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Biomedical subjects

R C Bell

Publications and source records attributed to R C Bell.

70 records · Page 4Linked to original sources

Tardive dyskinesia: characterization and prevalence in a statewide system.

The prevalence of tardive dyskinesia in a state-wide mental hospital system was assessed using a new quantitative rating scale and related to demographic, medication, and medical history variables. Twenty-six percent of patients had definite signs of tardive dyskinesia, about 12% moderately severe dyskinesia, and 40% exhibited at least some minimal symptoms. Tardive dyskinesia significantly increased with age, and females had a slightly but significantly greater prevalence rate than males. There was no difference in dyskinesia prevalence between patients on or off neuroleptics at time of rating, but patients on multiple neuroleptic drugs had higher prevalence of moderately severe dyskinesia.

Adult↗

The development of a computer assisted instruction and assessment system in pharmacology.

We describe the construction of a computer based system for instruction and assessment in pharmacology, utilizing a large bank of multiple choice questions. Items were collected from many sources, edited and coded for student suitability, topic, taxonomy and difficulty and text references. Students reserve a time during the day, specify the type of test desired and questions are presented randomly from the subset satisfying their criteria. Answers are scored after each question and a summary given at the end of every test; details on item performance are recorded automatically. The biggest hurdle in implementation was the assembly, review, classification and editing of items, while the programming was relatively straight-forward. A number of modifications had to be made to the initial plans and changes will undoubtedly continue with further experience. When fully operational the system will possess a number of advantages including: elimination of test preparation, editing and marking; facilitated item review opportunities; increased objectivity, feedback, flexibility and descreased anxiety in students.

Anxiety↗

Rubber men.

Explore the source record for details and available documents.

Adult↗

Immediate cystic duct occlusion using an endoluminal absorbable polyglycolic acid screw.

Endoscopic in situ occlusion of the cystic duct and ablation of the gallbladder could constitute a useful alternative to cholecystectomy in certain patients. The purpose of this study was to examine the feasibility of endoluminal occlusion of the cystic duct using a biodegradable polyglycolic acid screw and simultaneous gallbladder mucosal ablation with a Sotradecol-ethanol mixture. Eight pigs had operative cholecystotomy. A polyglycolic acid screw was twisted into the cystic duct after the proximal cystic duct mucosa was thermally ablated using electrocautery. Cholecystography confirmed occlusion of the cystic duct. Synchronous ablation of the gallbladder mucosa was then done by instilling absolute alcohol and 2% Sotradecol. The gallbladder was drained. Animals were sacrificed on days 14, 28, and 42. All animals survived operation and showed no untoward effects. Postmortem gross inspection showed gallbladders were shrunken and surrounded with adhesions from adjacent tissue. Cholangiography and cholecystography confirmed occlusion of the cystic duct in 6 of 8 pigs (75%). Histopathologic examination showed extensive areas of mucosal necrosis mixed with small areas of epithelial regeneration. Immediate occlusion of the cystic duct is possible using an endoluminal polyglycolic acid screw.

Animals↗

Personality disorders in recent-onset bipolar disorder.

The frequency and types of DSM-III personality disorders (PDs) were investigated in a sample of 26 recent-onset bipolar-disordered (BD) patients. Results showed that 62% of BD patients had PDs according to the Structured Interview for DSM-III Personality Disorders (SIDP). The most frequently diagnosed PDs were the histrionic, borderline, passive-aggressive, and antisocial categories. A comparison between the BD patients and a sample of 35 recent-onset schizophrenic patients showed significant differences for two PDs. Schizotypal PD was more frequently diagnosed in the schizophrenic group, while the BD group had a higher frequency of histrionic PD.

Bipolar Disorder↗

Laparoscopic fundoplication for symptomatic but physiologic gastroesophageal reflux.

Esophageal pH monitoring identifies some patients who have physiologic amounts of esophageal acid exposure but have a strong correlation between symptoms of esophageal reflux events. These patients with symptomatic physiologic reflux probably have enhanced sensory perception of reflux events and may be difficult to control with acid-suppressive therapy. Little is known about the role of fundoplication in such patients. Patients with no endoscopic evidence of gastroesophageal reflux disease and a normal 24-hour pH composite score (<22.4 in our laboratory), but a symptom index (SI = number of symptoms with pH <4/total number of symptoms) greater than 50% were offered laparoscopic fundoplication if acid-suppressive therapy was unsatisfactory. This group comprised 18 (4%) of 459 patients undergoing fundoplication at our institution. Heartburn, dysphagia, and reflux symptoms were scored on a scale of 0 to 10 with patients on and off medicine preoperatively, and at a mean of 7.2 months (range 1 to 32 months) postoperatively. The 18 patients with symptomatic physiologic reflux (6 males and 12 females) had heartburn as a major complaint. Preoperative response to proton pump inhibitors for heartburn was 72% and for all symptoms was 60%. The group had a mean pH composite score of 14 (range 4 to 22). The symptom used to calculate the symptom index was heartburn in 12 patients, regurgitation in three, chest pain in two, and cough in one. An average of 18 symptoms (range 2 to 56) were recorded. The mean symptom index was 82% (range 50% to 100%). A Nissen fundoplication was performed in nine patients and a Toupet fundoplication in nine. Surgery was successful (>90%) in alleviating reflux symptoms in 14 patients and partially successful (>75%) in three of the remaining four patients. Gas bloat and dysphagia were seen in one patient each. Fundoplication is effective at relieving reflux symptoms in carefully selected patients with symptomatic physiologic reflux, with minimal side effects.

Esophagus↗

Gingival cyst of the adult: a review and a report of eight cases.

The gingival cyst of the adult (GCA) is an uncommon gingival lesion that is usually found within attached or unattached soft tissues. It is generally considered to be a cyst of odontogenic origin, though this is still debated somewhat. This article reviews the diagnosis and treatment of GCA and summarizes the features of eight cases.

Adult↗