 7.1 mmol X 1(-1)). Plasma glucagon concentration increased during continuous running and intermittent exercise by 41% and 55%, respectively, and the increases in plasma noradrenaline concentration were 7.7- and 9.1-fold compared with the respective pre-exercise values. Immediately after the exercises plasma cyclic AMP, blood glucose and alanine levels were elevated significantly. The data suggest that the sympathoadrenal system is of major importance for liver glucose production during high-intensity exercises. Catecholamines directly stimulate liver glucose production and may indirectly stimulate it by enhancing the secretion of glucagon.

Adolescent↗
PubMed1985

Effect of physical exercise and sleep deprivation on plasma androgen levels: modifying effect of physical fitness.

The responses of plasma testosterone (T), sex hormone-binding globulin (SHBG) binding capacity, androstenedione (A), and luteinizing hormone (LH) to 21 km of marching exercise and to sleep deprivation stress were studied in army recruits. The effect of physical fitness on the exercise responses was evaluated, cross-sectionally, by comparing the stress responses in 11 fit and 11 less fit subjects, and, longitudinally, in 11 subjects after 4 months of physical training. The submaximal marching exercise did not significantly alter the plasma hormone levels compared to the control day levels. The fit subjects had a tendency toward smaller decreases in the mean plasma T and T/SHBG ratio during both control and exercise days than the less fit subjects. After 4 months of conditioning, the mean plasma T and T/SHBG ratio tended to decrease less during both control and exercise days, which was more evident in the well-conditioned subjects. The exercise caused a decrease in mean plasma LH, especially in the less fit subjects. After sleep deprivation stress, the morning levels of plasma T, A, and LH were significantly depressed, as a result of which the normal diurnal variation of the hormones disappeared.

Androgens↗
PubMed1985

Metabolic and hormonal changes in moderate and intense long-term running exercises.

The changes in selected muscle and blood metabolites - blood catecholamines, cyclic AMP, glucagon, growth hormone, insulin, and C-peptide--were measured in five male long-distance runners after moderate 90 min (4.3 min/km) and intense 45 min (3.3 min/km) of continuous running exercises. After the 45-min exercise, the mean concentrations of blood lactate and glucose were 2.8 and 8.8 mmol/l, respectively, and the muscle glycogen concentration had decreased by 31%. No changes could be found after the 90 min of running. The increase in blood glycerol concentration was greater after the 45-min exercise (5.8-fold) than after the 90-min exercise (3.9-fold), although the serum free fatty acid concentration increased significantly only during the 90-min exercise (1.6-fold). Plasma noradrenaline increases were 2.7-fold and 7.9-fold during the 90- and 45-min exercises, respectively, whereas the plasma adrenaline concentration was significantly elevated only after the 45-min exercise (4.7-fold). The respective changes of plasma cyclic AMP were 2.5- and 2.7-fold, and the increase in the concentration of plasma growth hormone was 5.8-fold after the 45-min exercise. The plasma insulin level decreased during the 90-min exercise, but was elevated after the 45-min exercise. The increase was greater than could be expected on the basis of the plasma C-peptide concentration. It is concluded that the hormonal and metabolic changes during submaximal long-term exercises are highly dependent on the intensity of exercise, even when the intensity of exercise is below the level of the anaerobic threshold.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗