PubMed Health⌕ Search

Biomedical subjects

J Carson

Publications and source records attributed to J Carson.

At least 73 records · Page 4Linked to original sources
PubMed1989

In gear for growth.

Explore the source record for details and available documents.

Awards and Prizes↗
PubMed1989

Which patients first: a study from the closure of a large psychiatric hospital.

The decision to close down large psychiatric hospitals has led to many districts determining current patient dependency levels by conducting surveys of their hospital inpatient populations. This paper reports on the Claybury Hospital survey, which used Baker and Hall's REHAB scale to measure the level of patient functioning. The 641 patients assessed comprised the total long-stay and elderly, mentally-ill population of the hospital, excluding only patients on admission wards. Of these, 403 (63%) patients were in the 'severe handicap' category. In contrast, only 97 (15%) had 'potential for discharge'. A comparison of Claybury scores with those from other hospitals suggests that Claybury patients function at a lower level. Evidence is presented of 'creaming off' with respect to how one particular district has chosen patients, and this leaves behind an increasingly disabled hard core of patients. These findings are discussed and compared with other similar studies, and with respect to the Government's care in the Community policy.

Activities of Daily Living↗
PubMed1988

Neglect contributing to tertiary hospitalization in childhood asthma.

Clinical experience demonstrates that many chronically ill children have an unstable course of illness ending in tertiary care, not because of extraordinary disease, but because they come from dysfunctional and neglectful households. Families frequently cannot or will not adapt to the demands of their chronically ill child. This study substantiates the extent to which neglect and family dysfunction have contributed to the need for hospitalization of asthmatic children at National Jewish. Neglect accelerates the cycle of morbidity and stress associated with illness. Using a measure of global functioning, we demonstrate a psychologic morbidity associated with medical neglect. We discuss children at imminent risk in their home environment and the process of seeking alternative placements. We acknowledge gaps in delivery of health care to this difficult, treatment-resistant population and encourage development of day treatment and home outreach programs.

Asthma↗
PubMed1988

The inter-rater reliability of Hall and Baker's REHAB scale: a cross-validation study.

The impending closure of many large psychiatric hospitals has led to the involvement of clinical psychologists in surveys of whole hospital populations. REHAB is a recent addition to the range of behaviour-rating scales. In a test of the inter-rater reliability of this scale, we have assessed the ratings from an initial sample of 50 patients. We obtained higher correlation co-efficients than expected given the larger number of raters used in our study. Some implications for the general use of rating scales in reprovision are discussed.

Adult↗
PubMed1988

Bronchial asthma in servicemen--a personal view.

This paper is a review of 59 serving male officers and soldiers with bronchial asthma who attended the Chest Clinic at the Cambridge Military Hospital during a defined period of time and who had been under the care of the author for periods of up to six years. The patterns of presentation, management, progress and outcome are described. Exercise induced asthma is seen as the biggest problem for servicemen often with otherwise mild asthma, and there is evidence that potential recruits are still not being adequately assessed. In younger men, exercise associated disability is an early symptom, but older individuals tend to divide into one group with early exercise related problems and another who remain able to exercise at least for a time. Response to prophylactic therapy is good, but it is often difficult to eliminate exercise induced wheeze in military training and relapse is common when prophylaxis is withdrawn. The effect of this on medical category is described and some of the implications are discussed.

Adolescent↗
PubMed1988

Effect of tolmetin glycine amide (McN-4366), a prodrug of tolmetin sodium, on adjuvant arthritis in the rat.

The glycine amide of tolmetin sodium (TGA) functions as a prodrug and was demonstrated to be more potent than the parent compound as an inhibitor of developing and established adjuvant arthritis in the female Lewis rat. In contrast, the glycine amide of indomethacin was less potent than indomethacin. The superiority of TGA relative to tolmetin sodium in alleviating this condition was demonstrated by inhibition of paw swelling and reduction of the degenerative bone changes that are associated with the progression of this chronic animal model of rheumatoid arthritis in humans. These properties were not evident when equimolar mixtures of tolmetin sodium and glycine were administered concurrently. Pharmacokinetic analyses revealed that TGA was absorbed completely and hydrolyzed to tolmetin in the female adjuvant arthritic rat. The combined effects of absorption, distribution and hydrolysis of TGA produced lower peak plasma tolmetin levels than an equivalent dose of tolmetin sodium, but plasma concentrations were sustained for a longer period of time contributing to an apparent increase in potency. Furthermore, TGA displayed a decreased propensity to cause gastrointestinal irritation compared to tolmetin sodium. Several additional amino acid amides of tolmetin were similar to the glycine amide in exhibiting increased potency and reduced gastrointestinal toxicity in comparison to equivalent doses of tolmetin sodium.

Animals↗
PubMed1986

Cholinergic function and memory: extensive inhibition of choline acetyltransferase fails to impair radial maze performance in rats.

The present study investigated the effects of a potent inhibitor of choline acetyltransferase (ChAT), BW813U, on the choice accuracy of rats in the radial arm maze. BW813U (100 mg/kg, IP) produced a rapid (within 1 hour) and substantial decrease in ChAT activity throughout the brain, ranging from 66% (hippocampus) to 80% (caudate nucleus) that lasted up to 5 days. A single injection (50 mg/kg, IP) into rats with lesions (using ibotenic acid) in the nucleus basalis magnocellularis and medial septal area, decreased ChAT activity by 75% and 60% in the cortex and hippocampus, respectively. Lesioned and unlesioned rats were trained on the radial arm maze until they reached a criterion level of performance. Each rat then received an injection of BW813U (50 or 100 mg/kg, IP). Choice accuracy was not impaired at any time following the injection. The lack of effect on performance may be due to 2 possible factors: The radial maze retention paradigm chosen may not be sufficiently difficult, or the decrease in acetylcholine production was not sufficient to affect behavior. Compensation by non-cholinergic neural systems might account for the insensitivity of the rats to significant cholinergic depletion.

Animals↗
PubMed1985

Exercised induced asthma in young male asthmatics with symptoms, and in remission.

A treadmill exercise test was carried out on 154 male subjects aged 15-25 years who gave a history of mild asthma in childhood, and on 31 similarly aged control subjects. The results were expressed as an exercise lability index, (ELI), based on measurement of FEV. The mean ELI of the control group was 7.6%, range 2.9-12.2% and a positive result in the asthma subjects was an ELI greater than 15%. Seventy five of the asthma subjects were found to have been asymptomatic for a year or more (group 1) and, in 15 of them (20%) the test was positive. The remaining 79 were currently symptomatic, or had been symptomatic within a year (group 2), and in 52 of these (66%), the test was positive. The difference between the two results was significant, p greater than or equal to 0.001. We believe this observation suggests that exercise induced asthma (EIA) cannot be demonstrated in the majority of asthmatics who are in remission.

Adolescent↗
PubMed1985

Selection bias in clinical trials.

Of 90 patients with intermediate or high-grade sarcoma eligible for a randomized trial of adjuvant doxorubicin (Adriamycin, Adria Laboratories, Columbus, Ohio), 48 were not entered: 24 (27%) by physician's choice and 24 refused randomization. Sixty-five percent of lower stage patients were randomized compared with 37% of those with higher stage (P = .02). Patients with extremity lesions were more frequently offered participation in the study (P = .07). Patients with lower stage lesions accepted randomization more readily than those with higher stage lesions (P = .01). As predicted by the higher stage and percentage of central lesions, the disease-free survival of nonrandomized patients was inferior to that of randomized patients (P = .15). Thus, patients at high risk appeared to avoid randomization and adjuvant doxorubicin in this trial, resulting in an inferior disease-free survival for the nonrandomized control group. Important questions generally require randomized trials that reliably determine relative treatment differences. If, however, the patients in a clinical trial are not representative of the entire patient population because of patient and physician selection biases, the generalizability of the results to the entire patient population may be compromised. For example, the prognosis of the general population cannot necessarily be inferred from the selected group in the study. In this study, the randomized and nonrandomized series yielded differing conclusions regarding treatment efficacy, even when an adjustment was made for known prognostic facts.

Clinical Trials as Topic↗
PubMed1985

Quantitative measurement of myocardial blood flow with oxygen-15 water and positron computed tomography: an assessment of potential and problems.

An in vivo measurement technique using 15O water and positron CT for quantitation of myocardial blood flow (MBF) was investigated. A closed-chest dog model and NeuroECAT scanner were used in the study. The in vivo technique involves i.v. infusion of 15O water for a duration of 2-3 min. Oxygen-15 water radioactivity in myocardium was imaged with a NeuroECAT scanner for 10 min, starting at the time of tracer infusion. A separate scan following inhalation of 15O CO was obtained to label the blood pool and to help remove the contribution of radioactivity in the blood pool during the 15O water scans. The integrated projection technique was used for calculating MBF. The quantitative microsphere technique for measurement of MBF was performed along with the 15O water study to provide reference values, with which the MBF values by the in vivo technique was compared. Results of 12 experimental runs (in seven animals) show the in vivo technique with 15O water and positron CT can give quantitative flow images of myocardium. The in vivo positron CT measurement was found to correlate well (r = 0.93) with the in vitro values (by microspheres) over the flow range of 40 to 150 ml/min/100 g.

Animals↗