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Biomedical subjects

W Fenton

Publications and source records attributed to W Fenton.

7 recordsLinked to original sources
PubMed1996

Residential alternatives to hospitalization for patients with severe and persistent mental illness: should patients with comorbid substance abuse be excluded?

Residential alternatives to hospitalization for adults with severe mental illness in crisis were not designed for, and often exclude, persons with coexisting substance abuse disorders. Given high comorbidity rates, however, it is important to know whether residential alternatives can be effective for patients with dual diagnoses. To explore the impact of comorbidity on treatment outcomes, structured interviews were conducted at admission and discharge with 92 consecutive admissions to a residential alternative. Using the Structured Clinical Interview for DSM-III-R, two groups were identified: 24 patients with and 68 patients without comorbid substance abuse disorders. At admission, the two groups were similar in demographic and clinical characteristics. The treatment was effective independent of comorbidity; at discharge, treatment success, symptom improvement, and patient satisfaction were similar for both groups. Persons with coexisting substance abuse disorders remained in residence a week longer, but the difference was not statistically significant. Residential alternatives appear suitable for patients with dual diagnoses.

Adult↗
PubMed1993

Investigation of the subcellular distribution of the bcl-2 oncoprotein: residence in the nuclear envelope, endoplasmic reticulum, and outer mitochondrial membranes.

A multidisciplinary approach was taken to investigate the intracellular locations of the 26-kDa integral membrane protein encoded by the bcl-2 gene. Subcellular fractionation analysis of a t(14;18)-containing lymphoma cell line revealed the presence of Bcl-2 protein in nuclear, heavy-membrane, and light-membrane fractions but not in cytosol. Sedimentation of heavy-membrane fractions in Nycodenz and Percoll continuous gradients demonstrated comigration of p26-Bcl-2 with mitochondrial but not other organelle-associated proteins. Fractionation of light-membrane fractions using discontinuous sucrose-gradients revealed association of Bcl-2 protein primarily with lighter-density microsomes (smooth endoplasmic reticulum) as opposed to heavy-density microsomes (rough endoplasmic reticulum). Immune microscopy studies using laser-scanning microscopy, pre- and postembedding electron microscopic methods, and six different anti-Bcl-2 antibodies demonstrated Bcl-2 immunoreactivity in the nuclear envelope and outer mitochondrial membrane in a patchy distribution. Furthermore, anti-Bcl-2 antibody immunoreactivity generally appeared to directly overlie the nuclear envelope in high magnification electron microscopic studies, reminiscent of nuclear pore complexes. Addition of in vitro translated p26-Bcl-2 to isolated translocation-competent mitochondria revealed transmembrane domain-dependent association of Bcl-2 protein with mitochondria but provided no evidence for import into a protease-resistant compartment, consistent with immunomicroscopic localization to the outer mitochondrial membrane. Taken together, the findings demonstrate that p26-Bcl-2 resides primarily in the nuclear envelope, endoplasmic reticulum, and outer mitochondrial membrane in a nonuniform distribution suggestive of participation in protein complexes perhaps involved in some aspect of transport.

Cell Fractionation↗
PubMed1993

Beginning careers in academic psychiatry for women--"Bermuda Triangle"?

OBJECTIVE: The proportion of women in leadership positions in academic psychiatry has not kept pace with the increase in the number of women entering the field. This study examines differences in career activities between women and men who graduated from the Yale University psychiatric residency training program and explores whether these differences can be explained by preresidency expectations, residency experiences, or training immediately after residency. METHOD: Departmental educational records of the Yale residency program were reviewed to determine professional interests expressed before psychiatric residency and training focus during residency for 355 residents in the 1970-1983 graduating classes. A 1984 follow-up study focused on their postresidency career activities. Differences in preresidency interests and experiences, training activities, and career paths between all female and male graduates and between women and men who chose academic careers were examined. RESULTS: After residency, the female graduates' marital status differed from men's--more had never married or were divorced. Women's professional activities diverged from men's; their practice pattern was different, they spent more hours teaching, and they had fewer publications in peer-reviewed journals. This divergence was not accounted for by differences in pretraining interests or in training focus during residency. The authors present possible explanations. CONCLUSIONS: Further research is indicated to determine the underlying causes of career differences between women and men in psychiatric practice and academia so that effective strategies for correcting the present inequality of women in senior faculty positions can be implemented.

Adult↗
PubMed1992

A national study of psychiatrists' professional activities.

OBJECTIVE AND METHOD: A mail survey was conducted in 1988-1989 to study the professional activities of U.S. psychiatrists. Data from the 19,431 active respondents are reported. RESULTS: Nineteen percent of the psychiatrists were women, an increase from the 17% reported in 1982. The median age of the respondents was 50 years. Nearly one-third of the respondents expressed interest in each of the following areas of subspecialization: adolescent psychiatry, substance abuse, geriatrics, and consultation-liaison psychiatry. More than one-fifth reported formal fellowship training in child/adolescent psychiatry. The psychiatrists worked an average of 48 hours per week--two-thirds in direct patient care--in an average of 2.3 different settings. The proportion of psychiatrists reporting private practice as their primary work setting showed a marked decline from 53% in 1982 to 45% in 1988. There was an increase from 4% in 1982 to 11% in 1988 in those whose primary work setting was a private psychiatric hospital. The typical caseload was over 60 patients, with roughly half that number seen each week. For inpatients treated, the two most common diagnoses were affective disorders and schizophrenic disorders. In a typical week psychiatrists treated about one-half of their outpatients with individual psychotherapy; three-fifths of these were also treated with medications. The average net income for psychiatrists working 35 hours or more per week was $99,850 for men and $73,174 for women. CONCLUSIONS: Major trends evident from this study are subspecialization, medicalization, privatization, feminization, and organizational diversification.

Adult↗
PubMed1986

Typhus-induced facial necrosis.

A patient with open wounds on his hands developed a severe case of typhus following exposure to a wild rabbit. Typhus resulted in extensive necrosis of the mid-face, including the nasal alae, pinna, and lips. The patient also sustained extensive extremity necrosis. A brief review of the epidemiology, pathophysiology, and treatment of this cause of facial necrosis is presented, as well as a discussion of dopamine gangrene. While this uncommon entity probably played a large part in the necrosis of this patient's extremities, these peripheral lesions are also compatible with typhus.

Adult↗