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Biomedical subjects

R Rosser

Publications and source records attributed to R Rosser.

32 records · Page 2Linked to original sources
PubMed1981

Comparison of the serum protein binding of maprotiline and phenytoin in uraemic patients on haemodialysis.

The serum protein binding of maprotiline and phenytoin has been compared in a group of 22 uraemic patients receiving haemodialysis. Determination of protein binding was carried out in vitro using equilibrium dialysis at 37 degrees C and 14C-labelled drug. The mean percentage unbound maprotiline found in patients (10.0%, SD 2.5) was not significantly different from that obtained in healthy volunteers (mean 10.5%, SD 1.0). However, there was a significantly increased variability in binding in patients compared with healthy subjects. The mean percentage unbound phenytoin in the same patients (22.2%, SD 3.3) was significantly greater than that obtained in healthy control subjects (12.5%, SD 0.6). Although there was no correlation between maprotiline and phenytoin binding and serum concentrations of alpha 1-acid glycoprotein, there was a significant correlation between percentage unbound maprotiline and serum albumin concentrations. The findings indicate that the binding of this tricyclic antidepressant is essentially normal in uraemia, although there may be increased interindividual variability in the free fraction of drug.

Adolescent↗
PubMed1981

The pharmacokinetics of nortriptyline in patients with chronic renal failure.

1 The pharmacokinetics of single oral doses of nortriptyline were studied in twenty patients with chronic renal failure, eight of whom were receiving treatment with haemodialysis. 2 The median nortriptyline half-life was 25.2 h (range 14.5-140.0 h) and the median nortriptyline clearance was 32.3 l/h (range 8.1-122.0 l/h). 3 No differences were observed between the dialysed and non-dialysed groups. 4 Comparisons of nortriptyline half-life and clearance between the patients and groups of physically healthy subjects revealed no significant differences. 5 There was no significant linear correlation between age and either of these measurements. In the twelve patients not receiving haemodialysis there was no correlation between nortriptyline clearance and glomerular filtration rate. 6 Chronic renal failure is not associated with a significant alteration in nortriptyline metabolism as measured by its half-life or clearance, but the drug should nonetheless be used with caution, and monitored whenever possible. However, the marked inter-individual differences observed in nortriptyline half-life and clearance in patients with chronic renal failure may not be solely responsible for their unpredictable response to tricyclic antidepressant therapy, and other possible contributory factors are discussed.

Adolescent↗
PubMed1981

An unusual case of visual perseveration.

A patient is described with an unusual type of visual perseveration caused by a right parietal infarct. The mechanism of visual perseveration is discussed with particular reference to the increased movement of the perseverated image which our patient described.

Aged↗
PubMed1979

The psychopathology of feeling and thinking in a schizophrenic.

This paper describes the process and technique of brief analytic psychotherapy with a 22-year-old schizophrenic man who was treated twice weekly for ten months and then followed up for two years. During therapy, re-integration occurred in his affective and cognitive processes. Despite his subjective experience of loss of the capacity for thought and for verbal and non-verbal communication, he had an unusual ability for conveying the stages by which he moved from total confusion and thought disorder to normal intellectual functioning, and for understanding the connections between his various experiences. Four phases of therapy are defined: a phase of disintegration and undifferentiation lasting six weeks, a phase of depression lasting for five weeks, a phase of multiple feelings lasting for fourt thought disorder to normal intellectual functioning, and for understanding the connections between his various experiences. Four phases of therapy are defined: a phase of disintegration and undifferentiation lasting six weeks, a phase of depression lasting for five weeks, a phase of multiple feelings lasting for fourt thought disorder to normal intellectual functioning, and for understanding the connections between his various experiences. Four phases of therapy are defined: a phase of disintegration and undifferentiation lasting six weeks, a phase of depression lasting for five weeks, a phase of multiple feelings lasting for fourteen weeks, and a phase of self-sustained development, starting in the twenty-fifth week and continuing beyond the end of therapy. The patient identified two major types of divisions between thinking, feeling and acting parts of himself and between masculine and feminine parts. Insight into these divisions helped him to understand disorders in his perception of time, and in thinking, remembering and using words and other symbols. His descriptions are presented here in the hope that they may throw light on the difficulties of similar, but less articulate, patients.

Adult↗
PubMed1978

A scale of valuations of states of illness: is there a social consensus?

A difficult task in designing indices of health and measures of health output is deriving a scale of valuations of a set of defined states of health or illness. A scale derived by structured interview of 70 subjects and tested on a further 50 subjects is described. The method aims for a ratio scale and the extent to which this has actually been achieved is discussed. Scale values appear to be independent of the sex, age, socio-economic group, religious belief and past medical history of the subject, but have some association with current experience of illness. There is agreement between scale values obtained from medical nurses and patients and agreement between the different values obtained from psychiatric nurses and patients.

Female↗
PubMed1976

Thyrotoxicosis and lithium.

Two cases are presented in which treatment with lithium was complicated by thyrotoxicosis. The underlying physiological mechanisms are discussed. Lithium suppresses thyroid function, so the early stages of thyrotoxicosis may be clinically undetectable. The symptoms and signs of thyrotoxicosis may be confused with the side effects of lithium, and if lithium is withdrawn severe rebound thyrotoxicity may occur. Furthermore, some of the side effects of lithium may be aggravated by thyrotoxicity. These cases provide further evidence of the importance of routine screening of thyroid function before starting treatment with lithium.

Adult↗