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Biomedical subjects

P Toren

Publications and source records attributed to P Toren.

At least 19 recordsLinked to original sources
PubMed1999

Image vividness as a psychophysiological regulator in Posttraumatic Stress Disorder.

This study examined the relationship between image vividness and psychophysiological responses to trauma-related stimuli in participants with Posttraumatic Stress Disorder (PTSD). An auditory stimulus related to a shared trauma was presented to participants with and without PTSD and physiological parameters (heart rate and blood pressure) were measured concurrently. A negative correlation was noted in the PTSD group between image vividness and the level of physiological response. When the PTSD group was divided into high and low vividness, the physiological response was higher than that of the non-PTSD controls only when image vividness was low. The results are discussed in the context of Lang' s theoretical model, emphasizing the role of image vividness in the mediation and regulation of psychophysiology.

Acoustic Stimulation↗
PubMed1999

Ondansetron treatment in patients with Tourette's syndrome.

Ondansetron, a selective 5-HT3 antagonist, may lower mesolimbic dopaminergic hyperactivity. The present open-label pilot study evaluated the effect of ondansetron in Tourette's syndrome. Six Tourette's syndrome men aged 14-48 years resistant to haloperidol participated in the study. Assessments included the Yale Global Tic Severity Scale (YGTSS), Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), and Tourette's syndrome-Clinical Global Impression (TS-CGI) scale. The maximal ondansetron dosage (8-16 mg per day) was given for 3 weeks. Ondansetron treatment was associated with a significant decrease in the severity of tics. Two patients showed a definite response (score improvement of 40% or more), and two showed a probable response (> 25%). Two patients did not improve. Side-effects were transient and included abdominal pain (n = 5) and constipation (n = 2). Ondansetron may possess anti-tic effects in some Tourette's syndrome patients.

Adolescent↗
PubMed1999

Image control and symptom expression in posttraumatic stress disorder.

Despite the devastating impact of affective dysregulation in posttraumatic stress disorder (PTSD), there has been little research on how trauma relates to affect regulation. This study examines the relationship between the cognitive capacity to control mental images and symptoms of individuals with (N = 23) and without (N = 23) PTSD after exposure to SCUD missile attacks during the Gulf War. The capacity to control mental images, symptoms of posttrauma, anxiety, and anger were assessed. PTSD subjects with a high image control reported a higher capacity to control anger, lower levels of anger state and expression, and lower levels of intrusive symptoms compared with PTSD subjects with low image control. In individuals without PTSD, results show that the better the image control, the lower the control of anger and the higher the expression of anger. Image control seems to play different functions in the emotional regulation of normal subjects (facilitatory) and PTSD patients (protective).

Affect↗
PubMed1999

Image control from childhood to adolescence.

Despite the recognized importance of imagery use by children as well as the developmental relevance for maturity and health of imagery properties such as vividness and control, only a few studies have investigated imagery of children. The aim of the present study was to examine the development of control of mental images in a sample of boys and girls aged 7 to 17 years. Children were assessed on two aspects of mental imagery, vividness and control, and teachers were asked to rate the children's intellectual and socioemotional performance. Analysis showed that the capacity for image control increased in adolescence and that children characterized by vivid and uncontrolled imagery received the lowest ratings from teachers, whereas those with nonvivid and controlled imagery received the highest ratings. The implications of these results were discussed in relation to normal and abnormal development as well as suggestions for research.

Adolescent↗
PubMed1998

Cholesteryl hydroperoxyoctadecadienoate from oxidized low density lipoprotein inactivates platelet-derived growth factor.

Both oxidized low density lipoprotein (ox-LDL) and platelet-derived growth factor (PDGF) have been implicated in the genesis of various inflammatory responses, including atherosclerosis. We demonstrate here a novel interaction between specific oxidized lipids derived from ox-LDL and PDGF. The lipid moieties of ox-LDL caused concentration-dependent inactivation of PDGF as measured by loss of its mitogenic activity and its binding to high affinity receptors. Reverse-phase and normal-phase HPLC were used to purify the inactivating component in the lipid mixture. By fast atom bombardment mass spectrometry and infrared spectroscopy, we identified the inactivating lipids as the 9- and 13-hydroperoxy derivatives of cholesteryl linoleate, cholesteryl hydroperoxyoctadecadienoate. When a series of cholesteryl esters were subjected to oxidizing conditions, only those containing two or more double bonds caused inactivation of PDGF; the extent of inactivation increased with increased levels of oxidation. Exposing PDGF to cumene hydroperoxide, t-butyl hydroperoxide, or hydrogen peroxide did not affect the activity of the mitogen. The oxidized lipid had no effect on the mitogenic activity of epidermal growth factor but did abolish the mitogenic activity of basic fibroblast growth factor and the antiproliferative activity of transforming growth factor beta1. The inactivation of PDGF and other cytokines by lipid hydroperoxides may occur in such processes as vascular disease, inflammation, and wound healing.

Arteriosclerosis↗
PubMed1998

Use of atypical neuroleptics in child and adolescent psychiatry.

BACKGROUND: This article reviews the published clinical experience with atypical neuroleptics in children and adolescents. METHOD: A computerized literature search was conducted (MEDLINE, 1974-1998) to retrieve all reports on the use of atypical neuroleptics in children and adolescents. A hand search was performed as well. All relevant clinical data were collated by type of drug. RESULTS: We found 5 blind placebo-controlled clinical trials (105 patients), 24 open-label clinical trials (387 patients), and 33 case series (115 patients) describing the use of the atypical neuroleptics clozapine, risperidone, olanzapine, sulpiride, tiapride, amisulpride, remoxipride, and clothiapine in children and adolescents. Some of these agents, especially clozapine, risperidone, and olanzapine, were found to be efficacious in the treatment of schizophrenia, bipolar disorders, and pervasive developmental disorders. The role of atypical neuroleptics as augmenters of serotonin reuptake inhibitors in obsessive-compulsive disorder is unclear. Risperidone appears to possess anti-tic properties in patients with Tourette's disorder. CONCLUSION: The most convincing evidence of the efficacy of atypical neuroleptics in children and adolescents concerns clozapine in the treatment of schizophrenia. Data on other atypical neuroleptics in other disorders are still sparse, and further research is needed. Some of the atypical neuroleptics may become the first-line treatment for childhood schizophrenia and pervasive developmental disorders.

Adolescent↗
PubMed1998

Pathological laughter: common vs. unusual aetiology and presentation.

Pathological laughter and crying is a well known clinical phenomenon which in most cases appears in association with diverse neurological and psychiatric symptoms and signs. It is not a disturbance of affectivity but rather of the motor concomitant of affective expression. Its main clinical characteristics are: absence of voluntary control and absence of the corresponding change in mood. It is not accompanied by the emotional lability of the organic brain syndromes, it does not present the inappropriate jocularity of the patients with frontal lobe disturbance, it is not due to the intoxicating effect of alcohol or addictive drugs and there are no typical symptoms of manic syndromes (such as grandiose self-esteem, flight of ideas, hyperactivity, etc.). In this paper three cases of pathological laughter are presented, two of these associated with organic brain conditions. The discussion will deal in particular with aetiological considerations and psychopathology of the third case which was unusual because it was a monosymptomatic condition and seemed to be the expression of a posttraumatic stress disorder.

Adult↗
PubMed1997

Lack of effect of methylphenidate on serum growth hormone (GH), GH-binding protein, and insulin-like growth factor I.

The aim of this study was to assess the growth hormone (GH) axis in methylphenidate (MPH)-treated and untreated boys with attention-deficit and hyperactivity disorder (ADHD), by evaluating serum GH, GH-binding protein (GHBP) activity, and insulin-like growth factor I (IGF-I) levels as compared to age-matched normal controls. Blood samples were taken from 42 boys (aged 6-16 years) diagnosed as having ADHD according to DSM-III-R criteria and confirmed by using the Schedule for Affective Disorder and Schizophrenia for school-age children (K[Kiddle]-SADS). A total of 21 patients were treated with MPH (5-20 mg/day; 0.15-0.77 mg/kg/day), on a drug holiday protocol, for 1-36 months, and 21 were drug naive. A total of 46 age-matched normal boys at height and weight within normal range served as controls. No significant differences were detected between the MPH-treated ADHD children, the untreated ADHD children, and the control children on fasting serum GH levels, GHBP activity, or IGF-I levels. Active treatment with MPH, in ADHD children on a drug holiday protocol, does not cause changes in GH axis as manifested by normal values of GH, GHBP, and IGF-I.

Adolescent↗
PubMed1997

An open trial of clozapine in neuroleptic-resistant childhood-onset schizophrenia.

BACKGROUND: Studies performed with schizophrenic adults who were resistant to classical neuroleptics showed improvement in 30% of the patients when treated with clozapine. Very early onset schizophrenic patients benefit only partially from conventional antipsychotics and are at increased risk of developing extrapyramidal symptoms; clozapine may offer an alternative treatment for these patients. METHODS: Eleven neuroleptic-resistant children (< 13 years) with schizophrenia were treated with clozapine. Improvement was monitored during the first 16 weeks using the Brief Psychiatric Rating Scale, Positive and Negative Syndrome Scale and Clinical Global Impression. The mean clozapine dosage was 227.3 (s.d. 34.4 mg/day at the end of the 16 weeks. RESULTS: There was an overall statistically significant reduction in all parameters, especially positive symptoms, implying a favourable outcome. Most of the improvement occurred during the first 6 to 8 weeks. The major side-effects were somnolence and drooling (no agranulocytosis). CONCLUSION: Clozapine may be a promising drug for the treatment of resistant childhood-onset schizophrenia.

Adolescent↗
PubMed1996

Chronic GnRH agonist administration down-regulates platelet serotonin transporter in women undergoing assisted reproductive treatment.

The effect of pretreatment with the gonadotropin releasing hormone (GnRH) agonist D-Trp6-LHRH (Decapeptyl) on platelet serotonin transporter in women undergoing assisted reproductive treatment (ART) was investigated and compared with women treated with human menopausal gonadotropin (Pergonal). The study group (n = 10) was exposed for 12 days to 3.2 mg Decapeptyl C.R. while a comparison group (n = 9) was exposed to 11 days of human meno-pausal gonadotropin (Pergonal). All patients were assessed with the Hamilton depression and anxiety scales before and after treatment, and platelet and plasma samples were collected at the same time points. Plasma levels of estradiol, progesterone. FSH and LH were determined by radioimmunoassay (RIA). Platelet serotonin transporter was labeled using high affinity [3H]imipramine binding. The GnRH analogue induced ovarian suppression as reflected by low plasma estradiol levels, while Pergonal administration induced ovarian stimulation. An elevation in the Hamilton depression and anxiety scale scores was observed in the Decapeptyl treated group; this mood alteration was associated with a significant decrease (19%, P < 0.05) in the density (Bmax) of platelet [3H]imipramine binding sites. No significant change was observed in the Bmax of the Pergonal treated group. These results indicate that ovarian suppression (menopausal-like state) in young women is associated with depressed and anxious mood and decreased serotonin transporter density.

Adult↗
PubMed1996

T cell subsets in obsessive-compulsive disorder.

Stress can produce immunosuppression leading to increased susceptibility to infection, tumor growth or autoimmune disease. It has been recently noted, however, that certain kinds of stress need not increase the risk of immune pathology. The present study looked for immune pathology in an anxiety-related disorder. Acute exacerbation of obsessive-compulsive disorder (OCD), an anxiety spectrum disorder, served as a model for stress. Seven OCD subjects in acute exacerbation, and 9 healthy age-matched control subjects participated in the study. T cell subsets were determined at baseline in both OCD and control groups, and after 6 weeks on clomipramine in the OCD group. No statistically significant changes in lymphocyte subsets were found between the control and the untreated patient groups. Likewise, no statistically significant changes were found in patients before and after treatment. The negative findings of the present study supports the view that stress need not compromise immunologic function. Various aspects of stress, which may turn the immune system vulnerable, are discussed as well.

Adult↗
PubMed1995

Case study: emergence of transient compulsive symptoms during treatment with clothiapine.

Serotonergic dysregulation in obsessive-compulsive disorder has been repeatedly demonstrated. Recent reports on the emergence of obsessive-compulsive symptoms in patients treated with clozapine support a hyposerotonergic hypothesis of obsessive-compulsive disorder. The authors report the emergence of de novo compulsive symptoms in a drug-naive 8-year-old schizophrenic child, shortly after the initiation of treatment with clothiapine. Clothiapine, an atypical antipsychotic agent, shares with clozapine its strong antiserotonergic properties. It seems that antagonistic activity of atypical neuroleptics at postsynaptic serotonergic receptors might be responsible for the development of iatrogenic obsessive-compulsive symptoms.

Antipsychotic Agents↗