PubMed Health⌕ Search

Biomedical subjects

I Gold

Publications and source records attributed to I Gold.

12 recordsLinked to original sources
PubMed1989

[Pemphigus vegetans, a rare variant of pemphigus vulgaris].

Pemphigus vegetans is a variant of pemphigus vulgaris with different clinical manifestations. Diagnosis may be difficult because of the varied presentations. A 46-year-old woman with this condition had been treated for Behcet's disease because of oral lesions. On admission, prior to dermatological consultation, she was thought to have an infectious disease. The diagnosis of pemphigus vegetans was confirmed by histological and immunofluorescence studies.

Diagnosis, Differential↗
PubMed1989

Neurogenic bladder due to herpes zoster infection in an infant.

A case is presented of Herpes zoster (HZ) infection in a 2.5-month-old infant with the added complication of a neurogenic bladder. The patient's mother suffered from varicella during the 18th week of pregnancy. The patient had a typical herpetic rash at the age of 2.5 months, and developed constipation and a neurogenic bladder. While the constipation improved, bladder atonicity led to hydroureters necessitating bilateral ureterostomies. Urinary tract involvement of HZ is well known in adults and is reversible. To our knowledge this is the first report of such a complication of HZ infection in infants.

Chickenpox↗
PubMed1989

Psychiatric screening in the emergency department: its effect on physician behavior.

The purpose of our prospective, controlled study was to determine whether providing the results of a psychiatric screening instrument, the General Health Questionnaire (GHQ), to emergency physicians would result in a change in the detection and management of patients with psychosocial problems. Five hundred ninety-nine emergency department patients were enrolled, 242 in the control and 357 in the intervention group. Noncritical patients, selected by presenting complaint, were given the GHQ to complete before physician evaluation; those whose GHQ scores were high (10 or higher) were identified as having a greater likelihood of having psychosocial problems. During the intervention phase, physicians were provided the patient's GHQ score before beginning their evaluation, as well as a specific mechanism for psychosocial referral. A significantly greater proportion of patients with high GHQ scores in both study groups were judged by physicians to have a psychiatric problem (P less than .0001). During the intervention phase, patients with high scores more frequently were assigned a psychiatric diagnosis (14.1% vs 7.7%) and received psychosocial referral (36.1% vs 5.7%). However, only the latter difference was statistically significant (P less than .0001). The majority (85.7%) of patients offered psychosocial referral accepted their referral. There was no difference in the number of laboratory tests ordered or medical/surgical referrals requested between patients in the control or intervention groups with high scores. Therefore, providing GHQ results to emergency physicians led to more frequent psychiatric diagnoses and psychosocial referrals of patients with high GHQ scores but did not alter their medical management.

Attitude↗
PubMed1986

Infantile seizures caused by voluntary water intoxication.

A case of infantile seizures of unusual etiology and presentation is described. Water intoxication with resultant epilepticus was caused by ingestion of nearly 150 ml/kg of fresh water on the day of presentation. It is unclear why the infant voluntarily consumed so much water, but heat illness is the most probable cause.

Diagnosis, Differential↗
PubMed1986

A survey of the form of the mental status examination administered by emergency physicians.

The mental status examination (MSE) is an integral and universal tool of medicine. We studied the form and content of the MSE performed by emergency physicians. An 11-item questionnaire was developed to determine the indications, amount of time necessary to evaluate mental status, the content of MSEs utilized, and the ideal characteristics of a short, standardized MSE. A study group of a random sample of 120 of 1,174 American Board of Emergency Medicine-certified emergency physicians and a validation group were surveyed by questionnaire, which was returned by 80% and 62%, respectively. Emergency physicians agreed that there are numerous specific indications to evaluate mental status including head injury (99%), behavioral abnormality (98%), drug ingestion (96%), and psychiatric complaint (95%); however, few would test it in abdominal pain (21%) or extremity injury (17%). Seventy-two percent take less than five minutes to evaluate mental status in the emergency department. Most emergency physicians uniformly test the same set of items selected from the formal MSE, including level of consciousness (95%); orientation to time (87%), place (86%), and person (84%); spontaneous speech (80%); and behavioral observation (72%) to evaluate mental status. Almost all of the physicians (82%) perceived a need for, and would use, a short standardized MSE that would take less than five minutes to perform. Results from the validation group confirmed the accuracy of the survey technique used. Our study demonstrated a perceived need for a short, standardized MSE in emergency medicine.

Attitude of Health Personnel↗
PubMed1986

The referral of patients from freestanding emergency centers to a hospital emergency department.

This retrospective study is a review of patients referred from a network of eight freestanding emergency centers FECs to a hospital emergency department during January and February 1984. During that time, 17,387 patients were seen at the FECs. Sixty-three (0.36%) of these patients were referred to the base hospital, of which 28 (44%) were admitted and six (9.5%) were admitted to a critical care unit. Four of the six critical care admissions arrived by ambulance. One was unstable and required cardioversion in the ED. Of the patients discharged from the hospital 70% were satisfied with FEC and 97% with hospital treatment. Of admitted patients, 89% were satisfied with FEC and 100% were satisfied with hospital treatment. For a similar illness in the future, 23% of all patients would return to a FEC, 28% would go to a private practitioner, and 48% would go directly to a hospital.

Ambulances↗
PubMed1985

Psychiatric screening in the emergency department: validation of the General Health Questionnaire.

Both a 28-item psychiatric scale, the Goldberg General Health Questionnaire (GHQ), and the National Institute of Mental Health (NIMH) Diagnostic Interview Schedule (DIS) were administered to 25 emergency department patients to determine the validity of the GHQ as a screening instrument for psychopathology in the emergency department setting. There was a significant association (P = 0.0343) between GHQ scores and DIS assessment. The sensitivity of the GHQ in this series was 55.6% and the specificity was 87.5% when compared with the DIS. This suggests that the GHQ may prove to be a valuable screening tool for patients with somatic complaints to detect unsuspected psychiatric illness in the emergency department.

Adult↗
PubMed1979

Severe hypernatremia caused by age, isolation, and obstructive uropathy.

Although this is an extremely interesting case report from a medical viewpoint, inasmuch as it presents an unusual cause of hypernatremia, it is probably even more important because of its sociologic implications. The basic underlying causes are common in the aged, and as the number of senior and ultimately senior senior citizens increases, a repetition of the events enumerated here can be predicted in increasing numbers of patients.

Aged↗