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Biomedical subjects

L Reich

Publications and source records attributed to L Reich.

67 records · Page 4Linked to original sources
PubMed1976

EEG sleep changes as predictors in depression.

The authors conducted a study of 18 depressed patients to see whether EEG sleep measurements might provide a predictive tool for response to antidepressant medication. They found that although the sedative characteristics of amitriptyline did not differentiate good responders from poor responders until the third week of drug treatment, the good responders showed significant increases in REM latency, decreases in REM sleep time, decreases in REM sleep percent, and decreases in REM activity after only 2 nights of drug treatment.

Amitriptyline↗
PubMed1975

Sleep disturbance in schizophrenia. A revisit.

Rapid eye movement (REM) sleep mechanisms may play a role in the pathophysiology of schizophrenia, but results have been inconclusive and studies of sleep in schizophrena have been deficient in identifying, comparing, and differentiating between subcategories of schizophrenia. Twenty-nine hospitalized, drug-free schizophrenics were divided into three subgroupsācute, latent, and schizoaffective. The REM intensity measures and REM latency were found to differentiate significantly the schizoaffective group. Sleep-continuity indexes separated the latent and acute groups. Seven patients who later required treatment with tricyclic an tidepressants had base line REM latencies significantly lower and hospitalizations significantly more prolonged than the patients who did not require antidepressants. Sleep measurements may thus identify diagnostic subgroups of schizophrenia as well as predict which schizophrenic depressive syndrome or a concurrent affective syndrome.

Acute Disease↗
PubMed1975

The coordination of mental health services at the neighborhood level.

The neighborhood health center is becoming a major locus of mental health care delivery. Because of their strategic position at the neighborhood level, mental health care systems in the comprehensive health center locus have been able to develop linkages with both general health and community mental health systems to provide a broad continuum of coordinated health and mental health care. Four models identified in a survey of 19 neighborhood mental health programs are described. The authors suggest that persistent problems in coordination of care between neighborhood mental health and other caregiving systems would be considerably alleviated by a fiscal reimbursement scheme that rewarded integration rather than fragmentation of care.

Community Health Centers↗
PubMed1975

Poly (adnenosine diphosphoribose) synthase activity of isolated nuclei of normal and leukemic leukocytes.

Poly(adenosine diphosphoribose) (ADPR) synthase activities of nuclei isolated from normal human and leukemic leukocytes were assayed by incubation with radioactive NAD+. The synthase activity of leukemic leukocyte nuclei was significantly higher than that of normal leukocyte nuclei. The average length of polymers formed by isolated leukemic nuclei under the prescribed experimental condition ranged from 3.1 to 5.3 ADPR residues per chain, while those produced by normal leukocytes nuclei was 1.7 and 2.6 residues per chain. Isolated leukemic and normal leukocyte nuclei were incubated with and without NAD+ and the ability to carry out DNA synthesis was measured. The endogenous DNA synthesis of NAD-treated and untreated nuclei was the same. This finding parallels the result obtained with Novikoff hepatoma cell nuclei and differs from the observation with rat liver or testis nuclei.

Cell Nucleus↗
PubMedDate not supplied

Comparison of butorphanol nasal spray and fiorinal with codeine in the treatment of migraine.

Butorphanol tartrate is a synthetic mixed agonist-antagonist opioid analgesic. Its transnasal dosage form, which may be self-administered when the use of an opioid analgesic is appropriate, was previously shown to provide rapid relief of migraine pain. In this double-blind, parallel-group, outpatient study, we compared butorphanol nasal spray 1 mg followed in 1 hour by an optional second 1-mg dose with the orally administered analgesic, Fiorinal with Codeine (one capsule containing butalbital 50 mg, caffeine 40 mg, aspirin 325 mg, and codeine phosphate 30 mg). Patients (N=321) were assigned by randomization to one of two treatment groups (butorphanol or Fiorinal with Codeine) and instructed to self-administer medication when migraine pain reached an intensity of moderate or severe and to record study-related events in a diary for 24 hours posttreatment. Efficacy analyses were performed on data from 275 patients who took study medication and returned a patient diary; 136 in the butorphanol group and 139 in the Fiorinal with Codeine group. During the first 2 hours after treatment, butorphanol was more effective than Fiorinal with Codeine in treating migraine pain as measured by pain intensity difference scores, percentage of responders (pain decreased to mild or none), percentage of pain-free patients, and degree of pain relief, with a more rapid time to onset of 15 minutes. A similar percentage of patients in the two groups used rescue medication during the first 4 hours, after which more butorphanol-treated than Fiorinal with Codeine-treated patients used rescue medication. Butorphanol patients had more side effects, less improvement in digestive symptoms, and less improvement in functional ability than Fiorinal with Codeine patients.

Administration, Intranasal↗
PubMedDate not supplied

A prospective study of platelet-transfusion therapy administered to patients with acute leukemia.

Nineteen recently diagnosed patients with acute leukemias received prophylactic platelet transfusions when thrombocytopenic. Platelet concentrates were always transfused within eight hours of collection. The result of each transfusion was carefully monitored for the posttransfusion platelet increment. One patient died four days after admission to the present study. Seven patients died 1 to 14 months after the institution of antileukemic chemotherapy. Four patients received marrow transplants 1 to 2 months after starting chemotherapy and, therefore, were longer evaluated in this study. One patient was lost to follow-up after seven months of observation. The remaining six patients are alive and have been followed for 9 to 18 months. During the period of observation, none of the patients developed any evidence of refractoriness to platelet transfusion therapy. Although this series does not permit any firm conclusions to be made, it appears that the magnitude of the problem of alloimmunization to platelet transfusion therapy may be overemphasized.

Acute Disease↗
PubMedDate not supplied

Inadvertent intrathecal use of ionic contrast media for myelography.

PURPOSE: To describe instances of inadvertent intrathecal injection of ionic contrast media and to consider treatment approaches, and diagnostic and medicolegal issues. METHODS: Ten cases of inadvertent injection, of which nine were reported to the manufacturers/authors and one appeared in the literature, are related with emphasis on similarity of reactions. RESULTS: Six criteria are enumerated and used to coin the term "ascending tonic-clonic seizure syndrome." CONCLUSIONS: Therapeutic possibilities seem limited, but several methods for controlling seizures are suggested. The importance of identifying the contrast material is underscored. Awareness of the grave possibility of administering the wrong contrast material is the first step in avoiding this problem; awareness of the symptoms is the first step toward therapy.

Adult↗