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Biomedical subjects

J J Silverman

Publications and source records attributed to J J Silverman.

At least 19 recordsLinked to original sources
PubMed1985

Posttraumatic stress disorder from pentaborane intoxication. Neuropsychiatric evaluation and short-term follow-up.

Fourteen individuals briefly exposed to a toxic industrial compound, pentaborane, were evaluated for neuropsychiatric abnormalities four to 12 weeks after exposure. Results of physical, neurological, and routine laboratory evaluations were normal. Initial and persistent psychiatric symptoms, neuropsychological deficits, electroencephalographic changes, elevated central nervous system neurotransmitter levels, and ventricular brain ratios (computed tomographic scan) provide evidence of central nervous system damage. Seven patients met diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, ed 3, for posttraumatic stress disorder, and seven patients had neuropsychological test evidence of mild brain dysfunction. No statistically significant relationship was found between neuropsychiatric test results and psychiatric diagnoses. These results contradict previous literature that reports most symptom resolution within the first week after exposure to pentaborane. Results suggest that patients suffered a combination of organic brain insult and psychological trauma.

Accidents, Occupational↗
PubMed1985

Surgical staff recognition of psychopathology in trauma patients.

This study investigated the recognition of psychopathology by the surgical team in 56 trauma patients independently evaluated by the authors for current psychiatric diagnosis using research criteria. Thirty-four per cent of patients (N = 19) met criteria for one or more psychiatric disorder, with alcohol abuse/dependence the most frequent diagnosis (N = 16). Examination of medical records showed no mention of psychopathology or related treatment plan for 13 of 19 patients (68%). Three patients' charts had brief comments related to the psychopathologic diagnosis, and three charts documented requested psychiatric consultation. This study demonstrates that substantial treatable psychopathology was undocumented and untreated in a trauma surgery patient population.

Adult↗
PubMed1985

Current concepts of geriatric pain and its treatment.

Because stress and depression are prevalent in the elderly, the opportunity for pain to intensify stress and depression may be greater in older people than in the general population. Evidence that pain-related psychosomatic complaints are more frequent in the elderly further complicates the issue. Antidepressants that affect serotonergic systems may have analgesic properties independent of their antidepressant properties; eg, amitriptyline and doxepin. These drugs may have a more rapid effect on pain than on depression.

Acute Disease↗
PubMed1984

Neuropsychological function following mild exposure to pentaborane.

Neuropsychological tests and self-report personality inventories were administered to 14 workers and rescue squad personnel approximately 2 months following mild exposure to pentaborane, a highly toxic volatile liquid boron hydride. Performance decrements were evident on 5 of 11 neuropsychological tests, including Block Design and measures of sustained attention and recent memory. Neuropsychological deficits were not related to emotional changes reported on the Hopkins Symptom Checklist nor to the presence of CT scan abnormality. These results indicate mild residual brain dysfunction following pentaborane intoxication, including possible dysfunction in subcortical regions mediating memory processes and in cortical areas mediating visuo-spatial abilities.

Adolescent↗
PubMed1984

Manic syndrome after metrizamide myelography.

Depression, anxiety, and delirium have been associated with metrizamide myelography. The authors report a patient who developed an organic affective disorder with manic symptoms several hours after metrizamide myelography.

Aged↗
PubMed1982

A survey of consultation-liaison psychiatry program characteristics and functions.

A survey of medical school affiliated consultation-liaison psychiatry programs has provided useful information on several aspects of current C-L program activity, including: (a) patients seen and treatments provided; (b) C-L training; (c) program structure (and fiscal operations); and (d) subjective appraisal by program directors. Data on patients, diagnostic categories, and treatments support the findings of similar, previous studies. Training and research appear to be continuing at past levels rather than increasing. Limited information on fiscal operations and program structure preclude adequate assessment of their strengths and vulnerabilities. Recording of better data and the development of more aggressive management techniques are proposed as appropriate foci of attention for C-L program leaders.

Education, Medical↗
PubMed1982

Psychosis associated with clonazepam therapy for blepharospasm.

A 73-year-old woman with no previous psychiatric history received clonazepam maintenance therapy for essential blepharospasm. Visual, auditory, and tactile hallucinations as well as paranoid delusions were documented. Dose reduction resulted in complete disappearance of the hallucinations and reduction of paranoia to an acceptable level, with no exacerbation during the subsequent 12 months. To our knowledge, this is the first well documented report of psychosis induced by clonazepam. Psychosis was probably related to clonazepam-induced increased central nervous system serotonin and possible predisposition to organic brain syndrome by undocumented causes. Dose reduction is suggested as an alternative to discontinuing the drug when hallucinations or paranoia arise during clonazepam therapy, if no other satisfactory treatment is available and if adequate patient monitoring and protection exist.

Aged↗
PubMed1979

The brassiere shop: a front line of assistance to the mastectomy patient.

This report presents information received from a sampling of breast prosthesis fitters which is of importance to surgeons working with mastectomy patients. The characteristics of various types of external prostheses are described. Shop fitters relate their attitudes about patients, describe patients' reactions to cancer and surgery and the problems encountered in proper fitting, and discuss their limitations as counselors. Fitters' negative attitudes toward reconstruction mammaplasty are also presented. The authors discuss these attitudes and raise questions about appropriate interaction between surgeons and prosthesis fitters.

Breast Neoplasms↗