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Price J, Gardner R. The paradoxical power of the depressed patient: a problem for the ranking theory of depression. THE BRITISH JOURNAL OF MEDICAL PSYCHOLOGY 1995; 68 ( Pt 3):193-206; discussion 207-22. [PMID: 8527357 DOI: 10.1111/j.2044-8341.1995.tb01827.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The social ranking (or social competition) theory of depression suggests that the capacity for episodes of depressed mood evolved as a mechanism for inhibiting challenge. Depressed mood induces the sufferer to accommodate to low social rank, or to losing in social competition, or to adopting the one-down position in a complementary relationship (Price, 1991; Price, Sloman, Gardner, Gilbert & Rohde, 1994; Sloman, Price, Gilbert & Gardner, 1994). Thus depressed patients should be observed to forego the privileges of high rank and of winning, such as exercising social power and getting their own way. However, several commentators have noted that depressed patients often seem to be very powerful, and even appear to use their depression to manipulate others. This paper attempts to reconcile the theory to such observations.
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Sachs BP, Fretts RC, Gardner R, Hellerstein S, Wampler NS, Wise PH. The impact of extreme prematurity and congenital anomalies on the interpretation of international comparisons of infant mortality. Obstet Gynecol 1995; 85:941-6. [PMID: 7770264 DOI: 10.1016/0029-7844(95)00056-w] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To identify the potential impact that different definitions of live births and practice patterns have on infant mortality rates in England and Wales, France, Japan, and the United States. METHODS United States data were obtained from the 1986 linked national birth-infant death cohort, and those for the other countries came from either published sources or directly from the Ministries of Health. RESULTS In 1986 in the United States, infants weighing less than 1 kg accounted for 36% of deaths (32% white and 46% black); 32% resulted from fatal congenital anomalies. These rates were much higher in both categories than in England and Wales in 1990 (24 and 22%, respectively), France in 1990 (15 and 25%, respectively), and Japan in 1991 (9% for infants weighing less than 1 kg, percentage of fatal congenital anomalies unknown). These cases are more likely to be excluded from infant mortality statistics in their countries than in the United States. CONCLUSIONS In 1990, the United States infant mortality rate was 9.2 per 1000 live births, ranking the United States 19th internationally. However, infant mortality provides a poor comparative measure of reproductive outcome because there are enormous regional and international differences in clinical practices and in the way live births are classified. Future international and state comparisons of reproductive health should standardize the definition of a live birth and fatal congenital anomaly, and use weight-specific fetal-infant mortality ratios and perinatal statistics.
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Abstract
Using the frameworks of attachment and social hierarchy theories, strategies seen in depression and in normal life are better understood. A hierarchial encounter elicits the "Involuntary Subordinate Strategy" ("ISS") in the loser, which terminates the "ISS" and brings the encounter to an end. These are psychophysiological mechanisms deeply rooted in our phylogenetic ancestry. Loss of a love object also elicits ineffective anger or rage which may, in turn, trigger the ISS. A prolonged intense ISS manifests in depression. Factors are examined that prevent "acceptance" of losing, thereby contributing to an escalation of the ISS and culminating in depressive illness. Psychotherapeutic implications include cognitive restructuring to enable the patient to explore options that might turn off the ISS such as "acceptance" (without making negative self-evaluations), changing unrealistic ideals and aspirations, leaving the scene, or becoming more self-assertive. Case examples are given to illustrate these interventions.
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Abstract
Depressive personality and depressive illness are examined from an evolutionary adaptationist standpoint. It is postulated that the depressive state evolved in relation to social competition, as an unconscious, involuntary losing strategy, enabling the individual to accept defeat in ritual agonistic encounters and to accommodate to what would otherwise be unacceptably low social rank.
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Gardner R, Wilkerson J, Johnson JC. Molecular characterization of the DNA of Anatid herpesvirus 1. Intervirology 1993; 36:99-112. [PMID: 8294188 DOI: 10.1159/000150328] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
A plaque-purified isolate of the Holland strain of Anatid herpesvirus (AHV-ppc3) was purified by differential and buoyant density sedimentation. The virus buoyant density was 1.215 g/cm3 in sucrose. AHV-ppc3 DNA was analyzed by sedimentation velocity studies in neutral or alkaline sucrose gradients. Based upon a comparison with T4 DNA, the DNA of AHV-ppc3 was found to have a sedimentation coefficient of 59.7 S and a molecular mass of 1.19 x 10(8) daltons. Between 15 and 22 bands were observed in agarose gel electrophoresis with AHV DNA cut by BamHI, EcoRI, PstI or BglII. The possibility of isometric forms is indicated by the finding of restriction fragments having molar ratios differing from 1.0. The mean molecular mass calculated from the fragments was 1.18 x 10(8) daltons. Terminal fragments were identified using exonuclease II and BgII. In alkaline sucrose gradients, AHV DNA fragments with the largest of the most abundant species have a sedimentation coefficient of 69 S and a calculated mass of 6.0 x 10(7) daltons. The buoyant density of AHV-ppc3 DNA in cesium chloride was 1.723 g/cm3 corresponding to a % G + C content of 64.3. This finding was supported by thermal melts of the DNA in SSC/10 in which the thermal melting point was 82.7 degrees. The data support a model for AHV in which the viral duplex DNA is linear, without covalently closed termini or significant base modifications, but with single strand nicks or gaps. The % G + C content of AHV DNA is the highest reported for any avian herpesvirus in the alpha-herpesvirinea subgroup.
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Gardner R. Psychological care of neuro-oncology patients and their families. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 1992; 1:553-6. [PMID: 1472842 DOI: 10.12968/bjon.1992.1.11.553] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
This article examines the psychological needs of neuro-oncology patients and their families and presents two case histories which illustrate the way in which patients and their families can be brought to terms with their situations through skilled nursing intervention.
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Wassef AA, O'Boyle M, Gardner R, Rose RM, Brown A, Harris A, Nguyen H, Meyer WJ. Glucocorticoid receptor binding in three different cell types in major depressive disorder: lack of evidence of receptor binding defect. Prog Neuropsychopharmacol Biol Psychiatry 1992; 16:65-78. [PMID: 1557508 DOI: 10.1016/0278-5846(92)90009-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
1. In order to further understand the apparent glucocorticoid resistance in major depressive disorder, circadian variation in cortisol concentration, dexamethasone suppression and glucocorticoid receptor binding in mononuclear leukocytes, polymorphonuclear leukocytes and cultured skin fibroblasts were measured in rigidly defined major depressive disorder patients and non-depressed psychiatric controls. 2. Mononuclear leukocytes binding to glucocorticoid correlated significantly with polymorphonuclear leukocytes binding to glucocorticoid, but both determinations failed to differentiate major depressive disorder and control subjects. 3. Initial and post-dexamethasone in vitro fibroblast binding to glucocorticoid was not different between major depressive disorder and non-depressed control subjects. 4. The phenomenon of glucocorticoid resistance in major depressive disorder remains unexplained.
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Schottstaedt MF, O'Boyle M, Gardner R, Holzer CE. Long-term Evaluation of a Psychiatry Clerkship. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 1991; 15:137-145. [PMID: 24449112 DOI: 10.1007/bf03341937] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
For over 14 years, students completing a psychiatry clerkship were asked to rate their educational experience. Comparisons were made across clinical assignment, length of rotation (6 vs. 8 weeks), and teaching modes. Consultation and acute services were rated higher than open adult or child/adolescent services. General units were rated higher than specialty units. Ratings were higher for 8-week rotations, and case conferences were preferred to lecture formats. Ratings were not significantly correlated with National Board of Medical Examiners examination scores, which were higher during years with 8-week rotations and case conferences. There was a tendency for students on the consultation and acute services to enter psychiatry residencies at a higher rate.
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Gardner R. Screening of admissions to accident and emergency. Br J Psychiatry 1991; 159:296. [PMID: 1773262 DOI: 10.1192/bjp.159.2.296a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Morris B, Richardson K, Eddy P, Zhan XC, Haley A, Gardner R. Mutagenesis of the AC3 open reading frame of African cassava mosaic virus DNA A reduces DNA B replication and ameliorates disease symptoms. J Gen Virol 1991; 72 ( Pt 6):1205-13. [PMID: 2045787 DOI: 10.1099/0022-1317-72-6-1205] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Small insertions were made independently at each of four unique restriction sites on African cassava mosaic virus (ACMV) DNA A to disrupt the three overlapping complementary-sense open reading frames (ORFs) herein designated AC1, AC2 and AC3. The DNA A mutants were assayed for their infectivity by agroinoculation of monomeric constructs to Nicotiana benthamiana plants containing chromosomal insertions of ACMV DNA B. Disruption of the AC3 ORF alone resulted in a delay and amelioration of disease symptoms which correlated with reduced replication of DNA B. Normal replication of DNA A still carrying the AC3 ORF mutation was found in extracts from these plants. No ACMV DNA or symptoms were observed in corresponding inoculations with either the simultaneous disruption of the overlapping AC2 and AC3 ORFs or disruption of the AC1 ORF. Complementation by the inoculation of different mutant pairs produced a delay in disease symptoms followed by repair of mutated sites. A DNA A construct with the virus-sense AV1 (coat protein) ORF deleted was infectious producing typical ACMV disease symptoms. A similar construct with a larger deletion encompassing the complementary-sense AC3 ORF produced symptomless infections. The DNA recovered from plants revealed DNA A of normal size where the position of the deleted ORF was replaced with cloning vector DNA. Significantly reduced DNA B replication was observed for the AC3 deletion construct.
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Gardner R. Rekindling hope. NURSING TIMES 1991; 87:50-2. [PMID: 2020579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Hozack WJ, Cole PA, Gardner R, Corces A. Popliteal aneurysm after total knee arthroplasty. Case reports and review of the literature. J Arthroplasty 1990; 5:301-5. [PMID: 2290084 DOI: 10.1016/s0883-5403(08)80087-3] [Citation(s) in RCA: 53] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Vascular complications after total knee arthroplasty include arterial occlusion, arterial severance, arteriovenous fistula, and arterial aneurysm. Both a false aneurysm and a true aneurysm of the popliteal artery are described. The false popliteal aneurysm resulted from direct surgical trauma and required excision and repair. The true popliteal aneurysm was unsuccessfully treated with excision, transfemoral thrombectomy, and bypass surgery. Many of the vascular complications after total knee arthroplasty may be preventable and the following prudent guidelines are suggested. Careful preoperative evaluation is critical, including past medical history, palpation of pedal pulses, and review of radiographs to identify abnormal calcification in the vessels. Vascular consultation may be necessary. Should a vascular complication occur, immediate intervention with the advice and assistance of a vascular surgeon is imperative.
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Enis JE, Gardner R, Robledo MA, Latta L, Smith R. Comparison of patellar resurfacing versus nonresurfacing in bilateral total knee arthroplasty. Clin Orthop Relat Res 1990:38-42. [PMID: 2225640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Twenty-five patients who received bilateral total knee prostheses were studied to evaluate the advantages and disadvantages of patellar resurfacing. Only patients with advanced patellofemoral disease were included in the study. In all patients, patellar resurfacing had been done in the right knee but not in the left knee. The DePuy porous-coated implant was used in all cases. Subjective criteria were compared with objective criteria, which included range of motion, knee flexion and extension, and roentgenographic evaluation. The findings in this study suggest that patellar resurfacing can offer the patient a superior knee with regard to pain relief and strength.
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Gardner R. Personal View. West J Med 1990. [DOI: 10.1136/bmj.300.6722.476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Wassef A, Smith EM, Rose RM, Gardner R, Nguyen H, Meyer WJ. Mononuclear leukocyte glucocorticoid receptor binding characteristics and down-regulation in major depression. Psychoneuroendocrinology 1990; 15:59-68. [PMID: 2367616 DOI: 10.1016/0306-4530(90)90047-d] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Some patients with major depressive disorder (MDD) have elevated plasma cortisol concentrations and show failure to suppress cortisol secretion upon administration of dexamethasone (DEX), yet they do not have Cushingoid features. To study whether this represents glucocorticoid (GC) resistance, [3H]-DEX-binding assays were used to measure, in vitro, the GC receptor affinity (1/Kd) and number (Bmax) in mononuclear leukocytes of 11 MDD patients and 15 control subjects. No receptor abnormalities were detected in the MDD group; thus any cellular defect leading to a lack of responsiveness to GC in the MDD patients, if present, probably lies beyond the initial receptor binding. DEX (1.0 mg orally) was administered to study in vivo GC receptor down-regulation. Compared to the control group, fewer depressed subjects down-regulated Bmax after DEX. By paired t-test, Bmax decreased significantly in the control group but not in the depressed group. Receptor number on the control day did not correlate significantly with the degree of receptor down-regulation, severity of depression or cortisol concentrations across all the subjects. These results do not lend support to previous reports suggesting that GC resistance in MDD results from a GC receptor-binding abnormality, and they emphasize the importance of considering receptor studies in the context of GC-mediated cell processes in order to identify the exact cellular defect(s) leading to GC resistance.
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Gardner R. Management of self-inflicted stab injury. Br J Hosp Med (Lond) 1989; 42:510. [PMID: 2611479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Acien P, Shaw RW, Irvine L, Burford G, Gardner R. CA 125 levels in endometriosis patients before, during and after treatment with danazol or LHRH agonists. Eur J Obstet Gynecol Reprod Biol 1989; 32:241-6. [PMID: 2676640 DOI: 10.1016/0028-2243(89)90042-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The levels of CA 125 in the serum of 54 patients with endometriosis were measured before, during and after treatment with Danazol or LHRH analogues. Patients with minimal and mild endometriosis had mean pre-treatment values significantly higher than control subjects in the luteal phase of the cycle or postmenopausal women (p less than 0.05), but levels were within the overall control range. In contrast, 78.6% of patients with moderate or severe endometriosis had levels in excess of 30 mu/ml and the mean values for these groups were significantly elevated (p less than 0.005). Levels of CA 125 fell, to those found in normal controls, during treatment, but rose again following cessation of treatment. Six of 12 subjects whose follow-up values of CA 125 exceeded 30 U/ml had a proven recurrence of endometriosis, whilst only 2 of 31 patients with values less than 30 U/ml had laparoscopically proven recurrence.
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Gardner R. Orchiectomy care study. NURSING TIMES 1989; 85:38-9. [PMID: 2717453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Crook D, Gardner R, Worthington M, Nolan J, Stevenson JC, Shaw RW. Zoladex versus danazol in the treatment of pelvic endometriosis: effects on plasma lipid risk factors. HORMONE RESEARCH 1989; 32 Suppl 1:157-60. [PMID: 2533147 DOI: 10.1159/000181334] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Plasma lipid risk markers for coronary heart disease (CHD) are influenced by sex steroid concentrations. Therapies that alter sex hormone levels have the potential to affect CHD risk. Zoladex had no effect on plasma lipids, but increased high density lipoprotein (HDL) subfraction 3, a lipoprotein of uncertain clinical significance. Danazol increased low density lipoprotein and decreased HDL concentrations to give a lipid profile associated with increased risk of CHD.
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Stevenson JC, Lees B, Gardner R, Shaw RW. A comparison of the skeletal effects of goserelin and danazol in premenopausal women with endometriosis. HORMONE RESEARCH 1989; 32 Suppl 1:161-3; discussion 164. [PMID: 2533148 DOI: 10.1159/000181335] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The skeletal effects of two therapies for endometriosis that produce hypo-oestrogenism in 23 premenopausal women have been studied. Eleven women received goserelin 3.6 mg monthly by subcutaneous implant and 12 women received danazol 600 mg daily, orally, both for 6 months. Goserelin causes a small decline in spinal bone density, but a greater loss of density in the proximal femur. Preliminary results show no evidence that bone loss is reversible after stopping therapy. Danazol treatment is not associated with loss of bone. Prolonged or repeated courses of treatment with goserelin alone could lead to a clinically significant adverse effect on the skeleton.
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Kochamba G, Chiu RC, Gardner R. Muscle-powered cardiac assist: a new alternative on the horizon. J Cardiovasc Nurs 1988; 2:76-83. [PMID: 3351556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Abstract
The blood counts of 80 patients with depression were examined (50 unipolar, 30 bipolar). Many had reduced numbers of circulating lymphocytes. This abnormality was more common in the unipolar group (52%) than in the bipolar group (27%). When those patients with an abnormal dexamethasone suppression test response in both groups were compared, the relative and absolute lymphocyte counts were significantly lower in unipolars. Although cortisol hypersecretion may reduce lymphocyte numbers it is not yet clear whether the findings can be satisfactorily explained in this way.
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