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Biomedical subjects

D M Garner

Publications and source records attributed to D M Garner.

At least 37 records · Page 2Linked to original sources
PubMed1989

Determination of unlabeled and 13C6-labeled moricizine in human plasma using thermospray liquid chromatography-mass spectrometry.

Moricizine hydrochloride is an orally effective antiarrhythmic agent currently marketed in the Soviet Union and undergoing clinical testing in the United States. To facilitate the simultaneous analysis of unlabeled and 13C6-labeled moricizine in human plasma, a specific and sensitive method employing liquid-liquid extraction followed by thermospray liquid chromatography-mass spectrometry (LC-MS) was developed. Plasma samples, after addition of [2H11]moricizine as an internal standard, were extracted into methylene chloride under alkaline conditions. Extracts were evaporated, reconstituted with mobile phase, and chromatographed on an ODS column. The LC mobile phase consisted of methanol-0.1 M ammonium acetate containing 0.2% triethylamine (65:35) and it was used at a flow-rate of 1.5 ml/min. Under these conditions, moricizine and [13C6]moricizine coeluted at 1.2 min, while [2H11]moricizine eluted slightly earlier. The MS system consisted of a Finnigan 4600 TSQ and a Vestec thermospray interface. Selected ions at m/z 428, 434, and 439 were scanned at 0.2 s per ion. Over a plasma concentration range of 10-800 ng/ml, intra-day precision (n = 3) ranged from 1.8 to 13.3% and intra-day accuracy ranged from 1.9 to 15.8%. This method was successfully used to assay human plasma samples from a pilot moricizine bioavailability study in which tablets and solution containing moricizine hydrochloride and [13C6]moricizine, respectively, were simultaneously administered.

Carbon Isotopes↗
PubMed1989

Predictors of postpartum adjustment.

Identification of women at risk for problems in postpartum adaptation could allow interventions that might prevent difficulties. Eighty-five women were followed from the second trimester of pregnancy to 12 months postpartum. One year postnatally, 27 women were found to have low global severity index scores on the Symptom Check List (SCL-90) (less than or equal to 0.16), while 17 women had high global severity index scores (greater than or equal to 0.46). The high scoring group were also significantly more dissatisfied with their marriages and their partners. The high scorers also had significantly higher global severity index scores and lower intimacy with spouse scores when measured at 12-16 weeks gestation. The SCL-90 and the Miller Social Intimacy Scale, when used in the second trimester of pregnancy, appear to predict the women who may have adjustment problems in the postpartum period.

Adaptation, Psychological↗
PubMed1988

Anxiety reduction after chorionic villus sampling and genetic amniocentesis.

This study compares anxiety levels in women undergoing prenatal testing by means of chorionic villus sampling versus genetic amniocentesis. Chorionic villus sampling can be performed earlier in a pregnancy (8 to 12 weeks' gestation) but has a higher risk of miscarriage. Randomized to undergo chorionic villus sampling or genetic amniocentesis as part of a trial examining the safety and accuracy of these procedures, the women were studied at four time periods: time 1, before prenatal testing (9 to 12 weeks' gestation); time 2, after the chorionic villus sampling results were received (13 weeks); time 3, before the genetic amniocentesis results were known (18 weeks), and time 4, after all results were known (22 weeks). Although they were still at risk for miscarriage, members of the chorionic villus sampling group showed a sharp drop in anxiety levels immediately after receiving their results. The genetic amniocentesis group remained anxious until the last test time. In summary, prenatal testing by means of chorionic villus sampling resulted in earlier and sustained anxiety reduction.

Adult↗
PubMed1988

Affective and anxiety disorders in the long-term follow-up of anorexia nervosa.

This study investigated the incidence and onset of affective and anxiety disorders in women who were diagnosed with anorexia nervosa five to fourteen years earlier. Based on the clinical outcome of anorexia nervosa, patients were classified as asymptomatic, improved or symptomatic. Affective and anxiety disorders were assessed by a structured psychiatric interview (Diagnostic Interview Schedule). Results indicated that affective and anxiety disorders developed frequently, regardless of outcome of anorexia nervosa. Major depression and anxiety disorders developed before the eating disorder in one-half and three-quarters of these cases respectively. The symptomatic group had a significantly higher incidence of anxiety disorders prior to the development of their eating disorder compared with the asymptomatic group.

Anorexia Nervosa↗
PubMed1987

Psychological adaptation to pregnancy in childless women more than 35 years of age.

Forty-five pregnant childless women with a mean age of 36.6 years (+/- 1.7) were compared with 42 nulliparous pregnant women with a mean age of 26.7 years (+/- 2.8). Initial interviews determined the basic demographic data, the reasons for delaying pregnancy, attitudes to pregnancy, and plans concerning careers. Psychological tests were given to measure anxiety, depression, anger, marital intimacy, sense of autonomy, and role expectations. These psychological tests were applied to all patients at 12 to 16 weeks' gestation and again at 28 to 32 weeks' gestation. The demographic information from the two groups was remarkably similar. Although their ages differed by 10 years, their career goals, their family incomes, reasons for delaying pregnancy, and reasons for now getting pregnant revealed minimal differences. The Maffer Feminine Identity Scale revealed that the younger women held more traditional attitudes toward a woman's roles than the older group. The Sociotrophy-Autonomy Scale indicated that the older women were more independent than the younger pregnant patients. The Symptom Checklist indicated that the older group were less troubled by pregnancy than the control group, and although their level of distress increased as the pregnancy progressed, they remained better adjusted as they entered the last trimester of their pregnancies.

Adult↗
PubMed1987

Psychotherapy outcome research with bulimia nervosa.

Recent psychotherapy studies for bulimia nervosa are reviewed and it is concluded that many interventions lead to statistically and clinically significant reductions in the frequency of bingeing and vomiting and other associated symptoms; however, the results are more variable if success is defined as abstinence from symptomatic behavior. Treatment and patient variables which seem to be associated with positive response to treatment are reviewed and serious methodological concerns are raised. Carefully controlled dismantling trials are recommended in order to isolate factors which are critical for symptom change.

Bulimia↗
PubMed1987

A prospective study of eating disturbances in the ballet.

A group of 35 ballet students was assessed and then retested between 2 and 4 years later to determine the persistence of eating symptoms and to identify factors which predict eating disorders. Of those interviewed at follow-up, 25.7% had anorexia nervosa and 14.2% had either bulimia nervosa or a 'partial syndrome'. 'Drive for thinness' and 'body dissatisfaction' scales of the Eating Disorder Inventory were the only measures which predicted development of eating disorders at follow-up. The finding that most cases of anorexia nervosa gained weight at follow-up was similar to an earlier report; however, the view that these disorders were benign adaptations to the ballet subculture was challenged by the observation that many continued to experience significant eating disorder symptoms at follow-up. Findings indicate that vulnerable adolescents may be identified early using economical self-report measures as the initial step in a two-stage screening process.

Adolescent↗
PubMed1987

Body image measurement in eating disorders.

The current paper reviews the methods used for assessing body image in anorexia nervosa and bulimia nervosa. A major concern in the assessment of body image in the area of eating disorders has been the apparent failure to recognize the complexity of the body image construct. The development of a range of standardized measures of body image has been an important advancement in recent years; however, it would be premature to assume that any of these methods assesses body image in its entirety. Rather, each provides an operational index of one aspect of this multidimensional construct. The relationship between different dimensions of body image and their respective operational measures remains a potentially valuable area for investigation. Few studies have employed multiple measurement techniques and it is recommended that future investigations incorporate convergent measures which tap perceptual, affective and cognitive elements of the broad body image construct. Factors such as reliability and validity of the different measures of body image must be considered in planning studies with eating disorder patients. Reliability is particularly important because it sets an upper limit on validity. Most studies may be criticized for not addressing the validity of measures employed. Concurrent, convergent, discriminant and predictive validity should be demonstrated for existing as well as new methods. The issue of construct validity which remains a more general concern in the area of body image applies to the investigation of eating disorders. There is the danger that 'body image disturbances' become reified based upon group differences on a particular operational measure. Therefore, conclusions must be cautious even when inferences are drawn from measures which appear to have 'face validity'. The literature on body image in eating disorders has expanded rapidly during the past several years. Generally, it has confirmed the clinical impression that these patients display serious distortions in the feelings, attitudes and perceptions related to their bodies. Hopefully, future research will clarify the mechanisms of action of these body image disturbances and provide insights which will lead to improved treatment.

Adolescent↗
PubMed1987

Cognitive style of patients with bulimic and diet-restricting anorexia nervosa.

Recent studies have reported that subjects with bulimic anorexia nervosa are more behaviorally impulsive than those with diet-restricting anorexia nervosa. This study found that bulimic anorexic patients made significantly more errors on the Matching Familiar Figures Test than restricting anorexic and comparison groups. This preliminary finding leads to the speculation that bulimic patients are more cognitively impulsive than restricting anorexic patients.

Adult↗
PubMed1987

Eating disorders: implications for the 1990's.

In the past decade much has been learned about the clinical features, diagnosis and understanding of people with anorexia nervosa and bulimia nervosa. In order to provide the next level of improvement in our care for these patients, our understanding of certain problems must be addressed by empirical research. Areas which require further study include the definition of high risk groups, the refinement of diagnoses, understanding factors which result in chronicity, determining the complications of chronicity and comparative evaluations of different treatments. These five areas are outlined in this article. Populations at risk for anorexia nervosa and bulimia nervosa may be those who must be thin and achieve according to career choice, those with a particular family and personal psychiatric history; obesity and chronic medical illnesses may be further risks. Improved diagnostic understanding has occurred by the differentiation of bulimic from restricting subtypes of anorexia nervosa. Further work must determine the relationship between the bulimic subtype of anorexia nervosa and bulimia in normal weight women and to further clarify the relationship between eating disorders and affective disorders. A number of factors may result in a chronic illness. These have been described on a variety of levels. The consequences of starvation in altering an individual's thinking, feeling and behaviour do play a role. It is not clear what factors at a neurochemical level contribute to this. Elevated endogenous opiates decreased noradrenergic function and decreased serotonin may be important. Information about the chronic complications is required for clinicians to understand the broad range of difficulties that may develop over time so that clinicians may use this information in planning treatment strategies.(ABSTRACT TRUNCATED AT 250 WORDS)

Anorexia Nervosa↗
PubMed1986

Integration and sequencing of treatment approaches for eating disorders.

General principles for the management of eating disorders are viewed with particular emphasis on correcting disturbed eating and weight within the current cultural context. A range of different therapeutic options are outlined with indications for the integration and sequencing of these as part of a multidimensional model of treatment.

Anorexia Nervosa↗
PubMed1985

Similarities among bulimic groups selected by different weights and weight histories.

Four groups of bulimic patients with different weights and weight histories were compared on measures of eating and psychological functioning. Results with the Eating Disorder Inventory and Eating Attitudes Test indicated that groups were similar in terms of attitudes toward food, eating and body dissatisfaction as well as other traits which have been identified as relevant to eating disorder patients. Results also indicated that the referral patterns of patients with different weight histories have changed over time; previously, most patients had anorexia nervosa either currently or historically but more recently many patients are presenting with symptoms of equal severity but with no history of anorexia nervosa. It is concluded that diagnostic categories for bulimia formed solely on the basis of weight variables may not be clinically useful.

Adult↗