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Biomedical subjects

T Silber

Publications and source records attributed to T Silber.

14 recordsLinked to original sources
PubMed2000

Assessing African American adolescents' risk for suicide attempts: attachment theory.

The threat of separation from a parent theoretically increases the risk of adolescent suicide attempts. The present study evaluated this and other hypothesized risk factors in a sample of adolescent suicide attempters and nonsuicidal controls, using the Psychiatric Consultation Checklist (Lyon, 1987). Stepwise logistic regression was used to predict group membership. It was found that threat of separation from a parental figure, insomnia, neglect, substance abuse, suicidal ideation, and failing grades were the strongest predictors of suicide attempt. Ten predictor variables correctly identified 97% of suicide attempters and 86% of nonattempters. Unexpected findings included high levels of truancy, threatening others, and separation from a parent before the age of 12 among nonattempters.

Adolescent↗
PubMed1997

Testing the hypothesis of the multidimensional model of anorexia nervosa in adolescents.

This study statistically tested six hypothesized risk factors of the model for anorexia nervosa. Forty-three adolescents with anorexia nervosa and 85 controls were administered the EAT, EDI, and FES. In addition, 43 parents of anorexics and 85 parents of controls completed the Family History Data Sheet, the FES, and the Perfect Child Questionnaire. Three of six hypothesized risk factors were confirmed: family history of depression, feelings of ineffectiveness, and poor interceptive awareness. Log-linear analysis indicated that the hierarchical model that best fit the data had significant two-way interactions with anorexia nervosa, G2 (11, N = 128) = 65.87, p < .001. In addition, alcohol and drug abuse or dependence figured prominently in the family history of patients with anorexia nervosa. The multidimensional model for anorexia nervosa holds up as an exploratory model of this condition in the adolescent age group.

Adolescent↗
PubMed1986

Long-term morbidity and mortality in morbidly obese adolescents after jejunoileal bypass.

To evaluate the long-term results of jejunoileal bypass in the treatment of morbidly obese adolescents, we studied 11 patients who underwent surgery between 1972 and 1974. More than 10 years after surgery, 45% of the patients had extremely satisfactory results (correction of morbid obesity). Three patients died within the year after surgery, two of them under extenuating clinical circumstances. There have been no subsequent deaths. All eight survivors were found to have metabolic abnormalities to various degrees. Two patients had a total of five pregnancies; each had one healthy infant, and three pregnancies ended in abortion (one spontaneous). Two patients had significant medical problems related to the procedure but basically remained in good health, whereas three patients had severe symptoms requiring reanastomosis. Of the five patients who continue with the bypass, none has become significantly obese. They have all maintained a weight loss of between 45 and 90 kg, and as adults express strong feelings in favor of the procedure. This series demonstrates that, although significant weight loss was maintained, and improvement in the quality of life for half of our patients was dramatic, side effects and complications continue to develop, mandating careful follow-up for an indefinite time.

Adaptation, Psychological↗
PubMed1980

[Complications after surgery of ENT-tumors. A comparison between preoperatively irradiated and nonirradiated patients].

Complications after preoperative high-dosage radiation of head and neck cancer are reported: 1. Preoperative radiation leads to complications in 42% compared to surgery alone in 20%. The results are statistically significant (alpha = 2%). 2. The complications after preoperative radiation are more severe (three ruptures of the carotid artery, three defects, which could only be managed by flap rotation). These results indicate the preoperative high-dosage radiation implies the risk of major surgical complications.

Adult↗
PubMed1980

Use of a sex rap group in an adolescent medical clinic.

This paper reports on a five-year experience with an open-ended weekly group in an Adolescent Medical Clinical. An interdisciplinary staff leading this group includes a counselor trained in sex education, a nurse, a pediatrician and a psychiatrist. The object of the group is to offer an opportunity to adolescent boys and girls to focus on diverse problems of concern to them in an atmosphere of support and sharing. The initial focus is on sexual issues and leads to family planning, but more importantly, there is a general focus on the constructive organization of their life and on investigation of the growth of personal relationships. This teen group gives staff a medium for understanding clinical problems which concern adolescents, while the adolescents are supported in gaining understanding of themselves. In this process there is a development of trust in the clinic as a whole, with better utilization of the entire Adolescent Program.

Adolescent↗
PubMed1980

Abortion in adolescence: the ethical dimension.

The purpose of this essay is to present a bioethical approach to the abortion dilemma in adolescence. It is addressed to health workers involved in the medical care of adolescents and to those involved in adolescent counseling. The introduction presents an overview of the subject in the U.S.A., its medical significance (obstetric, gynecologic, psychologic) as well as some anthropological historico-legal data relating to adolescent abortion. This is followed by a practical description of ethical theory. The main body of the presentation consists of a review of the most important contributions of bioethical thought as they relate to abortion. Adolescent abortion in particular is addressed in the context of issues such as autonomy, rights and responsibility. This includes a description of moral development in adolescence and an analysis of moral aspects of treatment of adolescents. Some personal comments and propositions are made, with the aim of generating further contributions.

Abortion, Induced↗
PubMed1976

Obstetric care in a family health-oriented university associated neighborhood health center.

The structure, staffing, and planning methods of the obstetric component of a family-oriented University Hospital associated family health care facility are briefly described. The interviews and screening procedures are outlined necessary to develop a broad data base for total health care planning. The roles of the members of the multiprofessional team employed are described with particular emphasis on the use of a nurse midwife as the primary obstetric care professional. Management procedures are referred to as well as the educational component present within such a program. The program is evaluated in terms of clinical outcome, patient and professional acceptance, and cost.

Adolescent↗