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Biomedical subjects

D Mierlak

Publications and source records attributed to D Mierlak.

5 recordsLinked to original sources
PubMed1996

The MICA therapeutic community: challenges for residents and staff.

Therapeutic communities (TCs) are residential self-help programs for recovering addicts. Traditional TCs are staffed by recovered addicts. Recently the TC model has been modified for the treatment of chemical abusers with severe mental illness. These programs are to varying degrees staffed by mental health professionals. Furthermore, they are often housed in institutions whose model for care is based on service to patients rather than self-help. There are inherent conflicts in the modified TC which is a hybrid of these two treatment approaches. This paper explores issues related to the roles of patients, mental health professionals, and the parent institution in the TC modified for the treatment of the mentally ill chemical abuser.

Attitude of Health Personnel↗
PubMed1995

Does physical improvement reduce depressive symptoms in HIV-infected medical inpatients?

The Beck Depression Inventory, Karnofsky Scale of Physical Performance, and a visual-analogue scale to assess subjective distress were administered to 32 HIV-infected medical inpatients shortly after admission and prior to discharge. Twenty-eight percent of subjects had severe depressive symptoms on admission. Most of these subjects remained in the severe range of depressive symptoms at discharge, despite physical improvement comparable to subjects with lower levels of depressive symptoms. In contrast, subjects with moderate depressive symptoms on admission showed a significant decrease in depressive symptoms at discharge. The results suggest that the etiology and management of depressive symptoms in HIV-infected medical inpatients may differ depending on the initial severity of depressive symptoms.

Activities of Daily Living↗
PubMed1988

Modulation of neurotransmitter receptor desensitization: chlordiazepoxide stimulates fading of the GABA response.

Benzodiazepines are neuromodulatory drugs that potentiate GABA-mediated conductance increases. We report the findings of an investigation into the effect of a full benzodiazepine-positive modulator (agonist), chlordiazepoxide (CDPX), on desensitization of the GABA response in chick spinal cord neurons maintained in primary monolayer cell culture. GABA application initially increases cell conductance, which then desensitizes. CDPX increases the apparent rate constant and extent of desensitization for the GABA response. The observed values for rate constant and extent of desensitization in the presence of CDPX are significantly greater than the values predicted for an equivalent peak response to GABA alone. Flunitrazepam, another full positive modulator, also stimulates the rate constant for GABA-induced desensitization. Furthermore, a weak partial benzodiazepine-positive modulator, Ro 15-1788 (an imidazodiazepine) (1) exhibits little or no potentiation of GABA-induced desensitization, and (2) antagonizes the ability of CDPX to stimulate GABA desensitization. The results demonstrate a novel form of neuromodulator action: the stimulation of receptor desensitization that cannot be explained by channel blockade. Thus, benzodiazepine modulators have the capacity to increase GABA receptor desensitization while increasing the peak response to GABA.

Animals↗
PubMedDate not supplied

Modified therapeutic community treatment for homeless dually diagnosed men. Who completes treatment?

We studied a modified therapeutic community designed for the treatment of patients with combined substance abuse and psychiatric disorders. This model has been ap117117plied on a limited basis in clinical practice, and little is known about the characteristics of patients who are likely to complete the prescribed stay in such a program. In this report, we present characteristics of 189 homeless dually diagnosed men who entered a shelter-based, modified therapeutic community with a prescribed 6-month stay. Thirty-four percent of admissions completed the prescribed stay. These patients were more likely to have fewer inpatient psychiatric admissions and more job experience than those who did not complete their stay. Findings are discussed in terms of their similarities and differences to findings from traditional therapeutic communities for the singly diagnosed.

Adult↗