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Biomedical subjects

R M Carney

Publications and source records attributed to R M Carney.

At least 55 records · Page 3Linked to original sources
PubMed1987

Prevalence of major depressive disorder in patients receiving beta-blocker therapy versus other medications.

Depression is believed to be a common side effect in patients receiving beta-blocker therapy. However, diagnoses of depression defined by current diagnostic criteria may not be more common in patients receiving beta-blockers than in patients with the same medical disorder receiving other medications. Seventy-seven patients undergoing elective cardiac catheterization for evaluation of chest pain received a semi-structured diagnostic psychiatric interview. Twenty-one percent of the patients receiving beta-blockers and 33 percent of the patients receiving medications other than beta-blockers met the current American Psychiatric Association criteria for major depressive disorder (DSM-III) (p = NS). The mean heart rate and state anxiety scores for patients taking beta-blockers were significantly lower than those measured in patients taking medications other than beta-blockers. No other medical or demographic differences were observed between the two groups. Despite the methodologic limitations of the study, there does not appear to be a difference in the point prevalence of depression between patients receiving beta-blockers and those receiving other medications.

Adrenergic beta-Antagonists↗
PubMed1987

Exercise training reduces depression and increases the performance of pleasant activities in hemodialysis patients.

This study compares the effects of a structured exercise training program to the therapeutic benefits of a 'support' group on the depressed mood and reduced performance of pleasant activities by hemodialysis patients. After 6 months of an aerobic exercise training program, the 10 exercisers showed a significant increase in maximal aerobic capacity (VO2max) and a significant decrease in dysphoric mood when compared to 7 patients attending the support group. Support group participants reported a significant decrease in pleasant activities while there was no change in the exercisers. Eighteen months after the exercise training program, the exercisers reported continued low levels of depressed mood, and were performing significantly more pleasant activities than they reported prior to the exercise program. The results of this study suggest an exercise training program may be useful in the psychosocial rehabilitation of some hemodialysis patients.

Activities of Daily Living↗
PubMed1986

Exercise training reduces coronary risk and effectively rehabilitates hemodialysis patients.

This study examines the effects of 12 months of endurance exercise training (cycling, walking and jogging) on lipid profiles, glucose metabolism, blood pressure, anemia and psychological function in 14 hemodialysis patients. Maximal aerobic capacity (VO2max) increased 18% in the exercisers (p less than 0.01), but did not change in 11 controls. This was associated with a reduction in depression, a decrease in dosages of antihypertensive medications, a significant increase in hematocrit and hemoglobin levels (red cell mass rose, plasma volume did not change), a decrease in plasma triglyceride by 23% (p less than 0.05) and an increase in high-density lipoprotein cholesterol (HDL-C) levels by 21% (p less than 0.01) (both HDL-C and triglyceride levels worsened in the sedentary controls), and an 18% increase in glucose disappearance rates (p less than 0.05) in spite of a 52% decrease in fasting insulin levels (p less than 0.01), suggesting that insulin sensitivity improved. These results demonstrate that some of the complications present in hemodialysis patients may be caused by their sedentary life-style, rather than endstage renal disease itself. This suggests that rehabilitation through exercise is possible for these patients. By reducing coronary risk factors in hemodialysis patients, exercise training may also decrease their heightened morbidity and mortality from atherosclerotic complications. These possibilities need to be examined in a longitudinal study.

Adult↗
PubMed1985

Behavior therapy and the anxiety disorders: some conceptual and methodological issues.

Some of the methodological and conceptual issues relevant to behavior therapy treatment outcome studies for anxiety disorders are presented. The practice among behavioral researchers of measuring anxiety from 3 response systems (verbal, physiological and motoric-behavioral) is discussed. It is emphasized that many of the popular methods used to assess the 3 response systems have unknown or poor reliability or validity. From the point of view of treatment variables, it is noted that many behavioral treatment procedures are not reported in sufficient detail to allow replication or comparisons to be made across studies. In addition, it is argued that in order to improve the existing treatment procedures, it will be necessary for each study to assess the subjects' adherence to the treatment regimen, as well as their proficiency with any skills required to carry out the treatment plan. Finally, the importance of 'placebo' control groups is discussed in the context of identifying the specific factors in behavioral treatments which are responsible for change in the targeted symptoms. It is concluded that behavior therapy holds promise as an effective treatment for the anxiety disorders.

Anxiety Disorders↗
PubMed1984

Weight gain after cessation of cigarette smoking. A possible role for adipose-tissue lipoprotein lipase.

Cigarette smokers weigh less than nonsmokers and gain weight when they stop smoking. Increased activity of lipoprotein lipase in adipose tissue in some smokers may represent a compensatory response to their reduced body weight. Consequently, we hypothesized that the enzyme's activity may be related to the rate at which smokers gain weight when they stop smoking. To test this hypothesis, we measured body weight and fasting lipoprotein lipase activity in adipose tissue in 15 cigarette smokers before they stopped smoking. The changes in body weight during the first two weeks of abstinence were correlated with the base-line lipase activity in these smokers (r = 0.82, P less than 0.0002). This relation remained significant in the 12 subjects who were still abstinent at three weeks (r = 0.63, P less than 0.03). These results suggest that lipoprotein lipase activity in adipose tissue has a counterregulatory role in the maintenance of body weight and adipose-tissue mass in smokers. The higher the level of lipase activity when the weight-reducing influences of cigarettes cease, the greater the rate at which weight is gained during the first three weeks of abstinence.

Adipose Tissue↗
PubMed1983

Clinical applications of relaxation training.

Progressive muscle relaxation is a rational therapeutic alternative in such common functional syndromes as tension headache, migraine, and insomnia. Evidence of its efficacy and guidelines in clinical application are offered.

Anxiety↗
PubMed1983

Psychological effects of exercise training in hemodialysis patients.

To assess the psychological effects of exercise training in hemodialysis patients 4 dialysis patients, matched by age, sex, and medical history with 4 controls, received psychological testing before and after a 6-month period of exercise training. The trained patients had a 28% improvement in graded exercise treadmill stress test duration and a 13% improvement in aerobic capacity. This was associated with a significant reduction in anxiety and depression (p less than 0.06), but no measurable change in these moods occurred in the control groups. These results suggest that exercise training may improve psychological functioning in dialysis patients.

Adult↗
PubMed1983

Therapeutic benefits of exercise training for hemodialysis patients.

Twenty-five hemodialysis patients were randomized into comparable exercising (E, N = 14) and sedentary control (N = 11) groups. After baseline testing, training was 3 to 5 times weekly for a mean of 12 +/- 4 (SD) months. Maximal aerobic capacity increased 21% (P less than 0.01), and the durations for the graded exercise stress test improved 19% (P less than 0.01) in E, but did not change in controls (8 +/- 4 months). Declining blood pressures in 8 hypertensive E led to reductions in antihypertensive medications; no changes occurred in 9 hypertensive controls. Exercise lowered plasma total triglyceride levels 33% (280 +/- 258 to 175 +/- 95 mg/dl; P less than 0.01), but no change occurred in total and low-density lipoprotein cholesterol concentrations. High-density lipoprotein cholesterol levels rose 16% in E (31 +/- 9 to 36 +/- 12 mg/dl; P less than 0.02), but did not change in controls. An increase in the affinity of insulin for receptors on mononuclear cells was associated with a 20% decrease in fasting plasma insulin levels (24 +/- 7 to 19 +/- 2 microU/ml, N = 8; P less than 0.05) and a 42% improvement in glucose disappearance rates (1.9 +/- 1.0 to 2.6 +/- 1.2% per min, N = 6) in E. There were no changes in the body weights or diets of the patients. A 27% increase in red blood cell mass (P less than 0.02) with no change in plasma volume resulted in a 27% increase in hematocrit (24 +/- 3% to 31 +/- 5%, P less than 0.01) and a 20% increase in hemoglobin (8 +/- 1 to 10 +/- 2 g/dl; P less than 0.01) in E.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1982

Effects of covert sensitization on facial EMG: a pilot study.

Two subjects currently undergoing covert sensitization treatment were asked to imagine alternately the covert scene and a pleasant imagery scene while EMGs from the corrugator and forearm extensor muscle sites were continuously monitored. Visual inspection of the data suggests that corrugator EMG can reliably discriminate the covert-sensitization scene from the pleasant imagery and from resting baseline conditions. Facial EMG may have potential for objectively studying imagery and its role in covert sensitization and other imagery-based treatments.

Adult↗
PubMed1981

Facial electromyography as a predictor of treatment outcome in depression.

Electromyograms (EMGs) from the corrugator, zygomatic and splenius capitis muscle sites and Beck depression inventory scores were obtained from 21 depressed in-patients shortly after admission and after two weeks in hospital. Contrary to the result of a previous study by other investigators, significant covariaton between depressive symptoms and corrugator EMG levels was not seen. However, consistent with a second finding of the previous study, initial corrugator EMG levels were shown to be significantly predictive of treatment outcome. Further, initial EMG from the zygomatic was also found to predict changes in depression. The explanation is unclear and further research is needed.

Adult↗
PubMed1980

The metabolic and psychological effects of exercise training in hemodialysis patients.

The effect of exercise training on metabolic abnormalities and psychological function was assessed in seven hemodialysis patients. Their initial work capacity was low and improved after 8 months of training. Exercise was associated with a reduction in the dose of antihypertensive medications in four patients and a decrease in phosphate binder therapy in three patients. There was also a rise in hematocrit levels (% delta = 34 +/- 20%, P less than 0.03) and the hemoglobin concentration (% delta = 37 +/- 23%, P less than 0.05) of five males. Plasma glucose levels fell (-5 +/- 2%, P less than 0.05, n = 5) and the glucose disappearance rate improved (20 +/- 7%, P less than 0.02), while hyperinsulinism decreased (-36 +/- 20%, P less than 0.02, n = 5) during training. There was no change in body weight or diet. Exercise lowered plasma triglyceride levels (-41 +/- 28%, P less than 0.02, n = 6) and raised the high-density lipoprotein cholesterol concentration (20 +/- 21%, P less than 0.05, n = 6). Psychological testing (n = 4) demonstrated that exercise training was associated with an improvement in depression, hostility, anxiety, social interaction, and outlook for the future. These results suggest that exercise can improve some of metabolic abnormalities and psychological dysfunction which exists in some dialysis patients.

Adult↗
PubMedDate not supplied

A comparison of EMG and SCL in normal and depressed subjects.

Skin conductance level (SCL) and electromyograms (EMGs) recorded from three muscle sites were compared for 15 female hospitalized psychiatric patients meeting diagnostic criteria for primary affective disorder and 15 age-and race-matched controls. The depressed subjects had significantly lower SCL and significantly higher resting EMG levels recorded from one muscle site. Electromyogram and SCL were not found to be significantly correlated with each other or with measures of anxiety or depression for the patients with primary affective disorder. Normal controls, however, showed significant correlations between a measure of depression and both EMG and SCL. These results are discussed with suggestions for future research.

Adult↗
PubMedDate not supplied

Severe depression is associated with markedly reduced heart rate variability in patients with stable coronary heart disease.

OBJECTIVE: The purpose of this study was to investigate the relationship between depression and heart rate variability in cardiac patients. METHODS: Heart rate variability was measured during 24-hour ambulatory electrocardiographic (ECG) monitoring in 40 medically stable out-patients with documented coronary heart disease meeting current diagnostic criteria for major depression, and 32 nondepressed, but otherwise comparable, patients. Patients discontinued beta-blockers and antidepressant medications at the time of study. Depressed patients were classified as mildly (n = 21) or moderately-to-severely depressed (n = 19) on the basis of Beck Depression Inventory scores. RESULTS: There were no significant differences among the groups in age, gender, blood pressure, history of myocardial infarction, diabetes, or smoking. Heart rates were higher and nearly all indices of heart rate variability were significantly reduced in the moderately-to-severely versus the nondepressed group. Heart rates were also higher and mean values for heart rate variability lower in the mildly depressed group compared with the nondepressed group, but these differences did not attain statistical significance. CONCLUSION: The association of moderate to severe depression with reduced heart rate variability in patients with stable coronary heart disease may reflect altered cardiac autonomic modulation and may explain their increased risk for mortality.

Aged↗
PubMedDate not supplied

The relationship between depression and aerobic capacity in hemodialysis patients.

Depression and a reduction in the performance of pleasant activities have been reported in patients with end-stage renal disease receiving hemodialysis therapy. The purpose of this study was to examine the relationship between depression and the patients' capacity to engage in physical activity. The patients' VO2max, or maximal oxygen consumption, was found to be positively associated with three standardized self-report measures of depression in a sample of 15 patients receiving hemodialysis. The clinical and theoretical implications of this finding are considered.

Adult↗
PubMedDate not supplied

Major depressive disorder predicts cardiac events in patients with coronary artery disease.

Fifty-two patients undergoing cardiac catheterization and subsequently found to have significant coronary artery disease (CAD) were given structured psychiatric interviews before catheterization. Nine of these patients met criteria for major depressive disorder. All 52 patients were contacted 12 months after catheterization, and the occurrence of myocardial infarction, angioplasty, coronary bypass surgery and death was determined. Results of the study show that major depressive disorder was the best predictor of these major cardiac events during the 12 months following catheterization. The predictive effect was independent of the severity of CAD, left ventricular ejection fraction, and the presence of smoking. Furthermore, with the exception of smoking, there were no statistically significant differences between those patients with major depressive disorder and the remaining patients on any variable studied. The possible mechanisms relating major depressive disorder to subsequent cardiac events are discussed. It is concluded that major depressive disorder is an important independent risk factor for the occurrence of major cardiac events in patients with CAD.

Angioplasty, Balloon↗