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Biomedical subjects

E J Wiseman

Publications and source records attributed to E J Wiseman.

15 recordsLinked to original sources
PubMed1997

Outcomes of patients in a VA ambulatory detoxification program.

OBJECTIVE: The study examined outcomes of patients enrolled in a Veterans Affairs ambulatory detoxification program. METHODS: Descriptive statistical data were collected by routine clerical processes at a VA medical center. Patients' outcomes were operationally defined to include completion of the detoxification program, dropout or discharge, or re-enrollment in the program; admission to inpatient detoxification; and referral to, entry into, and completion of substance abuse rehabilitation after detoxification. Outcomes were determined for 517 of the 577 patients consecutively referred to the program during nine months in 1995. Patients met established criteria for mild to moderate alcohol withdrawal syndrome. RESULTS: Of the 517 patients, 453 successfully completed outpatient detoxification. Twenty patients dropped out, 19 were discharged, 37 re-enrolled, and 25 were admitted for inpatient detoxification. Of the 453 patients who completed outpatient detoxification, 434 were referred for further treatment; 415 entered and 322 completed the next treatment phase. CONCLUSIONS: The completion rate for patients in the outpatient detoxification program and rates for continuing and completing further treatment were higher than in previous studies. Measures of poor short-term outcome (dropout, re-enrollment, and admission to inpatient detoxification) also compared favorably with previous studies. Unique factors contributing to outcomes included systematic screening, medical protocols for detoxification, psychosocial therapies, program-supported housing, and attention to patient satisfaction.

Adult↗
PubMed1996

Relation of denial of alcohol problems to neurocognitive impairment and depression.

Forty-six participants in an alcohol rehabilitation program were assessed to determine whether neuropsychological impairment was associated with a higher level of denial of alcohol-related problems and whether depressive symptoms were associated with a lower level of denial. Denial was measured based on the discrepancy between patients' rating of their alcohol-related problems on a visual analogue scale and a psychiatrist's rating. The neuropsychological functioning of the 15 patients in the group who denied alcohol problems was similar to that of the other patients. A modest inverse correlation was found between the level of depressive symptomatology and the level of denial.

Adult↗
PubMed1996

Comparison of DSM-III-R symptoms for alcohol dependence between patient self-report and clinician interview or the Structured Clinical Interview for DSM-III-R.

This study sought to determine which Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (DSM-III-R), symptoms of alcohol dependence were most sensitive to under-reporting by 78 inpatients from alcohol treatment programs. We hypothesized that patients would be more reluctant to report social/behavioral symptoms (lost time, hazardous behavior or major role interference, and reduced activities) than psychological or physiological symptoms. Patient endorsement of symptoms on a self-administered diagnostic questionnaire was compared with parallel items on the Structured Clinical Interview for DSM-III-R (SCID) and clinician interview. Bias and Prevalence Adjusted Kappas for individual symptom agreement ranged from -.02 to .87. Subjects endorsed fewer symptoms per category than either the SCID or clinician interview. Using a Student-Newman-Kuels post-hoc analysis at the p < .05 level, we found that mean agreement for the social/behavioral category was significantly lower than mean agreement for the other categories.

Adult↗
PubMed1996

Reliability of paper-pencil assessment of drug use severity.

This research examines whether self-reported information about drug use severity can be obtained as reliably using a paper/pencil format as the traditional interviewer format. A sample of 67 patients seeking treatment for substance use disorders was recruited from a Veterans Administration Medical Center. Subjects self-reported information related to drug use severity using both paper/pencil and interview formats. The results of comparisons of the two approaches indicate that method of test administration does not affect the test-retest reliability for most questions tested. Test-retest reliability estimates for these relatively brief indicators of drug use severity generally ranged from good to excellent. Although assessing drug use severity using a paper/pencil format is certainly not appropriate for all individuals with substance use disorders, for many individuals and situations it may prove to be a cost-effective alternative to the interview format. Further research is required to determine if parallel paper/pencil versions of widely used interviews can be developed.

Adult↗
PubMed1996

Combined use of cocaine with alcohol or cigarettes.

Cocaine abusers (N = 42) from an inpatient drug rehabilitation program were interviewed regarding combined use of cocaine with alcohol or cigarettes. Concurrent use of alcohol and cocaine was reported by 37 patients and concurrent use of cigarettes and cocaine by 41 patients. All but two concurrent users reported simultaneous use of alcohol or cigarettes with cocaine. Increased cocaine effect was perceived by 43% of simultaneous alcohol users compared with 15% of simultaneous cigarette users. Patients experienced decreased craving for cocaine and alcohol during treatment, but craving for cigarettes remained essentially unchanged.

Adult↗
PubMed1996

The older driver: a handy tool to assess competence behind the wheel.

Predicting with certainty which older patient will have driving problems is not possible, as standardized guidelines do not exist. In the absence of guidelines, the mnemonic SAFE DRIVE outlined in this article can help you identify important risk factors for unsafe driving. Risk factors included in SAFE DRIVE are problems with vision and reaction time, intellectual impairment, a poor safety record, alcohol abuse, use of certain medications, poor attentional skills, impaired executive functions, and a family report of driving problems. Most of these factors can be identified with a careful history, physical examination, in-office tests of cognitive function and alcohol use, and an interview with family member(s).

Aged↗
PubMed1993

Conversion mnemonic.

Explore the source record for details and available documents.

Attitude of Health Personnel↗
PubMed1991

Potassium channel blockers: could they work in Alzheimer disease?

Many of the actions of potassium channel blockers, such as 4-aminopyridine, appear to complement the deficits in Alzheimer disease. The two clinical studies in the literature are contradictory, so potassium channel blockers may still merit trial in Alzheimer disease.

4-Aminopyridine↗
PubMed1991

A checklist for managing the dementia patient.

Primary care physicians seeing a growing number of elderly demented patients must consider a number of problem areas when treating such patients. This article offers the mnemonic FICS'M (Family, Intellectual status, Continence, Sleep, and Mobility) to help physicians address treatable problems associated with dementing illnesses. Strategies are offered to minimize morbidity from the particular problem and from the treatment, such as trying "low toxicity" therapies and medications with few side effects. Other medical, ethical, and legal issues are discussed, including handling dangerous behaviors and abuse, nursing home placement and autopsy, and specific treatment of both the dementia itself and associated disorders--agitation, depression, and delirium.

Aged↗