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Biomedical subjects

R L Binder

Publications and source records attributed to R L Binder.

At least 55 records · Page 3Linked to original sources
PubMed1991

Women clinicians and patient assaults.

Although there has been an increased awareness of the problem of assaults against clinicians, this is the first report to specifically focus on issues related to women clinicians and patient assaults. The author discusses issues related to women's feelings of vulnerability and lack of authority. She describes special risks for women clinicians including sexual assaults, rape fantasies, and maternal transferences, which can lead to assaults, and vulnerability during pregnancy. In addition, the author discusses psychological reactions after assaults and makes recommendations for preventing assaults.

Fantasy↗
PubMed1991

Is money a cure? Follow-up of litigants in England.

American and British authors collaborated on a follow-up study in England of accident victims who brought litigation which had been resolved. Eighteen subjects who had complained of psychiatric symptoms during the course of the litigation were recruited from the British psychiatrist's files. Based on review of court documents and extensive interviews of the subjects, the authors describe case examples that demonstrate a complicated relationship between monetary compensation and outcome. Some of the litigants improved after they received compensation, but this seemed to be related to issues besides the money, e.g., feelings about their impairment, family support, the loss or gain of a relationship, personality characteristics, and ability to return to work. The authors discuss the results of this study in light of differences between the British and American legal systems.

Accidents↗
PubMed1990

Absence of papillomavirus in skin tumors induced in SENCAR mice by a two-stage carcinogenesis protocol.

SENCAR mice are unusually sensitive to induction of papillomas and squamous cell carcinomas by initiation with 7,12-dimethylbenzanthracene (DMBA) and promotion by 12-O-tetradecanoylphorbol-13-acetate (TPA). Tumors induced by this protocol were tested for the presence of papillomavirus by immunohistochemistry, Southern blot, reverse Southern blot and dot blot hybridization techniques. Papillomavirus antigens were not detected in any of 235 tumors or 142 non-tumor-bearing skin samples analyzed. Southern blots and dot blots, using a mixed probe of cloned rodent papillomavirus DNA from the multimammate rat, Mastomys natalensis, and the European harvest mouse, Micromys minutus, did not reveal the presence of either episomal or integrated papillomavirus genomes in total cellular DNA extracts from the tumors or non-tumor-bearing skin. To circumvent the possibility that insufficient cross-homology existed to detect a papillomavirus genome with the mixed probe used, DNAs extracted from six papillomas were labeled and each used to probe reference blots that contained 25 cloned papillomavirus genomes excised from their vectors. No evidence for the presence of a papillomavirus genome was detected by this method. Therefore, it is unlikely that papillomaviruses play a role in the induction of tumors in SENCAR mice by two-stage carcinogenesis protocols.

9,10-Dimethyl-1,2-benzanthracene↗
PubMed1990

Clozapine and seizures.

Clozapine is a newly released antipsychotic that is associated with a higher prevalence of seizures than traditional neuroleptics. The authors describe four patients who developed seizure activity during clozapine treatment and provide recommendations for clinical management of this problem.

Adult↗
PubMed1990

The relationship between admission symptoms and hospital assaults.

Assessments at hospital admission of patients' potential for violence often rely on limited information, such as the patient's mental status, because detailed clinical and historical information may not be readily available. This study examined the relationship between symptoms at admission as measured by the Brief Psychiatric Rating Scale and later violence of 127 psychiatric inpatients. Patients who showed higher levels of thinking disturbance, hostile-suspiciousness, and agitation-excitement at the time of admission were at greater risk of becoming assaultive during the hospitalization. The findings suggest the usefulness of specific symptom profiles for identifying acute psychiatric patients at risk for violence.

Female↗
PubMed1990

The relationship of gender to violent behavior in acutely disturbed psychiatric patients.

On the basis of extensive review of the medical records of 253 patients hospitalized in a locked psychiatric unit, the authors found that before hospitalization, men engaged in significantly more physical attacks and fear-inducing behavior than did women. During short-term psychiatric hospitalization, although men continued to engage in more fear-inducing behavior, women engaged in proportionately more physical attacks. To control for possible confounding variables, the authors repeated the analyses after stratifying by demographic and diagnostic variables that were distributed differently among men and women. The same pattern of relationships between gender and violence was found. The authors give case examples and discuss possible explanations and implications of the findings.

Acute Disease↗
PubMed1990

Violence by geriatric patients who need psychiatric hospitalization.

The authors examine issues related to violent behavior exhibited by elderly patients during episodes of mental illness that are severe enough to warrant psychiatric hospitalization. The medical records of 195 geriatric patients admitted to a psychiatric hospital over a 9-year period were reviewed. During the 2 weeks before admission, 20% of the geriatric patients physically assaulted others, 20% engaged in fear-inducing behavior, and 60% were not violent. Patients with senile organic psychotic conditions were significantly more likely to attack others than were patients with other diagnoses. The most common victims of the patients' violent behavior were family members. The authors discuss the implications of these findings for treatment of geriatric psychiatric patients and their families.

Age Factors↗
PubMed1990

Clozapine--a new and different neuroleptic.

These discussions are selected from the weekly staff conferences in the Department of Medicine, University of California, San Francisco. Taken from a transcription, it has been edited by Homer A. Boushey, MD, Professor of Medicine, and Nathan M. Bass, MD, PhD, Associate Professor of Medicine, under the direction of Lloyd H. Smith, Jr, MD, Professor of Medicine and Associate Dean in the School of Medicine.

Adult↗
PubMed1989

Factor structure of a brief symptom checklist for acute psychiatric inpatients.

A 36-item symptom checklist (the HSCL-36) was assembled and assessed based on previous factor-analytic research with the Hopkins Symptom Checklist-90 (HSCL-90), which had focused on outpatients. Acute psychiatric inpatients (N = 243) completed the HSCL-36 after admission to a university hospital. The responses were factor analyzed using a principal axis extraction. Varimax rotation yielded six interpretable factors, for which factor-based subscales were derived. Five of the six subscales were found to be reliable using coefficient alpha. Results are compared with studies that used self-report symptom checklists with outpatients. Future directions for research are discussed.

Acute Disease↗
PubMed1989

Characterization of the induction of ornithine decarboxylase activity by benzoyl peroxide in SENCAR mouse epidermis.

The induction of epidermal ornithine decarboxylase (ODC) activity by benzoyl peroxide (BPO) was characterized to evaluate the usefulness of this effect as a short-term marker of BPO-induced mouse skin tumor promotion. The maximal induced levels of ODC specific activity, after a single topical dose of BPO, were greater than 2-fold higher when a cold scraping method was used to prepare epidermis rather than the commonly used heat treatment method. Therefore, the cold scraping method was used for all the work reported here. Application of a single 20 mg dose of BPO to the dorsal skin of SENCAR mice caused a relatively small induction of epidermal ODC activity, to a level less than 1/40 that induced by a single 2 micrograms dose of 12-O-tetradecanoylphorbol-13-acetate (TPA). Furthermore, the time-courses of induction were different after single doses of TPA and BPO, with peak activities observed at approximately 6 and approximately 24 h after treatment respectively. In contrast, after a total of five 20 mg doses of BPO were topically applied (one dose every 2 days), ODC activity was transiently induced to an average level greater than 15 times after a single dose. Additionally, on this dosing regimen, the peak of ODC activity shifted to approximately 4 h after the last treatment, so that the time-course of ODC induction resembled that after multiple applications of TPA. The extent of epidermal ODC induction by BPO was found to be a complex function of the frequency of dosing and the number of treatments. However, when BPO treatments were administered from 1 to 7 days apart, similar maximal induced levels of ODC activity were eventually achieved after application of multiple doses. Importantly, the dose-response for the induction of ODC activity by five doses of BPO (applied one dose every 2 days) was highly correlated with published data on the dose-response for tumor promotion by this organic peroxide, indicating that ODC induction is a good short-term marker of BPO-induced tumor promotion in SENCAR mice.

Animals↗
PubMed1989

Relationship between preadmission threats and later violent behavior by acute psychiatric inpatients.

The medical charts of 253 patients admitted to an acute psychiatric inpatient unit were reviewed for evidence of threats of violence within the two weeks before admission and violent behavior during the first three days of hospitalization. Fifty-eight percent of the patients who had made threats before admission required seclusion for dangerous behavior in the hospital, and 32 percent of the patients who had made threats physically assaulted someone in the hospital. The association between preadmission threats and subsequent violence was especially strong among schizophrenic patients. Compared with schizophrenic patients who did not threaten others, those who had made preadmission threats were more likely to be physically and verbally assaultive and were more likely to require seclusion. Manic patients who had made threats were more likely than those who had not made threats to be verbally assaultive while in the hospital.

Adolescent↗
PubMed1989

Violent behavior and length of psychiatric hospitalization.

The relationship between violent behavior and length of hospitalization was studied in a retrospective chart review of 253 patients admitted to a university-based acute inpatient unit. Violent behavior was defined as physical attacks on persons or fear-inducing behavior before admission or during initial hospitalization, and its value as a predictor of length of stay was assessed in multiple regression analyses that also included 20 demographic and clinical variables. Violence per se was not an important predictor of length of stay, but violence associated with a diagnosis of schizophrenia was an important predictor. Schizophrenic patients who physically attacked others shortly after admission were more likely to have an extended stay than other patients. The study demonstrates the importance of considering clinically meaningful patterns, such as the interaction between diagnosis and violent behavior, when predicting length of stay.

Adolescent↗
PubMed1989

Violence in geriatric patients with dementia.

Although the elderly have been studied as victims of violent behavior, there has been little investigation of this population as perpetrators of violence. Using the method of retrospective chart review, this study examines the issue of violence by geriatric patients with dementia who need acute psychiatric hospitalization. Of 52 patients, 44 percent engaged in physical attacks and/or fear-inducing behavior during the two weeks prior to admission, and 29 percent engaged in similar behavior within the first 72 hours of hospitalization. Married patients and those who lived with family were overrepresented in the group of violent patients. The authors discuss possible explanations and implications of these findings.

Aged↗
PubMed1988

Effects of diagnosis and context on dangerousness.

The authors extensively reviewed the medical records of 253 patients hospitalized on a locked, university-based psychiatric unit. They found that schizophrenic and manic patients were more likely than patients with other diagnoses to be assaultive before admission. In the hospital, however, manic patients were the most likely to be assaultive. The results of this study show that the risk of violence among different diagnostic groups of patients varies according to context and is moderated by situational variables. These findings have implications for the assessment of dangerousness before and during hospitalization.

Acute Disease↗
PubMed1988

Predictors of violence in civilly committed acute psychiatric patients.

The authors investigated the relationship between community violence and violence in the hospital for patients hospitalized through emergency civil commitment. The medical charts of 238 patients involuntarily admitted to a university-based acute inpatient unit were reviewed for evidence of violence during the 2 weeks before commitment and the first 72 hours of hospitalization. Patients who were violent in the community were more likely to be violent in the hospital. A discriminant function analysis was used to identify the combination of information concerning community violence and patient background characteristics that most efficiently predicted which patients were violent during emergency commitment.

Adolescent↗
PubMed1987

Evaluation of a school-based sexual abuse prevention program: cognitive and emotional effects.

This study evaluated a school-based child sexual abuse prevention program which consisted of separate 2-hour workshops for children, parents, and teachers. Questionnaires concerning the children's knowledge about sexual abuse prevention and level of emotional distress were developed and administered to 88 children, ages 5-12, and 60 parents before and after the program. In addition, 12 teachers completed questionnaires about the children's level of emotional distress within 2 weeks after the program. Comparison of the children's knowledge before and after the program showed significant increases in knowledge about strategies for coping with potential abuse situations. Also individual children's responses were compared with their parents' responses. After the program the parents had a more accurate appraisal of their children's knowledge, and in addition, there was a significant increase in how much parents reported that they had talked with their children about sexual abuse. In terms of possible adverse emotional effects of the program, neither teachers nor parents noticed signs of increased emotional distress. In addition, the children reported that the program made them feel safer and better able to protect themselves. The findings support the value of providing sexual abuse prevention programs to children.

Affective Symptoms↗
PubMed1987

Three case reports of behavioral disinhibition with clonazepam.

Recent reports have supported the innovative use of clonazepam in the treatment of various psychiatric conditions. This report alerts clinicians that, although helpful in some patients, clonazepam can cause behavioral disinhibition and worsening of symptoms in other patients.

Adult↗