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Biomedical subjects

L J West

Publications and source records attributed to L J West.

At least 19 recordsLinked to original sources
PubMed1991

Dental management of the patient with major depression.

Major depression is a psychiatric disorder in which mood, thought content, and behavioral patterns are impaired for long periods of time. It is a common disorder, with an increasing prevalence among young adults. It may be associated with a disinterest in performing appropriate preventive oral hygiene techniques, a cariogenic diet, diminished salivary flow, rampant dental decay, advanced periodontal disease, and oral dysesthesias. Many medications used to treat the disease magnify the xerostomia and increase the incidence of dental disease. Appropriate dental management necessitates a vigorous preventive dental education program, the use of saliva substitutes and anticaries agents containing fluoride, and special precautions when prescribing or administering analgesics and local anesthetics.

Anesthesia, Dental↗
PubMed1990

Serious adverse drug reactions to pyrimethamine-sulphadoxine, pyrimethamine-dapsone and to amodiaquine in Britain.

All reports of adverse reactions with pyrimethamine-sulphadoxine (Fansidar), pyrimethamine-dapsone (Maloprim), and amodiaquine spontaneously reported through the UK national post-marketing system were reviewed. Retrospective reporting rates of serious reactions associated with these drugs were analysed using prescription data from the Department of Health, derived from the Prescription Pricing Authority, and relevant pharmaceutical companies. Whilst interpretation of these data requires caution, they allowed comparison with reporting rates from other studies. The reported rate for all serious reactions to pyrimethamine-sulphadoxine was 1:2100 prescriptions, and for cutaneous reactions was 1:4900 prescriptions, with a fatality rate of 1:11,100. The reported rate for serious reactions to pyrimethamine-dapsone was 1:9100 prescriptions, and for blood dyscrasias was 1:20,000 prescriptions, with a fatality rate of 1:75,000. The reported rate of blood dyscrasias associated with amodiaquine was 1:2100 users with a fatality rate of 1:31,000. Serious hepatic disorders occurred in 1:11 1000 pyrimethamine-sulphadoxine prescriptions, 1:75,200 pyrimethamine-dapsone prescriptions, and in 1:15,650 amodiaquine users. 35% of cases received these drugs needlessly as they were not exposed to drug resistant strains of Plasmodium falciparum. Since few serious reactions have been reported to chloroquine plus proguanil, these data support guidelines which restrict the use of reviewed drugs for those at greatest risk of infection. Dosage data indicated that fatalities had taken higher doses and continued prophylaxis after onset of symptoms. Two thirds of serious reactions to the compound antimalarials were reported in females.

Adolescent↗
PubMed1984

Alcoholism.

After heart disease and cancer, alcoholism is America's third largest health problem; it affects 10 million people, costs $ 60 billion, and is implicated in 200 000 deaths annually. Alcohol is involved in 50% of deaths by motor vehicle and fire, 67% of murders, and 33% of suicides. It contributes to morbidity in certain malignancies and to many diseases of the endocrine, cardiovascular, hematopoietic, gastrointestinal, and nervous systems. The fetal alcohol syndrome occurs in a third of the infants born to women who drink more than 150 g of ethanol daily during pregnancy; another third of the infants become mentally retarded. The prevalence of alcoholism is lower in elderly than in middle-aged persons, but detection is difficult and vulnerability to harm is great in the elderly, due to both pharmacokinetic factors and increased tissue sensitivity. Alcohol and aging are additive in their harmful effects. Although modern medical treatment is helpful, alcoholics are frequently misdiagnosed and mismanaged by health professionals. Total abstinence from alcohol should be a primary goal of treatment.

Age Factors↗
PubMed1982

Controlled drinking by alcoholics? New findings and a reevaluation of a major affirmative study.

Controlled drinking has recently become a controversial alternative to abstinence as an appropriate treatment goal for alcoholics. In this study we reexamine the evidence underlying a widely cited report by Sobell and Sobell of successful controlled drinking by a substantial proportion of gamma (physically dependent) alcoholic subjects in a behavior therapy experiment. A review of the evidence, including official records and new interviews, reveals that most subjects trained to do controlled drinking failed from the outset to drink safely. The majority were rehospitalized for alcoholism treatment within a year after their discharge from the research project. A 10-year follow-up (extended through 1981) of the original 20 experimental subjects shows that only one, who apparently had not experienced physical withdrawal symptoms, maintained a pattern of controlled drinking; eight continued to drink excessively--regularly or intermittently--despite repeated damaging consequences; six abandoned their efforts to engage in controlled drinking and became abstinent; four died from alcohol-related causes; and one, certified about a year after discharge from the research project as gravely disabled because of drinking, was missing.

Alcohol Drinking↗