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Biomedical subjects

B V Reifler

Publications and source records attributed to B V Reifler.

63 records · Page 4Linked to original sources
PubMed1982

Managing families of the demented elderly.

Dementing illness affects about 10 percent of people over 65 years of age, and families encounter many problems as they attempt to care for these relatives. Physicians can assist in several ways, beginning with establishing an accurate diagnosis, as terms such as "senility," "dementia," and "hardening of the arteries" are imprecise and may convey an attitude of hopelessness. A psychiatric, medical, and laboratory evaluation usually leads to a specific diagnosis. About one half of all cases are due to Alzheimer's disease, but there is frequently a treatable component to the demented patient's condition. In addition to making an accurate diagnosis and treating reversible problems, physicians can assist the family in having the patient do all he or she is capable of including increasing specific activities, can help the family understand that even their best efforts may not lead to improvement, can point out ways for the family to balance the patient's needs with their own, and can teach the family how to communicate more effectively with the patient.

Activities of Daily Living↗
PubMed1981

Treatment results at a multi-specialty clinic for the impaired elderly and their families.

Geriatric and Family Services at the University of Washington provides a comprehensive evaluation and treatment program for the impaired elderly, and also offers support, counseling and practical advice for their families. Although most of the 76 patients in this first-year study had cognitive impairment, about one-fourth of them showed unequivocal motor, cognitive and/or affective improvement with treatment for previously undetected illnesses. The rating of "unequivocal improvement" required objective data, as well as corroboration by the patient and family. These therapeutic gains and the increased public interest led to expansion of the program.

Aged↗
PubMed1981

Thiothixene plasma levels and clinical response in acute schizophrenia.

Plasma levels of cis and trans thiothixene were compared to clinical response in 8 acutely schizophrenic inpatients. While absolute plasma levels did not appear to correlate with clinical condition, the data did suggest that increases or decreases in cis plasma levels correlated with corresponding improvements or deteriorations in clinical condition in thiothixene responsive patients. While the results are very preliminary, the authors suggest that future studies differentiate the cis and trans isomers, and analyze relative as well as absolute changes in plasma levels as compared to clinical changes.

Acute Disease↗
PubMed1980

A clinic for the impaired elderly and their families.

The need for improving psychiatric services to the elderly and for recognizing the importance of the family in caring for the impaired elderly led to the establishment of the Geriatric and Family Services, an outpatient clinic. This clinic provides psychiatric, medical, social, nursing, and architectural evaluations and recommendations for impaired older persons and also provides support and practical advice to the family. Most of the clinic's patients suffer from a dementing illness; of this group most have dementia of the Alzheimer's type. The authors studied the appointment-keeping behavior of the patients and also surveyed the patients' families as an indication of the clinic's success. Out of 50 patients the broken-appointment rate, as well as the drop-out rate, was 2%; 90% of the families who responded to the questionnaire indicated they would recommend the clinic's services to others.

Adaptation, Psychological↗
PubMed1979

Recognition of depression in a university-based family medicine residency program.

Physicians diagnosed depression in 4.5 percent (59/1,321) of all patient encounters in this study conducted in a university based family medicine residency program. A subset of residents permitted the investigators to interview those patients who were diagnosed as depressed or who were judged to be at high risk for a missed diagnosis of depression. Of the six patients whom the residents diagnosed as depressed and who agreed to be interviewed, two did not meet the criteria for depression but in neither case was this discrepancy judged clinically significant. Of the 24 patients at high risk for a missed diagnosis who agreed to be interviewed, four met the diagnostic criteria and three of these four missed diagnoses were judged as possibly of clinical significance. While the physicians in this study diagnosed depression more frequently than in previous similar studies, this does not appear to represent over-diagnosis, although the small number of patients interviewed requires that interpretations be made cautiously. The authors suggest that if a primary care physician diagnoses depression in less than 2 percent of patient encounters, he or she should consider the possibility of missed diagnoses.

Academic Medical Centers↗
PubMedDate not supplied

A comparison of the use of tricyclic antidepressants by psychiatrists and non-psychiatric physicians.

In a chart review comparing use of tricyclic antidepressants (TCAs) by psychiatrists and non-psychiatrists, the psychiatrists performed significantly better in documenting a diagnosis of depression, and in documenting length of treatment and continued need for patients already on a TCA. In other areas including route and frequency of administration, and use of multiple psychoactive drugs, there was no difference between the two groups. The authors conclude that performance by psychiatrists is better than for non-psychiatrists but below what might be set as reasonable standards, particularly in the area of documenting specific signs and symptoms of depression in patients receiving a TCA.

Antidepressive Agents, Tricyclic↗