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Biomedical subjects

R Perline

Publications and source records attributed to R Perline.

9 recordsLinked to original sources

Field triage for on-scene helicopter transport.

This prospective study evaluated the use of basic vital signs, two mechanisms of injury, and time-distance factors as field triage criteria for on-scene helicopter transport of 130 patients to a trauma center serving a rural area. The vital signs criteria included any one or more of the following: level of consciousness (LOC) less than or equal to unresponsive to verbal stimulation; respiration rate (RR) less than or equal to 10 or greater than or equal to 30; systolic blood pressure (BP) less than or equal to 90; pulse (P) less than or equal to 60 or greater than or equal to 120. The flight crew recorded vital signs taken by the first responder capable of basic assessment. Entrapment and associated fatalities in motor vehicular accidents were recorded and flight logistics were examined. The presence of one or more abnormal signs identified a group of seriously injured trauma patients (mean Injury Severity Score = 29.1) with 24% mortality compared to a predicted mortality of 32% (p less than 0.02). Unresponsiveness to verbal stimulation in the field was the single most predictive criterion, yielding sensitivity of 93% and specificity of 85%. Time-distance criteria were helpful to determine helicopter use.

Adolescent↗

Effect of 5-hydroxytryptophan on serum cortisol levels in major affective disorders. I. Enhanced response in depression and mania.

The serum cortisol concentration following administration of 5-hydroxytryptophan (5-HTP), 200 mg orally, a precursor of serotonin (5-HT), was significantly greater in unmedicated depressed and manic patients than in normal controls. Increases in serum cortisol levels greater than 5 micrograms/dL were significantly more frequent in both unmedicated depressed and manic patients than in the normal controls. There was significant test-retest reliability. Baseline serum cortisol concentration correlated negatively with the cortisol response to 5-HTP in normal controls. These results suggest increased 5-HT receptor sensitivity may be present, possibly in the hypothalamus or pituitary, in some patients with affective disorders. These results are consistent with the hypothesis that decreased serotonergic activity, which would be expected to produce increased 5-HT receptor sensitivity, may be present in both depression and mania.

5-Hydroxytryptophan↗

Effect of 5-hydroxytryptophan on serum cortisol levels in major affective disorders. II. Relation to suicide, psychosis, and depressive symptoms.

Serum cortisol levels were significantly higher after administration of 5-hydroxytryptophan (5-HTP), 200 mg orally, in unmedicated patients with affective disorders than in controls. The magnitude of the serum cortisol increase correlated positively with the Schedule for Affective Disorders and Schizophrenia-Change (SADS-C) depression syndrome ratings and correlated negatively with psychotic symptoms in 26 patients with major depression. The serum cortisol response was greater in four depressed and three manic patients who made suicide attempts than in 33 patients who were not suicidal or only had suicidal thoughts. The cortisol response was also greater in patients with bipolar depression than in those with unipolar depression and those with a first-degree relative with an affective disorder. Absence of psychotic symptoms and commission of suicidal acts were associated with an increased cortisol response to 5-HTP in the depressed patients. The cortisol response to 5-HTP in the manic patients also tended to correlate with the SADS-C manic syndrome score.

5-Hydroxytryptophan↗

Effect of 5-hydroxytryptophan on serum cortisol levels in major affective disorders. III. Effect of antidepressants and lithium carbonate.

Serum cortisol levels were significantly increased following administration of 5-hydroxytryptophan (5-HTP), 200 mg orally, to patients with affective disorders. A three- to five-week period of treatment with lithium carbonate or monoamine oxidase (MAO) inhibitor augmented the mean 5-HTP-induced increase in serum cortisol concentration in manic or depressed patients, respectively: tricyclic antidepressant (TCA) and second-generation antidepressant treatment diminished the mean serum cortisol response in patients with major depression. These results are consistent with the hypothesis that lithium carbonate may enhance serotonin (5-HT) receptor sensitivity, whereas TCA and second-generation antidepressants diminish 5-HT receptor sensitivity. The enhancement of the cortisol response to 5-HTP by MAO inhibitors may be due to decreased metabolism of 5-HT. It is important to assess the effect of thymoleptic drug treatment on various responses to biogenic amine precursors or agonists in patients rather than laboratory animals.

5-Hydroxytryptophan↗

Facial affect recognition in schizophrenia. Is there a differential deficit?

Several studies have suggested that schizophrenics have a deficit in their ability to recognize the affect expressed in photos of human faces. In this study, the performance of 17 chronic schizophrenics was compared to that of 17 controls on both a test of facial affect recognition and a control task involving facial recognition. Compared with controls, chronic schizophrenics tended to perform more poorly on the test of facial affect recognition, but this difference was eliminated when facial recognition was entered as a covariate. When all test items, including those with poor reliability and discriminatory power, were included in the analysis the schizophrenics showed a significant deficit in facial affect recognition which persisted even when facial recognition was used as a covariate.

Adult↗

Biological studies of DSM-III psychotic disorders. I. Platelet measures and apomorphine-induced growth hormone response.

The relationship between DSM-III schizophrenia, major affective disorders, and the psychotic disorders not elsewhere classified (PDNEC) can be explored through studies which attempt to determine whether these disorders can be differentiated from one another and normal controls by biological measures. Preliminary results of an ongoing project which utilizes measures of blood platelet monoamine oxidase (MAO), serotonin (5-HT) uptake, and 5-HT content, and the apomorphine-induced increase in growth hormone (GH) to accomplish these goals are reported here. DSM-III major affective disorders (bipolar disorder and major depression) can be differentiated from normal controls by the V max of platelet 5-HT. Platelet 5-HT V max of bipolar disorder, depressed type, is significantly different from that of schizophrenia and PDNEC. Elevated platelet 5-HT content is present in black schizophrenic patients compared to black normal controls. Platelet MAO was increased in a small group of schizophreniform female patients. There was no difference in the apomorphine-induced GH response between any of the diagnostic groups. If confirmed in a larger series of patients, these results tend to identify the PDNEC more closely with schizophrenia than the major affective disorders.

Adult↗

A lod score method for detecting linkage on the X chromosone between a marker locus and a major gene locus for a quantitative.

A sequential lod-score method is proposed for detecting linkage on the X chromosome between a marker locus and the locus of a major gene influencing a quantitative trait, The method uses information from sons of doubly heterozygous mothers. The average number of families required to detect linkage is substantially less than that of the fixed sample-size method proposed by Hill.

Female↗