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At least 73 records · Page 4Linked to original sources
PubMed1991

A clinical study on intellectual impairment in parkinsonian patients during long-term treatment.

The severity of intellectual impairment of 89 patients with Parkinson's disease was evaluated with the Osaka Intelligence Scale for the Aged (OISA). Based on their intelligence levels, the patients were divided into three groups: normal, slight dementia and dementia. EEGs, psychiatric complications such as hallucination, degree of motor disability, history of medication, relationship between changes in intelligence and total amount of administered drugs were also examined. There was no significant correlation between the length of duration of the illness and the degree of intellectual impairment. Two characteristic subgroups were found among our subjects: a group of patients who rapidly became demented after the onset of Parkinsonism, and a group of patients whose intelligence was preserved for a longer period. The mean age of the onset of the disease in the former group was older than that of the latter. Patients of the former group exhibited psychiatric complications and EEG abnormalities more frequently. The severity of motor disability and medications administered at the time of the OISA examination did not differ between the two groups. Deterioration of the intelligence of the patients with Parkinson's disease did not correlate with the total amount of the administered antiparkinsonian drugs.

Adult↗
PubMedDate not supplied

Adverse effects of angiotensin converting enzyme (ACE) inhibitors. An update.

The angiotensin converting enzyme (ACE) inhibitors are a group of effective drugs with a unique mechanism of action. These drugs have proven to be useful for hypertension and congestive heart failure. Early clinical trials of captopril used doses that are now known to be inappropriately high, and dose-related adverse effects were observed frequently. The recognition that lower doses are effective has reduced the incidence of adverse reactions and resulted in improved patient tolerance. When patients are properly selected and correctable risk factors are removed, serious side effects are uncommon. Unfortunately, the early reputation of nephrotoxicity persists, as does the belief that significant blood dyscrasias, endocrine effects and rash are serious risks for the average patient. After wide use of captopril, enalapril and lisinopril, and investigational trials of nearly a dozen newer agents, a sufficiency of clinical observation, experimental evidence and accurate postmarketing recording of events is accumulating to allow insight into the major toxicities with regard to more intelligent patient selection, more rational dosing and proper identification of risk factors. The most common adverse reactions are cough and skin rash. It appears that the agents are generally not cross-reactive with regard to skin rash, although it is not clear whether this effect is drug-specific or class-specific with regard to cough. Statistically but not clinically significant lowering of haemoglobin and hematocrit is common; these effects are inconsequential in most patients. Neutropenia, once thought to be prevalent, now appears to be so only in patients with autoimmune or collagen-vascular disease; the majority of patients outside these groups are at low risk. Hyperkalaemia is a frequent occurrence. This should not be surprising in view of the effect of the ACE inhibitors on plasma aldosterone. When dietary potassium intake is regulated and sources of altered potassium excretion are identified, hyperkalaemia is seldom a serious problem. Identification of sodium and water deficits allows correction before the drugs are started, and the frequency of hypotension and hyperkalaemia caused by the drugs is quite low if these factors are properly managed. An unexpected finding emerging in recent years is the dry cough associated with ACE inhibitor therapy. Its mechanism is not definitely known. Nonsteroidal anti-inflammatory drugs may control this symptom in some patients. The frequent observation of proteinuria in patients taking ACE inhibitors has gained notice and sometimes caused undue alarm. It is difficult to separate disease effects in diabetes and hypertension from true drug effects.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1975

The use of antibiotics in biliary tract disease.

Antibotics are often used in the treatment of patients with biliary tract disease. Certain drugs are relatively contraindicated if there is preexisting liver dysfunction. Not all antibiotis achieve a high level in bile, and knowledge of their individual excretion rate is important for intelligent use.

Ampicillin↗
PubMed1985

The long-term effects of cranial irradiation on the central nervous system.

Cranial irradiation and chemotherapy may have significant long-term deleterious effects on children with brain tumors. Intellectual deterioration, endocrinopathies, leukoencephalopathy, extraneural metastases, and oncogenesis may all complicate the treatment of central nervous system neoplasia. These long-term effects of therapy have important implications, as some are amenable to treatment and others may be prevented by the careful monitoring of drug and radiation administration. Until recently, the survivals of children with brain tumors were limited, so that concerns over long-term effects of therapy were unnecessary. As children with certain types of brain tumors now have a better prognosis, these long-term and possibly remediable effects have important implications. This article emphasizes radiation effects on intellect, endocrine function, and oncogenesis. Recommendations for baseline and longitudinal evaluations of children with brain tumors are suggested.

Achievement↗
PubMed1986

An unusual cluster of tardive dyskinesia in schizophrenia: association with cognitive dysfunction and negative symptoms.

Factors associated with the emergence or nonemergence of involuntary movements (tardive dyskinesia) during long-term neuroleptic treatment were investigated in an atypical, isolated population of 31 schizophrenic inpatients with an unusually high prevalence of this syndrome. Patients with involuntary movements could not be distinguished from those without such movements by general characteristics or conventional indices of neuroleptic or anticholinergic treatment. However, they were more likely to show either marked cognitive dysfunction or muteness. These findings support the proposal that, at least in schizophrenia, subtle organic changes may contribute to vulnerability to the emergence of involuntary movements.

Adult↗
PubMed1992

Development of microcomputer-based mental acuity tests.

Recent disasters have focused attention on performance problems due to the use of alcohol and controlled substances in the workplace. Environmental stressors such as thermal extremes, mixed gases, noise, motion, and vibration also have adverse effects on human performance and operator efficiency. However, the lack of a standardized, sensitive, human performance assessment battery has probably delayed the systematic study of the deleterious effects of various toxic chemicals and drugs at home and in the workplace. The collective goal of the research reported here is the development of a menu of tests embedded in a coherent package of hardware and software that may be useful in repeated-measures studies of a broad range of agents that can degrade human performance. A menu of 40 tests from the Automated Performance Test System (APTS) is described, and the series of interlocking studies supporting its development is reviewed. The APTS tests, which run on several versions of laptop portables and desktop personal computers, have been shown to be stable, reliable, and factorially rich, and to have predictive validities with holistic measures of intelligence and simulator performances. In addition, sensitivity studies have been conducted in which performance changes due to stressors, agents, and treatments were demonstrated. We believe that tests like those described here have prospective use as an adjunct to urine testing for the screening for performance loss of individuals who are granted access to workplaces and stations that impact public safety.

Alcoholic Intoxication↗
PubMedDate not supplied

NSAIDs: maternal and fetal considerations.

Nonsteroidal anti-inflammatory drugs (NSAIDs) gained popularity in the late 1970s. Inhibition of prostaglandin synthesis with indomethacin has been reported to be effective for prevention of labor and for treatment for symptomatic polyhydramnios. Concern about its possible constrictive effect on the fetal ductus arteriosus has limited its use in pregnancy. Maternal indomethacin therapy has also been associated with reduction in urine production in the fetus and with oligohydramnios. Obstetricians have discouraged pregnant women from taking analgesic doses of aspirin, mainly because of the availability of paracetamol (acetaminophen), which causes less gastric irritation, but also because of fear of maternal and fetal hemorrhage and of possible premature closure of the ductus. These fears largely derive from studies on patients taking large doses and from extrapolation from other NSAIDs. The likelihood that treatment with 60-75 mg/day of aspirin markedly reduces the incidence of preeclampsia and fetal intrauterine growth retardation makes it important to reexamine its use. This review describes the pharmacology and pharmacokinetics of aspirin with particular reference to pregnancy and considers teratogenesis, prolongation of pregnancy and labor, maternal bleeding, fetal and neonatal bleeding, possible effects on the ductus arteriosus and pulmonary circulation, and possible nonspecific effects on intelligence and breast feeding and acute toxicity in the neonate.

Abnormalities, Drug-Induced↗
PubMed1990

Depo Provera: a profile of current users.

This retrospective study reviewed the current users of Depo-Medroxy-Progesterone-Acetate (Depo-Provera) from April to June, 1987, within the Family Planning Association of Victoria's Richmond Clinic. The profile that emerged from the study showed the clients were of average intelligence, well informed, had tried other methods of contraception, had a high number of unplanned pregnancies and chose to use Depo-Provera as other methods of contraception were unsuitable.

Adolescent↗
PubMed1975

Neuropsychological effects of chronic asymptomatic increased lead absorption. A controlled study.

Twenty-seven asymptomatic children with confirmed chronic increased lead absorption were compared with 27 matched control children for evidence of neuropsychological impairment. Evaluation of each child included a complete history, physical examination, quantitative neurological tests, and comprehensive psychological tests. There was significantly increased incidence of hyperactive behavior in the subjects with increased lead levels, but there was no significant difference in any of the quantitative test results. Uncontrolled variables, especially lead absorption in infancy and adverse environmental pressures other than lead, still leave questions about the relationship between chronic lead exposure and behavior of intelligence.

Chelating Agents↗
PubMed1988

Educational late effects in long-term survivors of childhood acute lymphocytic leukemia.

Records of levels of school achievement in long-term survivors of childhood acute lymphocytic leukemia were obtained for 23 children who had received 2,400-rad cranial irradiation and intrathecal methotrexate and standard chemotherapeutic agents 8 to 10 years previously. The children had been evaluated with standardized tests of intelligence at the time of diagnosis and periodically thereafter. Declines in IQ and cognitive dysfunctions have been previously described. School placements, educational histories, attendance records, learning strengths and weaknesses, social/emotional adjustments, and grade level achievements in reading and mathematics as measured by standardized achievement tests are reported here. Children achieved less than the expected levels in both reading and mathematics given both pretreatment and most recent IQ scores. Neither sex nor initial IQ were related to achievement scores. Children experienced difficulty with attention/concentration, memory, sequencing, and comprehension when performing school tasks. Individual children showed different degrees of dysfunction, but results of this study suggest that there are patterns of specific learning disabilities rather than global retardation. A small number of children achieved greater than expected levels, indicating that individualized instruction, tutoring, and parental support may reduce some learning deficits. Early educational intervention is recommended for similarly treated patients.

Age Factors↗
PubMed1977

Patient compliance: the effect of the doctor as a therapeutic agent.

This paper is a review of the available literature on patient complicance with medical regimens. An effort is made to focus on those features or characteristics associated with compliance or noncompliance that are clinically relevant for the practicing physician. These include the intelligence of the patient, the patient's knowledge of his disease, the complexity of the medical regimen, the influence of the family, the health belief model, and the doctor-patient relationship. From this review of research data, 12 concrete suggestions are presented for the purpose of enhancing patient compliance and enabling the doctor himself to be more effective as a therapeutic agent.

Attitude to Health↗