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Biomedical subjects

M Kesselman

Publications and source records attributed to M Kesselman.

14 recordsLinked to original sources
PubMed1993

Morbidity and mortality patterns of ventilator-dependent children in a home care program.

We evaluated the effectiveness of the Home Care Program of Children's Hospital of Winnipeg for ventilator-dependent children by retrospectively examining morbidity and mortality from February 1, 1979, to July 31, 1992. For the 22 study subjects, the cause of chronic respiratory failure was neurologic disorders for 14 (64%) (group A) and pulmonary disorders for eight (36%) (group B). There were no significant differences between groups A and B in the average number of hospital days, readmission rate, or length of stay per admission. Eleven patients have remained ventilator-dependent at home, four no longer require mechanical ventilation, and seven died. Factors such as diagnosis, type of family, home location, age at initiation of mechanical ventilation, and initial duration of hospital stay did not influence morbidity or mortality in either group. Within the overall mortality rate of 32% is a higher rate among patients whose disorders initially carried a poor prognosis. Ventilator-dependent children can be successfully managed at home, with few nonelective hospital readmissions, through a well-organized home care program.

Adolescent↗
PubMed1992

Use of a structured interview to diagnose anxiety disorders in a minority population.

A structured interview--the Anxiety Disorder Interview Schedule--Revised (ADIS-R)--was used to assess the presence of panic disorder and other anxiety disorders in 100 psychiatric outpatients at an inner-city municipal hospital, most of whom were black and of low socioeconomic status. The ADIS-R identified seven patients as having a primary diagnosis of panic disorder and 16 as having a secondary diagnosis of panic disorder. None of the patients received a primary diagnosis of panic disorder from the outpatient clinical staff, who did not use the ADIS-R. The authors conclude that a structured interview is an effective tool for identifying panic disorder in a minority population, in whom the disorder is generally underdiagnosed.

Adolescent↗
PubMed1986

Assessing the family environment of schizophrenic patients with multiple hospital admissions.

The authors compared the responses on the Family Environment Scale of 12 schizophrenic inpatients who had been hospitalized more than three times in the previous 12 months and a control group of 12 similarly diagnosed inpatients who had been admitted less frequently. Responses of the patients' families were also computed. Patients who were admitted more often reported greater family conflict and less freedom to express emotions. Family responses revealed significantly more incongruity among family members of the more frequently hospitalized patients than among those of the control group. The authors suggest that studies be conducted to determine if the data obtained by the scale are analogous to data on expressed emotion obtained by the more complex Camberwell Family Interview; if so, the Family Environment Scale could be an alternative to the Camberwell Family Interview in studies of schizophrenic patients and their families.

Adolescent↗
PubMed1983

Predicting psychiatric admission from an emergency room. Psychiatric, psychosocial, and methodological factors.

The determinants of psychiatric hospitalization, especially nonspecific issues, have been studied extensively. The methodological problem of correlational non-cross-validated findings are seen as contributing to our uncertainties about the critical issues involved in the decision to admit. A cross-validated multiple regression analysis of determinants of hospitalization in an inner-city municipal hospital revealed two determinants of hospitalization: severity of schizophrenic symptoms and active suicidal and/or homicidal ideation. They accounted for one third of the variance without shrinkage. Quasi-experimental designs may be the most efficient means of studying the remaining unexplained variance.

Commitment of Persons with Psychiatric Disorders↗
PubMed1980

Psychiatric problems in third-year medical students.

Each year as many as one of four medical students experience sufficient emotional pain to seek psychiatric consultation. In many cases the precipitating stress relates to specific stresses associated with the phase of training. In the third year increased clinical responsibility may evoke feelings centered on caretaking, sexuality, and aggression that cannot be contained by an as yet fragile emerging professional identification. The authors present four case histories of third-year medical students to illustrate the complex interaction between family background, motivations to enter medicine, and the specific patient experience that resulted in sufficient distress to require psychiatric consultation.

Adjustment Disorders↗
PubMed1976

Asymmetry of information processing in hallucinators and nonhallucinators.

In previous work we had developed evidence suggesting that hallucinating schizophrenics differ from nonhallucinators in the pattern of errors made in a shadowing task. Non hallucinators appeared to be less willing to guess when they were unsure. The errors of the hallucinators seemed more semantically elaborate. The experiment had not been designed to study these factors and the current experiment was conducted using a technique reported by Pisoni et al. These workers had studied normal Ss in an immediate recall task, using semantically well integrated (SWI) or poorly integrated (SPI) sentences. Pisoni et al. had shown that right ear presentation produced more accurate recall of SWI as compared to SPI sentences, whereas left ear presentation failed to discriminate these sentences. Utilizing the methods of Pisoni et al., we replicated their findings in a normal control group. The results from our hallucinating and nonhallucinating groups were different from each other, the nonhallucinators being less accurate, discriminating semantic integration level on left rather than right ear input, and making more fragmented errors. Little support could be found for attributing this pattern of performance to nonspecific aspects of the procedures. It appears that the nonhallucinators process information differently from hallucinators. These differences may reflect alterations in language development. It is speculated that such differences might be consistent with interference with the development of brain asymmetry.

Age Factors↗