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Biomedical subjects

H H Harsch

Publications and source records attributed to H H Harsch.

At least 19 recordsLinked to original sources
PubMed1992

Categorization of types of medical/psychiatry units based on level of acuity.

Medical/psychiatry units can be categorized by the level of acuity of medical and psychiatric illness. Type I units are categorized as those that primarily provide psychiatric care with a low level of medical acuity. Type II units include general medicine or medical subspecialty units that are associated with a psychiatric liaison service and provide low levels of psychiatric care to those admitted to the general medical setting. Type III and Type IV units are characterized by a true departure from the current ward settings and care for patients who have concurrent and more severe medical and psychiatric problems in a unified setting. Both of these units require special physical changes in the ward structure, additional nurse training, and coordinated physician coverage to function effectively.

Acute Disease↗
PubMed1992

Quality assurance in a setting designed to care for patients with combined medical and psychiatric disease.

In an attempt to address the needs of patients with combined medical and psychiatric illness, a variety of clinical centers are now creating medical/psychiatry units. These units differ widely in their clinical capabilities, yet no adequate delineation of safeguards regarding quality of care currently exists. This article discusses minimum quality guidelines for four types of medical/psychiatry units that are based on the level of acuity of patients' medical and psychiatric disease.

Acute Disease↗
PubMed1991

A profile of academic medical-psychiatric units.

Medical-psychiatric inpatient programs are a relatively recent phenomenon. Although interest in these programs seems widespread, they are still found primarily at academic medical centers. The authors surveyed 11 such academic units. Variations found between their patient populations, milieu, and organization suggest that these programs, in general, are still in an early stage of evolution. It is hoped that these data will provide a descriptive base of how these programs have developed.

Academic Medical Centers↗
PubMed1991

Bupropion.

Explore the source record for details and available documents.

Antidepressive Agents↗
PubMed1989

Length of stay on a psychiatry-medicine unit.

To assess the efficiency of a medical-psychiatric unit over 3 years, several studies were carried out on one combined psychiatry-medicine unit. On the Behavior Evaluation and Treatment Unit of the Medical College of Wisconsin, Division of General Hospital Psychiatry, average length of stay was calculated in successive cohorts of 28-31 consecutive patients (total 358 patients). Medical-surgical and psychiatric diagnoses were compared over a 2 1/2-year span; psychiatry diagnoses were compared to those on other units; and acuity of illness was measured comparatively by various methods. Length of stay decreased from more than 20 to less than 15 days. This effect did not appear to be directly related to diagnostic changes. Only minor increases in range of psychiatric diagnostic categories and changes in proportion of certain disorders were found. The acuity level was descriptively intermediate between that of a general medicine and that of a general psychiatry unit. Factors that could be related historically to these findings were discussed.

Adult↗
PubMed1989

Treatment in combined medical psychiatry units: an integrative model.

Approximately 14 medical psychiatry units have opened over the last 15 years due to the recognition of the frequent concurrence of medical and psychiatric illnesses. This article discusses the clinical problems encountered when medical care and psychiatric care are integrated and their impact on medical and nursing staff. Group therapy programs on medical psychiatry units may enhance psychiatric treatment and help maintain a psychiatric focus by both patients and staff, despite the patients' significant medical problems. Medical psychiatric units must adopt an integrative model of care that includes all disciplines involved on the units if they are to meet their goal of providing effective medical and psychiatric care.

Combined Modality Therapy↗
PubMed1987

Neuroleptic malignant syndrome: physiological and laboratory findings in a series of nine cases.

A series of nine cases of neuroleptic malignant syndrome (NMS) are presented with peak measures of autonomic dysfunction and laboratory findings. Urine abnormalities, consisting of proteinuria, casts, or cells, were an associated finding in these cases. Severe hypophosphatemia was present in two patients. Relative dehydration before the onset of the syndrome in eight of the nine patients supports the suggestion that it is a risk factor for the development of NMS. The withdrawal of dopamine agonists was also seen as a trigger for NMS. Autonomic instability and muscular rigidity occurred separately in some cases. Creatine phosphokinase elevation and fever did not necessarily parallel the duration or the degree of muscular rigidity, and this finding supports the idea of a central cause for the symptoms. A systematic approach is presented for the evaluation and treatment of NMS. Observations implicate central dopaminergic mechanisms in the regulation of autonomic functioning and the maintenance of peripheral muscle membrane stability.

Adolescent↗
PubMed1985

Induction of mania by L-dopa in a nonbipolar patient.

The authors present a case of mania associated with the prolonged ingestion of large doses of L-dopa. Prior reports relating L-dopa therapy to mania in patients with bipolar disorders are discussed. The induction of a classic manic syndrome by catecholamine augmentation is possible in a nonbipolar individual.

Adult↗