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Biomedical subjects

R D Franks

Publications and source records attributed to R D Franks.

At least 19 recordsLinked to original sources
PubMed1989

Increased platelet intracellular calcium concentration in patients with bipolar affective disorders.

Using the fluorescent indicator Fura 2, we measured the free intracellular calcium ion concentration in blood platelets of patients with untreated mania, bipolar depression, and unipolar depression; patients who had recovered from bipolar depression or mania; and age- and sex-matched controls. The baseline intracellular calcium ion concentration was significantly increased in platelets from patients with mania compared with controls. The free intracellular calcium ion concentration after stimulation with platelet-activating factor and thrombin was significantly higher in platelets of manic and bipolar depressed patients than in all other groups. The degree to which intracellular calcium ion concentration increased over baseline after stimulation was significantly lower in unipolar than in bipolar patients. These findings suggest that platelets of manic and depressed bipolar patients have a similar enhancement of intracellular calcium ion activity that is distinctly different from the decreased ability of platelets of unipolar patients to mobilize intracellular calcium in response to stimulation.

Adult↗
PubMed1989

Noncognitive criteria for assessing students in North American medical schools.

In 1986 the authors mailed a one-page questionnaire to 135 North American medical schools requesting information about written expectations for students that contain noncognitive criteria. Eighty-eight questionnaires (65.2%) were returned, and 48 schools (54.5%) indicated they possessed written noncognitive criteria. Those schools having noncognitive criteria were asked to submit the criteria for review and were questioned about their reasons for establishing such criteria. Those schools not having noncognitive criteria were asked whether they perceived a need for such criteria and had plans for developing them. The study showed an increasing trend to create criteria that assist in administrative actions when problems arise. In the 31 sets of noncognitive criteria submitted for the study, the rank order of specific expectations was, from most to least frequently mentioned: honesty, professional behavior, dedication to learning, appearance, respect for law, respect for others, confidentiality, aid to others, substance abuse, and financial responsibility. The authors make recommendations for schools wishing to create noncognitive criteria and explain why they feel such criteria should receive the recognition and importance given to cognitive criteria.

Attitude↗
PubMed1987

Neurophysiological assessment of sensory gating in psychiatric inpatients: comparison between schizophrenia and other diagnoses.

Gating of auditory sensory responsiveness was examined in 75 psychiatric inpatients using a conditioning-testing paradigm with the P50 wave of the auditory evoked response, in which pairs of stimuli are presented to the subject. In previous studies, most schizophrenics did not decrement the second response to the extent seen in normals. Acutely ill patients, who were representative of patients admitted to a public university teaching service and a proprietary hospital, were used to examine the extent to which diminished sensory gating is found in diagnoses other than schizophrenia. About half of these patients showed diminished sensory gating that correlated with measures of severity of illness. The data, taken together with that from other studies using this paradigm, suggest that diminished sensory gating, like several other psychophysiological abnormalities, is a trait deficit in schizophrenia, but a state deficit in many other mental illnesses.

Adjustment Disorders↗
PubMed1987

Verapamil: a new antimanic drug with potential interactions with lithium.

Verapamil is a calcium channel blocking agent with possible antimanic properties. In two elderly manic patients taking the medication in combination with lithium carbonate, profound bradycardia developed and was followed by a fatal myocardial infarction in one case. Clinical implications and possible mechanisms of cardiovascular interactions between verapamil and lithium are discussed. Caution is advised in the use of lithium and verapamil together.

Aged↗
PubMed1986

Calcium antagonists in mania: a double-blind study of verapamil.

Five of seven acutely manic patients improved significantly when taking verapamil but not placebo in a double-blind crossover study. This finding adds support to two other formal studies of verapamil, several case reports of verapamil in manic patients, and one small study of nifedipine suggesting that some calcium antagonists may have antimanic properties. Indirect evidence links this antimanic action to correction of a disturbance of intracellular calcium dynamics in affective disorders. However, the effectiveness of calcium antagonist drugs could also be related to some property other than interference with the action of calcium within brain neurons.

Adult↗
PubMed1985

The Mezzich MMPI regression formula revisited.

In a sample of depressed psychiatric inpatients, the Mezzich regression formula, based on five MMPI scales, correlated moderately with clinicians' judgments and yielded few false negative diagnoses in identifying patients with unipolar Major Depressive Disorder, but was less effective in eliminating false positives.

Adult↗
PubMed1985

ECT in the presence of increased intracranial pressure and respiratory failure: case report.

Despite the safety of electroconvulsive therapy (ECT) in the presence of such potentially dangerous CNS disorders as CNS infections, brain tumor, and normal pressure hydrocephalus, increased intracranial pressure is still considered an absolute contraindication. In addition, although ECT has been administered to patients with pneumonia, it has never been used when respiratory failure is present. The safe and effective use of ECT in a patient in whom life-threatening refusal to cooperate with medical therapy appeared to be caused by a combination of depression and organic brain disease is reported.

Depression↗
PubMed1983

Neurophysiological evidence for a defect in inhibitory pathways in schizophrenia: comparison of medicated and drug-free patients.

Central nervous system inhibitory neuronal mechanisms were assessed in clinically stable chronic schizophrenic patients treated with neuroleptic drugs to provide data for comparison with those obtained previously from acutely psychotic, unmedicated patients. An early positive component of the auditory average evoked response recorded at the vertex 50 msec after a click stimulus (P50) was studied. After stimuli were delivered at 10-sec intervals to establish a baseline response, inhibitory mechanisms were assessed in a conditioning-testing paradigm, by measuring the change in response to a second stimulus following the first at either 0.5-, 1.0-, or 2.0-sec intervals. At the 0.5-sec interval, normal controls had over an 80% mean decrement in response, whereas schizophrenics showed a mean decrement of less than 10% but there was no significant difference in suppression between medicated and unmedicated patients. However, the amplitude of P50, which was smaller in unmedicated schizophrenics than in normal subjects, was significantly increased in the medicated patients. The data suggest that inhibitory mechanisms which are dysfunctional in acutely psychotic.

Acoustic Stimulation↗
PubMed1983

Intracellular calcium ions in affective disorders: a review and an hypothesis.

Recent advances in knowledge about calcium's role as an intracellular regulator promise to broaden our understanding of possible pathophysiologic mechanisms in affective disorders. In this paper, we review the influence of calcium on mood, the intracellular dynamics of the calcium ion, and the possible interaction of lithium with these actions. We then discuss similarities with lithium of calcium antagonists, a class of drugs that influences calcium's action within cells, and report preliminary findings of their possible usefulness in treating mania. Finally, we hypothesize ways in which alterations in intracellular calcium ion concentration may be associated with mania and depression, and suggest methods of studying this hypothesis.

Bipolar Disorder↗
PubMed1983

Neurophysiological studies of sensory gating in mania: comparison with schizophrenia.

The action of central nervous system mechanisms involved in sensory gating was assessed in acutely psychotic manic patients. An early positive component of the auditory average evoked response, recorded at the vertex 50 msec after a click stimulus, was studied. Stimuli were delivered at 10-sec intervals to establish a base-line response. Sensory gating mechanisms were then tested using a conditioning-testing paradigm to assess the change in response to a second stimulus following the first at either 0.5-, 1.0- or 2.0-sec intervals. A similar paradigm had been used previously to assess deficits in this function in acute and chronic schizophrenics. We found a deficit in sensory gating in acutely manic patients. similar to that found in schizophrenics, although the variability in response was more marked in the manic patients. We followed these patients during their treatment on lithium carbonate and found a return of these neuronal functions towards normal values which corresponded to their clinical improvement. A series of stable euthymic bipolar patients were found to have responses indistinguishable from normal controls. The data suggest that deficits in neuronal gating functions, similar to those found in schizophrenia, can be seen during acute mania but these deficits return to normal as the acute psychosis abates.

Adolescent↗
PubMed1982

Long-term lithium carbonate therapy causes hyperparathyroidism.

Twelve patients taking lithium carbonate for two to 13 years were compared with age- and sex-matched controls to determine whether long-term lithium carbonate therapy is associated with alterations in calcium metabolism. As a group and individually, patients had significantly higher levels of serum total calcium, ionized calcium, and parathyroid hormone. When compared with serum calcium levels, patients' parathyroid hormone levels were significantly more likely than those of controls to indicate hyperparathyroidism. Lithium carbonate-induced mild hyperparathyroidism appears to be more common than had previously been suspected.

Adult↗
PubMed1982

ECT use for a patient with malignant hyperthermia.

The authors used dantrolene as a prophylactic during ECT with a depressed patient susceptible to malignant hyperthermia. Succinylcholine and tricyclic and MAO-inhibiting antidepressants can precipitate malignant hyperthermia and were thus avoided.

Adult↗