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Biomedical subjects

E Kaufman

Publications and source records attributed to E Kaufman.

At least 55 records · Page 3Linked to original sources
PubMed1994

Comparison between intranasal and intravenous midazolam sedation (with or without patient control) in a dental phobia clinic.

Two new modes of sedation; patient-controlled sedation (PCS) and intranasal sedation (INS) were compared with the traditional bolus intravenous sedation (BIVS) while delivering dental care to apprehensive patients in a specialized dental fear clinic. Effective sedation was evaluated in a randomized, prospective study in 42 ASA 1 and 2 patients, in a factorial design. Eighteen patients were sedated with .5% midazolam INS. Ten patients received intravenous PCS via a patient-controlled analgesia pump containing midazolam, and 14 patients received intermittent intravenous boluses of 1 mg midazolam given as needed (BIVS). Appropriate local anesthetic nerve blocks with 2% lidocaine with 1:100,000 epinephrine, and supplementary inhalation of nitrous oxide and oxygen via a nasal mask, were also given to all patients in the study. The dosage requirement with PCS was higher than that found with INS or BIVS. However, PCS produced some anxiety reduction when compared with INS and BIVS. It also reduced interfering movements during treatment more effectively than the other sedation modes. No complications were detected in any of the patients and they were able to leave the clinic within 1 hour after completion of treatment.

Administration, Intranasal↗
PubMed1994

A control profile of adult children of alcoholics: a preliminary investigation.

In order to more precisely investigate the nature of control and self-control issues for adult children of alcoholics (ACA), a group of ACAs was compared to a group of sex and age matched healthy normals and a sex matched group of college students on the Shapiro Control Inventory (SCI). The SCI provides a profile that is both general domain (positive sense of control, desire/efforts for control, agency of control, and mode of control) and domain specific (body, mind, interpersonal, self, career, environment). Analysis of variance and subsequent planned comparisons on the SCI showed significant differences between the ACA and the two comparison groups in general domain sense of control, in three of the four general domain mode quadrants, and in the domain specific areas of body, mind, interpersonal, and career. Individual areas where ACA subjects felt most out of control were weight, significant other, and family of origin; 89.5% felt concern with self-concept, stress, and relationship with significant other. Although a small subset of ACAs had a strikingly high "in control" profile, most did not. Finally, the sense of control profile of ACAs is compared with two clinical populations--borderline and depression--and is shown to fall midway between the clinical and normative groups. Guidelines and suggestions for further research are offered.

Adolescent↗
PubMed1993

Comparison of oral triazolam and nitrous oxide with placebo and intravenous diazepam for outpatient premedication.

Triazolam was evaluated as an oral sedative agent for dental outpatients in two studies in the oral surgery model. The first study demonstrated that 0.25 mg of triazolam in combination with nitrous oxide provides therapeutic effects but with a more rapid recovery than a 0.50 mg dose in combination with nitrous oxide. In the second study, triazolam produced a significant anxiolytic effect that was comparable to the effects of diazepam titrated to the usual clinical endpoint (mean dose = 19.3 mg). Less impairment in cognitive-psychomotor impairment and ambulatory function was seen after triazolam in comparison with diazepam. Triazolam appears to be a safe, effective alternative to parenteral sedation with a benzodiazepine for dental outpatients.

Administration, Oral↗
PubMed1993

Analysis of [1-13C]D-glucose metabolism in cultured astrocytes and neurons using nuclear magnetic resonance spectroscopy.

The metabolism of [1-13C]D-glucose by astrocytes, neurons and mixed astroglial/neuronal cultures derived from the striatum of fetal rats was studied using NMR. Metabolic activity was studied in resting and depolarized cells (55 mM K+), with dibutyryl cyclic-AMP added to the medium to promote cell differentiation, and with glutamate (0.1 mM) included in the medium. Due to sample limitations the accumulation of 13C label in metabolites within the cells was not sufficient to quantitate. Of the metabolites released into the medium by the astrocyte cultures and the mixed astroglial/neuronal cultures, measurable amounts of label were present in lactate C-3 and C-2, glutamine C-2, C-3 and C-4, acetate C-2, citrate C-2 or C-4 and C-3, glycerol C-1 or C-3, succinate C-2 or C-3 and several unidentified metabolites. Of the labeled metabolites released into the medium, only succinate was markedly affected by K(+)-induced depolarization, dBcAMP, or glutamate. The label in succinate was increased, especially in the K(+)-depolarized astrocyte cultures (3- to 6-fold). The neuronal cultures consumed [1-13C]D-glucose much more slowly than the astrocyte cultures or the mixed cultures. Except for lactate C-3, there was no measurable 13C in metabolites in the medium of the neuronal cultures.

Acetates↗
PubMed1992

Recent developments in understanding and treating drug abuse and dependence.

Although some progress appears to have been made in curbing the spread of drug abuse, it is still widespread in American society. The authors summarize current relevant issues in addiction psychiatry. New developments are described in the areas of epidemiology, heredity and environmental influences, neuroreceptors and neurotransmitters, AIDS, diagnostic classification, psychopathology, psychodynamics, new psychotherapeutic approaches, the efficacy of psychotherapy, and pharmacologic treatment. New findings confirm the important role of the psychiatrist and other mental health practitioners in many aspects of drug abuse research and treatment.

Combined Modality Therapy↗
PubMed1992

Staircase assessment of the magnitude and time-course of 50% nitrous-oxide analgesia.

The analgesic effect of 50% nitrous oxide and oxygen on thermal pain sensations was evaluated in a placebo-controlled, double-blind crossover design. In a session immediately before oral surgery, 20 patients used a seven-point verbal scale to rate the intensity of pain sensations evoked by three-second thermal stimuli delivered to 14 sites on the volar forearm at 20-second intervals by a 1-cm-diameter contact thermode. Subjects rated 36 stimuli while breathing room air and then two additional sets of 36 stimuli while inhaling 50% nitrous oxide and oxygen during one set and oxygen placebo during the other. Each of these two stimulus sets was preceded by a two-minute induction of the agent, and the sets were separated by a three-minute washout period. Order of administration was randomized and counterbalanced. Stimulus temperatures were adjusted continuously by an interactive computer program so that response could be maintained at predetermined levels. This method resulted in a continuous measure of analgesia in units of stimulus intensity. Results showed that, in comparison with placebo, nitrous oxide significantly increased the stimulus temperatures (mean = 0.42 degrees C) required to make the same response [F (11,209) = 6.76, p less than 0.0001], indicating analgesia. This increase was one-third to one-half that observed with clinical doses of intravenous fentanyl. Analgesic effects were apparent at three min and wanted 10 min after termination of nitrous-oxide inhalation. These times closely correlated with previous measures of alveolar concentration, further supporting the fast but modest analgesic action of nitrous oxide.

Anesthesia, Dental↗
PubMed1992

Transligamentary anesthesia: a review.

Intraligamentary anesthesia or, as we prefer to call it, transligamentary anesthesia (TLA) is one of the more recent developments in the field of pain blockage in dentistry. This review article organizes the vast amount of information, both current as well as past, found in the dental literature. After a general historical introduction, indications for TLA use are explained. This is followed by a technical examination of the anesthesia, including the various syringes in use, the preferred injection technique, and the types and volume of anesthesia solutions used. Other aspects of TLA, including the rate of success, onset time, duration, and animal/laboratory studies, are then examined. The various advantages and disadvantages of TLA are discussed along with adverse reactions, limitations, and patient acceptance. The article closes with a look at the diagnostic possibilities of the injection as well as a call for future research on this important development.

Anesthesia, Dental↗
PubMed1992

Dental anxiety and oral health in young Israeli male adults.

Dental anxiety may be a serious limiting factor in providing adequate dental treatment. The present study sought to define the prevalence of dental anxiety in a cross-section of young Israeli adults (389 male Israeli army recruits) to correlate anxiety scores with their oral health status and to compare the findings with existing data. The main stimuli triggering anxiety were found to be in the following descending order: seeing the needle, feeling the drill, and feeling pain despite local anaesthesia. A positive correlation was found between the degree of anxiety and the dental status; the highest percentage of untreated patients was found in the high anxiety group. It is concluded that young adult Israeli males manifest dental anxiety in a manner similar to that reported in the United States and Sweden. Dental anxiety may be an important factor in the avoidance of seeking dental care.

Adolescent↗
PubMed1991

Pulp narrowing in renal end stage and transplanted patients.

A comparison of relative dental pulp size in chronic renal disease patients with dental pulp size in healthy controls revealed a significant pulp narrowing in the kidney disease group (n = 44). A strong correlation between the chronicity of the renal disease and the pulp narrowing was found in the premolar and molar teeth of the tested group. A review of the literature concerning pulp narrowing is also presented.

Adolescent↗
PubMed1991

Evaluation of students' performance in obtaining local anaesthesia in children.

This study was designed to determine the success of various local anaesthesia techniques as assessed by the presence or absence of pain during restorative procedures performed by senior undergraduate dental students in a pedodontic clinic. Data gathered from the treatment of 151 patients by 43 students recorded the frequency of pain complaints during procedures for which local anaesthesia had been employed. It was found that 73% of the administrations were successful. The proportion of children who complained of pain during the operative procedure was significantly higher in those with a previous history of a painful dental experience.

Adolescent↗
PubMed1991

Postgraduate medical fellowship training in alcoholism and drug abuse: national consensus standards.

This paper describes the historical background of the Consensus Standards for Postgraduate Medical Fellowships in Alcoholism and Drug Abuse, developed for the American Academy of Psychiatrists in Alcoholism and Addictions and the Association for Medical Education and Research in Substance Abuse. These standards were prepared by a National Advisory Committee of the Center for Medical Fellowships in Alcoholism and Drug Abuse, which includes 23 leading figures in academic medical training in the addiction field. The standards define general information, facilities and resources, the educational program, and the specific knowledge and skills appropriate to fellowship training. The standards were designed to provide a model for optimal training for residency affiliated fellowships to be used by faculty, trainees, and organizations setting training standards.

Alcoholism↗
PubMed1991

The attitude of patients at risk for infective endocarditis toward dental treatment.

This study deals with four major characteristics that directly affect motivation and attitude of patients at risk for infective endocarditis (IE) toward oro-dental health. Dental anxiety, self image, recognized importance of oro-dental care, and active coping were self-assessed by 25 patients at risk for IE and by a matched control group. The study group demonstrated less dental anxiety, lower self image and higher levels of recognized importance of oro-dental care than the controls, while active coping did not differ between the two groups. A review of the relevant literature is also presented.

Adult↗
PubMed1991

Comparison between the psychopathological profile of dental anxiety patients and an average dental population.

The psychological characteristics of 38 patients with extreme dental fear were compared with those of an age and sex matched control group chosen from the average population visiting the dental clinic. The results were assessed by means of the Kleinknecht Dental Anxiety test, the Brief Symptom Inventory and Spielberger Anxiety State questionnaires. The majority of the dental fear patients were women, the male/female ration being 0.29. In the sample group, the dental anxiety manifested as a state and not as a trait: the anxiety state mean score of the dental phobic group was significantly higher than that of the controls (p less than 0.05), while the mean score for anxiety trait did not differ. Profound psychopathological distress other than anxiety was present only among the phobic males.

Adolescent↗
PubMed1990

Viralization due to Leydig cell tumor diagnosis by magnetic resonance imaging. Case management report.

A 3-year-old boy who presented with signs of virilization had a Leydig cell tumor of the left testis that could not be detected by physical examination or by high resolution ultrasonography. His very small tumor was demonstrated by magnetic resonance imaging. The implications of adding this sensitive method of imaging to the evaluation of prepubertal virilization of presumed testicular etiology are discussed.

Child, Preschool↗
PubMed1990

The relationship between child and adult psychopathology in children of alcoholics.

Children of alcoholics (COA) and adult children of alcoholics (ACA) are identified as a group with recognizable characteristics resulting from their childhood situation. The major conclusions in the literature regarding the psychosocial consequences of being a COA are reviewed. Two lists, one for children and one for adults, are provided which summarize these consequences. Variables which influence these effects are discussed, as well as the development of adult psychopathology from child psychopathology. Treatment strategies designed to prevent this development are reviewed briefly and a resource table for COAs is presented.

Adolescent↗
PubMed1990

Predicting the posttreatment depressive state of an alcoholic patient.

Seventy-eight patients admitted to an alcohol treatment program were studied to identify variables capable of forecasting a patient's posttreatment depressive state. Factor analysis reduced a large number of items to 12 factors. Pearson correlations showed that Factor VII--Physical and Neurological Complaints and the pretreatment depressive state were both significantly (p = .002) correlated to the posttreatment depressive state. Multiple regression yielded a significant equation (p = .001) confirming that an alcoholic patient who has a high level of pretreatment depression and physical/neurological complaints, and who exhibits little or no irritability or agitation will tend to sustain a high level of posttreatment depression.

Adult↗