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Biomedical subjects

R K Shelley

Publications and source records attributed to R K Shelley.

12 recordsLinked to original sources
PubMed1988

The expression of an N-CAM serum fragment is positively correlated with severity of negative features in type II schizophrenia.

The expression of a 70-kD serum fragment of the neural cell adhesion molecule (N-CAM) in schizophrenia is described. Schizophrenic patients (n = 40) were found to have statistically significant increases (p less than 0.0001) in serum N-CAM levels when compared to normal individuals (n = 26), and this could not be associated with age or sex. This difference was more marked (p less than 0.0001) between type II schizophrenics (n = 13) and normal individuals (n = 26) than when patients in the overlap group between type I and type II schizophrenia (n = 18) were compared to normal individuals (p less than 0.001). This difference remained significant (p less than 0.01) when overlap patients were compared to those of type II schizophrenia. Furthermore, schizophrenic patients with lower serum N-CAM proved to be better responders to neuroleptic therapy. We suggest that these elevated serum N-CAM levels reflect an increased synaptic turnover rate in this psychotic state.

Adult↗
PubMed1987

Are there ethnic differences in lithium pharmacokinetics and side-effects?

Possible ethnic differences in the pharmacokinetics of lithium carbonate were systematically examined in Caucasian and Afro-Caribbean volunteer subjects under standardized conditions. The two groups did not differ with regard to weight, age or renal function. Rates of absorption were similar, but there was a non-statistically significant trend towards more rapid distribution and elimination, smaller area under the serum curve and greater urinary excretion in the Caucasian group. There were no differences in side-effects. The results support the view that ethnic differences in blood levels found with other psychotropic drugs are due to altered drug metabolism and suggest that lithium pharmacokinetic data derived from Caucasian subjects can be safely extrapolated to Afro-Caribbean.

Absorption↗
PubMed1987

Lithium toxicity and mefenamic acid. A possible interaction and the role of prostaglandin inhibition.

An elderly patient with bipolar manic-depressive psychosis, stabilised satisfactorily on lithium carbonate, developed acute symptoms of lithium toxicity shortly after commencing mefenamic acid. Vulnerability factors for the interaction may have included age, history of cardiac failure, and impaired glomerular function. It is hypothesised that the interaction may have been mediated by inhibition of prostaglandin activity.

Bipolar Disorder↗
PubMed1987

Potentiation of small cell lung cancer-related SIADH by trifluoperazine.

The syndrome of inappropriate anti-diuretic hormone secretion (SIADH) is a feature of approximately 7% of cases of small cell lung cancer (SCLC). The elaboration of peptide hormones by this tumour is well recognised and cerebral oedema resulting from inappropriate ADH secretion may be a life-threatening complication of this illness, requiring prompt intervention. We report a patient with SCLC who presented with SIADH which worsened abruptly each time he was treated with trifluoperazine for a co-existing psychosis.

Carcinoma, Small Cell↗
PubMed1986

Single dose pharmacokinetics of 5 formulations of lithium: a controlled comparison in healthy subjects.

The single dose pharmacokinetics of 4 lithium preparations (Camcolit-400, Priadel, Liskonum, Litarex) and a new micro-encapsulated formulation were compared in normal volunteers using a balanced cross-over design. The data show an inverse relationship between rate of release and bioavailability. The pharmacokinetic characteristics of Camcolit-400 and Priadel were similar; both showed earlier and greater peak serum concentrations than the other 3. The new formulation, which accounted for most of the significant variance, had the slowest rate of release and the lowest bioavailability. Statistical analysis showed significant differences between the 5 preparations for C-max, T-max, 12-h serum levels, AUC and urinary excretion, but not for the 24-h serum levels. No serious untoward side-effects were noted.

Adult↗
PubMed1986

Does clinical clerkship alter students' attitudes to a career choice of psychiatry?

A 50-item questionnaire, designed to link attitudes to psychiatry directly with how these might influence a career choice of psychiatry, was administered to medical students before and after their clinical clerkship in psychiatry. Many of these changed in a positive direction, e.g. 'job satisfaction', 'life-style', 'training available' and 'multidisciplinary approach'. The influence of important people in their lives was predominantly negative; this may emphasize the impact of psychiatric 'role models'. Male and female students differed in how they changed. Males appeared influenced by external factors, e.g. 'work hours' and 'career structure', and females by internal ones, e.g. 'interest in knowing more about self'. Females were also more likely to wish for a career in psychiatry. Psychiatry was ranked higher in career choice at the end of the clerkship.

Attitude of Health Personnel↗
PubMed1983

Day patient versus in-patient: factors determining selection of acutely ill patients for hospital treatment.

In a prospective study the criteria and characteristics associated with the admission of acutely ill psychiatric patients to in-patient or day hospital care were examined. Over a four-month period, 54 patients were admitted to hospital and 43 to a day hospital. There was significantly more schizophrenics in the hospital. Day hospital patients were significantly younger, had shorter psychiatric histories, were considered less severely ill and had more insight into their illness. Hospital patients had poorer employment histories, and perceived their families as less supportive; admission had more often been requested by them or their families.

Acute Disease↗