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Biomedical subjects

S B Lippmann

Publications and source records attributed to S B Lippmann.

At least 37 records · Page 2Linked to original sources
PubMed1991

Clomipramine for obsessive-compulsive disorder: prescribing guidelines.

Clomipramine is a newly marketed tricyclic antidepressant drug prescribed for obsessive-compulsive disorder (OCD). It selectively blocks neuronal uptake of serotonin. Clomipramine has been prescribed in Europe and Canada for 20 years in management of depression. Studies have now shown clomipramine to be effective in treating OCD. Dry mouth, visual disturbances, constipation, sexual dysfunction, somnolence, tremors, and dizziness are among the commonly reported side effects. Like other tricyclics, clomipramine exhibits a potential for cardiotoxicity, especially by impairing conduction and/or orthostasis. It also has the effect of lowering seizure threshold. Overdose risk is considerable. Careful medical supervision and adherence to prescribing guidelines are presumed to reduce medication risk factors. The outstanding benefit of this drug is its proved efficacy in the management of obsessive-compulsive disorder, as the first pharmacotherapy approved for this previously rather treatment-resistant condition.

Clomipramine↗
PubMed1990

Psychiatric consultation for patients with self-inflicted gunshot wounds.

The study describes 260 persons referred over a 12-year period for psychiatric consultation after shooting themselves. The population consisted primarily of young, white men between the ages of 20 and 29. The abdomen was the most common site of injury for both sexes. Previous suicide attempts and past psychiatric histories were uncommon, but alcohol was involved in 25% of cases. Major depression and alcohol abuse were the most common psychiatric diagnoses. Tasks for the psychiatric consultant include dealing with reactions of hospital staff, instituting appropriate suicide precautions, determining future suicidality and psychiatric disposition, and helping patients cope with family reactions to the suicide attempt and with the psychological effects of disfiguring injuries.

Adolescent↗
PubMed1990

Anorexia nervosa in males.

Although anorexia nervosa is usually considered a disorder of young women and girls, 5% to 10% of cases occur in men and boys. Onset can range from prepubertal years to adulthood. The unique conflicts that may lead to anorexia nervosa in males must be considered when treating these patients.

Adaptation, Psychological↗
PubMed1990

Attempted suicide by black men and women: an 11 year study.

Two hundred and thirty-two black patients (103 men, 129 women) who attempted suicide were referred for psychiatric consultation from January 1976 through August 1987. Black male attempters were (1) more often schizophrenic; (2) more apt to be intoxicated; (3) more commonly psychotic; and (4) more prone to use violent methods. Black women were more likely to manifest clinical depression and much more inclined to choose drug overdose as a method. Women were also more apt to jump from buildings or bridges and deliberately set themselves ablaze. Referrals of suicide attempters increased for both sexes over the study period, and violent methods, particularly firearm use, rose steadily among black women over the 11 1/2 years. Recommendations for providing care to black suicide attempters include (1) appreciation of the psychological effects of racism; (2) increased sensitivity to depressive features in black schizophrenics; (3) consideration of affective disorders in young black males frequently involved in violent acts; and (4) awareness of one's own racially biased attitudes.

Adolescent↗
PubMed1989

Chronic depression. Issues in long-term management.

Patients with protracted depression respond well to long-term maintenance antidepressant therapy. A precise diagnosis is a prerequisite to therapeutic decisions. Diagnosis may be missed and treatment inadequate if symptoms are attributed solely to aging or to life's circumstances. Proper dosage is determined by the patient's age and metabolic capabilities, and patient education increases compliance. Although the patient may deny the need for psychotherapy, continued support and a life review help the patient acquire insights and adjust to changes. The patient can sustain progress by keeping active, pursuing interests, and socializing. The aim of long-term antidepressant pharmacotherapy is to reduce morbidity, restore productive and optimal functioning, and enhance the quality of life. The attainment of previous levels of function is the gauge of success.

Aged↗
PubMed1989

When to use psychiatric referral in the ED.

Not all patients presenting to the emergency department with psychiatric complaints need psychiatric referral. Specific guidelines are therefore essential to aid in the appropriate screening of such patients and to expedite diagnosis and treatment.

Emergency Service, Hospital↗
PubMed1989

What about mandatory AIDS testing?

Mandatory testing for AIDS is controversial. Such screening has been suggested for prisoners, immigrants, prostitutes, military personnel, and persons contemplating marriage or pregnancy. Quarantining and even tatooing have also been recommended for persons with AIDS. The advent of mass testing raises the issues of (1) proper allocation of scarce AIDS resources; (2) the need for confidentiality of examination reports; (3) the value of this assessment without the existence of a definitive treatment; (4) the possibility of both false positive and false negative results; and (5) the provision of counseling for people with positive testing. Other concerns involve public health needs versus individual rights, and the confidentiality of the doctor-patient relationship. Past epidemics serve as paradigms for the role of mandatory screening and quarantine in a public health crisis. As testing for AIDS is expanded, anticipate that adverse reactions such as panic, depression, grief, compulsive behavior, and suicide attempts will increase. The physician must provide counsel on such matters as "safe sex" practices, avoidance of needle sharing, and early warning signs of AIDS and ARC.

AIDS Serodiagnosis↗
PubMed1988

Should the mentally ill adopt children? How physicians can influence the decision.

No established criteria exist for determining whether a person with a mental illness should or should not be allowed to adopt children. The basis for opinion in such cases can be derived from previous custody cases described in the literature. The interest of the potential parent, as well as the child, must be a primary consideration. Physicians are often called on to make recommendations regarding the parental fitness of a mentally ill person. An intensive assessment of the potential adoptive parent, including a thorough history and investigation of the person's resources and support systems, is necessary before a recommendation can be made.

Adoption↗
PubMed1988

Emotional adjustment to cardiac transplantation.

Emotional adjustment to cardiac transplantation is a phasic process. Each step is associated with a milestone in the transplantation protocol. The adjustment process is divided into seven distinct stages: 1) transplant proposal, 2) evaluation, 3) awaiting a donor organ, 4) perioperative period, 5) inhospital convalescence, 6) discharge, and 7) post-discharge adaptation. Patient adjustment to transplantation is influenced by the adaptive task of each stage in the procedure, personality factors, previous experience with illness, and social support. Patients need time to adjust to each stage. Do not pressure them into premature acceptance of transplantation. Verbalization of feelings should be encouraged, and adequate support ensured. Contact with already transplanted patients is helpful to surgical candidates. Psychiatric assistance can greatly aid in patient management and emotional adjustment.

Adaptation, Psychological↗
PubMed1988

Suicide and AIDS.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Post-traumatic stress disorder in Vietnam veterans.

Post-traumatic stress disorder evolved from the concepts of shell shock and traumatic war neurosis. In Vietnam veterans, the disorder is associated with unemployment, marital discord, alcoholism and increased autonomic system response to perceived symbols of war trauma. A combination of psychotherapy and pharmacotherapy is the recommended treatment.

Humans↗
PubMed1988

Tricyclic antidepressant blood levels.

Plasma concentrations of tricyclic antidepressant drugs vary widely among patients. At routine dosage, unexpectedly low plasma levels are noted in some patients, while toxic levels can occur in others. Individual variability may be due to genetic differences in metabolism or to other factors including drug interactions and poor compliance. Pharmacologic management of depressed patients is often improved when guided by plasma concentration monitoring.

Adult↗
PubMed1987

Neuroleptic malignant syndrome as a possible postoperative complication: a case report.

Neuroleptic therapy for postoperative agitation in a mentally retarded schizophrenic patient is described. Clinical features consistent with neuroleptic malignant syndrome (NMS) developed. NMS is a dangerous, drug-induced complication of neuroleptic administrations that can be a differential diagnostic problem. Already often misdiagnosed, this syndrome is especially likely to be unrecognized in nonpsychiatric settings, and may occur postoperatively. Failure to recognize NMS may lead to reexposures to the offending agent, with potentially grave consequences.

Adult↗
PubMed1987

Hemoglobin C in association with hereditary persistence of fetal hemoglobin.

Hemoglobin C and hereditary persistence of fetal hemoglobin (HPFH) are an uncommon combination of hemoglobinopathies. Several tests are needed to verify this condition, among them hemoglobin electrophoresis and Kleihauer-Betke staining of a peripheral blood smear. Family studies are useful in delineating the genetics of the hemoglobinopathy but could not be performed in our case. In more confusing cases or with an unusual subtype, more extensive testing may be required. HPFH, by itself, is without clinical manifestations. It may be confused with other conditions; therefore, its presence in patients with hematologic symptoms requires more precise definition of the hemoglobin abnormality.

Adult↗