Biomedical subjects
Publications and source records attributed to T McCarty.
Women therapists involved in the long-term treatment of severely disturbed patients can be faced with interruptions due to childbearing. In the following cases, use of an alternate therapist during pregnancy-related leaves of absence was helpful in bridging the therapeutic pause and allowed the patients to make significant gains.
Subjects who had adapted to experimental alveolar-palatal prostheses for 2 weeks were able to speak naturally with them after a lapse of a month. Physiologic data on jaw motions and tongue-palate contacts during speech showed a rapid return to compensatory articulatory patterns. A single subject who had previously adapted to an experimental prosthesis over a period of a week made the same type of compensatory jaw adjustments when speaking with the prosthesis again 1 year later.
In experimental allergic orchitis (EAO), a lesion characterized by mononuclear invasion of seminiferous tubules can be adoptively transferred within 1 to 4 days by testicular injection of peritoneal exudate cells (PEC) from syngeneic strain 13 guinea pigs (GP) immunized with homologous testicular antigens in complete Freund's adjuvant (CFA). This study examined the role of T lymphocytes, macrophages, and polymorphonuclear neutrophils (PMN) in the adoptive transfer. Guinea pig PEC contained 7% T lymphocytes, rare B lymphocytes, and over 90% of macrophages and PMN. After T lymphocytes were depleted by rabbit erythrocyte (E) rosette and Hypaque-Ficoll gradient centrifugation, cell preparations that contained 73% of original macrophages and 15% original T lymphocytes were obtained, and these cells did not transfer EAO (0 of 18 testes). In contrast, cell preparations enriched in T lymphocytes by nylon wool column or E rosette contained 1.5% of the original macrophages and 59% of the original T lymphocytes transferred EAO to 70% of the testes, starting at 1.5 x 10(6) T lymphocytes per testis. The number of T lymphocytes correlated with the incidence of adoptive transfer; the correlation existed regardless of the number of macrophages or PMN present. Finally, EAO was adoptively transferred to recipients that had total-body irradiation. The results indicate that (a) T lymphocytes are capable of transferring lesions of EAO, (b) in the transfer, the T lymphocytes did not function as helper T cells, since the transfer need not involve participation of host lymphoid cells, and (c) by inference, testis antigen-reactive T lymphocytes exist.
Consultation-liaison psychiatry arose in the mid-1960s from the matrix of psychoanalytically oriented psychosomatic medicine. The influence of psychoanalysis and psychoanalytically trained academic psychiatrists gradually waned. The liaison aspect of consultation-liaison psychiatry faded in the early 1980s, and most consultation-liaison services are now primarily high-quality consultation services that contribute much to university teaching hospitals. The consultation-liaison service at the University of New Mexico (UNM) and several others have eliminated the term "liaison." The consultation service at UNM sees relatively few patients with classic psychosomatic disorders. The majority of requests to UNM's consultation service relate to suicide attempts, delirium, complicated medical problems with psychiatric illness, substance abuse, burns, trauma, and competency evaluations.
The objective of this study was to investigate the views of consultation-liaison (C-L) psychiatrists on assisted-death practices. A 33-question anonymous survey was distributed at the Academy of Psychosomatic Medicine Annual Meeting in November 1995. The instrument explored perceptions of acceptability of assisted death in six hypothetical patient situations as performed by four possible agents. The response rate was 48% (184 conference attendees participated, i.e., completed and returned the surveys). With little variability, the respondents were unwilling to perform assisted death personally and also did not support assisted death as performed by nonphysicians. The respondents were somewhat more accepting of referral or other physicians' involvement in such practices. Assisted death was viewed differently than withdrawal of life support. Several variables were analyzed for their influences on the views expressed. The C-L psychiatrists in this study expressed opposition to assisted death practices. Their views varied somewhat depending on the patient vignette and the agent of death assistance. The authors conclude that C-L psychiatrists may wish to develop their present therapeutic and evaluative role in patient care to alleviate suffering, without hastening patient death.
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BACKGROUND: The AT&T was developed from a perspective which proposes that panic disorder with agoraphobia arises from interaction between a specific biological predisposition, expressed in spontaneous panic attacks, and a general anxiety-prone cognitive style. Many items of the original AT&T, a putative measure of the cognitive component, were complex and ambiguous; and normative data were not available. METHOD: In this research, the items were simplified and clarified. A community sample of northern New Mexico Hispanics and geographically matched non-Hispanic whites was identified from an earlier epidemiological study. The sample included 151 Anglos and 168 Hispanics; 98 respondents aged 18-34, 75 aged 35-49, 69 aged 50-64, and 77 aged 65 or more; and 111 men and 208 women. RESULTS: Factor analysis produced one major factor with high loadings from the 15 negatively worded items, that accounted for about 41% of the total variation in the 15 items. The mean major factor score for Anglos was 1.65 with a standard deviation of 0.48, and for Hispanics was 1.76+/-0.52. F = 4.17, df = 1/311, P < 0.05, and effect size d = 0.22. There were no significant age or gender effects. Item analysis of the major factor produced item/total correlations from 0.49 to 0.68 and a Cronbach's alpha of 0.91. In a separate clinical sample of 30 patients with panic disorder, the test-retest correlation of the major factor at baseline and after 8 weeks of treatment was 0.75. In the community sample, the correlations of the major factor with anxiety-related clusters of the SCL-90 were: Somatization, 0.36; Anxiety, 0.53: and Phobia, 0.44. CONCLUSIONS AND RECOMMENDATIONS: We recommend that the AT&T be reduced to the 15 items of its major factor, and we supply quantiles and moments based on the full community sample of 319 as a standard of comparison. Further research with the AT&T in clinical samples of patients with anxiety disorders is ongoing.