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Biomedical subjects

D Shaffer

Publications and source records attributed to D Shaffer.

72 records · Page 4Linked to original sources
PubMed1984

Behavior and bladder disturbance of enuretic children: a rational classification of a common disorder.

A group of 126 enuretic children were evaluated as to their psychiatric and neurological states, functional bladder volume and environmental circumstances. Few differences were found when the children were grouped according to presence or absence of social disadvantage, the presence of a family history of enuresis, or the nature of onset of enuresis. No classification differentially predicted response to treatment. However, children with an associated psychiatric disorder had significantly lower bladder volumes and had more developmental delays. It is concluded that the classifications of primary or secondary enuresis, or familial or non-familial, etc., are of little practical value. When psychiatric disorder is found, it is probably related to other constitutional abnormalities. Rather than there being two separate groups of enuretic children with behavior disorder and low functional bladder volume, these two abnormalities are found in conjunction.

Child↗
PubMed1983

A children's global assessment scale (CGAS).

We evaluated the Children's Global Assessment Scale (CGAS), an adaptation of the Global Assessment Scale for adults. Our findings indicate that the CGAS can be a useful measure of overall severity of disturbance. It was found to be reliable between raters and across time. Moreover, it demonstrated both discriminant and concurrent validity. Given these favorable psychometric properties and its relative simplicity, the CGAS is recommended to both clinicians and researchers as a complement to syndrome-specific scales.

Adolescent↗
PubMed1979

The impact of psychiatric intervention on patients with uncontrolled seizures.

There is much evidence that emotional stess can trigger both neurogenic and hysterical seizures in susceptible patients. We reviewed out experience with 37 patients whose seizures appeared to be precipitated at times by emotional stress and had not been controlled by anticonvulsant medication alone. Approximately 70 per cent of patients demonstrated substantial improvement in seizure control after psychiatric treatment and maintained this improvement during follow-up. The findings of this study suggest that patient characteristics associated with better prognosis include normal intelligence, partial (as opposed to generalized) neurogenic seizures, a diagnosis of hysterical seizures, a less severely abnormal EEG, and being hypnotizable. After psychiatric treatment, 32 per cent of patients had their anticonvulsant medication reduced and another 16 per cent had it discontinued.

Adolescent↗
PubMed1978

Psychiatric aspects of pregnancy in schoolgirls: a review.

This review has searched the literature to examine the hypothesis that illegitimate pregnancy in girls of school going age is an indicator of underlying psychopathology and, in particular, that pregnancy or sexual activity provide a form of gratification for otherwise deprived young girls. Surveys suggest that precocious sexual activity is more common in disadvantaged young teenagers and that pregnant schoolgirls are especially likely to come from large families, and to have unskilled parents. There is a suggestion that the younger groups of pregnant teenagers come from unsatisfactory home backgrounds. However, these conclusions are derived from inadequate studies and should be treated with caution. Relatively few sexually active teenagers use contraceptives but there is no evidence that this represents a subconscious intent to conceive and there is greater support for more straightforward explanations. There is a further suggestion that girls who continue with their pregnancy when the choice for termination is available are more disadvantaged than girls who obtain a termination, although the reasons for this association are not clear. Children born to very young mothers appear to do less well than children born to older mothers. However, it may be that this difference can be attributed to greater overall disadvantages in the younger group rather than to specific age related deficiencies in 'mothering ability'. The problems of schoolgirl pregnancy are compounded by interruption of her schooling and early re-conception. There is evidence that these complications can be lessened by the provision of specially designed intervention programmes.

Abortion, Induced↗
PubMed1978

Trial of an alpha-adrenolytic drug (indoramin) for nocturnal enuresis.

The investigation of methods of treatment known to be effective in controlling nocturnal enuresis may yield information on the pathophysiology of the condition. An attempt has been made to mimic the known alpha-adrenolytic action of imipramine by treating a group of 14 enuretic school-children with a competitive alpha-adrenoceptor blocking substance, indoramin. Treatment in the doses used had no significant effect on night-wetting frequency.

Adrenergic alpha-Antagonists↗
PubMed1975

Psychiatric outcome of localized head injury in children.

Previous studies have shown a high prevalence of psychiatric disturbance in children with brain injury. Studies on localized lesions have suggested that injury to the young organism carries a better prognosis for recovery of function than injury at a later age. The present study was designed to investigate these phenomena systematically. A representative sample of children (n = 98) who had been hospitalized for treatment of a compound depressed fracture, associated with a dural tear and visible damage to the underlying cortex, was identified from the records of neurosurgical units throughout the United Kingdom. The children were aged between 3 months and 12 years at the time of injury and between 5 and 15 years at the time of examination. The interval between injury and examination varied but the sample was designed to include only children who had been injured at least two years before examination. The children were examined neurologically and psychometrically, a detailed account of their current psychiatric state was obtained from one or both parents, and their mental state was assessed in a standard psychiatric examination. Preliminary data are presented which relate psychiatric, educational and intellectual status at the time of examination to site and severity of injury, age at injury, and to a number of psychosocial variables.

Adolescent↗
PubMedDate not supplied

Use of Dacron cuffed silicone catheters as long-term hemodialysis access.

Sixty-five Dacron cuffed, dual lumen, silicone central venous dialysis catheters (Quinton PermCath, Seattle, WA) were inserted in 51 patients as the sole form of permanent access for chronic hemodialysis. Six and 12 month actuarial survival rates of patients for all catheters were 53% and 35%, respectively. When calculations included revisions, 6 and 12 month actuarial catheter survival rates were 61% and 43%, respectively. The major limiting factors in survival using long-term catheters remain infection and thrombosis. Dacron cuffed, dual lumen, central venous, dialysis catheters can provide long-term vascular access for hemodialysis in high risk patients.

Actuarial Analysis↗