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Biomedical subjects

J P Hes

Publications and source records attributed to J P Hes.

At least 19 recordsLinked to original sources
PubMed1997

Length of hospitalization and disposition of elderly vs younger delirium patients in psychiatric hospitals.

Although it is commonly accepted that delirium patients require the full facilities of general hospitals, practical experience has shown that delirium patients of all ages continue to be admitted to psychiatric institutions. The present study was designed to detect any differences in the length of hospitalization and disposition (discharge back to the community, transfer to a general hospital, death during the index hospitalization, transfer to another psychiatric hospital) between elderly (> 65 years) and younger delirium patients admitted to psychiatric hospitalization. Our hypothesis was that the prognosis (represented in this study by the above-mentioned measures) of elderly delirium patients in a psychiatric hospital would be poorer compared with younger delirium patients. We studied psychiatric case register data of 805 patients with delirium admitted to psychiatric hospitals during the period 1984-1993. Our sample was divided into four ICD-9-CM categories: delirium in dementia, delirium tremens (DT), drug-induced delirium, and acute and subacute delirium. No significant differences in the length of hospitalization were found between < 65- and > 65-year-old patients in the categories studied. There were disposal differences between the two age groups in the acute and subacute delirium parameters, but findings in the other categories were similar. Practical implementation of the results in terms of appropriate place of management of delirium patients in a psychiatric hospital is discussed.

Adult↗
PubMed1995

Diagnosis of dementia by different specialties.

The present study was undertaken to describe, explore and compare the specific methods and services provided by physicians of different specialties (general practitioners, geriatricians, neurologists, psychiatrists and geriatric psychiatrists) in the evaluation process of patients with suspected dementia in Israel. A self-administered questionnaire--mailed to 203 physicians (response rate 37%)--included items covering medical and specialty training, numbers of patients examined, evaluation approaches, use of formal diagnostic criteria, use of mini-mental tests, use of dementia severity rating scales, use of psychiatric and behavioral rating scales, and the use of laboratory examinations. Results indicate that the majority of physicians in all specialties either provided history taking, physical and neurological examination, or referred for it elsewhere. Deficiencies were noted regarding the use of psychiatric examination by the nonpsychiatric specialties, and provision of ADL evaluation by all specialties (except geriatricians). All specialties made a minimal use of neuropsychological tests. DSM-3/DSM-3R criteria for dementia were widely used by all specialties (except general practitioners). MMSE was the most widely used brief cognitive screening test. However, only a minority of general practitioners and psychiatrists made use of it. Laboratory tests in dementia evaluation were widely used by most physicians, irrespective of specialty. Further research is needed in order to define in more specific terms the advantages contributed by each specialty separately and in collaboration to the diagnostic process of dementia.

Activities of Daily Living↗
PubMed1993

Psychiatric hospitalization of dementia patients by commitment order in Israel.

Commitment order by a district psychiatrist is one of several modes of involuntary admission into a psychiatric hospital. Data regarding all the commitment orders by district psychiatrists in 1990 for elderly patients age 65 years or more were obtained from the national psychiatric case register. Demographic and clinical characteristics of patients diagnosed as ICD-9 senile organic psychotic conditions have been compared with the same characteristics of patients suffering from ICD-9 affective psychoses, schizophrenic disorders, paranoid states and transient organic psychotic conditions. The conclusions are: (a) Dementia patients are underrepresented in this sample of commitment orders; (b) from a demographic point of view dementia patients are no different from other psychiatric patients, age being the sole exception; and (c) from a clinical point of view dementia patients differ from other committed psychiatric patients in three ways: (i) their commitment is usually their first hospitalization; (ii) they are discharged from hospital within a two-month period; and (iii) they are referred for continuation of treatment in a non-psychiatric system. We conclude that psychiatric admissions under commitment order constitute a temporary solution for a very small group of dementia patients.

Aged↗
PubMed1990

Staff attitudes toward violence in the general hospital. A comparison between Amsterdam and Tel Aviv.

This study reports the results of a cross-cultural comparative investigation of violent behavior of patients, relatives, and visitors toward the medical staff in two general hospitals. The situation in an Israeli community general hospital in Tel Aviv was compared to that of a Dutch university hospital. General impressions existed that violence appeared to be a serious problem in the hospital in Tel Aviv, whereas there are scarcely any reports of violence in general hospitals in the Netherlands. Semistructured interviews with members of the medical and nursing staff confirmed these impressions. In Israel, the "aggressor" would be described as a young male without any specific traits, whereas in the Netherlands, he would be associated with alcohol abuse, drug addiction, and would possibly belong to street gangs or be a member of a minority group. Circumstances that may lead to violence are mentioned and situational, and social and cultural influences are discussed.

Aggression↗
PubMed1983

Extreme sinus bradycardia associated with lithium therapy.

Extreme sinus bradycardia and T wave changes are described in a patient receiving lithium therapy. Ischemic heart disease was excluded by the results of radionuclide study and an exercise stress test. The electrocardiographic changes were shown to be related to lithium therapy, as documented by the inverse correlation between heart rate and plasma lithium levels.

Bipolar Disorder↗
PubMed1978

Suicide attempt and the emergency room of the general hospital.

Data are presented on 270 consecutive cases of suicide attempts examined by a psychiatrist in a community general hospital's emergency room in Tel Aviv, Israel, during the years 1972--1974. The rates were 55:100,000, 42:100,000 and 33:100,000 respectively. The male-female ratio was 1:4. Predominantly young women having emotional problems used an overdosage of tranquillizers in an attempt to secure help. The second category of patients attempting suicide were males suffering from mental illness.

Adolescent↗
PubMed1977

Koro in a Yemenite and a Georgian Jewish Immigrant.

Koro is a syndrome consisting of fears that the male organ is withdrawing into the abdominal cavity and ultimately this will lead to death. The syndrome is observed among inhabitants of South East Asia and seems to be extremely rare outside that geographical area. In this paper one case of koro is described in a Yemenite Jewish immigrant and another in a Georgian Jewish immigrant to Israel. Some of the theoretical aspects and implications of the koro syndrome are discussed.

Adult↗
PubMed1976

Lithium therapy in Israel.

Lithium therapy for manic-depressive patients started in Israel in 1967. A questionnaire survey in 1975 had a response frequency of 50%. Of the 314 patients diagnosed as manic-depressives, 239, or 76%, received lithium carbonate treatment.

Bipolar Disorder↗