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Biomedical subjects

R C Carson

Publications and source records attributed to R C Carson.

10 recordsLinked to original sources
PubMed1991

Dilemmas in the pathway of the DSM-IV.

It is argued that the format for developing recent versions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) taxonomy is constrained in ways that seriously impair the quality of the product. These constraints include inappropriate assumption of a categorical model, ensured persistence of traditional categories of disorder, excessive concern with interdiagnostician agreement, insufficient attention to the issue of construct validity, and excessive preoccupation with clinician acceptance. These problems and certain others are illustrated with an analysis of the nosologic status of the schizophrenia construct. There is a significant danger that the adequacy of DSM-IV will be compromised by continuing difficulties of this sort.

Humans↗
PubMed1991

Pancreas transplantation. A new program.

Sixteen pancreatico-duodenal transplants were performed on 15 insulin-dependent diabetics, aged 25-46, during a 20-month period beginning May 1, 1988. Fourteen patients received a combined cadaveric pancreas/renal transplant with bladder drainage. One patient received a second pancreas transplant 24 hours after the first pancreas graft failed due to portal vein thrombosis. One patient received a pancreas graft 3 years after kidney transplantation. Complications included five cases of hematuria, two bladder leaks, two wound infections, one cytomegalovirus pneumonia, three cases of graft pancreatitis, one pseudocyst, one urine reflux pancreatitis requiring conversion to pancreatico-enterostomy, and two late deaths. Average time to discharge was 17 days following transplant, with 2.9 re-hospitalizations per patient and an average of 38 in-hospital days during the first 6-12 months. Seventeen rejection episodes occurred in 12 patients, diagnosed by declining urine amylase and pH and/or finding of rejection on kidney biopsy. Patient and kidney graft survival is 87 per cent. Pancreas graft survival is 81 per cent (1-20 months follow-up). All patients are insulin-independent and normoglycemic. Mean glycosylated hemoglobin concentration is 4.0 +/- 0.9 post-transplant vs. 7.5 +/- 0.6 pretransplant. Mean serum creatinine is 1.4 +/- 0.7 mg/dl. A new program of pancreas transplantation can be successful in carefully selected diabetic patients, with special attention to avoidance of preservation injury to the pancreas during multiorgan donor procurement. Combined pancreatic/renal transplantation is believed to be the therapeutic treatment of choice in Type I diabetic patients who have impaired renal function and have no significant cardiovascular disease.

Adult↗
PubMed1990

Assessment: what role the assessor?

The advent of automated assessment contains the seeds of both threat and promise for professional assessors. Placing the problem in the historical and sociological contexts, this article examines computer-based test interpretation (CBTI) and the frequently misunderstood role of actuarial data in relation to it. I argue that sound clinicianship is central not only to the development of adequate CBTI systems, but also to the systems' appropriate and skillful use in practice. When properly utilized by otherwise well-qualified clinicians, CBTI can substantially enhance practice.

Attitude of Health Personnel↗
PubMed1990

Pancreatitis necessitating urinary undiversion in a bladder-drained pancreas transplant.

After successful combined pancreaticoduodeno-renal transplant in an insulin-dependent diabetic, recurrent episodes of transplant pancreatitis were treated with Foley catheter drainage. The apparent cause of pancreatitis was increased pressure on the pancreatic duct due to infrequent voiding and a large bladder. A frequent voiding program partially relieved the pancreatitis, but final resolution necessitated conversion of the pancreaticoduodeno-cystostomy to a Roux-en-Y duodenojejunostomy at 6 months posttransplant. Both renal and pancreatic function are stable after 1 year, with no recurrence of pancreatitis since urinary undiversion. We believe pressure pancreatitis or urine reflux pancreatitis to be an infrequently reported cause of graft dysfunction in bladder-drained pancreas transplant recipients.

Acute Disease↗
PubMed1989

Personality.

Explore the source record for details and available documents.

Cognition↗
PubMed1989

Seizure-induced delay of puberty in female rats: effects of age, stress and opioid antagonists.

We have shown that pre- and post-pubertal female rats are sensitive to seizures. For example, daily convulsions commencing at 24 days of age delay puberty. Here we examine the effect of seizures at various ages. In addition, because opioid peptides are implicated in regulating the onset of puberty and are activated by convulsions, we also investigate the effect of opioid antagonists in the seizure-induced delay of puberty. A single daily electroconvulsive shock (ECS) was given for 10 days to neonatal (days 2-11), infantile (days 15-24) and juvenile (days 22-31) rats. The treatment delayed vaginal opening (VO) in juvenile rats. Neonatal and infantile rats were unaffected. VO was also delayed by daily ECS for only 5 days in the late juvenile (days 27-31) period. The opioid receptor antagonists naloxone, naltrexone and nalmefene injected before and after single daily ECS were unable to block this effect of ECS on VO. To examine whether the effect of ECS is related to stress, we examined several stressors known to induce opioid-mediated alterations in gonadotrophin secretion. Footshock, immobilization and ether stress administered in the juvenile period (days 27-31) did not affect the timing of VO. In addition, rats anaesthetized with halothane, and then given ECS, still showed a delay of VO. These data demonstrate that rats in the late juvenile stage of development are most sensitive to convulsions. We also suggest that opioids are not critical to the mechanism by which the ECS disturbs puberty, and that ECS elicits its effect seemingly independently of the convulsive stress.

Aging↗