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Biomedical subjects

L Robbins

Publications and source records attributed to L Robbins.

At least 19 recordsLinked to original sources
PubMed1992

Outpatient repetitive intravenous dihydroergotamine.

The efficacy of the repetitive intravenous dihydroergotamine (DHE) inpatient protocol for refractory headache is well established. We conducted a retrospective and prospective study of long-term headache patients at our clinic to evaluate this regimen in an outpatient setting. Treatment consisted of oral metoclopramide and four doses of DHE, with the total dose equaling 4 mg., administered over two days. Patients were followed for up to 10 weeks while they continued to receive prophylactic medication. Responsiveness was rated in terms of decreased frequency or severity of headache: excellent (75% to 100%), moderate (50-75%), mild (25-50%), and none (0-25%). In the retrospective study, 69% (43/62) of patients with chronic daily muscle-contraction-type headache and severe migraine had an excellent response at two days. An excellent or moderate response was sustained over three weeks in 65% (32/49) of the study group (13 patients were dropped from the study for failing to comply with record keeping requirements). At the 6- and 10-week follow-up evaluations, the majority of patients (76% and 70%, respectively) reported mild or no relief. Among patients with refractory daily headache or frequent severe migraine studied prospectively, 80% (28/35) reported an excellent response at two days. After six weeks, 66% (23/35) showed excellent or moderate relief. For both groups combined, 73% (71/97) of patients showed an excellent response to DHE at two days, with 43% (33/77) sustaining excellent or moderate relief at six weeks. Side effects, including nausea, leg cramps, facial flushing, increased blood pressure, diarrhea, burning at the injection site, and tightness in the throat and/or chest, were generally mild and transient.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

MRI in migraineurs.

Forty-six migraineurs and 69 age- and sex-matched controls referred for MRI scans of the brain were evaluated for the incidence of intracranial pathology. Axial long TR/short TE and long TR/long TE and sagittal short TR/short TE scans were performed in all patients. Enhancement with Gd-DTPA was performed in all controls and in nine migraineurs. Six of 46 (13%) of the migraineurs had white matter lesions versus three of 69 (4.3%) of the controls. The white matter lesions in migraineurs were seen in a younger age group than in the controls. These findings agree with recent MRI studies. Ischemia or an immune-based white matter demyelination are possible mechanisms for the white matter lesions.

Adolescent↗
PubMed1991

Migraine and anticardiolipin antibodies--case reports of 13 patients, and the prevalence of antiphospholipid antibodies in migraineurs.

Thirteen patients with both migraine and positive anticardiolipin antibodies (ACL) are discussed. Several of the patients were treated with immunosuppressives, aspirin, and anticoagulants. In addition, one underwent plasmapheresis. Sixty-eight migraineurs were screened for the presence of anticardiolipin antibodies. Low positive IgG ACL were identified in 13 patients, medium positive ACL were present in two patients, and one patient had high IgG levels for ACL. The number of positives in migraineurs was significantly higher than in controls.

Adult↗
PubMed1991

Competency to stand trial: description and initial evaluation of a new computer-assisted assessment tool (CADCOMP).

The authors describe a Computer-Assisted Determination of Competency to Proceed (CADCOMP), a new instrument that collects data directly from the defendant through an interactive computer program and renders a report covering relevant historical, psychopathological, and legal information. The comprehensive report could be utilized by the clinician to focus the clinician's interview with the defendant on areas requiring further probing, thus reducing the time required to assess competency. Preliminary reliability and validity assessment studies are reported. The results support the predictive validity of CADCOMP used as a screening instrument and found the CADCOMP to be sufficiently reliable to be used for screening purposes.

Adult↗
PubMed1989

Manipulation of oxygenation in a human tumour xenograft with BW12C or hydralazine: effects on responses to radiation and to the bioreductive cytotoxicity of misonidazole or RSU-1069.

The influence of altered tumour oxygenation on the responses to radiation and/or bioreductive 2-nitroimidazole compounds was studied in a well differentiated, human, colon adenocarcinoma (MAWI), grown as a subcutaneous xenograft in nude mice. Tumour growth delays were measured after local, single 5-18 Gy doses of X-rays. BW12C, which inhibits dissociation of oxyhaemoglobin, produced radioprotection similar to that resulting from clamping off the tumour blood supply during irradiation. Hydralazine, a vasoactive agent, also appeared to give radioprotection. BW12C or misonidazole (MISO) alone had no measurable inhibitory effect on xenograft growth. Hydralazine or RSU-1069 slightly increased the time for tumours to reach 6 times their original volumes. When hydralazine was given 40 min after a dose of 800 mg/kg of MISO, without X-rays, growth delays in excess of 5 tumour volume doubling times resulted and fewer tumour cells were present in histological sections. Lower doses of MISO combined with hydralazine were ineffective. Other combinations of bioreductive cytotoxic agents and methods of manipulation of tumour blood flow/oxygenation induced slight and inconsistent growth delays. Hydralazine was injected after irradiation of tumours in mice previously treated with various doses of MISO in an attempt to exploit the bioreductive cytotoxic potential of MISO in conjunction with its radiosensitizing properties; however, tumour growth delays were similar with or without hydralazine after irradiation. Thus, post-irradiation restriction of tumour blood flow appears to be an ineffective therapeutic strategy in this human xenograft tumour model.

Adenocarcinoma↗
PubMed1989

Flow cytometric analysis of lymphocyte subsets in peripheral blood of chronic headache patients.

Lymphocyte subsets from 5 groups of patients with different types of chronic headaches were analyzed by flow cytometry to determine the number of cells bearing the following markers: T11 (E-rosette receptor), T3 (total T cells), T4 (T-helper/inducer cells), T8 (T-cytotoxic/suppressor cells), B1 (B-cells), NKH-1 (Natural killer cells), I2 (Class II histocompatibility antigens, monomorphic determinants) and Mo2 (monocytes). In 4 of 5 of these groups, the absolute number of T8 lymphocytes was significantly lower than that of control group. In addition, the T4:T8 ratio was higher in these 4 groups. These findings may suggest a relationship between the immune system and the cause of chronic headaches.

Antibodies, Monoclonal↗
PubMed1989

Post-traumatic headache with scintillating scotoma treated with phenytoin (Dilantin).

A post-traumatic headache patient was experiencing "flashing lights" in her visual field that correlated with sharp waves on the EEG. Phenytoin markedly improved the symptoms. The value of the EEG in post-traumatic headaches is reviewed. The use of phenytoin in headache syndromes and in prevention of post-traumatic epilepsy is discussed.

Accidents, Traffic↗
PubMed1989

Sexual assessment and the aging female.

Due to an increasing population of elders, more women are in need of geriatric gynecologic care. Many of these women are capable of being active sexual partners throughout their lifetimes. However, there are a number of factors that can influence sexual relationships, including personal and societal values, the normal physiologic changes associated with aging and the availability of a sexual partner. Obtaining accurate histories and appropriate physical data regarding sexual functioning are important. Measures that will aid the collection of a complete database, along with pertinent physical assessment, are discussed. Options for treatment and education of the elderly woman in the area of sexual needs are presented to assist health care providers in their role as sex educators and counselors for older women.

Aged↗
PubMed1988

Sexual maturity as a criterion for classification of phallometric stimulus slides.

With the acceptance of behavior modification techniques in the 1970's as the standard modality of treatment of sex offenders, the ability to diagnose the paraphilic arousal patterns became of primary importance. The use of the penile plethysmograph in the assessment of sex offenders is regarded as the most accurate measure of these sexual arousal patterns. This method measures the vasocongestive engorgement of the penile corporea while the offender is exposed to deviant and nondeviant sexual stimuli. The stimuli may be slides of nude males and females of varying ages, audiotaped descriptions of erotic scenarios or videotaped scenes of sexual interaction. Researchers who have used slides to determine the age and gender preference of the sex offenders have typically categorized the slides in arbitrarily established age categories that have varied from one research study to another. The use of age as a criterion does not take into account the variation in growth and maturation among children and adolescents. To increase reliability and standardization of research techniques, the authors propose that the stages of sexual maturity as set forth by Tanner (1962, 1978) be used in lieu of age.

Adolescent↗
PubMed1987

Development of a computerized sexual assessment laboratory.

Computer-assisted psychological assessment has been operational for 25 years. It has been well received by patients and shows a degree of reliability that is comparable to that of conventional testing. The authors report on the development of a computerized psychosexual assessment laboratory in a forensic facility housing convicted sex offenders who volunteered for treatment. The development of the laboratory was in response to the need for uniform psychosocial data on each resident that can be used for making better diagnoses, developing personalized treatment programs, and assessing treatment outcome. The process of selecting the psychological tests and programming them for interactive administration is described, as are the testing procedures using the penile plethysmograph with stimuli based on the Tanner developmental stages. A computer-assisted psychosocial assessment that produces a psychosocial history was developed. The laboratory's overall value in the treatment program is assessed.

Arousal↗
PubMed1986

Fibronectin in severe sepsis.

Fibronectin was given in the form of cryoprecipitate of human plasma to patients with severe surgical sepsis in a double blind, prospective and randomized clinical study. Of the 19 patients assigned to the control group receiving no fibronectin, only eight (42 per cent) survived. Of the 12 patients given the cryoprecipitate, nine survived (75 per cent) (p less than 0.05). In the control group, initial serum fibronectin levels were depressed to 121 micrograms per milliliter (normal = 313). The mean values in the blank plasma controls did not increase after 24 hours, with a mean of 122. In contrast, the group treated with cryoprecipitate increased serum fibronectin values after 24 hours to 216 micrograms per milliliter, up from initial values of 161 micrograms per milliliters. Improvements in pulmonary function, serum bilirubin and serum creatinine values were also noted, but the changes fell short of statistical significance. Fibronectin appears to benefit patients in severe surgical sepsis in this study of a relatively small number of patients.

Adult↗
PubMed1985

Embolic stroke complicating systemic lupus erythematosus.

Embolic stroke complicating systemic lupus erythematosus has been infrequently reported. We examined a 25-year-old woman who suddenly became hemiplegic. Two-dimensional echocardiography identified a source of emboli. At cardiac surgery, friable thrombotic vegetations were found adhering to the mitral valve leaflets, left ventricular septal wall, and chordae tendineae. At autopsy several weeks later, careful pathologic examination of the heart failed to reveal evidence of thrombus formation or endocarditis. An embolus identical in appearance to the thrombotic vegetations described at cardiac surgery was found lodged in the left middle cerebral artery underlying the recent brain infarction. To our knowledge, this is the first report of embolic stroke in systemic lupus erythematosus caused by extensive cardiac thrombus formation in the absence of underlying endocarditis.

Adult↗
PubMed1983

Achievement motivation in medical students.

Medical students were assessed by questionnaire in their third and fourth years regarding attitudes about sex role, medical school, and career plans and in the third year about fear of success. Nine percent of each sex were judged to fear success. Stereotypical responses were reported by the students. Males, anticipating that they would work more than 60 hours per week, looked forward to academic careers, while females more often desired the sharing of financial and child care responsibilities with spouses. Attitudes toward chores were egalitarian, but in reality women performed most routine household activities. Both sexes agreed upon the characteristics that are necessary to be a good student as well as to succeed in later life. Women were more inclined toward artistic and domestic interests and helping others, while men were more interested in scientific investigation, athletics, and adventure. The implications of these similarities and differences for the students' future careers are discussed.

Achievement↗