Search PubMed⌕ Search

Biomedical subjects

R E Drake

Publications and source records attributed to R E Drake.

198 records · Page 11Linked to original sources
PubMed1976

Dynamics of subatmospheric pressure in the pulmonary interstitial fluid.

Systems analyses are presented for several aspects of pulmonary fluid dynamics, especially those related to (1) transport of fluid between the pulmonary interstitial spaces and the alveoli, (2) the possibility of a mechanism for concentrating protein in the lymph vessels, and (3) the effects of very high resistance to fluid flow in the alveolar septal wall. The analysis of fluid transport between the interstitial space and the alveoli, assuming that there is no active secretory or active absorptive process, shows that the interstitial fluid pressure in the normal lung cannot be more positive than the fluid pressure in the alveoli. Since the surface tension of this fluid causes it to have a subatmospheric pressure, the calculated maximum pressure for interstitial fluid in the normal lung is about -2 mmHg (-0.266 kPa). At any pressure more positive than this the alveoli will fill with fluid. The systems analyses for concentrating protein in the pulmonary lymphatics and for the effects of high resistance to fluid flow in the alveolar septal wall offer possible explanations for very negative pressures of pulmonary interstitial fluid, even though calculations of the interstitial fluid pressure based on the assumption that the colloid osmotic pressure of pulmonary interstitial fluid is equal to the osmotic pressure of pulmonary lymph give estimated pressures of pulmonary interstitial fluid approaching 0 mmHg.

Animals↗
PubMedDate not supplied

Depressive symptoms in schizophrenia: comprehensive differential diagnosis.

Depression is a common complication of schizophrenia and is associated with increased morbidity and mortality. Contrary to traditional clinical wisdom, depressive symptoms occur during all phases of schizophrenia and are not restricted to the postpsychotic period. In this review, the authors summarize current empirical research and offer a practical approach to the identification of depressive subtypes in schizophrenia. The following subtypes are considered: (1) depressive symptoms occurring secondary to organic factors (caused by medications, substance abuse, or underlying medical problems); (2) nonorganic depressive symptoms occurring with acute psychotic symptoms (intrinsic to the acute psychotic episode or schizoaffective disorder); and (3) nonorganic depressive symptoms occurring without acute psychotic symptoms (prodromal symptoms, negative symptoms, acute dysphoria, secondary depressive syndrome, or chronic demoralization). The authors discuss each of these entities and offer guidelines for diagnosis.

Depressive Disorder↗
PubMedDate not supplied

Clinicians' practices in personality assessment: does gender influence the use of DSM-III axis II?

We assessed clinicians' practices in the process of personality assessment according to DSM-III axis II criteria. Forty-six clinicians rated personality traits and disorders on two versions of a clinical profile constructed to meet DSM-III axis II diagnoses of histrionic, narcissistic, borderline, and dependent, differing only in the sex of the patient. Clinicians tended to use only a single diagnostic category and to make significantly different personality attributions and diagnoses depending on the patient's sex. The sex of the clinician had no impact on the process. We conclude that clinicians viewing a case study tend to make global judgments about personality disorders and are influenced by the patient's gender, even when it has no known relevance. We interpret these findings in terms of critical set theory.

Diagnosis, Differential↗
PubMedDate not supplied

Gender differences in patients with schizophrenia and substance abuse.

Co-occurring substance abuse is common among people with chronic mental illnesses such as schizophrenia. Although gender differences have been established among substance abusers in the general population and among people with schizophrenia, little is known about gender differences in people with the dual disorders of schizophrenia and substance abuse. This study examines gender differences in 37 women and 135 men with dual disorders, and finds many differences consistent with those found in people with single disorders: dually diagnosed women had more social contact and fewer legal problems but greater problems with victimization and medical illness compared with dually diagnosed men. Unexpectedly, men and women had similar courses and severities of substance abuse. These findings may be critical in planning effective services that explicitly address women's family and social needs, issues related to victimization, and high rates of medical illness.

Adult↗
PubMedDate not supplied

Depression: adaptation to disruption and loss.

Assisting the depressed person to cope with disruption and loss and the experiences associated with each stage of his recovery is usually a long-term process involving concerted efforts to promote a restoration of self-worth, personal control, and organization. In this article the authors have attempted to elucidate the problem of depression as a clinical phenomenon, to explore its predisposition, and, through the use of a conceptual model, to discuss its psychodynamics. The processes involved in coping with disruption and loss -- processes which tend to be evoked repeatedly during recovery and resolution since each failure or delay encountered is experienced as another loss and disruption by the individual -- were described and illustrated schematically.

Adaptation, Psychological↗
PubMedDate not supplied

Helping depressed clients discover personal power.

TOPIC: Alleviating depression through cognitive therapy. SOURCE: The author's clinical work and review of the literature. GOAL: To describe the empowerment of depressed clients. CONCLUSION: Clients who are depressed can be helped by examining "who they are" as compared to "who they believe they are."

Cognitive Behavioral Therapy↗
PubMedDate not supplied

Recent advances in psychiatric rehabilitation for patients with severe mental illness.

Over the past decade substantial advances have been made in the psychiatric rehabilitation of persons with severe mental illnesses such as schizophrenia and bipolar disorder. In this review we highlight progress in several areas that have been the focus of extensive research, including case management, social skills training, supported employment, family intervention, and integrated treatment for comorbid substance use disorders. We also identify characteristics of successful psychiatric rehabilitation programs: (1) effective interventions tend to be direct and behavioral; (2) rehabilitation programs have specific effects on related outcomes, with limited generalization to other domains; (3) short-term interventions are less effective than long-term ones; (4) interventions need to be delivered close to patients' natural environments; and (5) effective programs often combine skills training and environmental support.

Family Relations↗
PubMedDate not supplied

Dual diagnosis: a review of etiological theories.

The etiology of the high prevalence of substance use disorders in patients with severe mental illness (schizophrenia or bipolar disorder) is unclear. We review the evidence of different theories of increased comorbidity, organized according to four general models: common factor models, secondary substance use disorder models, secondary psychiatric disorder models, and bidirectional models. Among common factor models, evidence suggests that antisocial personality disorder accounts for some increased comorbidity. Among secondary substance use disorder models, there is support for the supersensitivity model, which posits that biological vulnerability of psychiatric disorders results in sensitivity to small amounts of alcohol and drugs, leading to substance use disorders. There is minimal support for the self-medication model, but the accumulation of multiple risk factors related to mental illness, including dysphoria, may increase the risk of substance use disorder. Secondary psychiatric disorder models remain to be convincingly demonstrated. Bidirectional models have not been systematically examined. Further clarification of etiologic factors, including the identification of subtypes of dual diagnosis, may have implications for developing more effective prevention efforts and treatment.

Antisocial Personality Disorder↗