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Biomedical subjects

Q R Regestein

Publications and source records attributed to Q R Regestein.

16 recordsLinked to original sources
PubMed1991

Is the poor sleep of shift workers a disorder?

OBJECTIVE: The purpose of this article is to describe the impact of shift work on sleep, as recently acknowledged in official nosologies of sleep disorders, and to discuss whether sleep altered by shift work actually constitutes a disorder. METHOD: The authors review subjective responses to recent survey questions about sleep and polygraphic measurements of sleep in shift workers and describe sleep clinic experiences with complaints related to shift work. FINDINGS: Shift work entails wide variation in work schedules, sleep quality, and worker tolerance and a high prevalence of night-shift sleepiness. It probably affects rates of drug use, health status, and family organization. Clinical presentations were rare, highly varied, and empirically treated. The United States, unlike other countries, has no legal restrictions on shift work. CONCLUSIONS: As a clinical phenomenon, sleep altered by shift work is common and varied, probably expresses nonphysiological sleep-wake scheduling, and is little treated. Further study of its health effects and consideration of whether it is a "disorder" or a "problem" seem warranted.

Adult↗
PubMed1978

Pedophilia occurring after onset of cognitive impairment.

Four married patients are reported who first manifested pedophilia and other signs of disinhibition after sustaining illnesses that led to cognitive impairments. Although pedophilia may often be related to a long-standing inadequacy of sexual functioning, the onset of pedophilia in an individual without a previous histroy of sexual perversion may indicate the presence of recently sustained cognitive impairments.

Adult↗
PubMed1977

Sudden catatonic stupor with disastrous outcome.

Catatonic stupor occurred in two psychiatric inpatients, predisposing them to staphylococcal pneumonia, venous thrombosis, and pulmonary embolism. Disastrous outcomes ensued. Catatonic stupor can lead to fatal complications, and aggressive medical and psychiatric therapy is indicated.

Acute Disease↗
PubMed1976

Episodic 24-hour cortisol secretory patterns in patients awaiting elective cardiac surgery.

The 24-hour pattern of plasma cortisol concentration in four patients on the day before major elective surgery was compared with that of five similarly hospitalized control subjects to study the effect of the expectation of surgery on the secretion pattern. Using an indwelling venous catheter, which extended outside the patient's room, to collect blood samples every 20 minutes for 24 hours, it was found that cortisol was secreted episodically in both control subjects and presurgical patients. The nychthermal patterns of plasma cortisol concentration in the two groups were indistinguishable for most of the day despite the occurrence of intermittent events which appeared to cause anxiety in the presurgical patients. However, between 9 PM and 11 PM, while each presurgical patient was being preoperatively prepared (body shaving, wash, and enema), a major pulse of cortisol secretion occurred, raising the plasma cortisol concentration to between 6.9-10.5 standard deviations above that of the control subject mean for that time of day. We conclude that 1) expectation of a major surgical procedure for several weeks does not result in chronic activation of the pituitary-adrenocortical axis, 2) many discrete anxiety-provoking events do not evoke cortisol secretory episodes, 3) most episodes of cortisol secretion are part of an endogenous cyclical pattern with a circadian distribution and are not a direct result of environmental stimuli, and 4) preoperative preparation evokes a major cortisol secretory response in patients awaiting surgery. Whether that release of cortisol is a response to the physical manipulations or the psychological implications of that stimulus is presently unknown.

Adult↗
PubMed1975

A case of prolonged, reversible dementia associated with abuse of electroconvulsive therapy.

Standards for the use of electroconvulsive therapy (ECT) are being considered in Massachusetts. While the relative safety of ECT is sometimes used to justify its extensive use, ECT is abused in some cases, causing prolonged deficits in sensorium. A case of an ECT-induced, prolonged, reversible dementia is presented as an example of present abuses and the need for standards.

Dementia↗