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Biomedical subjects

R Gardner

Publications and source records attributed to R Gardner.

At least 91 records · Page 5Linked to original sources
PubMed1982

Psychological and social evaluation in cases of deliberate self-poisoning seen in an accident department.

The outcome in 115 consecutive patients with mild self-poisoning seen by junior medical staff and discharged from the accident department was compared with that of 98 similar patients admitted to the medical wards. Psychiatrists saw only four patients in the accident department and 25 admissions. In making their assessments the junior medical staff considered psychosocial factors as well as the patients' physical condition. Most patients recommended for further care, and discharged from the accident department, subsequently received it. Repetition rates were similar in the two groups and there had been no suicides when patients were followed up at one year. It is feasible for junior staff in an accident department to decide whether patients with self-poisoning need admission or may be discharged with or without subsequent referral for psychiatric or social work help.

Emergency Service, Hospital↗
PubMed1982

Mechanisms in manic-depressive disorder: an evolutionary model.

Characteristics of mania describe individuals who are human counterparts of "alpha" members of nonhuman species. Depressive characteristics described low rank or "omega" persons. These similarities provided initial support for a model of manic-depressive disorder that hypothesizes these bipolar states to be (1) basically identical to an organismic state also experienced by persons at the corresponding extremes of social rank, (2) triggered unusually easily and maintained unusually rigorously in spite of social reality (in contrast to those for whom the organismic state and social reality are congruent), and (3) genetically transmitted via mechanisms that enhance this ease of onset and rigidity of maintenance (v mechanisms presumed to be state specific). This theoretic model defines some illness components as variations of normal states, others as pathologic, and still others as reactive. This conception may guide investigative work with experimental animals.

Adaptation, Biological↗
PubMed1982

The dexamethasone suppression test as a predictor of sleep deprivation antidepressant effect.

An abnormal dexamethasone suppression test (DST) result, a sensitive and specific marker for endogenous depression, was found to be associated with an antidepressant response to sleep deprivation in patients who met DSM-III criteria for Major Depressive Episode regardless of whether they met criteria for melancholia or psychotic subtypes of this disorder. These findings support previous reports of an association between an abnormal DST result and antidepressant effects of sleep deprivation in depressed patients. Our results extend the positive association between an abnormal DST result and the antidepressant response to sleep deprivation to include depressed patients who are clinically nonmelancholic during their current episode but who have an abnormal DST result.

Adult↗
PubMed1982

Vascular smooth muscle cell growth kinetics in vivo in aged rats.

Age is a risk factor in the development of atherosclerosis. In this study we investigated the hypothesis that proliferation of vascular smooth muscle cells (SMCs), an integral part of atherosclerotic plaque formation, changes with age. SMC growth kinetics of old rats (21-24 months) were compared to those of young adult rats (3-4 months). Rat aortas were denuded of their endothelium and the animals were killed after [3H]thymidine and Evans blue injections at 0-28 days after denudation. Incorporation of [3H]thymidine into SMC peaked in the young animals by day 2, whereas the older animals responded to endothelial removal with greater incorporation at day 2 and a more sustained rate of incorporation peaking at day 4. The [3H]thymidine incorporation curves decreased sharply from their peaks at 2 and 4 days, respectively, and paralleled each other after day 7. [3H]Thymidine uptake reflected the subsequent SMC intimal growth as measured morphometrically, with old animals showing greater numbers of intimal SMC than did the younger animals. The difference in response of SMC to injury with age suggests that aging produces a change in the vascular SMC that enhances proliferation. This change in response implies that the more pronounced atherosclerotic plaque growth seen with aging may be a result of an age-related increase in response to injury rather than merely the accumulation of time-related intimal change.

Aging↗
PubMed1982

Attribution of control, essays, and early medical school experience.

The research examines the workings of two mediating variables, attribution of control and social support, in a nonlinear model of stress research. Measuring in stressfully stimulating experience of being a first-year medical student, we found that a short instrument assessing locus of control in recent experience displayed stability and sensitivity to change in measuring two independent dimensions: internal and external loci of control. An independent variable, writing weekly essays for a faculty member who read them, commented on them supportively, and quickly returned them, interacted with time in producing changes in the student's attribution of control. The supported (essay) group became less internal and more external while demonstrating a lesser correlation with reported stress; and the nonwriting students augmented their perceptions of internal control but reported more correlated stress and less correlated reward. Miller's minimax theory of controllability derived from the experimental literature provided an explanation of these findings.

Adult↗
PubMed1981

Dexamethasone suppression test and selection of antidepressant medications.

Endogenous depressives with abnormal dexamethasone suppression tests (DSTs) respond better to somatic antidepressant treatments than those with normal DSTs. Whether the DST also aids in the selection of specific antidepressants has not been determined. A pilot report suggested that patients with abnormal DSTs might be noradrenaline-deficient and respond preferentially to imipramine or desipramine, whereas those with normal DSTs might be serotonin-deficient and respond best to amitriptyline or clomipramine. Attempting to replicate this observation, we studied 26 patients diagnosed with Research Diagnostic Criteria as major depressive disorder, endogenous subtype, and with DSM-III as having melancholia. All were drug-free during baseline evaluation. All had abnormal DST results, with post-dexamethasone plasma cortisol levels exceeding 5 microgram/dl. We treated subjects with either imipramine or amitriptyline and compared clinical response with weekly Hamilton Depression Rating Scales, completed by raters blind to both DST results and the research question. Thereapeutic plasma levels were documented. We found no significant differences in treatment response between the subgroups. Twenty of the 26 subjects did well. The imipramine-treatment group failed to have either earlier response or better final outcome. These data fail to replicate suggestions that DST results assist in the selection of either imipramine or amitriptyline.

Amitriptyline↗
PubMed1981

Mattis Dementia Rating Scale: internal reliability study using a diffusely impaired population.

The Mattis Dementia Rating Scale (MDRS) was developed to determine the degree of cortical deficit in those individuals with extremely low scores on the Wechsler Adult Intelligence Scale (WAIS) and the Wechsler Memory Scale (WMS). The purpose of this study was to potentiate the usefulness of this rating scale by determining its internal reliability when applied to patients with diffuse cerebral impairment. Subjects, ranging in age from 65 to 94 years, were chosen on the basis of their presenting an organic brain syndrome wtihout obvious localizing features nor evidence of reversible etiology. Responses to the MDRS were scored on split-half forms. Analysis of the scores using the Rulon formula for split-half reliability yielded a correlation coefficient of .90, indicating that the MDRS is very consistent internally. In addition, the MDRS is shown to be a useful test for discriminating the degree of impairment in individuals with organic mental syndrome.

Aged↗
PubMed1981

Speech pause time: a marker of psychomotor retardation among endogenous depressives.

Speech pause time (SPT)-the silent interval between phonations during automatic speech-is elongated during depressive episodes among endogenous depressives. Phonation time is unchanged. To follow up and expand earlier small-scale studies of these psychomotor findings we conducted a prospective determination of SPT among 24 unipolar (UP) depressives, 12 bipolar (BP) depressives, and 19 nondepressed controls. SPT was lengthened among both UP and BP depressives during their episodes. This elongation disappeared with clinical improvement. Nondepressed controls did not have longer SPT. During states of clinical remission, depressives and controls had comparable SPT values. Replications are required, but the measurement of SPT appears to be a useful, objective technique for identifying and monitoring psychomotor deceleration among depressives.

Bipolar Disorder↗
PubMed1980

Two nephelometric methods compared with a radial immunodiffusion method for the measurement of IgG, IgA and IgM.

1. The IgG, IgA and IgM concentrations of a group of 100 or more human sera found by both the rate nephelometric Beckman Immunochemistry System and the endpoint Behring Laser Nephelometer procedure gave good correlations when compared to results obtained by an endpoint radial immunodiffusion method. The correlation coefficients for the Behring method comparisons were 0.958 for IgG, 0.979 for IgA and 0.966 for IgM when only values under 850 IU of IgM/ml were considered. The Beckman system gave correlation coefficients of 0.984 for IgG, 0.993 for IgA and 0.986 for IgM when IgM concentrations were under 500 IU/ml. Determinations from all three methods agreed well except for very high IgM values which were considerably higher by RID. 2. Both nephelometric methods are fast and precise. The average within-run coefficients of variation were 2.6% for the Behring method, 2.2% for the Beckman system and 2.1% for radial immunodiffusion while average between-run precision values of 6.9% for the Behring method, 3.7% for the Beckman system and 4.9% for radial immunodiffusion were found. The Beckman rate system has the advantage of one point calibration, ease of data processing and elimination of sample blanks.

Densitometry↗
PubMed1979

Implementing a consultation-liaison service in a psychiatrically underserved area.

Most multidisciplinary consultation-liaison services are developed in settings where there are both psychiatric residents and an adequate psychiatric liaison faculty. In this paper, the authors report some of the obstacles and attempts at overcoming them in the implementation of such services in an underserved area in which there is a scarcity of both residents in training and psychiatric liaison faculty. The process of collaboration between a primary-care-oriented medical school and a community general hospital is described, and roles of program participants are defined. Special attention is paid to funding problems.

Curriculum↗