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Biomedical subjects

R A Maricle

Publications and source records attributed to R A Maricle.

17 recordsLinked to original sources
PubMed1998

Mood response to levodopa infusion in early Parkinson's disease.

Mood response to levodopa infusion was studied in 18 Parkinson's disease (PD) patients during the first year of levodopa therapy before and after 2-hour (1.0 mg/kg/h) levodopa infusions at baseline and 6- and 12-month follow-up. Mood elevation was greatest after a 2-day levodopa holiday at the 6- and 12-month assessments. Age, sex, duration and severity of PD, and ongoing oral levodopa dose did not correlate with mood response. Mood response in these patients differs from that seen in advanced patients, possibly because of sensitization to levodopa's mood effects.

Affect↗
PubMed1995

Mood and anxiety fluctuation in Parkinson's disease associated with levodopa infusion: preliminary findings.

Pilot data on mood and anxiety changes in 15 Parkinson's disease patients with motor fluctuations are described based on ratings every 30 min for 5 h bracketing a 2-h constant-rate levodopa infusion. Robust mood and anxiety effects slightly preceded but temporally paralleled fluctuations in motor tapping scores. Research nurse ratings blind to patient ratings corroborated the changes. The magnitude of changes in mood and anxiety scores did not correlate with the magnitude of changes in tapping scores. The findings of this uncontrolled study suggest mood and anxiety fluctuations may be a common and potentially important component of levodopa-induced fluctuations.

Affect↗
PubMed1995

The Charles Bonnet syndrome: a brief review and case report.

A case of a woman with visual hallucinations in the absence of other organic or psychiatric findings--symptoms consistent with a diagnosis of Charles Bonnet syndrome--is reported. The women was HIV positive, although asymptomatic for conventional complications of HIV infection. After considering possible causes of the hallucinations, including prescription drug effects and conversion or factitious disorder, the authors suggest that the woman's symptoms may have been associated with undetectable effects of HIV on the brain.

AIDS Dementia Complex↗
PubMed1995

Dose-response relationship of levodopa with mood and anxiety in fluctuating Parkinson's disease: a double-blind, placebo-controlled study.

We investigated the effect of levodopa on mood and anxiety in eight Parkinson's disease patients with motor fluctuations. Each patient received 0.0-, 0.5-, and 1.0-mg/kg/hr levodopa infusions in randomly assigned order under double-blind conditions on consecutive days. Mood elevation and anxiety reduction based on half-hourly patient rating and a corresponding increase in tapping speed occurred with active drug infusion but not placebo infusion. The effects were dose related. The higher-dose infusion rate produced more rapid onset, greater magnitude, and longer duration of response. We conclude that mood and anxiety fluctuations related to levodopa dosing are robust pharmacologic, and not placebo, effects.

Affect↗
PubMed1992

Improving quality assurance through psychiatric mortality and morbidity conferences in a university hospital.

To make quality assurance more outcome oriented, the department of psychiatry in a university hospital developed a program of psychiatric mortality and morbidity conferences for reviewing cases with undesirable outcomes. The conference combines aspects of a traditional medical mortality and morbidity conference with features of utilization review and risk management. Case review is focused on mortality, morbidity, or specific indicators developed by the departmental services involved and on a determination of whether an adverse outcome was avoidable, possibly avoidable, or unavoidable. The authors summarize the 100 cases reviewed in the first seven months. They believe the focus on outcome gives the method a useful role in quality assurance; advantages include its recognizable contributions to continuing education and training.

Aged↗
PubMed1992

Assessing delirium in the acute care setting.

Delirium is a common, disruptive, costly, and at times lethal condition found among patients in the acute care setting. Nurses can be the first to discover its presence and thereby reduce the time to treatment. Identifying delirium requires a knowledge of its clinical features, a mastery of the bedside cognitive mental status examination, critical judgment in distinguishing delirium from other psychiatric disorders, and appropriate nursing interventions based on ongoing assessment. In this article we review elements of such an approach and illustrate common clinical challenges for nurses with case examples.

Acute Disease↗
PubMed1991

Correlations of cardiac function and SCL-90R in heart transplantation candidates.

Measurements of cardiac function and Symptom Checklist-90R (SCL-90R) data were retrospectively analyzed in two independent groups of cardiac transplant candidates in an effort to identify organic correlates of depressive syndromes. In the first study, no significant inverse correlations were found between depression measures and cardiac index as had been predicted. However, elevated right atrial pressure was associated with increased scores of the SCL-90R depression subscale (DEP) and global symptom index (GSI). A significant positive correlation was also found between the phobia subscale and cardiac index. In a second sample, again, cardiac index did not correlate inversely with DEP or GSI. The phobia-cardiac index correlation was replicated but the right atrial pressure correlations were not. Combining both groups, there were significant correlations between six SCL-90R subscales (including DEP and GSI) and cardiac index. All were positive correlations, refuting the initial hypothesis and suggesting patients with the best cardiac function reported the worst psychological distress and that patients with the worst cardiac function reported the least psychological distress. Possible explanations for these findings are discussed.

Cardiac Output↗
PubMed1989

Depression in patients being evaluated for heart transplantation.

In the evaluation of 68 consecutive heart transplant candidates, 37 (54%) had one or more depressive syndromes. Premorbid psychiatric risk factors of depression were prevalent throughout the group. Statistically significant associations with depression were found with age, educational and occupational levels, and a history of past depressive episodes, but not with family psychiatric history, parental loss in childhood, history of serious childhood illness, or history of substance abuse. Of the 43 patients transplanted, 16 of 22 who were depressed preoperatively required psychiatric intervention postoperatively compared to 8 of 21 who were not depressed; 75% had a beneficial response to treatment. We recommend that a diagnosis of depression not be considered reason to exclude otherwise suitable candidates for cardiac transplantation.

Adult↗
PubMed1988

Medication-associated depression: a two and one-half year follow-up of a community sample.

A community sample of forty subjects (of a total of 50) were followed up an average of two and one-half years after a SADS/RDC diagnosis of depression. The group was composed of twenty-one subjects whose depressions were judged to be associated with a medical illness or medication use and nineteen without this association. There was no difference in outcome as measured by persistence or recurrence of depression when groups were defined by associated medical illness. There was a significant difference when groups were defined by association with medication use. Of the nine subjects whose depressions were associated with medication, six were still depressed at follow-up; all six had continued to use implicated "depressogenic" medications. The three who were not depressed at follow-up were no longer using the originally implicated medications. The use of depressogenic medication appears to influence the course and/or duration of depression and must be accounted for in epidemiological studies and clinical practices.

Aged↗
PubMed1987

The prevalence and significance of medical illness among chronically mentally ill outpatients.

The prevalence and significance of medical illnesses were examined in a sample of chronically mentally ill patients from an urban community mental health program. Eighty-eight percent had at least one significant medical illness, 51% had at least one previously undiagnosed illness and 53% were judged to be in need of some form of medical attention. The bulk of these illnesses were typical of primary care problems. In terms of causal significance, nearly as many medical illnesses appeared to be the result of the psychiatric disorder (18%) as vice versa (22%). Community mental health programs should make provisions for the medical needs of patients in comprehensive management programs.

Adult↗
PubMed1986

Organic solvent-induced encephalopathy in industrial painters.

Although organic solvents are essential components of an industrial economy, they are not used without risk. The relationship between excessive exposure to organic solvents and subsequent development of chronic encephalopathy has been recognized for nearly 100 years. Fifteen industrial painters who underwent evaluation in an occupational health clinic for symptoms that they related to their work were found to have a high prevalence of neurasthenic symptoms, most frequently, memory loss and personality change. Although neurologic and screening laboratory examinations showed no consistent abnormalities, psychological tests documented poor short-term memory and an array of neuropsychologic deficits. Personality profiles revealed depression, anxiety, and preoccupation with somatic concerns. These findings agree well with previous reports of "chronic painter's syndrome." Heightened awareness among industrial physicians and prospective studies to evaluate existing threshold limit values and personal protective equipment requirements are indicated.

Adult↗
PubMed1975

Hypertension in Oregon pesticide-formulating workers.

In a statewide survey of hypertension prevalence among pesticideformulating workers and controls in Oregon, we found no difference in mean systolic and diastolic blood pressure values but a modest excess of hypertension prevalence among chlorophenoxy herbicide workers which was largely explained by a greater constitutional predisposition to hypertension as estimated by positive family histories. Neither our study nor other published to date are adequate to allay the suspicion that chronic pesticide exposure may increase the risk of hypertension manifestation.

Adolescent↗
PubMedDate not supplied

The lack of predictive value of preoperative psychologic distress for postoperative medical outcome in heart transplant recipients.

This follow-up study of 58 heart recipients an average of 2 years after transplantation did not show that the Symptom Checklist 90R, a self-report measure of psychologic distress, predicted medical outcome. Mortality and medical morbidity (graft rejection and infection rate) were the outcome variables used. The findings tend to argue against the validity of some aspects of the psychiatric screening of transplant candidates if prediction of patients' ultimate risk of mortality or medical morbidity is the validation standard.

Adult↗