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Biomedical subjects

C Carver

Publications and source records attributed to C Carver.

14 recordsLinked to original sources

7-alkylidenecephalosporin esters as inhibitors of human leukocyte elastase.

A series of 7-alkylidenecephalosporins and 7-vinylidenecephalosporins, as their benzhydryl esters, have been tested as inhibitors of both porcine pancreatic elastase and human leukocyte elastase. Selected 7-alkylidenecephalosporin esters are found to be potent inhibitors of HLE. One category of new inhibitors is the 7-(haloalkylidene)cephalosporins. In contrast to previously reported cephalosporin-based elastase inhibitors, these haloalkylidene cephems show optimum inhibitory activity as sulfides, rather than as sulfones. They are efficient and irreversible inhibitors. A second class of active compounds is represented by the benzhydryl ester 7-(cyanomethylidene)cephalosporin sulfone. In contrast to the activity of these new inhibitors, the benzhydryl ester of the mechanism-based beta-lactamase inhibitor, 7-[(2'-pyridyl)methylidene]-cephalosporin sulfone showed little inhibitory activity as an elastase inhibitor. 7-Vinylidenecephalosporins were also relatively poor inhibitors, although the terminally unsubstituted allene sulfide showed activity as an inhibitor of PPE. A modeling analysis suggests the 7-alkylidene substituents can be readily accommodated in the S1 pocket. A potential mechanism of inhibition is proposed.

Animals↗

Outcome of surgery for chronic pancreatitis.

BACKGROUND: In patients with chronic pancreatitis, surgery is indicated for the management of intractable pain or for the treatment of complications. METHODS: Sixty-three consecutive patients (49 men and 14 women of median age 40 (range 20-72) years) who had undergone surgery over an 8-year interval for chronic pancreatitis were studied. The mortality and morbidity rates associated with surgery were assessed and quality of life was reviewed based on relief of symptoms, analgesic use, employment and long-term sequelae. RESULTS: Forty-four patients (70 per cent) had alcoholic chronic pancreatitis. In 60 patients the principal indication for surgery was intractable pain. Eighteen patients had a duodenum-preserving resection of the pancreatic head (Beger operation); the other surgical procedures were Whipple resection (15), left-sided resection (13), total pancreatectomy (seven), pseudocystjejunostomy (five), pancreaticojejunostomy (one) and bypass procedures (four). The median inpatient stay was 12 days; 23 patients had postoperative complications including one death (2 per cent). There was improved pain control (P < 0.001), a reduction in opiate analgesia use, increase in percentage weight gain (P < 0.01 at 2 years) and return to employment following surgery. Although there was an increase in diabetes mellitus and need for enzyme supplementation these were easily controlled. CONCLUSION: Surgery is an effective treatment in carefully selected patients with chronic pancreatitis but must be tailored to the pattern of disease in each individual.

Adult↗

It's time for CMA to put the lid on privatization.

Family physician Cynthia Carver wasn't heartened by the CMA's "last-minute retreat" from a call to pursue privatization of health care. During its August annual meeting, the association not only supported a strong, publicly funded health care system but also passed a number of resolutions related to the private sector and the appropriate role for regulated private medical insurance in Canada. Carver proposes that the energy being expended on schemes to delist, privatize, define core services and design payment schemes should instead be applied to improving the existing system.

Canada↗

A randomized clinical trial of cognitive marital therapy.

Thirty-three couples with severe marital discord referred to a psychiatric outpatient department were randomly assigned to Cognitive Marital Therapy or a control group. Cognitive Marital Therapy is a brief, structured couple therapy, which involves spouses in reciprocal self-disclosure of personal constructs. The control group received the same number of sessions of self-disclosure from a programmed marital enhancement text. Personal distress, marital adjustment, marital quality, and aspects of self-disclosure were measured before and after treatment. Symptoms of depression as well as somatic and compulsive complaints showed significant improvement in both groups. The wives exhibited a trend suggesting that they were making more self-disclosures to their spouses after counseling. No discernable differences in outcome were found between the marital therapy group and the control group. Marital intimacy and marital satisfaction did not improve significantly over the course of 10 therapy sessions. This study suggests that the role of self-disclosure in marital therapy needs further clarification.

Adaptation, Psychological↗

Dysthymia: a randomized study of cognitive marital therapy and antidepressants.

Preliminary data from a randomized study of the effectiveness of combined marital therapy and antidepressant medication in the treatment of dysthymic married women is presented. The study compares doxepin with placebo, and a marital therapy designed to enhance intimacy through facilitating self-disclosure between spouses with a more supportive and educational therapeutic approach. After ten weeks of combined treatment, the dysthymic women show statistically significant improvement on all the depression measures as well as on the intimacy scale. A trend is developing for greater reduction of depressive symptomatology in the group treated with self-disclosure. The evidence appears to suggest the possibility that the presence of a patient's husband as a supportive figure may of itself be a potent therapeutic manoeuvre in the treatment of dysthymic women.

Clinical Trials as Topic↗

Family therapy and schizophrenia: recent developments.

A review of recent studies of family interaction as a causal factor in the development of schizophrenia suggests a paucity of evidence supporting this point of view. However, research has suggested family variables may influence the course and outcome of schizophrenia. The impact of schizophrenia on the family has recently received more attention. Some research has identified differences between families of schizophrenics and the families of other diagnostic groups and controls. Whether these studies are beginning to influence the theory and practice of family therapy is discussed. Recent studies suggest the combination of long-acting medication and 'psychosocial' interventions may reduce the relapse rate of schizophrenia in the short term. This research suggests that family therapists must re-evaluate their role in the management of schizophrenia.

Adolescent↗

Barium bridge.

Explore the source record for details and available documents.

Barium Sulfate↗