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Biomedical subjects

J G Allen

Publications and source records attributed to J G Allen.

At least 199 records · Page 11Linked to original sources
PubMed1966

Post-transfusion hepatitis, a serious clinical problem.

Serum hepatitis and infectious hepatitis may have a common pathogen and their few clinical differences the result only of a difference in portal of entry. The risk of serum hepatitis from transfusions derived from prison and Skid Row populations is at least 10 times that from the use of volunteer donors. For every 100 patients receiving a single transfusion, the attack rate is 0.3 per cent when the donor is of the family or volunteer type and 3.2 per cent when the donor is from a prison or Skid Row population. The most practical methods of reducing the hazard of serum hepatitis from blood are to limit the use of blood by giving one transfusion instead of two, two instead of three, etc., and especially by excluding, if possible, all prison and Skid Row donors. It is urged that state and federal control of the quality of blood used for blood transfusions be studied with the possibility that measures may be taken to increase its safety. If it is necessary that blood from prison and Skid Row donors be used to meet the demands, such blood should be labeled as carrying a significantly increased hazard of transmitting serum hepatitis in order that the physician prescribing blood may take the necessary precautions.

Adolescent↗
PubMedDate not supplied

Pharmacokinetics of tenoxicam after oral administration in healthy human subjects of various single doses.

Single oral dose pharmacokinetics of tenoxicam in the dose range intended for therapeutic application of the drug have been defined in healthy human subjects. Twelve male volunteers were given, in random fashion, oral administration of 10, 20 or 40 mg of tenoxicam. Plasma drug levels were determined by a standard HPLC method with U.V. detection. Model-independent analysis showed the clearance, elimination half-life and apparent volume of distribution to be independent of dose with mean values of 0.096 L/h, 76 h and 9.2 L respectively. Interindividual variation was six-fold and individual variation less than two-fold. Similar values for kinetic parameters were obtained by model-dependent methods. The pharmacokinetics of oral tenoxicam were linear in the 10-40 mg dose range and the single dose data predict five-fold accumulation for once daily administration.

Administration, Oral↗
PubMedDate not supplied

Indications for extended psychiatric hospitalization: a study of clinical opinion.

The authors previously developed a conceptual model of factors bearing on length of stay from clinicians' vignettes describing patients considered ideal candidates for various lengths of stay. The previous study was conducted at The Menninger Clinic, the present study at Harding Hospital. The two hospitals provide a worthwhile contrast because Menninger specializes in long-term (LT) stays (averaging 1 year) and Harding in intermediate-term (IT) stays (averaging 2 to 3 months). The Harding findings generally replicated and complemented the Menninger results, and the authors used the combined data to generate a hypothesized set of general indications for various lengths of stay in these private psychiatric hospitals.

Aftercare↗
PubMedDate not supplied

Do clinicians agree about who needs extended psychiatric hospitalization?

This report examines the level of agreement among 194 staff members of The Menninger Clinic and Harding Hospital about the optimal length of stay for 71 types of patients selected on the basis of hypothesized suitability for various lengths of hospitalization. There were differences of opinion associated with hospital affiliation and professional discipline, but there was sufficient consensus to enable the development of comprehensive criteria for predicting required length of hospitalization. The validity of these criteria will be tested in a future treatment outcome study.

Attitude of Health Personnel↗
PubMedDate not supplied

Assessing need for extended psychiatric hospitalization.

The authors developed a set of rating scales to assess a wide range of variables believed by clinicians to influence the optimal length of hospital stay. They report the results of interrater reliability studies, a factor analysis of the scales, and a correlational study of the factors with actual length of stay. They describe the potential applications of the scales to clinical practice and research.

Female↗
PubMedDate not supplied

The adolescent athlete. Part III: The role of nutrition and hydration.

Physically active adolescents have energy requirements far beyond those who are sedentary. Unfortunately, interest in nutrition is rare unless connected to improved performance. The nurse practitioner has the opportunity to instill enthusiasm in the teenager about adequate nutrition and to educate athletes and families on the effects of diet on growth and sports performance. Alternative nutritional practices are investigated, as are potential dangerous starvation and dehydration risks. This article is the third of a three-part series addressing the nurse practitioner's role in health maintenance of the adolescent athlete.

Adolescent↗
PubMedDate not supplied

The adolescent athlete. Part I: Preseason preparation and examination.

The benefits of athletics to adolescent self-image and physical and social growth are widely recognized, but participation in sports also presents inherent risks to this population. Nurse practitioners assist in developing a safe athletic environment for teenagers through preseason preparation and anticipatory guidance. The health maintenance examination and preseason screening merge to form an educational opportunity for the teenager, parents, and coaches. This article is the first in a three-part series addressing the nurse practitioner's role in the health maintenance of the adolescent athlete.

Adolescent↗
PubMedDate not supplied

The adolescent athlete. Part II: Injury patterns and prevention.

Injuries are some of the most universal and blatant downfalls of participation in adolescent sports, and statistics clearly support the need for improved awareness of injury prevention. Teenagers at risk of athletic injury must be identified through increased nurse practitioner knowledge of common adolescent injury (traumatic and overuse), injuries most prevalent in specific sports, training principles, and sports psychology. The role of other support personnel is also investigated. This article is the second of a three-part series addressing the nurse practitioner's role in health maintenance of the adolescent athlete.

Adolescent↗
PubMedDate not supplied

Dissociative detachment relates to psychotic symptoms and personality decompensation.

Previous studies have addressed the prominence of psychotic symptoms in conjunction with multiple personality disorder (now dissociative identity disorder). The present study examines the relation between psychotic symptoms and a more pervasive form of dissociative disturbance, namely dissociative detachment. Two hundred sixty-six women in inpatient treatment for severe trauma-related disorders completed the Dissociative Experiences Scale (DES), and 102 of these patients also completed the Millon Clinical Multiaxial Inventory (MCMI-III). A factor analysis of the DES yielded two dimensions of dissociative detachment: detachment from one's own actions and detachment from the self and the environment. Each of these DES dimensions relates strongly to the thought disorder and schizotypal personality disorder scales of the MCMI-III. We propose that severe dissociative detachment, by virtue of loosening the moorings in inner and outer reality, is conducive to psychotic symptoms and personality decompensation.

Adult↗
PubMedDate not supplied

Dissociative detachment and memory impairment: reversible amnesia or encoding failure?

The authors propose that clinicians endeavor to differentiate between reversible and irreversible memory failures in patients with dissociative symptoms who report "memory gaps" and "lost time." The classic dissociative disorders, such as dissociative amnesia and dissociative identity disorder, entail reversible memory failures associated with encoding experience in altered states. The authors propose another realm of memory failures associated with severe dissociative detachment that may preclude the level of encoding of ongoing experience needed to support durable autobiographical memories. They describe how dissociative detachment may be intertwined with neurobiological factors that impair memory, and they spell out the significance of distinguishing reversible and irreversible memory impairment for diagnosis, patient education, psychotherapy, and research.

Amnesia↗
PubMedDate not supplied

Transference interpretation in the psychotherapy of borderline patients: a high-risk, high-gain phenomenon.

The effectiveness of transference interpretation in the psychodynamic psychotherapy of patients with borderline personality disorder has been highly controversial. Both highly expressive approaches that stress the value of transference interpretation and supportive strategies that eschew transference work have been advocated in the literature. We review this literature and identify three emerging trends in thought: (1) Primarily interpretive approaches should be reserved for patients with greater levels of ego strength. (2) Whichever technique is used, a strong therapeutic alliance is the foundation of treatment. (3) Expressive and supportive techniques should not be juxtaposed as polarized opposites; supportive interventions often pave the way for transference interpretation. Our psychotherapy process study revealed that transference interpretations tended to have greater impact--both positive and negative--than other interventions made with patients with borderline personality disorder. We conclude that such factors as neuropsychologically based cognitive dysfunction, a history of early trauma, patterns of object relations involving interpersonal distance, masochistic tendencies, and anaclitic rather than introjective psychopathology are among the patient characteristics that influence the impact of transference interpretation on the therapeutic alliance. Bias toward expressive technique and countertransference issues appear to be relevant to the therapist's difficulty in shifting to a more supportive approach when indicated.

Adult↗
PubMedDate not supplied

The spectrum of accuracy in memories of childhood trauma.

In the context of public outcry about "false memories" of childhood sexual abuse, many persons with posttraumatic stress disorder are dismayed by their confusion about the historical basis of their intrusive memories. Numerous interacting factors impinge on memory of trauma to yield a broad spectrum of accuracy. In their endeavors to reconstruct coherent narratives of traumatic experience, clinicians and their patients will benefit from thinking in shades of gray rather than in terms of "true" versus "false" memories.

Child↗