PubMed Health⌕ Search

Biomedical subjects

C Worthington

Publications and source records attributed to C Worthington.

18 recordsLinked to original sources
PubMed1992

An examination of factors influencing the diagnosis and treatment of black patients in the mental health system.

The Civil Rights Movement, which began in the 1950s and lasted through the mid 1970s played a major role improving the quality of life for black Americans. Although much has changed since the 1950s the roots of racism are deep and change occurs slowly. Race exerts an overwhelming influence on popular ideology and medical thinking. Many researchers have speculated that a strong association exists between race and diagnosis. Understanding the sociocultural background of the patient would aid in the distinguishing culturally bound behavior from behavior that reflects actual psychopathology. This review examines the professional literature on racial and ethnic factors as they pertain to the diagnosis and treatment of black patients in the mental health system.

Adolescent↗
PubMed1991

Dynamic stereotactic radiosurgery using a linear accelerator.

We describe a system for stereotactic radiosurgery with a linear accelerator. This technique allows treatment of small (less than 40 mm diameter) intracranial lesions, including vascular malformations, and primary and metastatic tumors that are deep within the brain or in areas not amenable to open surgery. A beam of ionizing radiation (1800 to 2500 cGy) is focused on the center of the lesion, which is determined by stereotactic localization. "Dynamic rotation" of the linac gantry and table continuously about this predetermined point ensures that only the lesion receives the full radiation dose, while the normal structures in the head receive minimal amounts of radiation. The system combines, for the first time in one place, elements of radiosurgical technique developed at various centers. Testing for accuracy compares favorably with results at other centers using linac-based systems as well as comparing favorably with the gamma knife.

Brain Neoplasms↗
PubMed1989

Economic evaluations in the Canadian Mental Health System. I: Theory behind economic evaluation.

Economic evaluation is becoming an increasingly important part of the evaluation of health and mental health services. Current models for conducting economic evaluation, including cost-effectiveness analysis, cost-benefit analysis, and cost-utility analysis, have great potential for improving the quality of decision-making and for making mental health programs more effective and efficient. This paper presents the basic economic theory underlying the various forms of economic evaluation and provides general guidelines for developing and conducting an economic analysis of a health program.

Canada↗
PubMed1989

Economic evaluations in the Canadian Mental Health System. II: From theory to practice in mental health care.

This paper follows from a previous paper which described the basic approaches to economic evaluation of health programs. The discussion in this paper builds and discusses the theoretical and practical concerns felt by practitioners and analysts about economic evaluations in mental health care. Two examples of economic evaluations that compare the costs of hospital care and community-based care are presented to illustrate some of the limitations of economic evaluation. Discussion also focuses on the difficulties involved in developing and conducting economic analyses in the mental health field, as well as problems faced in trying to generalize from one study setting to others.

Canada↗
PubMed1987

Stereotaxic biopsy and positron emission tomography correlation of cerebral gliomas.

Computer-directed stereotaxis was used to obtain tissue diagnosis in two cases of cerebral glioma, one low grade, and the other high grade. Both lesions had a similar computed tomographic appearance. Positron emission tomography was performed in each case using [18F]fluorodeoxyglucose. A correlation was made in each case between the metabolic activity of the tumor as measured by positron emission tomography, the radiographic appearance, and the tumor histology.

Adult↗
PubMed1986

Superselective intracerebral chemotherapy of malignant tumours with BCNU. Neuroradiological considerations.

Early experience shows that: Superselective intra-arterial catheterization above the ophthalmic artery minimizes the orbital complications. Catheterization in a distal branch may lead to the non-infusion of a part of the tumor territory. A much higher concentration of the drug is achieved by superselective intra-arterial infusion than by intravenous injection. Longer infusions seem more efficacious than bolus injection. Early trapping of the drug appears to be essential for therapeutic efficacy.

Blood-Brain Barrier↗
PubMed1986

Pharmacokinetics of superselective intra-arterial and intravenous [11C]BCNU evaluated by PET.

The pharmacokinetics of i.v. and superselective intra-arterial carbon-11 1,3-bis-(2-chloroethyl)-1-nitrosourea ([11C]BCNU) were directly compared for the first time in ten patients with recurrent gliomas using positron emission tomography (PET). Intra-arterial administration of [11C]BCNU achieved concentrations of the drug in the tumor that averaged 50 times higher than with a comparable i.v. dose. These preliminary results suggest that the degree of early metabolic trapping of BCNU in tumor correlates with the clinical response to this chemotherapy.

Adult↗
PubMed1985

Meningioma cysts.

We studied six cases of intracranial meningioma with cyst formation. Manifestations included focal neurologic signs (four cases), seizures (three cases), headache (three cases), and personality changes (two cases). CT revealed a cystic enhancing supratentorial lesion in five cases. Angiographic changes of meningioma were observed in only three cases, and correct preoperative diagnosis was made in only half the cases so studied. Histologically, all lesions were syncytial meningiomas. Cyst fluid was always xanthochromic, acellular, and highly proteinaceous. The variety of anatomic configurations suggests several pathophysiologic mechanisms in formation of the cysts that are commonly misdiagnosed preoperatively. Tissue analysis is needed for all cystic, enhancing lesions of the brain.

Adult↗
PubMed1985

Tension pneumocephalus after evacuation of chronic subdural hematoma and subsequent treatment with continuous lumbar subarachnoid infusion and craniostomy drainage.

We present a case of tension pneumocephalus after burr hole evacuation of bilateral chronic subdural hematomas. Subsequent treatment was effected with combined twist drill closed system drainage and continuous intrathecal infusion of a physiological solution. The clinical entity, tension pneumocephalus, and the use of continuous subarachnoid infusion and drainage as a method of cerebral reexpansion are discussed.

Aged↗
PubMed1977

The effects of methaqualone on the seizure susceptibility of mice.

Methaqualone produces dose- and time-dependent decreases in susceptibility to electrically, chemically, and sound-induced seizures. The antagonism of methaqualone to electroconvulsive shock can be dissociated from its effects on temperature regulation and plasma corticosterone. Studies with SKF525A, a drug known to block enzymes in the liver that metabolize drugs, suggest that methaqualone, rather than a metabolite produced in the liver, is responsible for its anticonvulsant effects. Tolerance to the anticonvulsant effects of methaqualone is also demonstrated.

Acoustic Stimulation↗
PubMedDate not supplied

Stereoscopic digital subtraction angiography in neuroradiologic assessment.

Digital subtraction angiography (DSA) with stereoscopic imaging was performed in 40 patients for evaluation of a variety of cerebrospinal disorders. It was facilitated by a C-arm mounted x-ray tube and imaging chain with 7 degrees angulation between image pairs. Stereoscopic digital imaging proved particularly useful in the preoperative assessment of aneurysms, arteriovenous malformations, and primary and metastatic tumors. The technique was also found to be useful as a real-time adjunct to therapeutic radiographic procedures, as an aid in stereotaxic procedures, and in follow-up of postsurgical patients. Although the intravenous route was occasionally used, especially in postoperative follow-up of aneurysms, the procedure was most often carried out via an intraarterial approach. Stereoscopy was useful in supplying depth information regarding the relations between lesions and surrounding normal and abnormal vasculature. This technique combines the demonstrated advantages of intraarterial DSA with the unique advantage of stereoscopic imaging to demonstrate three-dimensional detail, thus contributing significantly to diagnostic confidence. Disadvantages are discussed. Further refinements in the equipment are expected: generation of stereo images with one injection, thus increasing procedure efficiency and patient safety; a video stereoscopic viewing unit; and the ability to obtain precise measurements via computer of depth, position, distance between, and true size of objects.

Adolescent↗