Congenital cystic lesions in head and neck.

Congenital lesions by definition are present at birth; but certain congenital lesions of the head and neck, like branchial cysts and dermoid cysts, clinically present in childhood, early adulthood or late in life. A good history and a high degree of suspicion are the key to the adequate management of such lesions. Here we present a series of six case reports of congenital cystic lesions of the head and neck.

Centbutindole vs trifluoperazine: a double-blind controlled clinical study in acute schizophrenia.

Twenty-nine acute schizophrenic patients were treated under double-blind conditions for six weeks with either centbutindole in a dose range of 3 mg/day to 4.5 mg/day or trifluoperazine in the dose range of 15 mg/day to 22.5 mg/day. Both drugs produced a significant improvement in initial psychopathology. No significant differences were demonstrated between the two treatment conditions.

Effects of intravenous metoclopramide in 81 patients with tardive dyskinesia.

We compared acute effects of single intravenous administrations of metoclopramide (40 mg) and placebo in a double-blind crossover study involving 81 patients with tardive dyskinesia. Metoclopramide produced significantly greater reduction in mean total Abnormal Involuntary Movement Scale score as well as in ratings for six of the seven body areas, when compared with placebo. On adjusting each patient's metoclopramide response for his or her placebo response, we found that 35 of the 81 patients had 50% or greater placebo-corrected improvement. There were no apparent clinical differences between metoclopramide responders and nonresponders. Administration of 60 mg of metoclopramide to 15 patients produced greater improvement in tardive dyskinesia as compared with 40 mg; the incidence of acute dystonia, however, jumped from 10% with 40 mg to 33% with 60 mg.

Tardive dyskinesia in India: a prevalence study.

We screened the entire inpatient population (N = 1963) of a state hospital near Bombay, India, for tardive dyskinesia (TD) using specific diagnostic criteria. Prevalence of TD was found to be 9.6%, which was much lower than that reported from the Western countries. Percent prevalence of TD was greatest in the age group 41 to 50, after which it seemed to decline. TD patients had received neuroleptic treatment for significantly longer periods and in significantly greater amounts than non-TD patients. The principal reason for the relatively low prevalence of TD in India is probably the practice of using neuroleptics in comparatively small doses (mean daily dose is about 200 mg of chlorpromazine equivalents). A possible contribution of racial-genetic factors cannot be excluded.

Cross-cultural study of a biochemical abnormality in paranoid schizophrenia.

We studied 24-hour urinary excretion of phenylethylamine (PEA) and creatinine in 50 schizophrenic (39 paranoid and 11 nonparanoid) and 19 nonpsychiatric patients from Bombay, India. Methods for diagnosis, clinical assessment, and 24-hour urine collection were identical to those used in an earlier study done in a Washington, D.C. hospital. Clinical evaluations were done in Bombay, while urinary PEA and creatinine estimations were performed at NIMH, Washington, without knowledge of the subjects' identify. Paranoid schizophrenic patients had significantly greater 24-hour urinary excretion of PEA than both nonparanoid schizophrenic patients and nonpsychiatric controls. The mean amount of PEA per g creatinine in urine was also highest of paranoid schizophrenic patients. Our findings provide cross-cultural support to the possibility of abnormal PEA metabolism in at least some patients with paranoid schizophrenia.

Penfluridol in chronic schizophrenia.

Twenty-eight male chronic schizophrenic patients completed a 6 month treatment with a single weekly dose of 20 to 120 mg penfluridol, a new long- acting oral neuroleptic. Twenty-four patients showed significant improvement at the end of the trial period. Significant reduction in scores could be demonstrated in 21 out of 26 symptom variables. Central side-effects, reported by 19 patients, were mild and transient except in one patient who was withdrawn from the trial. Laboratory investigations and vital signs remained within normal limits.

A double blind study of pimozide versus chlordiazepoxide in anxiety neuroses.

Eighteen patients diagnosed as anxiety states were treated under double blind conditions for a four week trial period with pimozide and chlordiazepoxide after randomisation. No significant differences could be demonstrated between chlordiazepoxide and pimozide as far as therapeutic efficacy or toxicity were concerned. Pimozide administered in a single daily dose was as effective as chlordiazepoxide administered in divided daily doses for the relief of anxiety symptoms.