Single case study

Cannabinoids appear to have a very complex interaction with seizure activity, exerting both anticonvulsant and proconvulsant effects. Anecdotal testimonies abound (Grinspoon and Bakalar, 1993), but there has been very little controlled human research. In single-case studies both use and withdrawal of marijuana have been linked to the resumption of seizures (Keeler and Reifler, 1967 Consroe et al., 1975). In a randomised placebo-controlled blind study, patients who responded poorly to standard treatments experienced improved seizure control in response to cannabidiol administration. Cannabidiol does not interact with cannabinoid receptors, and animal studies indicate that it has different anticonvulsant effects to other cannabinoids (Cunha et al., 1980). As such it may prove to have useful therapeutic properties. 

In Chapter 5 the conceptual approach from the previous Chapter will be tested and evaluated and finally applied to a single case study in the Dutch chemical process industry. This exercise is performed to test the conceptual approach in practice. The findings of the case study will be evaluated and will lead to refinements in the conceptual approach. Finally a structured protocol will be derived and applied to the same case study to ascertain if the structured protocol is effective and suitable for practical use and leads to answering the research questions posed in Chapter 1. 

At this point, we can integrate much of what has been discussed above in a single case study. Antibody NPN43C9 was reported in 1988 as the first example of catalysis of hydrolysis of an amide bond, in fact of an active anilide. Its structure and mode of action have been well studied (Janda et al., 1988b), which makes it an appropriate example for this purpose. 

Hepatic Effects. A single case study was located regarding hepatic effects in humans after oral exposure to 1,4-dichlorobenzene. In this case report, the author describes a 3-year-old boy who had been playing with crystals containing 1,4-dichlorobenzene for 4-5 days before being admitted to the hospital. On admission, the boy was jaundiced and his mucous membranes were pale. After a blood transfusion. 

Noyes R, Perry PJ, Crowe RR, et al. Single case study seizures following the withdrawal of alprazolam. J Nerv Ment Dis 1986 174 50-52. 

Naylor MW, Grunhaus L, Cameron O. Single case study myoclonic seizures after abrupt withdrawal from phenelzine and alprazolam. J Nerv Ment Dis 1987 175 111-114. 

Bernstein GA, Hughes JR, Mitchell JE, Thompson T. Effects of narcotic antagonists on self-injurious behavior a single case study. J Am Acad Child Adolesc Psychiatry 1987 26 886-889. McDougle CJ, Holmes JP, Bronson MR, et al. Risperidone treatment of children and onset bipolar adolescents with pervasive developmental disorders a prospective, open label study. J Am Acad Child Adolesc Psychiatry 1997 36 685-693. 

In 1997 Brose et al. published the result of a single case study. SNX-111, administered i.t. by continuous, constant-rate infusion, produced dose-dependent pain relief in a 43-year-old male patient with a 23-year history of intractable deafferentation and phantom limb pain secondary to brachial plexus avulsion and subsequent amputation. Dizziness, blurred vision, and lateral-gaze nystagmus... 

Lithium diphenylthiophosphides add via ligand addition and, in the single case studied, couple preferentially to the more substituted allyl terminus (equation 293).224... 

Tong HY, Monson SJ, Gross ML, et al. 1989b. Elevated levels of 2,3,7,8-TCDD in the tissue of an agricultural sprayer of herbicides A single case study. Chemosphere 18 469-476. 

A single case study involving paroxetine described a 16-year-old who became manic with angry outbursts after 3 weeks on the drug (Oldroyd, 1997). Beech (2000) described an 8-year-old girl who became hypomanic... 

Effects of clonidine in schizophrenic patients with primary polydipsia three single case studies. Prog... 

Rosche J, Froscher W, Abendroth D, Liebel J. Possible oxcarbazepine interaction with cyclosporine serum levels a single case study. Clin Neuropharmacol 2001 24(2) 113-16. 

Two detailed single case studies were published in the 1990s. Maurer et al. (1990) compared the effects of oral THC (5 mg), codeine (50 mg) and placebo in a randomised, double-blind crossover study in a patient suffering severe pain... 

A single case study was located which described the death of a male worker exposed to an undetermined concentration of hydrazine once a week for 6 months (Sotaniemi et al. 1971). Death was attributed to hydrazine exposure, resulting in severe lesions of the kidneys and lungs with complicating pneumonia. 

Hepatic Effects. A single case study reported areas of focal necrosis and cell degeneration in the liver of a worker exposed to an undetermined concentration of hydrazine in air once a week for 6 months (Sotaniemi et al. 1971). Studies of workers exposed to 1,1-dimethylhydrazine have reported changes indicative of a hepatic effect including elevated scrum alanine aminotransferase activity, fatty degeneration, and a positive cephalin flocculation test (Petersen et al. 1970 Shook and Cowart 1957). Although the levels of hydrazine and 1,1-dimethylhydrazine exposure were not determined, these studies indicate qualitatively that tlie liver is a target for both hydrazines. 

Death. Data regarding the lethal effects of hydrazines in humans are limited to a single case study involving inhalation exposure to hydrazine. Death was reported in a male worker exposed to an undetennined concentration of hydrazine once a week for 6 months (Sotaniemi et al. 1971). Death in this case was due to lesions of the kidneys and lungs with complicating pneumonia. The effects on the kidneys and lungs, as well as effects in other tissues, were comparable to those observed in animals exposed to hydrazine. Therefore, death in this case is most likely attributed to hydrazine exposure. 

This chapter describes the history of another anthropogenic threat to biodiversity conservation,—the atmospheric deposition of air-bome pollutants—in relation to one conservation organization. The Nature Conservancy. As a single case study, it is symbolic of a growing trend in conservation. An ever-increasing body of science more accurately and directly links the consequences of human society s actions to the very natural resources upon which we depend for survival. As this evidence mounts, it calls into question the past actions and future roles and responsibilities that conservation organizations must play to conserve not only biodiversity for its intrinsic value, but also the essential ecological services provided by natural resources that are central to our very survival. 

Bamber, M. R. (2004). The good, the bad and defenceless Jimmy A single case study of schema mode therapy. Clinical Psychology and Psychotherapy 11 425-38. 

Bates, A. and Clark, D. M. (1998). A new cognitive treatment for social phobia A single-case study. Journal of Cognitive Psychotherapy 12 289-302. 

Case study tactics Use theory in single-case studies, use replication logic in multiple-case studies. 

A primary distinction in designing case studies is between single and multiple case designs. The single-case study is an appropriate design for the following circumstances ... 

Let us start by looking at the practices of one underground coal mine in New South Wales, which I shall call Eastern Colliery. Eastern is not alone in these practices, but just how widespread they are carmot be known on the basis of a single case study. Eastern ranks in the best-performing quartile of NSW imderground mines in terms... 

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