PubMed Health⌕ Search

Biomedical subjects

T Bacani-Oropilla

Publications and source records attributed to T Bacani-Oropilla.

9 recordsLinked to original sources
PubMed2001

Does peripheral neuropathy allow for the clinical expression of tardive dyskinesia by unmasking central nervous system changes?

Tardive dyskinesia (TD) is a severe and troubling complication of long-term typical neuroleptic use whose etiology remains obscure. While it is widely believed that central nervous system (CNS) dopamine receptor super-sensitivity is involved in the pathogenesis of the condition, it is unclear why some patients develop TD while others do not. It is proposed that a subclinical peripheral motoneuropathy with consequent enlarging of the motor units may act to unmask neuroleptic-induced CNS changes allowing for the expression of TD. To investigate this hypothesis we examined motor unit size with electrographic examinations in 14 patients (six with mild TD; eight without and all with psychotic illness). There were no differences between the two groups of patients. While the data do not appear to support the hypothesis, a larger study with more severely affected patients is required to more adequately test the hypothesis.

Adult↗
PubMed1994

The role of parkinsonism and antiparkinsonian therapy in the subsequent development of tardive dyskinesia.

Tardive dyskinesia (TD) is a side effect of prolonged neuroleptic treatment presenting as abnormal involuntary movements. This troublesome disorder occurs in only 15-30% of patients taking neuroleptics, suggesting that these individuals may be physiologically distinct so as to be predisposed. This study analyzed possible factors contributing to TD development. Fifty patients on depot neuroleptics for more than 7.1 years were prospectively examined for TD and drug-induced parkinsonism (DIP) using the Smith-Trims rating scale for an average of 5 years. The patients were assessed for the severity of the movement and if the movement increased or decreased with respect to neuroleptic dosage, anticholinergic dosage, parkinsonism, and other related factors. Both TD and DIP increased over time. In the patients whose dose of neuroleptic decreased, the increase in TD ratings was not significant. Using a forward stepwise regression DIP was found to increase as TD worsened but did not appear to predict subsequent TD development. Anticholinergic treatment showed a less significant correlation with the change in TD. These results have implications for the management of combined TD and DIP presentation.

Adult↗
PubMed1991

Violent patients. Are you prepared to deal with them?

The medical community is becoming increasingly concerned about violent patients in healthcare settings. Healthcare professionals should be trained to deal with aggressive patients, and they should have access to a room free of dangerous objects for evaluation and examination. Having security personnel stand by may be appropriate in some cases. Verbal intervention is the key to dealing with violent patients. The safest and most effective pharmacologic intervention is use of benzodiazepines, either alone or in conjunction with antipsychotic agents when indicated. Seclusion or restraint may be needed for some violent patients; in such situations, close patient monitoring and explicit documentation are essential. Physicians can be held liable for injuries patients sustain while being restrained, so staff members should receive instruction in safe physical intervention techniques.

Aggression↗
PubMed1991

Patients with mental disorders who work.

Mental illness can devastate persons intellectually and emotionally; with maintenance therapy, however, certain patients with chronic mental illnesses are capable of holding a variety of jobs. From the total population of psychiatric patients in our VA outpatient clinic, the 87 who were gainfully employed were identified to determine common factors among them. Affective disorders were the predominant diagnoses among patients who worked, while schizophrenia was more common among those who did not. Alcoholism was diagnosed in approximately 25% of working and nonworking groups.

Adult↗
PubMed1989

Chronic depression. Issues in long-term management.

Patients with protracted depression respond well to long-term maintenance antidepressant therapy. A precise diagnosis is a prerequisite to therapeutic decisions. Diagnosis may be missed and treatment inadequate if symptoms are attributed solely to aging or to life's circumstances. Proper dosage is determined by the patient's age and metabolic capabilities, and patient education increases compliance. Although the patient may deny the need for psychotherapy, continued support and a life review help the patient acquire insights and adjust to changes. The patient can sustain progress by keeping active, pursuing interests, and socializing. The aim of long-term antidepressant pharmacotherapy is to reduce morbidity, restore productive and optimal functioning, and enhance the quality of life. The attainment of previous levels of function is the gauge of success.

Aged↗
PubMed1989

When to use psychiatric referral in the ED.

Not all patients presenting to the emergency department with psychiatric complaints need psychiatric referral. Specific guidelines are therefore essential to aid in the appropriate screening of such patients and to expedite diagnosis and treatment.

Emergency Service, Hospital↗
PubMed1988

Should the mentally ill adopt children? How physicians can influence the decision.

No established criteria exist for determining whether a person with a mental illness should or should not be allowed to adopt children. The basis for opinion in such cases can be derived from previous custody cases described in the literature. The interest of the potential parent, as well as the child, must be a primary consideration. Physicians are often called on to make recommendations regarding the parental fitness of a mentally ill person. An intensive assessment of the potential adoptive parent, including a thorough history and investigation of the person's resources and support systems, is necessary before a recommendation can be made.

Adoption↗