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Biomedical subjects

A Brodsky

Publications and source records attributed to A Brodsky.

At least 37 records · Page 2Linked to original sources

[Afebrile infections in adult patients with acute leukemia].

Characteristics of afebrile infection episodes among adult patients with acute leukemia are here described. Afebrile episodes represented 14.3% of all infections. They significantly differed from the febrile episodes because: 1) they prevailed among patients with granulocyte count greater than 500/mm3 (p < 0.001); 2) they often involved patients in complete remission (p < 0.0002); 3) they affected more frequently the kidney and urinary tract than febrile infections (p = 0.0005) and 4) they lacked lung involvement (p < 0.01). The rate of documented infections by cultures, cytology or serological tests was not different between both infection types. Observed mortality during afebrile episodes was threefold less than febrile infections; this difference, however, did not reach statistical significance. In conclusion, afebrile infection in acute leukemia is a distinct clinical entity, unlike febrile infection.

Adolescent↗

The rebirth of forensic psychiatry in light of recent historical trends in criminal responsibility.

The forensic specialist's expertise lies in mapping the interaction of cognitive, affective, and physiologic processes as they affect and are affected by the choices people make, and in connecting this analysis with laws, legal criteria, and other standards. More simply and broadly, it lies in describing both the unique and the universal characteristics of any human being and distinguishing clearly between the two. This is a psychiatrist who conducts in a different arena, and from a more critical perspective, but for the same larger humane purpose, the in-depth journey into the self and its response to stress that is the essence of clinical practice.

Forecasting↗

Exact calculation of probabilities of false positives and false negatives for low background counting.

The purpose of this paper is to demonstrate the derivation and use of exact formulas, and their algorithms, for calculating the probabilities alpha of Type I errors, and beta of Type II errors, for low blank total counts (Poisson-distributed). The calculations are carried out to examine the alpha and beta probabilities at low blank levels of the decision level (DL) and minimum detectable amount (MDA) formulations as adopted in the Health Physics Society Standard, "Performance Criteria for Radiobioassay." These formulations are consistent with those published by L.A. Currie, which have received wide acceptance in defining lower limits of detection (LLD). Although Currie's formulation was derived assuming a normal distribution in net counts, the behavior of the distribution of net counts at low count levels, which is a distribution of the difference between two Poisson variates, is such that the MDA formulation in the standard could be considered acceptable for the purpose of providing one simple formulation of MDA. The derivations in this note can also be useful in other problems involving differences in Poisson variates, such as those in certain population studies.

Background Radiation↗

Beyond cognition: the role of disordered affective states in impairing competence to consent to treatment.

Most of the criteria for competence in current use emphasize cognitive rather than affective dimensions. Our clinical experience indicates that affective disorders may impair competence in a detectable and identifiable way. In particular, patients with major affective disorders can retain the cognitive capacity to understand the risks and benefits of a medication, yet fail to appreciate its benefits. A case study of a pathologic grief reaction is introduced to illustrate how cognitive and affective impairments may coexist and require separate remedial strategies for restoration. Further empirical work on the role of affective disorder in impairing competence is warranted and planned.

Aged↗

Stevens-Johnson syndrome, respiratory distress and acute renal failure due to synergic bleomycin-cisplatin toxicity.

A patient presenting with a cervix uteri epidermoid carcinoma had acute renal failure after treatment with cisplatin and bleomycin. She later developed fatal bleomycin-induced pneumonitis and Stevens-Johnson syndrome. This is a very rare association of adverse effects. The risk of causing a drug interaction thus increasing the severity of bleomycin undesired effects must be taken into account when a nephrotoxic drug is added to the former. The authors stress the importance of monitoring renal function under these conditions.

Acute Kidney Injury↗

Parens patriae considerations in the commitment process.

Seventy-one commitment-seeking decisions made by 36 clinicians in a state-funded mental health center were studied to determine the extent to which clinicians attend to legally mandated "dangerousness" criteria in seeking commitment. A previous finding that clinicians rely largely on the dangerousness criteria was replicated. In addition, clinicians were found to be sensitive to clinical indicators of the patient's need for treatment, a question which is central to the parens patriae approach to involuntary hospitalization. Further, patients who were judged to be more seriously ill or more dangerous were more likely to retract their requests for discharge. This finding suggests that the patient's request for release and the psychiatrist's petition for commitment together constitute an interactive, transactional process in which the clinician's and the patient's views of the patient's need for hospitalization influence each other.

Commitment of Persons with Psychiatric Disorders↗