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Biomedical subjects

R G Walton

Publications and source records attributed to R G Walton.

16 recordsLinked to original sources
PubMed1990

Mood disorders. Is your primary care patient depressed?

Treatment of patients with mood disorder can be one of the most rewarding experiences in medicine. Optimal treatment is contingent on accurate diagnosis according to current criteria and terminology. Major depression needs further categorization in reference to atypical or psychotic features, seasonal aspects, melancholia, mania, or dysthymia. Most patients with major depression need pharmacotherapy, often in combination with psychotherapy. A number of therapeutic regimens using various antidepressant agents are available.

Adolescent↗
PubMed1979

Pigmented skin lesions in black newborn infants.

Three findings from a study of one hundred black newborn infants examined for pigmented lesions are presented herein: significantly higher incidence than in prior neonatal examinations, a frequent clinical pattern of grouped macules, and an unusual histologic distribution of nevus cell theques. Fifty-one percent of the infants had congenital pigmented lesions. Biopsy specimens of thirty-two lesions were obtained, twenty-six showing histologic changes of lentigo, four melanocytic nevi (nevus-cell nevi), and two ephelides. Three of the four nevi were less than 1.5 cm in diameter and all were of the predominantly junctional type. Clinical appearance was not a consistent guide for classification in the newborn.

Black or African American↗
PubMed1978

Serum methadone as an aid in managing methadone maintenance patients.

Serial serum methadone levels were obtained in two patients who were experiencing significant difficulties (including subjective and objective evidence of the opiate withdrawal syndrome) while on methadone maintenance. A precipitous drop in blood levels of methadone was recorded 2 to 6 hours after ingestion. It was during this same time period that withdrawal symptoms were most severe. When methadone was administered on a divided dosage regimen, there was a dramatic clinical improvement in both patients and a marked flattening of the curve of serum methadone levels. This pilot study suggests that the current practice of administering methadone as a single daily dose to all patients needs reconsideration; serial serum methadone levels may be helpful in determining which patients do better on a divided dosage regimen.

Adult↗
PubMed1976

Pigmented lesions in newborn infants.

1058 newborn infants were examined. Forty-one (3-9%) had clinically discernible pigmented lesions compatible with melanocytic naevi. Biopsy was performed on thirty-four of the forty-one and of these; eleven, representing 1-01% of the infants, proved to be melanocytic naevi. No giant (garment) naevi were seen in this series. Two of the eleven naevi pathologically examined showed histological changes similar to those that have been reported in some giant naevi, but the remaining nine were not only different from criteria usually assigned to giant naevi, but they also differed from the usual adult naevi, in that most were predominantly junctional. None of the melanocytic naevi in this series showed any suggestion of malignant change. In newborn infants it is often impossible clinically to distinguish naevi from other types of pigmented lesions, as only eleven out of the thirty-four pigmented lesions were melanocytic naevi. Seven of the eleven melanocytic naevi were under 1-5 cm in diameter. No pigmented lesions were found on the palms, soles or genitalia.

California↗
PubMed1976

The incidence of birthmarks in the neonate.

The presence of various types of birthmarks was determined in 1,058 newborn infants under 72 hours of age. Of these, 79.5% were white, 6.2% were black, 11.2% were ladinos, and 2.6% were Asiatic. Mongol spots were present in 9.6% of the white babies, 95.5% of the black babies, 81% of the Asiatic babies, and 70.1% of ladino infants. Pigmented lesions were present in 42 (4%) of the infants. Biopsies obtained in 34 (3.2%) revealed that only one-third (11) of these were melanocytic nevi. Salmon patches were present in 40.3% of the infants, recognizable early strawberry marks in 2.6%, and port-wine strains in 0.3%. In addition to birthmarks, it was determined that 30.3% of the 508 babies examined at one of the two hospitals had toxic erythema of the newborn.

California↗
PubMed1975

Moles that cause concern.

It is strongly recommended that any pigmented lesion which cannot be diagnosed with certainty as benign should be excised and pathologically examined. In addition, any mole which is removed, no matter for what purpose, whether it is suspected of having malignant or premalignant changes or for cosmetic and functional purposes, should always be pathologically examined. If the lesion is suspected of showing malignant change, then if technically possible it should be completely excised. If the location is such, or if it is a sufficiently large lesion, that a simple complete excision cannot be performed at that time, then it is justifiable and good medical practice to do an incisional biopsy. However, if the pathological report shows that the tumor is malignant then the necessary radical surgery should be performed within 7 to 10 days of the initial biopsy. Under these circumstances, incisional biopsy does not adversely affect the prognosis. Under these circumstances, the incisional biopsy prevents unnecessary radical and sometimes mutilating surgery being performed for the treatment of a benign pigmented tumor.

Diagnosis, Differential↗
PubMed1971

Pigmented nevi.

Explore the source record for details and available documents.

Adolescent↗
PubMed1966

Pigmented nevi. Induced changes in the junctional component.

The pigmented nevus represents a potentially more dynamic lesion than has been indicated by most published studies. New nevus cell clusters frequently appear in the epidermis over the residual portion of a nevus that remains after partial surgical excision. Even in relatively inactive nevi in adults, new junctional nevus cells may be induced by surgical trauma. This stimulated growth usually regresses by the time one year or more has elapsed. The growth of nevus cells is probably comparable to that induced in other cells by traumatic injury. There is no evidence to suggest that it is related to the development of melanoma in pigmented nevi.

Humans↗
PubMedDate not supplied

Adverse reactions to aspartame: double-blind challenge in patients from a vulnerable population.

This study was designed to ascertain whether individuals with mood disorders are particularly vulnerable to adverse effects of aspartame. Although the protocol required the recruitment of 40 patients with unipolar depression and a similar number of individuals without a psychiatric history, the project was halted by the Institutional Review Board after a total of 13 individuals had completed the study because of the severity of reactions within the group of patients with a history of depression. In a crossover design, subjects received aspartame 30 mg/kg/day or placebo for 7 days. Despite the small n, there was a significant difference between aspartame and placebo in number and severity of symptoms for patients with a history of depression, whereas for individuals without such a history there was not. We conclude that individuals with mood disorders are particularly sensitive to this artificial sweetener and its use in this population should be discouraged.

Adult↗