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Biomedical subjects

D Lieberman

Publications and source records attributed to D Lieberman.

138 records · Page 8Linked to original sources
PubMed1977

An outpatient drug program for adolescent students: preliminary evaluation.

Adolescent students with drug problems were rostered by their schools at the program facility one-half day per week. Treatment was aimed at increasing communicativeness through art, video, music, group therapy, and individual counseling when appropriate. After 4 months, school personnel, students, and treatment staff indicated that drug taking had decreased and general adjustment improved. Statistically, the treatment group (N = 42) improved significantly more than a control group (N = 37) in school attendance. They also tended to do better in academic, behavior, and work habit grades although these differences did not reach statical significance. Further similar early intervention studies are warranted.

Adolescent↗
PubMedDate not supplied

Chlamydia pneumoniae community-acquired pneumonia: a review of 62 hospitalized adult patients.

In a prospective study, Chlamydia pneumoniae was identified as the etiological agent in 62 (17.9%) of 346 adult patients hospitalized over the course of one year for community-acquired pneumonia at the Soroka Medical Center in Beer-Sheva, Israel. The diagnosis of C. pneumoniae infection was based on serological testing of antibodies by the MIF technique. In 43 of these patients (69.4%), at least one other etiological agent, in addition to C. pneumoniae for community-acquired pneumonia was identified. Streptococcus pneumoniae was identified in 34 patients with C. pneumoniae (54.8%), as an additional causative factor in infection. Community-acquired pneumonia patients with C. pneumoniae were significantly older than non-C. pneumoniae patients (p = 0.03), had a higher APACHE II score on admission (p < 0.05), a higher rate of positive blood cultures (p = 0.02), and longer periods of hospitalization (p = 0.022). Seven patients with pure C. pneumoniae infection recovered, despite treatment which is not considered to be specific for C. pneumoniae. It was concluded that C. pneumoniae is a common etiological agent for community-acquired pneumonia in our region, particularly in the elderly, and is characterized by a high rate of concomitant infections with other pulmonary pathogens. No specific clinical or radiological pattern was discerned that could distinguish between C. pneumoniae community-acquired pneumonia and non-C. pneumoniae community-acquired pneumonia.

Adolescent↗
PubMedDate not supplied

IL-1beta and IL-6 in community-acquired pneumonia: bacteremic pneumococcal pneumonia versus Mycoplasma pneumoniae pneumonia.

Interleukin-1beta (IL-1beta) and interleukin-6 (IL-6) levels in 20 patients with bacteremic Streptococcus pneumoniae community-acquired pneumonia (CAP) were compared with these cytokine levels in 20 patients with Mycoplasma pneumoniae CAP. All 40 patients survived hospitalization and underwent a follow-up examination one month later. Serum IL-1beta and IL-6 levels were determined by the enzyme immunoassay (EIA) method using commercial kits. In the acute phase of CAP, IL-6 levels were significantly higher in the S. pneumoniae group (p = 0.014), while IL-1beta levels were higher in the M. pneumoniae group (p = 0.046). In the convalescence phase, the two cytokines were detected in a considerable number of patients in both groups. In this phase, only the level of IL-1beta was significantly higher in the M. pneumoniae group than in the S. pneumoniae group (p = 0.03). We conclude that the levels of IL-1beta and IL-6 are different between patients with S. pneumoniae-CAP and M. pneumoniae-CAP during the acute phase. In the convalescence phase, cytokine levels remain high in some of the CAP patients, but a significant difference between the groups exists only for IL-1beta. Further studies are required.

Adult↗
PubMedDate not supplied

Endoscopic palliation for esophageal cancer.

Endoscopic esophageal dilation, laser therapy, and plastic and metal stent placement provide effective palliation of dysphagia in most patients with esophageal cancer. Because the techniques and indication are still being refined, the choice of endoscopic palliation should be based on patient-specific factors such as location and character of the tumor and more importantly on the availability of physician expertise.

Alloys↗
PubMedDate not supplied

Esophageal intramural pseudodiverticulosis.

A 66-year-old man presented with severe chronic dysphagia and weight loss. A barium esophagogram revealed a proximal esophageal stricture and multiple pseudodiverticula. After death from aspiration pneumonia, a postmortem examination revealed extensive esophageal pseudodiverticulosis. Clinical presentation, pathogenesis, diagnosis, and management of this unusual disorder are reviewed.

Aged↗
PubMedDate not supplied

Changes in health status for persons with wrist or hand impairments receiving occupational therapy or physical therapy.

OBJECTIVE: The purpose of this study was to describe changes of health status as perceived by clients with hand or wrist impairments who received rehabilitation in acute, orthopedic outpatient facilities from occupational therapy or physical therapy personnel. METHOD: One thousand three hundred ninety-nine adults with wrist (n = 692) or hand (n = 707) impairments who were treated between July 1996 and June 1997 were selected from the Focus On Therapeutic Outcomes, Inc. (FOTO) national rehabilitation database. Each client completed a health status questionnaire on intake and discharge. Data consisted of number of outpatient visits, duration of treatment episode, and health status scores for six functional scales. Measures of intensity, global health status, global utilization, and client satisfaction were calculated. Outcomes were evaluated across occupational therapists and physical therapists. RESULTS: Clients perceived improvement (p < .05) in their health status over the course of therapy. Number of visits and measures of health status and client satisfaction were similar across type of therapist. Episode duration was longer (p < .05) and intensity was less (p < .05) for clients seen by occupational therapists. CONCLUSION: Clients receiving rehabilitation in acute orthopedic outpatient centers perceived improvement in their functional abilities and health and well-being (global health status and individual functional scales) over the time during which treatment was provided. Results confirm the responsiveness of the outcomes instrument to clinical change in the clients' perception of their health status over the course of therapy and support the use of health status as a measure of clinical outcome.

Activities of Daily Living↗
PubMedDate not supplied

Physician-only and physician assistant statutes: a case of perceived but unfounded conflict.

In the 1970s, after the US Supreme Court declared in Roe v Wade that a woman has a fundamental right to terminate a pregnancy, most states enacted laws decriminalizing abortion. Generally, these statutes legalized abortion when performed by a physician. (Only six states--AZ, KS, NH, OR, VT, WV--do not require explicitly that abortions be performed by physicians.) At around the same time, but for different reasons, most states adopted regulatory measures establishing and defining the profession of physician assistant (PA). These laws broadly define the scope of practice of PAs as the practice of medicine by trained and licensed professionals under the supervision of physicians. Inconsistencies between physician-only abortion laws and PA statutes have generated confusion in the medical community as to whether PAs, working under the supervision of physicians, can legally perform abortions. Using three case studies, this article examines the statutory dynamic against the backdrop of the severe and intensifying shortage of trained abortion providers in the United States. The authors conclude that the perceived conflict between physician-only and PA statutes should not preclude PAs from providing this vital service.

Abortion, Legal↗