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Biomedical subjects

C M Brodsky

Publications and source records attributed to C M Brodsky.

At least 19 recordsLinked to original sources
PubMed1999

Multicenter evaluation of implantable cardioverter defibrillator testing after implant: the Post Implant Testing Study (PITS).

To reassess the function of the implantable cardioverter defibrillator (ICD) many electrophysiology centers perform a second test after the initial test at implant. A prospective multicenter study evaluated the necessity and yield of routine postimplant defibrillator testing. The results of 843 postimplant defibrillator tests were collected from 31 centers. The 764 routine tests in which ventricular fibrillation was successfully induced were analyzed. Variables examined included patient age, presenting arrhythmia, underlying heart disease, left ventricular ejection fraction, defibrillator age, make and model of ICD, electrode system, defibrillation threshold, polarity, and waveform. The overall failure rate was 3.1% (24/764). Units tested later than 365 days after implant tended to have a higher failure rate than those tested within the first month or the next eleven months (6.5%, 3.0%, 2.3%, respectively, P = 0.374). The failure rate was higher in patients with left ventricular ejection fraction < 40% than those with higher ejection fractions (3.8% vs 2.0%, P = 0.167). These trends did not reach statistical significance. No other baseline characteristic was associated with higher failure rates. Routine testing of ICDs reveals an overall failure rate of 3.1%. While the rate was low, defibrillator failure places the patient at high risk for sudden cardiac death. As any failure in this population is associated with a high risk of sudden cardiac death, routine defibrillator testing may be justified.

Adolescent↗
PubMed1991

Depression and chronic fatigue in the workplace. Workers' compensation and occupational issues.

There is ample evidence that some forms of depression can be caused or aggravated by work. The relationship of work and chronic fatigue syndrome is questionable, but elements at work can aggravate the symptoms of chronic fatigue syndrome. The role of physicians who can support or discourage beliefs about physical illness is all important, both by what they say and how they treat. In the process of interaction, they can promote or discourage disability. The role of the physician in the workplace is to determine if an illness is work related, if it is disabling, if it requires treatment, and what treatment. The physician must advise if the worker can continue in his or her usual and customary employment and, if not, if he or she can be vocationally rehabilitated from a medical standpoint. Conditions in which physical symptoms are unsupported by physical findings and have diagnostic labels that describe the disorder without indicating either cause or pathology are especially troubling for the physician who must decide if the patient's job caused the symptoms.

Chronic Disease↗
PubMed1983

Psychological factors contributing to somatoform diseases attributed to the workplace. The case of intoxication.

Seventy persons who believed they had been injured by inhaling noxious fumes in the workplace and who consequently filed claims for Workers' Compensation benefits were studied. In most cases medical and psychiatric examinations found no organic basis to substantiate the existence of an organic syndrome. The subjects can be divided into two groups. Those in the first group regarded themselves as intact prior to their exposure to toxic fumes at work; while there was clear evidence of exposure to toxins in these cases, there was not evidence to support the subjects' claims of residual injury. Subjects in the second group first experienced symptoms and then became concerned. Subsequently they and some physicians explained the changes as consequences of the inhalation of toxins in the workplace. A small number of these individuals were diagnosed as "chemically hypersensitive." The premorbid personality traits, behaviors, and patterns and functions of disability that were observed are described.

Adult↗
PubMed1983

Culture and disability behavior.

A substantial amount of literature suggests that illness behavior in the United States is a product of a patient's core culture; equally credible findings do not support this contention. Most students and graduates in the health care professions believe that illness and disability behavior are affected by a patient's culture, but they are hard put to find convincing examples of that relationship. In experience with medical students studying the social and cultural bases of illness behavior, with patients who are disabled and with persons who claim disability in the absence of physical disease or disabling psychopathology, I observed no deviant disability behavior that was typical for the members of any cultural group, and no behavior was displayed by the members of one cultural group that was not seen in members of other cultural groups. No cultural stereotypes were upheld. I did find evidence that disability behavior is influenced by personality factors, social situations and the gains derived from the disability status. Evolving concepts of "entitlement," which are closely related to socioeconomic status, also have a significant influence. The impact of feedback from others in a person's many social and medical subcultures is a more crucial determinant of illness and disability behavior, except in those for whom illness and disability behavior is determined by the limitations imposed by the disease or by a personality structure resistant to cultural expectations and social feedback.

Culture↗
PubMed1977

Suicide attributed to work.

Workers' compensation laws provide death benefits for the survivors of those who commit suicide as a result of a work-incurred physical or psychological injury. A study of claims resulting from suicidal acts reveals that included in the indicted work conditions were sudden changes in organization, conflict of loyalties resulting from work change, reactions to pain and suffering following a physical work injury, and the economic and status deprivation resulting from disability and unemployment. Those treating subjects whose jobs were the sources of stress failed to recognize their patients' desperation and urged them to stay at their jobs.

Adaptation, Psychological↗
PubMed1976

Treatment of work-related health problems in a work clinic.

Little is known about patients who chronically express work problems through medical complaints or who develop or exaggerate physical problems to avoid work, the authors say. In 1973 a university-affiliated medical clinic set up a multidisciplinary work clinic to study and treat patients with work-related health problems. In general the clinic's first 18 patients showed emotional immaturity and social or psychiatric dysfunction, often severe. After treatment nine of the 18 returned to work, and two began vocational retraining and later took jobs. The authors believe that because of the close relationship between work and health, medical-care institutions must deal with work problems that patients present.

Adult↗