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Biomedical subjects

M L Belfer

Publications and source records attributed to M L Belfer.

At least 19 recordsLinked to original sources

Substance abuse and violence: cause and consequence.

Substance abuse has been associated with violent behavior for many decades. While the relationship is the same today as it was in the past, the pervasiveness of the association, and the consequences, are more dramatic. There are two ways in which substance abuse is related to violence. First, violence can be and is perpetrated under the influence of substances, and second, violence related to substance abuse stems from the trade in drugs, which is all too often focused in poor and underserved communities. The elimination of the market for drugs, and thus the reduction in the demand for drugs, will bring about a reduction in substance abuse-related violence.

Adolescent↗

Substance abuse with psychiatric illness in children and adolescents: definitions and terminology.

Substance abuse with psychiatric illness is commonly referred to as comorbidity, a term that lacks the specificity needed to further precision in research and clinical treatment, both of which are particularly important when dealing with children and adolescents. A review of the literature on this dual disorder in young people is followed by a discussion of diagnostic and treatment considerations and their implications for researchers and clinical practitioners.

Adolescent↗

Suicide in children and adolescents.

The suicidal child and adolescent present significant diagnostic and dispositional problems. The diagnosis and treatment of such patients by emergency room physicians are likely and essential. As precise a diagnosis as possible is critical to the appropriate treatment. Consultation with a psychiatric resource should be sought when any uncertainty exists.

Child↗

Temporomandibular joint dysfunction with facial pain in children.

Temporomandibular joint dysfunction with myofascial pain, a well-known clinical disorder in adults, is reported in children. In a series of 400 patients, 40 children less than 16 years of age were seen. Of these pediatric patients, 35% had a reactive depression as primary psychopathology. The multifactorial nature of the disorder is described. The need to differentiate this syndrome from recurrent otitis media and other pain syndromes is emphasized. A combined medical, oral surgical, and psychiatric management program is outlined.

Adjustment Disorders↗

Temporomandibular joint dysfunction: an occasional manifestation of serious psychopathology.

Temporomandibular joint dysfunction is multifactorial in etiology. In many patients, psychological factors contribute to the development of symptoms. This is a retrospective study of 25 patients who had temporomandibular joint dysfunction and facial pain as an early sign of significant primary psychopathology. The diagnoses were: acute depression, manic-depressive illness, hysteria, and schizophrenia. Diagnosis of the underlying psychopathology and recognition of its role in the etiology of temporomandibular joint symptoms permitted more effective treatment.

Adult↗

Body image and the process of reconstructive surgery.

Newer craniofacial operative techniques produce rapid changes in objective appearance and permit the study of body-image change. In 21 patients with either Crouzon's disease or Alpert's syndrome, a four-factor model of body-image development was applied that emphasizes cognitive growth, perception of body stimuli, stimuli from the environment in the form of comparison, and the response from others. Before a child is of school age, he has substantially defined his body image, therefore corrective surgery must be considered earlier. Although surgical intervention may produce significant objective physical change, there is not a correspondingly rapid change in body image. Four phases in the modification of body image are (1) the decision to undergo surgery, (2) the operative experience, (3) the immediate postoperative period, and (4) the reintegration stage. Recognition of this phasic process will help integrate care of these patients.

Acrocephalosyndactylia↗

A prospective study of corticosteroid and catecholamine levels in relation to viral respiratory illness.

Urinary 17-OHCS, epinephrine and norepinephrine levels were studied for one week before and one week after the onset of acute, severe Adenovirus 4 respiratory illness in 12 Army recruits during Basic Combat Training. During the pre-illness period, a tendency was frequently noted for all three hormone levels to show "spiking" elevations two to four days before illness onset. There was also a tendency for 17-OHCS levels to rise on the day before fever onset. The possible relationship of these pre-illness hormonal changes to stressful experiences and, in turn, to altered host resistance to infectious illness is discussed. Following onset of respiratory illness, 17-OHCS, epinephrine and norepinephrine levels all showed about 60 percent increases over the early pre-illness period baseline value. Elevations of these hormones persisted for about four to five days, roughly in correlation with fever duration, with only slight differences in configuration and timing of curves from one hormone to the next. The problem of evaluating which of several independent variables operating concurrently during infectious illness may be responsible for stimulating the final common neuroendocrine pathways is discussed.

17-Hydroxycorticosteroids↗

Cosmetic surgery as an antecedent of life change.

Of 42 patients who underwent cosmetic surgery, 4 patients, who gave no indication of an impending life change before surgery, obtained a legal separation or divorce 3-6 months later. These 4 patients had had strong parental domination and hostile relationships with younger siblings; they had a need for success on their own terms and for the rapid closure of potential conflict. The authors suggest that such patients are undergoing significant identity changes that become conscious only after cosmetic surgery, which tests out their shift from passivity and withdrawal to activity and participation.

Adult↗