Biomedical subjects
Publications and source records attributed to R D Turner.
Scientists often develop techniques that have obvious benefits for patients but then find great difficulty in introducing them into the National Health Service-usually because the necessary finance does not seem to be available. This article provides a practical guide.
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Twenty-six outpatients with major depression completed a 6-week, fixed dose trial of desipramine and provided plasma samples. Recovery after 6 weeks, defined in either of two ways, corresponded to lower desipramine levels, while clinical status at 4 weeks bore no apparent relationship to plasma levels. Upper limits of 140 or 155 ng/ml emerged depending on the outcome measure used. Patients with endogenous depression, those with primary depression, and those with abnormal dexamethasone suppression test results yielded similar therapeutic thresholds, while the sharpest blood level/response relationship emerged in the subgroup with an abnormal escape from dexamethasone.
Psychiatric patients presenting with chronic psychogenic polydipsia are often difficult to treat with standard psychiatric interventions. Pharmacologic intervention was attempted in three patients and was successful in one. One patient had a significant and sustained reduction of water intake while on 160 mg of propranolol. One patient did not improve with either propranolol or captopril while a third patient showed no improvement of serum sodium with demeclocycline nor reduction of water intake with propranolol. The potential mechanisms by which these pharmacologic agents might alter thirst in patients with primary polydipsia are discussed.
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Arterial vascular occlusion of hypernephromas may be performed by obstructiing the tumor vascular tree with the injection of ferromagnetic silicone microspheres. The powerful superconducting electromagnet confines the embolized iron-silicone compound to the neoplastic target organ. Radioactive material may or may not be added to the iron-silicone compound to give local direct radioactive radiation therapy to the tumor area. In experimental dogs up to 70,000 rad of beta radiation from the P32 source had been delivered homogeneously within the kidney when mixed with the ferrosilicone. This technique may well be used in cases in which a major operation is contraindicated or when preoperative necrosis of the tumor is advisable. Since the entire procedure can be done with the patient under local anesthesia in a radiology department it may be a valuable new technique in the future management of urological tumors, unilateral renal hypertension, solitary kidney pathology and so forth. Ferrosilicone material has not been found to be toxic. The application of a powerful superconducting electromagnet to the technique provides a means of confining the embolized iron-silicone compound to the target organ.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.