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Psychotic patients who also have endogenous depressive symptoms often require treatment with several drugs (usually a neuroleptic-antidepressant combination) or electroconvulsive therapy. Loxapine is a neuroleptic of the dibenzoxazepine class; it is metabolized in vivo to desmethylloxapine (amoxapine) and 8-hydroxyamoxapine, two compounds with… (More)
We have reported a unique example of an organic affective syndrome in a patient who had focal brain lesions, but whose initial neurologic examination was nonfocal. In retrospect, the only clue to an organic disorder was hyperreflexia in this patient with a history of alcohol abuse and clinical signs of a distal sensory neuropathy. This case emphasizes the… (More)
The dexamethasone suppression test (DST) is being used clinically as a diagnostic laboratory test for depression. Drug histories collected from 336 psychiatric inpatients revealed that 60% were taking one or more drugs suspected of altering DST results in either a false-positive or false-negative manner. Practical limitations of the DST as a biologic marker… (More)
We evaluated 100 primary care outpatients for signs of cognitive impairment using the Mini-Mental State Examination (MMSE). The 23 subjects scoring abnormal values (less than 24/30) were found to be cognitively impaired. Seventeen had previously undetected cognitive impairment, while six had prior diagnoses consistent with cognitive impairment. Independent… (More)
A patient with a previously undescribed spontaneous arrhythmic vertical eye movement termed slow-upward ocular bobbing is reported. The patient had a one-and-a-half syndrome due to pontine infarction. A simplified scheme for describing the variations of ocular bobbing is proposed based on the velocity and direction of the initial eye movement.
Holmes, et al. in 1979 compiled 125 studies in a bibliography of behavioral science in undergraduate and graduate education. Since 1979, 75 additional studies of behavioral science in medical education have been identified. The current updated bibliography contains 200 entries. Foreign medical journals, Index Medicus, and Psychological Abstracts were… (More)
Primary degenerative dementia (Alzheimer's disease) is characterized by intellectual decline with impairment of memory, judgment, and abstract thinking. Also common are personality changes and disturbances of higher cortical function such as aphasia, apraxia, and agnosia. Standardized brief cognitive tests are useful for evaluating mental status, which is… (More)
Depression is a significant problem in the elderly population and is often accompanied by cognitive changes and agitation. Hypothalamic-pituitary axis dysfunction may occur in some depressed elderly patients and represent a non-specific physiological hyperarousal state. Moreover, recent evidence confirms that antidepressants down-regulate beta-adrenergic… (More)
Since 1956, there have appeared 125 studies which focus on the issue of integrating behavioral science into undergraduate and graduate medical education.