PubMed Health⌕ Search

Biomedical subjects

R G Stern

Publications and source records attributed to R G Stern.

29 records · Page 2Linked to original sources
PubMed1992

Serotonin function in schizophrenia: effects of meta-chlorophenylpiperazine in schizophrenic patients and healthy subjects.

This study examined serotonin (5-hydroxytryptamine; 5HT) receptor responsivity in 22 chronic schizophrenic patients and 17 healthy control subjects. The 5HT agonist meta-chlorophenylpiperazine (MCPP) was used as a probe of serotonergic function. MCPP (0.35 mg/kg) or placebo was administered orally after a 3-week drug-free period in a randomized double-blind design. Hormonal (adrenocorticotropic hormone and prolactin), temperature, and behavioral responses and MCPP blood levels were assessed for 210 minutes after administration of the capsules. The schizophrenic patients had blunted temperature responses compared with those of the healthy control subjects: MCPP raised body temperature in the control subjects, but not in the patients. Behavioral responses also differed in the two groups: MCPP increased the total Brief Psychiatric Rating Scale (BPRS) score in the control subjects and tended to decrease it in the patients. In patients, MCPP decreased the BPRS psychosis subscore. Hormonal responses did not differ significantly in the two groups. These findings suggest that further exploration of 5HT function in schizophrenia is warranted.

Adrenocorticotropic Hormone↗
PubMed1991

Cholinergic strategies in the treatment of Alzheimer's disease.

Since the identification of the cholinergic deficit, strategies aimed at enhancing cholinergic neurotransmission have dominated the field of pharmacology in Alzheimer's disease (AD). These strategies include increasing acetylcholine precursor availability, delaying synaptic degradation and stimulating muscarinic receptors. Although most clinical trials report mild symptomatic improvements in some patients, support for large-scale clinical use of cholinomimetics in AD is not yet available. This article presents the most representative clinical trials, discusses the limitations of the cholinergic strategies and suggests future directions in the treatment of AD.

Acetylcholine↗
PubMed1991

Diagnostic and pharmacological approaches in Alzheimer's disease.

Alzheimer's disease is a chronic progressive disease affecting higher intellectual functioning. The clinical diagnosis is made when the onset of illness is insidious, the course slowly progressive and all the treatable causes of dementia have been ruled out. The use of more stringent criteria has improved clinical diagnosis, but at best only 80% of patients are accurately diagnosed. Ultimately the diagnosis depends upon pathological confirmation. The neuritic plaques and neurofibrillary tangles described by Alzheimer, although not pathognomonic for the disease, continue to be the basis for pathological diagnosis. The aetiology and pathophysiology of Alzheimer's disease are presently unknown. Epidemiological studies have suggested a genetic basis for the disorder, and many biochemical studies have linked it to degeneration of central cholinergic neurons, and possibly to abnormalities of other neurotransmitter systems. A marker which would permit accurate diagnosis early in the course of disease would be of major importance to researchers and clinicians alike. No marker has been found to date, although recent research results are promising. Various pharmacological strategies have been employed in the treatment of Alzheimer's disease. More recently attempts have focused on enhancing central cholinergic transmission. Despite the well-founded rationale for these studies, results have been modest.

Alzheimer Disease↗
PubMed1991

The use of benzodiazepines in the management of behavioral symptoms in demented patients.

Hard data on the efficacy of benzodiazepines in the treatment of behavioral disturbances in Alzheimer's disease are not available. Short-acting benzodiazepines, such as oxazepam, appear safer than long-acting benzodiazepines and more efficient than placebo in the short-term (4-8 weeks) treatment of behavioral disturbances in geriatric, psychogeriatric, and demented patients. It is unknown whether oxazepam is superior to neuroleptic drugs or other commonly prescribed sedatives in this context. To some extent these findings may apply to patients with Alzheimer's disease as well, but there are several arguments against an uncritical extrapolation of conclusions drawn from other geriatric populations to patients with Alzheimer's disease. When, despite the lack of well-founded knowledge in this field, such a treatment modality is chosen, short-acting benzodiazepines should be preferred over long-acting agents. Drug interactions and pharmacokinetic aspects of the specific agent in the individual patient should always be considered carefully. Future studies on the treatment of behavioral disturbances in Alzheimer's disease need to clarify which specific behavioral symptoms should be treated pharmacologically, which therapeutic agents have the most advantageous risk-benefit ratio in this context, and what is the optimal treatment duration.

Aged↗
PubMed1991

The treatment of cognitive impairment in Alzheimer's disease: beyond the cholinergic approach.

Despite the well-founded rationale for the use of cholinomimetic and monoaminergic agents in the treatment of Alzheimer's disease, thus far, these strategies have only led to modest results. None of the drugs assessed to date have been shown to improve cognitive function to a clinically significant degree in patients with Alzheimer's disease. Some agents have produced mild improvements on specific tests, whereas others seem to slow down the progression of the disease. This article provides a brief overview of the current trends in the treatment of cognitive dysfunction in Alzheimer's disease.

Alzheimer Disease↗
PubMed1984

EKG-gated digital subtraction angiography in the detection of pulmonary emboli.

Detection of pulmonary emboli was investigated using electrocardiographically gated (EKG-gated) intravenous digital subtraction angiography (DSA) in 6 anesthetized and paralyzed dogs. Six autologous blood clots were introduced into the internal jugular vein of each dog and both conventional pulmonary angiography and EKG-gated DSA performed in frontal and oblique projections. When two observers scored any definite or equivocal embolus as positive, sensitivity was 82.1% for one and 92.9% for the other; the respective positive predictive values (PPV) were 88.5% and 65%. When only definite emboli were considered positive, sensitivity was 75% for one observer and 71.4% for the other; PPV was 100% for both. The authors conclude that DSA can demonstrate individual emboli with good sensitivity and excellent precision. If several emboli are present, EKG-gated DSA should prove highly accurate; however, care must be taken because overinterpretation is more likely with DSA than with conventional pulmonary angiography.

Angiography↗
PubMed1984

Intrathoracic adenopathy: differential feature of AIDS and diffuse lymphadenopathy syndrome.

The presence of mediastinal and/or hilar adenopathy was assessed from the chest radiographs of two groups of homosexual men: 30 with diffuse, persistent lymphadenopathy syndrome and 45 with acquired immunodeficiency syndrome (AIDS). Intrathoracic adenopathy was not seen on the chest radiographs of the 30 men having diffuse, persistent lymphadenopathy and is therefore not a manifestation of that syndrome. Nine of the 45 men with AIDS demonstrated intrathoracic adenopathy. In each instance, adenopathy was indicative of serious intrathoracic disease. Seven of the nine had minimal or no respiratory symptoms. In four of the nine, the intrathoracic adenopathy detected from the chest radiographs was the first indication of AIDS. In six of the nine patients, one or more opportunistic infections were diagnosed from material obtained at bronchoscopy. Two patients had Hodgkin disease, diagnosed by lymph-node biopsy. The ninth patient, who died, had an immunoblastic sarcoma. Mediastinal and/or hilar adenopathy in patients with AIDS, or in patients at high risk for AIDS, necessitates immediate investigation, including bronchoscopy or lymph-node biopsy.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

CT-determined pulmonary artery diameters in predicting pulmonary hypertension.

This study was to determine if the diameters of pulmonary arteries measured from computed tomographic (CT) scans could be used 1) as indicators of pulmonary artery hypertension and 2) as a reliable base for calculating mean pulmonary artery pressure. The diameters of the main, left, proximal right, distal right, interlobar, and left descending pulmonary arteries were measured from CT scans in 32 patients with cardiopulmonary disease and in 26 age- and sex-matched control subjects. Diameters were measured using a special computer program that could display a CT density profile of the artery and its adjacent tissues. The upper limit of normal diameter for the main pulmonary artery was found to be 28.6 mm (mean + 2 SD). In the patient group, the diameters were correlated with data from cardiac catheterization. In these patients, a diameter of the main pulmonary artery above 28.6 mm readily predicted the presence of pulmonary hypertension. The calculated cross-sectional areas of the main and interlobar pulmonary arteries (normalized for body surface area [BAS]) were found to give the best estimates of mean pulmonary artery pressure (r = 0.89, P less than 0.001 and r = 0.66, P less than 0.001). Multiple regression analysis gave the useful equation: mean pulmonary artery pressure = -10.92 + 0.07646 X area of main pulmonary artery/BSA + 0.08084 X area of the right interlobar pulmonary artery/BSA (r = 0.93, P less than 0.0001). Because CT allows precise, noninvasive measurement of the diameter of pulmonary arteries, it can be of value in detecting pulmonary hypertension and estimating mean pulmonary artery pressure.

Adolescent↗