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C Carpenter

Publications and source records attributed to C Carpenter.

At least 37 records · Page 2Linked to original sources
PubMed1995

Bridging the professions: an integrated and interdisciplinary approach to teaching health care ethics.

In 1993, the authors introduced an interdisciplinary course in health care ethics at the University of British Columbia. They were motivated by two convictions: (1) an interdisciplinary approach to health care decision making is best; and (2) every significant health care decision has an ethical component. They wanted to encourage students from the various health care disciplines to participate in interdisciplinary decision making in their future practices by giving them an opportunity to study health care ethics together during their training. The authors give detailed descriptions of the objectives, format, curriculum, and evaluation of this innovative course in the hope that other educators who may want to develop similar courses can learn from their experience.

British Columbia↗
PubMed1995

Menthol vs nonmenthol cigarettes: effects on smoking behavior.

OBJECTIVES: The purpose of this study was to examine intraindividual differences in smoking behavior between smoking regular and mentholated cigarettes. METHODS: Healthy male smokers (n = 29) smoked either a regular or a mentholated cigarette in two separate sessions 1 week apart. Commercial brands with comparable tar, nicotine, and CO content were used. Smoking behavior was constrained by fixed 15-second interpuff intervals, but puff volume and number of puffs were unconstrained. RESULTS: When smoking the non-mentholated brand of cigarettes, participants smoked 22% more puffs and had 13% higher mean volumes per puff than they did when smoking the mentholated brand of cigarettes. The aggregate 39% excess exposure to cigarette smoke in the regular-cigarette condition was not accompanied by commensurate excesses in expired carbon monoxide or in physiological measures normally correlated with nicotine exposure. CONCLUSIONS: These findings parallel differences in physiological correlates of exposure to nicotine found in cross-sectional comparisons of African-American and White smokers and are consistent with the results of emerging laboratory investigations.

Adult↗
PubMed1994

Analysis of T-lymphocyte subpopulations in inflammatory bowel diseases by three-color flow cytometry.

In order to better define changes in the relative proportion of peripheral blood T-lymphocyte subpopulations in patients with inflammatory diseases of the bowel, we performed simultaneous three-color fluorescence-activated cytometric (FACS) analysis using fluorophore-conjugated monoclonal antibodies with specificity for CD4, CD8, Leu 8, and CD45RA on 22 normal control subjects, 28 patients with Crohn's disease (CD), 15 patients with ulcerative colitis (UC), and 11 patients with intestinal inflammation secondary to etiologies other than inflammatory bowel disease (NIBD). This staining combination allowed enumeration of distinct T-cell subpopulations as follows: virgin CD4+, recall antigen helper T cells, nonspecific B-cell helper T cell, virgin CD8+, cytotoxic effector and suppressor effector and recall antigen cytotoxic T cells based on a synthesis of published functional analyses. No differences in the proportion of CD4+ or CD8+ cells or in the CD4+/CD8+ ratios were evident when UC and NIBD patients were compared to normal subjects. A significant reduction in the proportion of CD4+ cells and an increase in CD8+ cells was observed, however, in the CD group. When two-color analysis was performed, several significant differences in the proportions of circulating lymphocytes were seen. Specifically, these included significant increases in the number of CD4+, Leu 8- (P < 0.01) cells in all disease groups and an increase in CD4+, CD45RA+ cells in the NIBD group. Conversely, significant decreases in the proportions of CD8+, Leu 8+ (P < 0.01) cells were evident in the Crohn's disease group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

The experience of spinal cord injury: the individual's perspective--implications for rehabilitation practice.

BACKGROUND AND PURPOSE: Research in rehabilitation has been focused primarily on provision of care issues and treatment intervention outcome measures. The input of the clients involved has not been solicited in a systematic way. As a physical therapist practicing in rehabilitation, the researcher became increasingly aware of a discrepancy between the perception of spinal cord injury and its consequences held by health professionals and those people who experience the injury over many years. It was recognition of this discrepancy that formed the background from which this study evolved. The purpose of this qualitative research study was to explore individual conceptions of the experience of spinal cord injury from the perspective of adult learning. SUBJECTS AND METHODS: Semistructured, in-depth interviews were conducted with 10 individuals who had sustained a traumatic spinal cord injury 3 to 5 years prior to the interview. Questions asked were nondirective and designed to trigger accounts of meaningful aspects of the subjects' disability experience since their injury. Data analysis entailed several thorough readings of the interview transcripts from which three categories of meaning developed and for which criteria were established. RESULTS: The categories of meaning--rediscovery of self, redefining disability, and establishing a new identity--represented commonalities of conceptions of the spinal cord injury and the resulting disability experience. The continuity of "self" was of primary importance to the ongoing experience of disability, and the learning involved was diverse and intensely personal. Strategies used by the subjects in achieving these categories are discussed. CONCLUSION AND DISCUSSION: Although the contribution of the rehabilitation instruction, and particularly that of individual health care professionals, was acknowledged by the subjects, the adequacy of the preparation of clinicians for their role as adult educators in the rehabilitation process is questioned. A theory of transformative learning is introduced as a possible explanatory model for the study findings, application of which may facilitate a more client-centered approach to rehabilitation practice.

Adult↗
PubMed1994

Case report: cardiotoxic calcemia.

The effects of hypercalcemia on the heart and the resulting alterations of the electrocardiogram are well established. However, there are only rare reports of arrhythmias caused by hypercalcemia in primary hyperparathyroidism. This article describes a case of severe hypercalcemia secondary to hyperparathyroidism causing tachy-brady syndrome.

Aged↗
PubMed1992

B-cell subsets defined by the Fc epsilon R.

The data summarized herein demonstrate the utility of the low-affinity Fc epsilon R in delineating murine B-cell subsets. In the peritoneal cavity, the Fc epsilon R appears to be a reliable marker in distinguishing between conventional (Fc epsilon R+) and Ly-1/sister (Fc epsilon R-) B cells. In the spleens of normal animals, flow cytometric and histologic studies established that a distinct population of Fc epsilon R- B cells is also present and comprises the marginal zones. Thus in the spleen, the Fc epsilon R may be the first murine marker to allow for selective purification and analysis of marginal zone B cells. Although it is unlikely that splenic Fc epsilon R- B cells are directly related to peritoneal Fc epsilon R- Ly-1/sister B cells, further studies will be required to address this question. Analysis of autoimmune mice revealed that the splenic Fc epsilon R- subset is greatly expanded in these animals and indicates that the Fc epsilon R may be a sensitive indicator of abnormalities within the B-cell compartment. Additional studies compared the functional capacity of Fc epsilon R+ and Fc epsilon R- B cells and tested the ability of these populations to isotype-switch and respond to polyclonal stimuli. The results showed that Fc epsilon R+ and Fc epsilon R- B cells from both the peritoneum and spleen can switch to produce IgG, and all but the peritoneal Fc epsilon R- B cells can switch to the IgE class. This latter result is certainly interesting and demonstrates an important functional difference between peritoneal and splenic Fc epsilon R- B cells. Finally, experiments with B-cell mitogens showed further differences between the Fc epsilon R+ and Fc epsilon R- subsets. Whereas Fc epsilon R- B cells appeared to be more sensitive to LPS stimulation, Fc epsilon R+ B cells were clearly more responsive to an anti-IgM signal. Taken together, the results show that the Fc epsilon R is likely to be useful in separating B cells with different phenotypic, histologic, and functional characteristics.

Aging↗
PubMed1992

Quality of life in persons with human immunodeficiency virus infection: measurement by the Medical Outcomes Study instrument.

OBJECTIVE: To assess the reliability and validity of the Medical Outcomes Study (MOS) Short Form Health Survey as an indicator for quality of life in patients infected with the human immunodeficiency virus (HIV). DESIGN: Patient interview survey. SETTING: The AIDS Health Services Program in seven sites: Newark and Jersey City, New Jersey; Nassau County, New York; Atlanta, Georgia; Dallas, Texas; Fort Lauderdale and Miami, Florida; New Orleans, Louisiana; and Seattle, Washington. PATIENTS: Patients (520) with HIV infection receiving health services at one of the above sites. MEASUREMENTS: All components of the MOS Short Form Health Survey were included in the interview. Minor modifications were made to adapt the survey to the particular circumstances of the study. Measured sociodemographic characteristics included age, sex, race, intravenous drug use, and education. Symptoms were assessed by closed-ended questions concerning memory, seizure, weakness or numbness, fever, chills, diaphoreses, dyspnea, diarrhea, and weight loss. Information on the frequency of symptoms was also collected. History of Pneumocystis carinii pneumonia and Kaposi sarcoma was noted. MAIN RESULTS: The sociodemographic characteristics resemble those of patients with the acquired immunodeficiency syndrome (AIDS) reported to the Centers for Disease Control (CDC): mean age, 36; men, 89%; nonwhite, 31%; intravenous drug use, 34%. Neurologic symptoms (memory trouble, seizures, weakness or numbness) occurred in 71% of patients; constitutional symptoms (fever, chills, night sweats, weight loss) in 69%; dyspnea in 50%; and diarrhea in 47%. Although older age, female sex, nonwhite race, and intravenous drug use were associated with lower MOS scores in several areas, the strongest single or adjusted indicator of lower MOS scores was the presence of symptoms. Finally, patients with HIV infection had significantly lower scores than did previously reported patients with other chronic medical conditions (P less than 0.001). CONCLUSIONS: The MOS survey is a reliable measure of quality of life for patients with HIV infection. These patients tend to have low scores, suggesting validity of the survey. The MOS survey is extremely sensitive to the effect of symptoms, which suggests that it might be useful as a quality-of-life indicator for AIDS clinical drug trials.

Adult↗
PubMed1992

Causes of death in persons with human immunodeficiency virus infection.

PURPOSE: Pneumocystis carinii pneumonia (PCP) was reported to be the predominant cause of human immunodeficiency virus (HIV)-related deaths prior to 1988, the year that effective prophylaxis against PCP entered routine use. Our study was performed to study the causes of HIV-related death since January 1988 in a region where patient tracking is virtually complete. PATIENTS AND METHODS: We surveyed physicians associated with the Brown University Acquired Immunodeficiency Syndrome (AIDS) Program who cared for greater than 95% of known HIV-positive patients in Rhode Island. These physicians identified all those HIV-infected persons who had died under their care between January 1988 and July 1990, and determined these patients' causes of death by chart review. For comparison, death certificates of identified persons were also reviewed at the Rhode Island Department of Vital Statistics. RESULTS: Among 126 deaths since January 1988, bacterial infections were the most common cause of death (30%), whereas PCP was responsible for only 16% of deaths. Persons not receiving any form of PCP prophylaxis were more likely to die from PCP than were those who received prophylaxis (26% versus 11% [p = 0.04]). Cause of death as recorded on actual death certificates was imprecise, although bacterial infections were again the most common cause indicated. Only one death occurred in a patient with a CD4 count greater than 200/mL, and this was not HIV-related. CONCLUSION: PCP has not been the leading cause of death in our region since January 1988. Bacterial infections contribute substantially to mortality, and this may influence future prophylactic regimens. HIV-related deaths in patients with CD4 counts greater than 200/mL are unusual.

AIDS-Related Opportunistic Infections↗
PubMed1992

The relationship between adrenal steroids and enrichment-induced brain growth.

The question of whether brain growth brought about by environmental enrichment is mediated by the adrenal cortex has not been answered. Accordingly, young male rats were either adrenalectomized (ADX) and infused with a constant maintenance dose of corticosterone (2 mg.kg-1.day-1) or sham-operated and implanted with a blank infusion device. Half of each surgical group was maintained in either impoverished (IC) or enriched conditions (EC). After 30 days, changes in forebrain growth and thickness of various cortical and subcortical regions were determined for each group. Enrichment and ADX independently increased forebrain weight and thickened cortical tissue at about the same anatomical sites. However, combined treatments were additive, not interactive. EC-induced brain growth is mimicked but not mediated by adrenalectomy.

Adrenal Glands↗
PubMed1990

A novel pathway for the formation of phosphatidylinositol 3,4-bisphosphate. Phosphorylation of phosphatidylinositol 3-monophosphate by phosphatidylinositol-3-monophosphate 4-kinase.

Three polyphosphoinositides containing phosphate at the D-3 position of the inositol ring can be generated in vitro by phosphorylation of phosphatidylinositol, phosphatidylinositol 4-phosphate, and phosphatidylinositol 4,5-bisphosphate by a phosphatidylinositol-3-kinase (Auger, K. R., Serunian L. A., Soltoff, S. P., Libby, P., and Cantley, L. C. (1989) Cell 57, 167-175. An alternative pathway for in vivo synthesis of one of these lipids was recently suggested: phosphatidylinositol 3,4-bisphosphate could be produced by phosphorylation of phosphatidylinositol 3-phosphate at the D-4 position of the inositol ring (Yamamoto, K., and Lapetina, E. G. (1990) Biochem. Biophys. Res. Commun. 168, 466-472). Here we demonstrate the presence of an enzyme in human platelets that phosphorylates [32P]phosphatidylinositol 3-phosphate to produce [32P]phosphatidylinositol 3,4-bisphosphate. This enzyme is Mg2(+)-dependent and its apparent molecular mass is approximately 150 kDa as estimated by sucrose gradient centrifugation and gel filtration chromatography. Unlike the major phosphatidylinositol-4-kinase in platelets that is stimulated by the detergent Nonidet P-40, the phosphatidylinositol-3-phosphate-4-kinase is inhibited by Nonidet P-40. Both activities are also differentiated by the action of adenosine. The discovery of this new enzyme raises the possibility that multiple pathways exists for generating D-3 phosphorylated phosphoinositides.

1-Phosphatidylinositol 4-Kinase↗
PubMed1990

No excess of DR*3/4 in Ashkenazi Jewish or Hispanic IDDM patients.

The gene frequencies, haplotype relative risks, and zygotic assortments of HLA-DR in three ethnically defined samples of insulin-dependent diabetes mellitus (IDDM) patients were determined in a prospective family study. Although DR3 and DR4 were positively associated with IDDM in the probands of 123 northern European, 94 Ashkenazi Jewish, and 49 New York Hispanic families, significant excess of DR*3/4 heterozygotes was observed only among the probands from families of northern European ancestry. There was also a significant decrease in the frequency of Bw62,DR4 haplotypes derived by northern European patients from their mothers compared with their fathers. This difference, together with data reported in the literature, suggests that the expressivity of the susceptible genotype(s) in IDDM patients may be modified by protective maternal effects associated with Bw62,DR4 and probably other DR4 haplotypes. Samples of IDDM patients from populations with high frequencies of these modifiers should have different DR-gene frequencies contributed by fathers and mothers, capable of accounting for the observed Hardy-Weinberg disequilibrium. We postulate that, because the mechanism of action of these modifiers is distinct from that of the susceptibility gene, the difference must be considered in devising strategies for elucidation of the mode of inheritance of the disease and for understanding the molecular nature of the susceptibility.

Diabetes Mellitus, Type 1↗
PubMed1989

Clinical observations in vibratory stimulation of the penis of men with spinal cord injury.

Less than 10% of men with complete spinal cord injury experience ejaculation in intercourse. Vibratory stimulation of the penis triggers a predictable series of body reactions in most men with lesions above the thoracic 11th spinal cord level. These reactions are very similar to the physical manifestations of the sexual response in men with intact nervous systems. Between half and three quarters of men with lesions above the thoracic 11th spinal cord level ejaculate. The spermatozoa count is within the normal range, but the percentage of motile spermatozoa is low. The reactions leading to ejaculation take between 30 sec and 3 min and are characterized by rhythmic abdominal and leg spasms, lowered, then elevated pulse rates, elevation of blood pressure, and after the culmination of these experiences, relaxation, tiredness, and a general feeling of well-being. Autonomic dysreflexia (elevation of the blood pressure and severe headache) was avoided with preventive medication. The observations suggest that interrelated ejaculatory centers may be located in the thoracic 11th-and-below areas of the spinal cord. The vibratory stimulation technique has positive implications for both the reproductive and sexual needs of men with spinal cord injury and their partners.

Adult↗
PubMed1989

Definition of IDDM-associated HLA DQ and DX RFLPs by segregation analysis of multiplex sibships.

Genetic variation of the DQ alpha and beta and of the DX alpha genes, detectable as RFLP in genomic DNA digests, has been suggested to improve the identification of individuals at high risk for insulin-dependent diabetes mellitus (IDDM). DNA from all members of 32 IDDM multiplex families was digested with six restriction endonucleases and the resulting fragments analyzed in Southern blots for hybridization with labeled cDNA probes for those genes. A computerized segregation analysis procedure was then used to assign fragments to haplotypes. Associations among fragments and between fragments and haplotypes characterized serologically and biochemically for their class II genes and IDDM-carrier status were calculated. The results indicate that the alleles of the DX alpha polymorphism maintain linkage disequilibrium with those of the DQ beta genes responsible for the well-known DQ beta 3.2-IDDM association, so that IDDM-carrier haplotypes carry disproportionally often both DQ beta 3.2 and DX alpha-TaqI-2.2kb. Thus, these RFLPs identify a DR-DQ-DX haplotype in high linkage disequilibrium, rather than the locus or loci that account for their high relative risk. However, four DR4-DQ beta 3.2 haplotypes that lack DX alpha-TaqI-2.2kb were encountered, two of which are "affected." These haplotypes suggest that the identification of the "disease locus" can be facilitated by the study of unusual haplotypes in which distinct IDDM-associated alleles occur separated from their neighbors of the standard genetic configurations.

Alleles↗