Biomedical subjects

W S Griffies

Publications and source records attributed to W S Griffies.

5 recordsLinked to original sources

PubMed1997

Roles of mental health professionals in multidisciplinary medically supervised treatment programs for obesity.

Excess weight is a major medical problem for more than one third of Americans and, after cigarette smoking, is the second largest cause of death. However, obesity treatments remain controversial, and only surgical therapies have patient volume and appropriate follow-up adequate to prove effectiveness. National Institutes of Health conferences on obesity treatments and the Institute of Medicine have suggested that all obesity treatment programs, including those which are medically supervised, should be multidisciplinary, involving professionals from the behavioral, nutritional, and exercise fields to facilitate delivery of a patient-treatment matching strategy. There are no models to suggest how these recommendations should be accomplished or whether they are financially feasible. We present a case management model that includes psychotherapists in a multidisciplinary obesity treatment program. More data are needed to show whether these suggestions improve cost-effectiveness of obesity treatments.

Behavior Therapy↗

PubMed1995

A combined treatment approach to anxiety in the medically ill.

Anxiety occurs frequently in patients who are medically ill. A proper search for the underlying cause of the anxiety is essential if the clinician is to make a correct diagnosis and initiate appropriate treatment. Two aspects of the patient's history are particularly important during assessment: the duration and severity of medical illness (and treatments) and the duration and severity of anxiety symptoms. When acute anxiety is encountered, the clinician must rule out a rapidly worsening medical condition, substance-induced anxiety (toxicity or withdrawal), and a psychological reaction to stressors associated with the medical illness. During evaluation of medically ill individuals with chronic anxiety, the clinician must rule out medical disorders that can mimic anxiety disorders, psychiatric disorders associated with anxiety symptoms, and poor adjustment to the medical illness. It is also worth remembering that anxiety disorders occur at an increased frequency in individuals who have chronic medical illness.

Aged↗

PubMed1989

Steroids in rhinoplasty.

A prospective double-blind randomized pilot study was performed to test the benefits of steroids versus placebo in controlling edema and ecchymosis in rhinoplasty within the immediate postoperative period. Thirty consecutive patients who underwent rhinoplasty with osteotomies were entered into the study. Sixteen patients received 10 mg of intravenous dexamethasone before the procedure and 14 patients received placebo. All rhinoplasties were performed by residents under the supervision of staff otolaryngologists. A 4-point scale was used to assess the extent of periorbital edema and ecchymosis at 24 hours postoperatively. A one-time bolus of 10 mg of dexamethasone was beneficial in decreasing edema and ecchymosis in rhinoplasty. This benefit was demonstrated statistically (p less than .005). No complications were attributed to the administration of dexamethasone.

Adolescent↗

PubMed1988

Spontaneous tonsillar hemorrhage.

Spontaneous tonsillar hemorrhage (STH) of non-iatrogenic causes occurs most frequently from infection. Infection can lead to erosion into a major vessel, such as the carotid artery or a smaller peripheral tonsil vessel. Whereas fatal erosion into a major vessel from a deep neck abscess was relatively common in the past, it is rare since the advent of antibiotics. Spontaneous tonsillar hemorrhage, when it does occur, appears to occur most commonly in a peripheral tonsil vessel from bacterial tonsillitis. Medical records of 860 patients with conditions considered to be susceptible to STH were reviewed. Ten cases of STH were identified. All were from peripheral tonsil vessel hemorrhage; none was secondary to major vessel erosion. Bacterial tonsillitis was the most common cause of STH and occurred in 8 of 10 cases. This condition accounted for an incidence of STH in tonsillitis of 1.1%. A history of chronic tonsillitis appeared to predispose a patient to STH. Other causes of STH were infectious mononucleosis and neoplasm. Seven of the ten peripheral STHs presented with bleeding from an obvious venous source. The other three patients had significant hemorrhages which led to arteriography. Arteriograms are indicated in patients with clinical features suggesting possible major vessel erosion or in those patients where significant bleeding is not from an obvious peripheral source. A peripheral STH can be successfully managed with local intervention and tonsillectomy.

Acute Disease↗

PubMed1985

The role of fine needle aspiration in the management of the thyroid nodule.

The role of fine needle aspiration (FNA) in the management of the patient with a thyroid nodule continues to be controversial. We present a retrospective study of 69 patients who underwent FNA for thyroid nodules over a two-year period. No false positive or false negative fine needle aspirations are reported in 22 patients who underwent surgery. From the results of this study and other studies in the literature, we feel that ultrasonography and thyroid scans are of minimal additional benefit in determining whether a nodule is benign or malignant. It is our opinion that FNA, along with clinical assessment, should be the diagnostic test to determine the management of the thyroid nodule in centers with personnel experienced in FNA.

Adult↗