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Biomedical subjects

T J Silber

Publications and source records attributed to T J Silber.

At least 55 records · Page 3Linked to original sources
PubMed1986

Approaching the adolescent patient. Pitfalls and solutions.

Over the last three decades, there has been increasing interest in adolescent health care. However, although appreciation of adolescent development and pathology has grown, a crucial topic has been neglected--the influence of the physician's underlying attitudes on his or her treatment of adolescent patients. This review discusses four potential pitfalls in the physician's approach to the adolescent patient: cultural stereotypes, generalization of expertise, countertransference, and professional narcissism. Case presentations illustrate the problems inherent in these areas. Finally, practical solutions to these problems are presented through a systematic approach to an adolescent's office visit, including the use of interviewing techniques, questionnaires, and figure drawings.

Adolescent↗
PubMed1985

Psychosis and seizures following the injection of penicillin G procaine. Hoigne's syndrome.

Psychosis and/or seizures following the administration of intramuscular penicillin G procaine have not been reported in the pediatric literature to our knowledge. This omission is regrettable in light of the frequency with which this treatment is indicated as therapy for gonococcal infections. We report clinical data from four patients afflicted by this reaction known as Hoigne's syndrome. The dramatic and unexpected manifestation of this condition calls for an immediate diagnosis to proceed with the appropriate treatment.

Adolescent↗
PubMed1985

Painless primary herpes.

An adolescent male developed painless but severe genital ulcerations. Evaluation confirmed primary herpes. The medical literature describes the classical presentation of primary genital herpes infection as multiple ulcerations and severe pain, but 5% of male patients present without pain. Consequently, the differential diagnosis of painless genital ulcerations should include Herpes progenitalis.

Adolescent↗
PubMed1985

Spiritual and religious concerns of the hospitalized adolescent.

One of the tasks of adolescence is the development of a value system. The way in which these values are expressed in relationship to illness in adolescence, however, has not been studied. The authors conducted a social science survey to study the spiritual concerns of hospitalized adolescents. One hundred and fourteen hospitalized adolescents, ranging in age from 11 to 19, answered a Likert scale questionnaire on Spiritual and Religious Concerns (SRQ). Analysis of variance was performed to correlate responses with sex, race, religion, type of school, and severity of illness. A subgroup of hospitalized adolescents, those with more serious disease, experienced intensified spiritual and religious concerns. In response to the questionnaire, over 15% of the patients requested further help. Our findings suggest that training in adolescent health care and the provision of services to teenagers ought to include teaching in the area of spiritual and religious values of teenagers, with emphasis on the hospitalized adolescent.

Adolescent↗
PubMed1984

The clinical spectrum of syphilis in adolescence.

Syphilis, due to the spontaneous healing of the initial lesion, is often overlooked by adolescent patients. If undetected and untreated the condition may bring disastrous consequences. To investigate how syphilis first appears, we reviewed the medical history of 33 patients diagnosed from 1977 to 1981. The following main symptoms were found: typical chancre (9%), atypical chancre (9%), rash (45.5%), and marked lymphadenopathy (12%). Four patients were discovered only by a positive serology; four patients with low titers were discovered to have been previously treated and were monitored for evidence of cure. All patients had a positive RPR and FTA-ABS. Eleven patients (33%) had a concomitant venereal disease or a positive past history. A significant number (48%) were troubled, delinquent, or homosexual; 10% were victims of sex abuse. Contrary to general belief, most patients do not consult for a primary chancre. Instead, they present with a broad spectrum of clinical manifestations ranging from a variety of dermatologic signs to diverse degrees of lymphadenopathy, to being completely asymptomatic. Syphilis was not the initial diagnosis in over one-third of our patients. Those caring for adolescents should maintain a high index of suspicion for this disease.

Adolescent↗
PubMed1984

Anorexia nervosa and nephrolithiasis.

A patient with primary anorexia nervosa developed acute abdominal pain and hematuria. Cytoscopy and retrograde pyelography confirmed nephrolithiasis. A calcium oxalate stone was passed. The association between anorexia nervosa and nephrolithiasis has not been previously reported. Dietary factors and chronic dehydration are known to contribute to the development of renal stones; therefore, the association may not be coincidental.

Adolescent↗
PubMed1984

Anorexia nervosa in black adolescents.

Anorexia nervosa has been considered rare or nonexistent among blacks. A report of the presentation and clinical course of this disorder in two black female adolescents illustrates a serious medical psychiatric problem that may be increasingly detected among predisposed teenagers of the black middle and professional classes. Unrecognized and incorrectly treated, the disease may run a fatal course in 20 percent of the cases. Differential diagnosis, etiology, and treatment of the condition are reviewed.

Adolescent↗
PubMed1984

Adolescent health care in Brazil.

The period of youth and adolescence has been shown to have continuous demographic growth in the developing world. Young nations thus have to contend with the specific health needs of teenagers and young adults. This is illustrated by an analysis of the health-care needs of Brazilian adolescents. The issues highlighted here are adolescent morbidity and mortality, current delivery of adolescent health care, and future directions of adolescent programs in Brazil.

Adolescent↗
PubMed1983

Apparent oral contraceptive failure associated with antibiotic administration.

The concomitant use of antibiotics and oral contraceptives should be included in the assessment of contraceptive failure. A case of unwanted adolescent pregnancy during the use of a semisynthetic penicillin and an oral contraceptive is presented and discussed. Advising a different contraceptive method or an additional contraceptive modality may be indicated in adolescents taking long-term antibiotic medication.

Adolescent↗