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Biomedical subjects

T Maruta

Publications and source records attributed to T Maruta.

15 recordsLinked to original sources

[MR imaging of bone metastasis].

One hundred and three patients with known malignancy and suspected bone metastasis underwent magnetic resonance imaging. In 93%, the metastatic lesions, detected both on plain films and radionuclide bone scans, showed decreased signal intensity on T1-weighted images and increased signal intensity on T2-weighted images. All lesions, except one lesion showing much blastic change on plain films, showed contrast enhancement with Gd-DTPA administration. Although further investigation is needed, a correlation between the type of primary malignancy and the signal intensity of the metastatic lesion is suggested. Among 312 metastatic lesions detected by MR imaging, 272 lesions (87%) and 134 lesions (40%) were also detected by radionuclide bone scans and plain films, respectively. In five cases, MR imaging clearly revealed the lesion compressing the spinal cord, which helped us formulate a therapeutic plan. We conclude that MR imaging is the most sensitive examination for detecting bone metastasis and is necessary for planning treatment.

Bone Neoplasms

Results of behavior modification in the treatment of chronic pain.

Two hundred patients with chronic pain were treated in an in-patient program in which behavior modification was the major therapeutic modality. The patients were characterized by having had pain of many years' duration, multiple operations, treatment failures, prolonged disability, compensation factors, and dependency on medication. At hospital dismissal, 59% of the patients had achieved moderate improvement or better. At a 3-mo follow-up, 40% of the admitted patients (75% of those successfully treated) were still doing well, and after 1 yr, 25% of those originally admitted continued to do well (65% of those successfully treated).

Adult

Series on pharmacology in practice: 1. Drugs that alter mood. I. Tricyclic agents and monoamine oxidase inhibitors.

In the last 20 years, the treatment of mood disorders has advanced immeasurably. We now have relatively safe and effective agents for the treatment of depression and mania. This review discusses two types of agents that elevate mood--tricyclic antidepressants and monoamine oxidase inhibitors--including the indications for their use and their modes of action, pharmacokinetics, side effects, and drug interactions.

Antidepressive Agents, Tricyclic

Drug abuse and dependency in patients with chronic pain.

Of 144 patients with chronic pain of nonmalignant cause, 35 (24%) were drug-dependent, 59 (41%) drug abusers, and 50 (35%) nonabusers. Codeine and oxycodone (Percodan) were most frequently abused. In regard to characteristics tested, differences between the groups were not great; but there was a significant difference in outcome between nonabuse and dependent groups. Early detection and treatment of drug abuse should minimize some of the difficulties involved in management of treatment-resistive patients with chronic pain.

Age Factors

Series on pharmacology in practice. 1. Drugs that alter mood. II. Lithium.

In the last two decades, there has been rapid progress in the pharmacologic treatment of affective disorders. In Part I of this review, drugs mainly used for depression (tricyclic antidepressants and monoamine oxidase inhibitors) were discussed. Here, lithium carbonate, the most effective drug for manic-depressive illness (bipolar depression) is the focus. Its indications, mode of action, pharmacokinetics, dosage, and side effects are discussed. A section on drug interactions with lithium deals with the combination effect of lithium used with antidepressant and other psychotropic agents.

Abnormalities, Drug-Induced

Psychiatric consultation in the chronic pain patient.

A process and technique for psychiatric evaluation of chronic pain patients are discussed. It is the task of a psychiatrist to rule in or rule out a psychiatric component rather than to assume the existence of "psychogenic" pain when there is a negative medical and surgical examination. Accurate communications about any psychiatric components to the referring physician, without premature judgment on "cause" of pain, lead to themost accurate decisions about future treatment.

Chronic Disease

Low back pain patients in a psychiatric population.

Thirty-one patients with low back pain resistant to medical and surgical treatment were studied. On admission to the psychiatric service, these patients revealed apparent features of conversion and hysterical personality, as characterized also by the MMPI profile. During hospitalization, however, there was increased appearance and recognition of anxious-depressive features. We suggest that these patients should be treated by the combined approach of supportive psychotherapy and physiotherapy, with appropriate use of antidepressants.

Adult

Program for managing chronic pain. I. Program description and characteristics of patients.

A program for the management of patients with treatment-resistant pain involves behavior modification, physical treatment, medication management, and counseling. The first 50 patients were characterized by pain of many years' duration, multiple operations, treatment failures, prolonged disability, compensation factors, and dependency on medication. In addition, they demonstrated loss of intellectual efficiency and were more psychologically deviant than the general medical population. Management problems were encountered in the following areas: patient acceptance, drug seeking, complicating psychopathology, complicating physical disorders, group dynamics, family reactions, and staff morale. Fifty-four percent of patients achieved moderate to marked improvement.

Adult