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Biomedical subjects

S Madakasira

Publications and source records attributed to S Madakasira.

16 recordsLinked to original sources
PubMed1992

Evaluation and treatment of premature ejaculation: a critical review.

OBJECTIVE: Premature ejaculation is the most prevalent male sexual dysfunction. The present article is a comprehensive review of the literature on premature ejaculation. METHOD: This critical discussion of the literature evaluates the definitional issues, theoretical conceptualizations, assessment strategies, and treatment alternatives for premature ejaculation. RESULTS: The review integrates the most recent findings on the diagnosis and treatment of premature ejaculation updating an earlier review with the addition of more than fifty recent articles and adding sections on treatment generalization and maintenance, medical evaluation, pharmacological intervention, and a discussion of methodological issues in the literature. CONCLUSIONS: The pause-squeeze technique remains the current treatment of choice for the disorder. However, this unitary treatment recommendation disguises a multidimensional disorder which has yet to evolve an operational definition, psychometrically sound assessment procedures, or clearly articulated etiology.

Combined Modality Therapy↗
PubMed1989

Amoxapine-induced neuroleptic malignant syndrome.

Amoxapine is a second-generation antidepressant possessing significant dopamine-blocking activity and extra-pyramidal side effects. The occurrence of neuroleptic malignant syndrome is described in a patient treated with amoxapine. The syndrome resolved rapidly following discontinuation of the drug. Older patients may be particularly at risk for this adverse reaction with amoxapine.

Amoxapine↗
PubMed1988

Child custody and relitigation: trends in a rural setting.

Types of child custody awards made in 884 divorce cases in a rural North Carolina County were compared and rates of postdivorce litigation were examined for each type of custody. Findings suggest a low frequency of joint custody awards and do not reveal any advantage of joint versus other forms of custody with regard to relitigation experience.

Child↗
PubMed1987

Acute posttraumatic stress disorder in victims of a natural disaster.

Five months after a tornado devastated a rural community in eastern North Carolina, the authors surveyed the mental health status of 116 disaster victims, using the Hopkins Symptom Checklist (HSCL) expanded to include most of DSM-III criteria for posttraumatic stress disorder (PTSD). A total of 69 (59%) victims met the criteria for acute PTSD, 19 of whom had a severe form. Although an inadequate degree of social support was more often noted in victims with severe PTSD, other demographic factors and degree of injury or property damage did not appear to be related to the presence of PTSD. Severity or presence of PTSD was supported by high scores on all HSCL subscale factors. These findings suggest a high incidence of acute PTSD in victims of natural disasters and the potential value of HSCL in screening for PTSD in large populations.

Acute Disease↗
PubMed1986

Cardiac antiarrhythmic effect of nortriptyline.

With a quinidine-like cardiac action, the tricyclic antidepressant drugs, imipramine in particular, have been proposed as potentially antiarrhythmic agents. The antiarrhythmic activity of nortriptyline is described in a depressed patient with premature ventricular complexes, and the basis for this activity is discussed.

Anti-Arrhythmia Agents↗
PubMed1985

Reliability of amitriptyline dose prediction based on single-dose plasma levels.

To assess prospectively the predictability of therapeutic dosage based on tricyclic antidepressant (TCA) concentrations after a single dose, 30 subjects were given amitriptyline. In the first 11 subjects maintained on a fixed amitriptyline dose regimen, predictive capacities of 18- and 24-hr single-dose levels were assessed and confirmed in relation to steady-state levels. For the other 19 subjects, the dose that would achieve a therapeutic steady-state concentration of 200 ng/ml was predicted from the 18-hr single-dose level and was rapidly instituted. Subjects achieved a mean steady-state TCA level of 204 ng/ml, with approximately 90% of the levels falling within the therapeutic range. There was clinical improvement within 2 wk in 84% of the subjects. Our results suggest that dose prediction based on TCA levels after a single dose is reliable and useful.

Adult↗
PubMed1984

Single-dose single-point method in amitriptyline therapy.

Twenty-one depressed patients participated in a study that assessed the predictability of amitriptyline (AT) dosage based on plasma drug concentrations after a single dose. In 11 patients maintained on a fixed dose regimen, the 18-h single-dose level was confirmed to be predictive of steady-state levels. The dose for the next 10 patients was derived from their 18-h level aiming to attain steady-state levels of 200 ng/ml. The patients achieved a mean steady-state level of 213 ng/ml with 80% attaining therapeutic levels. All the patients improved within 2 weeks. These preliminary results suggest that dose prediction based on a single-dose TCA level is reliable and beneficial.

Adult↗
PubMed1984

Monitoring tricyclic antidepressant plasma levels.

Patients receiving tricyclic antidepressants exhibit extreme variability in steady-state plasma concentrations because of differences in metabolism. At routine dosages, rapid metabolizers may have suboptimal concentrations while slow metabolizers can suffer from adverse effects due to inappropriately high concentrations. Neither may benefit from the drug therapy. Through analysis of plasma levels of tricyclic antidepressants, an optimal therapeutic response can be achieved, and the risk of serious side effects can be reduced.

Antidepressive Agents, Tricyclic↗
PubMed1981

Capgras syndrome in a patient with myxedema.

The authors describe what may be the first reported case of Capgras syndrome associate with, or precipitated by, myxedema. The patient's mental status dramatically returned to normal with gradual thyroid replacement. The authors suggest that tests for organicity be done routinely on patients manifesting Capgras features.

Aged↗
PubMedDate not supplied

Misuse of the dexamethasone suppression test as a diagnostic tool.

The diagnostic reliability and appropriateness of use of the Dexamethasone Suppression Test (DST) were assessed by a retrospective chart survey of ninety-nine psychiatric admissions to a community hospital. A change in psychiatric diagnosis between admission and discharge occurred in one-third of the patients. The diagnostic change appeared to be associated with the DST result more than the clinical findings. Such reliance on the test was not justified as the observed diagnostic confidence of the DST in supporting a diagnosis of major depression was only 38 percent. These findings suggest a misuse of the test as a diagnostic tool in routine practice.

Adolescent↗