Biomedical subjects
M Livingston
Publications and source records attributed to M Livingston.
Whiplash injury: misconceptions and remedies.
Misconceptions about whiplash injury and its common course are discussed. Different patient populations appear to suffer to varying degrees and social copying is evident in certain groups--features shared with the Australian 1983 to 1985 'epidemic' of 'repetitive strain syndrome'. Psychosocial factors and overtreatment delay recovery. Family physicians have the opportunity to properly assess and manage most patients. Wasteful therapy must be discouraged, and self care and patient responsibility encouraged.
Affective flattening in elderly patients.
Forty-eight consecutive patients not taking dopamine antagonists and without Parkinson's disease referred to a psychogeriatric service with a diagnosis of psychiatric disorder were assessed for affective flattening using an objective rating scale. Nearly half (44%) exhibited significant affective flattening, which proved open to reliable assessment. Affective flattening is a useful sign of pathology.
A double-blind comparative study of remoxipride and thioridazine in the acute phase of schizophrenia.
Sixty-one patients with acute schizophrenia received either remoxipride (75-375 mg daily) or thioridazine (150-750 mg daily) for 6 weeks. There was no statistically significant between-drug difference in improvement in mental state, as measured by the Brief Psychiatric Rating Scale, although the trend favoured thioridazine; global assessment of illness severity at the last rating also favoured thioridazine. Sedation, anticholinergic effects, autonomic dysfunction, and weight gain were significantly more common in patients receiving thioridazine. Both drugs produced few extrapyramidal effects, but both were associated with cardiovascular changes in two patients; neither drug produced significant abnormalities in laboratory tests.
Maintaining remission in mood disorders.
The natural history of bipolar and unipolar affective disorders is for increasing severity and frequency of attacks as the patient ages. A major challenge for clinicians is the initiation and maintenance of prophylaxis.
Treatment of acute major mood disturbance.
Depression is a common presentation in family practice, and together with mania, constitutes the group of psychiatric disorders known as major mood disturbance. There are many ways to approach these problems from classification to management. Drug treatment is thought to be more successful in the presence of biological symptoms, and the GP should be familiar with one or two drugs from each group for best effect.
Management of chronic schizophrenia.
Schizophrenia is usually a chronic illness characterised by a series of relapses. Long-term management aims to achieve symptomatic remission for as long as possible. Maintenance drug therapy should be considered and is about one-third of the acute dose. Support in the community as offered by multi-disciplinary teams at day centres and community organisations plays an important part.
Treating acute schizophrenic illnesses.
Schizophrenia has a lifetime expectancy of about 1 per cent and the GP can be involved in management at all stages. One important role is counselling and support for the family. In the drug treatment of schizophrenia, it is useful to become familiar with two or three drugs.
A double blind comparative study of remoxipride and thioridazine in the acute phase of schizophrenia.
This is the first comparative double blind study of remoxipride. Sixty-one patients with acute schizophrenia received either remoxipride (75-375 mg daily) or thioridazine (150-750 mg daily) for 6 weeks. There was no statistically significant between-drug difference in improvement in mental state, as measured by the Brief Psychiatric Rating Scale, although the trend favoured thioridazine; global assessment of illness severity at the last rating also favoured thioridazine. Sedation, anticholinergic effects, autonomic dysfunction and weight gain were significantly more common in patients receiving thioridazine. Both drugs produced few extrapyramidal effects, but both produced cardiovascular changes in two patients; neither drug produced significant abnormalities in laboratory tests.
Antipsychotic drugs: current use and future prospects.
A wide range of antipsychotic drugs is available. This paper reviews the profile of action of such drugs, the rationale for their use, and current prescribing practice. The treatment of psychotic illness in the future, with drugs, may be possible without causing unwanted movement disorder.
How illness affects patients' families.
This review describes the impact of illness on patients' families and the importance of this for doctors who wish to involve relatives in rehabilitation programmes. It is essential that studies of such impact employ reliable methodology in assessing patient outcome and relatives' functioning.
Respiratory obstruction following the Nadbath facial nerve block.
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Paramedics, chiropractors and health planners.
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Schizophrenia and neurosis.
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