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Biomedical subjects

J C Beck

Publications and source records attributed to J C Beck.

At least 145 records · Page 8Linked to original sources
PubMed1982

Group treatment for parents of the adult mentally ill.

Support and education groups for the families of the mentally ill have been in existence for at least 20 years. The authors describe a group treatment program established in 1979 for parents of chronically mentally ill individuals living in the community. The goal was to help parents become less overprotective, critical, and hostile so that clients would relapse less frequently and improve their social functioning during their time in the community. The groups provided parents with information and support. Some of the results of the groups include the implementation of new hospital procedures, more effective parenting, and a parent-initiated alliance on behalf of the mentally ill in the locality.

Adaptation, Psychological↗
PubMed1982

Dementia in the elderly: the silent epidemic.

The graying of America will be accompanied by an epidemic of major proportions--dementia or intellectual impairment--that will have an impact on all aspects of the helath care system, particularly on the institutional component of the long-term care system. Health professionals; federal, state, and local health planners; families; and others must recognize that many ameliorable or curable physical and emotional diseases in the elderly are associated with intellectual impairment that may be difficult to distinguish from irreversible brain disease of the Alzheimer type. We present information on the cause, physiopathologic mechanism, clinical presentation, appropriate laboratory studies, and anticipated outcomes in the various forms of intellectual impairment found in the elderly. Important new developments will occur in the next decade that will address the cause, pathogenesis, further refinement of laboratory investigation, and specific therapeutic intervention in dementia.

Aged↗
PubMed1981

Long-term effects of betamethasone on fetal development.

In previous studies, we noted that treatment of pregnant rhesus monkeys with betamethasone resulted in a marked increase in fetal lung distensibility. The purpose of the present study was to determine whether these changes persisted during subsequent in utero development. Pregnant rhesus monkeys were treated with 2 mg of betamethasone intramuscularly from day 120 to day 133 and underwent delivery by cesarean section one month later. The treated fetuses were found to have smaller lungs (-31%; p less than 0.005), and lower alveolar stability (-14%; p less than 0.025) than the control fetuses. Additional findings included smaller weights for the brain (p less than 0.01), liver, pancreas, and heart (p less than 0.05). Smaller adrenal (p less than 0.025) and larger pituitary weights (p less than 0.05) and lower plasma corticoid concentrations (p less than 0.001) indicated long-standing adrenal insufficiency in the treated fetuses. These persistent sequelae caution the indiscriminate and prolonged use of these potent glucocorticoids during pregnancy.

Adrenal Cortex↗
PubMed1981

The relationship of amniotic fluid fluorescence polarization to neonatal lung function.

Steady-state fluorescence polarization (FP) of 1,6-diphenyl-1,3,5-hexatriene (DPH) in monkey and human amniotic fluid was studied over a wide range of gestational ages. In both of these systems, the fluorescence polarization decreased with advancing gestational age. In the monkey, these measurements were correlated with both biochemical and physiologic parameters of lung function, including maximal lung volume, alveolar stability, percentage of disaturated phosphatidylcholine in lung homogenate, and lecithin/sphingomyelin ratio of amniotic fluid. Fluorescence polarization values correlated well with the lung disaturated phosphatidylcholine content expressed as a percentage of phosphatidylcholine, thus suggesting that the fluorescent probe interacts with a fraction of the amniotic fluid which is closely related to development of the pulmonary surfactant. system. Comparison of monkey and human amniotic fluid fluorescence polarizations showed a greater anisotropy of DPH in the monkey fluid at all stages of gestation, thereby indicating a greater microviscosity in monkey pulmonary surfactant.

Amniotic Fluid↗
PubMed1981

Amniotic fluid absorbance at 650 nm: a comparison with fetal lung maturity characteristics.

Using the rhesus monkey as an animal model we measured several indices of fetal lung maturation including pressure-volume characteristics and phospholipid concentrations and correlated them with the absorbance of amniotic fluid at 650 nm (A650). Those parameters, which are indicative of the presence of surfactant (i.e., deflation stability, lecithin-sphingomyelin ratio, lung phosphatidylcholine, as well as disaturated phosphatidylcholine), correlate significantly with the amniotic fluid A650, even after correction for gestational age. Maximal lung volume changes, thought to be reflective of alterations in tissue forces, did not correlate with A650. These data in the rhesus fetus indicate that the A650 reflects pulmonary surfactant characteristics independent of gestational age. Accordingly, this test may prove to be an accurate predictor of the risk of the respiratory distress syndrome.

Amniotic Fluid↗
PubMed1981

Glucocorticoids, hyperinsulinemia, and fetal lung maturation.

Glucocorticoids are reported to accelerate fetal lung development, whereas insulin is alleged to interfere with this effect of glucocorticoids. A paradox exists, however, in that glucocorticoids also induce hyperinsulinemia. The purpose of this study was to explore the interrelationships of betamethasone, hyperinsulinemia, and hyperglycemia to fetal lung maturation. In this rhesus preparation, maternal betamethasone administration produced an alarming increase in maternal and fetal plasma insulin values. A significant increase in total lung volumes also occurred, but lung surfactant properties (as measured by amniotic fluid lecithin/sphingomyelin concentrations, lung alveolar deflation stability, and lung phosphatidylcholine concentrations) remained unchanged. These findings are consistent with the following hypotheses: (1) Betamethasone-induced hyperinsulinemia impairs acceleration of surfactant production but does not negate increases in maximum lung volume; (2) betamethasone-induced increases in maximum lung volume occur through mechanisms other than alveolar surfactant alterations.

Amniotic Fluid↗
PubMed1981

An empirical investigation of psychotherapy with schizophrenic patients.

We examined the experience of schizophrenic patients who had been in psychotherapy for 1 year or longer. Therapists and their patients in a university-affiliated community mental health center were interviewed. One year later, followup interviews were conducted. Characteristics of participating patients, descriptions of therapy, behavioral changes, and relationships among these variables are reported. A comparison group of schizophrenics not in psychotherapy was interviewed once. The schizophrenic patients who maintain psychotherapies are isolated and quite impaired. Most patients and therapists report that psychotherapy helps; but there is little evidence of improved social functioning. Therapies that are associated with improved patient behavior are often conducted by more experienced therapists, and participants describe the therapeutic relationship in similar terms. Therapies without associated improvement are described in dissimilar terms by the participants. Results support the thesis that the process of psychotherapy with schizophrenics is related to outcome. Implications for training residents are discussed.

Adult↗
PubMed1981

Betamethasone and the rhesus fetus: effect on lung morphometry and connective tissue.

Pregnant rhesus monkeys (Macaca mulatta) at 67 to 85% of term pregnancy were treated with betamethasone for 3 days and then delivered by cesarean section. These treated fetuses had larger lung volumes (32.6 +/- 1.8 ml/kg of body weight) compared to gestational age-matched controls (22.9 +/- 3.2 ml/kg of body weight; P less than 0.025) but no alterations in surfactant properties as measured by amniotic fluid L/S ratios, alveolar deflation stability, or lung phosphatidylcholine. These findings suggest that betamethasone effects an increase in fetal lung volume by some method other than alteration in alveolar surfactant concentrations. Results also demonstrated an 11% increase in the collagen to elastin concentration in the treated fetuses as compared to the control animals (P less than 0.01), suggesting alterations in lung connective tissue. Morphometric studies done on the air-fixed inflated lung demonstrated a decrease in the number of alveoli per unit volume of lung among the treated animals (0.95 +/- 0.07 x 10(6)) compared to the control animals (1.19 +/- 0.08 x 10(6); P less than 0.025) and a reduction in the mean surface area of the lungs of the treated animals (506 +/- 10 cm2 per cm3) compared to the control animals (561 +/- 9 cm2 per cm3; P less than 0.005). These findings suggest that at least part of the increased maximal lung volumes is related to increased alveolar distensibility. Together, these pressure volume findings, biochemical studies, and morphometric analyses indicate that a major effect of betamethasone on the rhesus fetal lung is to alter lung connective tissue characteristics. Alterations in lung surfactant appear to be of less functional significance in this rhesus fetal model. The disparity between these findings and other animal studies might be due to differences in species, the preparation, or the method of glucocorticoid administration.

Animals↗
PubMed1981

Plasma prostaglandin in pregnant women with term and preterm deliveries.

Because of the involvement of prostaglandins in the labor mechanism, it was hypothesized that elevated prostaglandin levels would presage preterm deliveries. A comparison of plasma 13,14-dihydro-15-ketoprostaglandin F2 alpha (PGFM) levels was made between pregnant patients who eventually delivered at term (N = 22) and those who delivered preterm (N = 17). Maternal blood was collected from each patient at approximately 1-week intervals between 16 and 40 weeks' gestation and during labor. Mixed cord blood was also obtained at delivery. PGFM was measured in plasma by radioimmunoassay. Plasma PGFM concentrations did not vary throughout pregnancy. PGFM concentrations did increase during labor, and the highest levels were found in cord blood at delivery. Mean PGFM levels during labor and in cord blood were not significantly different between the preterm and term groups. In 1 preterm delivery patient the PGFM concentration during labor was higher than that of all other patients, including those who delivered at term. Excluding this patient, preterm labor PGFM concentrations were significantly lower (P less than .05) than those at term. In general, the study provides evidence that most cases of preterm labor are not characterized by elevated prostaglandin levels.

Adult↗
PubMed1980

Maternal administration of glucocorticoids.

No definite comment can be made, at this time, with respect to the safety of glucocorticoid therapy in the human fetus and newborn. Obstetricians and pediatricians need to be aware of the potential risks. Whether the fetal changes that have been reported thus far are permanent and whether they will have any postnatal functional significance are questions of major importance. Probably the greatest risk associated with antenatal steroid therapy is the potential abuse of this treatment. Longer treatment periods or higher doses of steroids will increase the risk for potentially adverse side effects. The recently stated opinion of Taeusch et al seems appropriate: "We conclude that steroids are effective in reducing risk of RDS, but safer and more efficacious approaches for the prevention of RDS should be sought" (91). Further studies are needed to determine the mechanisms of action of glucocorticoids and their risk/benefit ratios in regard to fetal and neonatal well being.

Animals↗
PubMed1978

Membrane potential-sensitive fluorescence changes during Na+-dependent D-glucose transport in renal brush border membrane vesicles.

When D-glucose was added to a suspension of renal brush border membrane vesicles equilibrated in a Na+-containing medium, there was a rapid transient increase in the fluorescence of the probe, 3,3'-dipropyl thiodicarbocyanine iodide (DiS-C3-(5)). This sugar-induced response was stereospecific for the D isomer, dependent on Na+, inhibited by phlorizin, and blocked by ionophores, valinomycin plus nigericin, which dissipate ionic gradients. The enhancement in fluorescence suggests the entrance into the vesicle of Na+, cotransported with the sugar. This would lead to the interior of the membrane vesicle becoming more positive, resulting in depolarization of the membrane potential. That the sugar induced the transport of Na+ was confirmed by direct measurement of 22Na+ uptake. Thus, the Na+-sugar co-transport system provides a mechanism for D-glucose to stimulate the flux of Na+ as well as for the Na+ electrochemical gradient to enhance the transport of D-glucose.

Animals↗
PubMed1978

The sodium electrochemical potential-mediated uphill transport of D-glucose in renal brush border membrane vesicles.

The uphill transport of D-glucose in renal brush border membrane vesicles was correlated with the Na+ electrochemical gradient. Each component of the electrochemical potential, the membrane potential (outside positive) or the Na+ chemical gradient, when assayed independently, supported the concentrative uptake of the sugar. When the two components were combined, the rates of D-glucose uptake were additive. Accumulation of D-glucose as a function of various Na+ gradients, in the absence of a membrane potential, suggests a 1:1 stoichiometry between sugar and Na+ uptake. These findings are consistent with the role of ionic gradients in energizing uphill solute transport.

Animals↗