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Biomedical subjects

J J Strain

Publications and source records attributed to J J Strain.

At least 199 records · Page 11Linked to original sources
PubMed1989

The problem of psychiatric diagnosis for the pain patient in the general hospital.

Because of the difficulty in applying psychiatric diagnostic nomenclature to the problem of pain in the medical setting, medical and surgical inpatients referred for a psychiatric consultation with pain as a presenting complaint (N = 167) are compared with "nonpain" patients (N = 1,634). "Pain" patients were more often male (p less than 0.05), had additional presenting problems of coping with their illness (p less than 0.0001), drug misuse and abuse (p less than 0.0001), and terminal illness (p less than 0.0001); evidenced less severity of psychiatric impairment (p less than 0.05); received different treatment recommendations; and were more likely to be assigned less frequently employed DSM-III psychiatric diagnoses than those most commonly found in consultation populations. However, these diagnoses were nonspecific for the problem of pain and provided minimal information about the nature of the pain. Enhancements of the diagnostic classification systems that would better address the nature of the psychiatric disorders associated with pain are presented.

Adaptation, Psychological↗
PubMed1989

Reliability, validity, and temporal stability of the geriatric depression scale in hospitalized elderly.

The reliability, validity, and temporal stability of the Geriatric Depression Scale (GDS) were studied in sixty-nine elderly patients who had their broken hips surgically repaired. The GDS demonstrated internal consistency reliability and concurrent validity with the Hamilton Depression Rating Scale. In addition, the GDS was stable across the hospital stay and thus appeared to be less influenced by the patients' acute health status.

Aged↗
PubMed1989

Psychiatric consults on medical and surgical wards: a six year study.

Using a psychiatric consultation database 1,463 consults were completed over a six-year period (1980 to 1986). Many variables were studied, including demographics, who requested the consults, the reasons for consultation, DSM-III diagnoses, and treatment recommendations. Most variables were unstable from year to year despite thorough and consistent supervision. This study demonstrates the vulnerability of traditionally reported consultation data in establishing norms for defining psychiatric morbidity in the hospital. Future recommendations are discussed.

Adult↗
PubMed1989

Increased hepatic lipid peroxidation with methionine toxicity in the rat.

Consumption of excess methionine by rats is known to cause membrane damage, liver enlargement and accumulation of iron in the spleen. In this study two groups (n = 5) of male, Wistar rats were pair-fed either a methionine supplemented (20.0 g/kg) or control (2.0 g/kg) diet for 7 weeks. Hepatic and erythrocyte copper-zinc superoxide dismutase activities were significantly reduced (P less than 0.05 and P less than 0.001 respectively) by methionine supplementation while the activities of catalase (P less than 0.01 and 0.05) and glutathione peroxidase (P less than 0.05) were significantly increased. Methionine supplementation also increased hepatic lipid peroxidation (P less than 0.01), as measured by the level of thiobarbituric acid reactive substances, and iron (P less than 0.001) concentrations. These changes are indicative of increased oxidative stress resulting from methionine toxicity.

Animals↗
PubMed1988

Screening devices for diminished cognitive capacity.

This study compares three commonly used tests to detect organic mental disorders: the Mini-Mental State (MMS), Cognitive Capacity Screening Examination (CCSE), and Tachistoscope (T-Scope). Ninety-seven medical-surgical inpatients at the Mount Sinai Hospital referred for psychiatric consultation had a Missouri Mental Status Examination performed by a psychiatrist who also rated the patients' organic mental disorder as "none," "mild," "moderate," or "severe." The CCSE, MMS, and T-Scope, respectively, showed: sensitivity--0.54, 0.52, 0.68; specificity--0.85, 0.76, 0.79; and positive predictive value--0.83, 0.74, 0.79. False negatives occurred more often among those patients with mild organic mental disorders with all instruments (p = 0.05), while the T-Scope could not be administered in 27% of the patients. Screening instruments with increased acceptability, sensitivity, and specificity need to be developed to identify a potentially life-threatening disorder.

Adult↗
PubMed1988

Interventions in consultation-liaison psychiatry: the development of a schema and a checklist for operationalized interventions.

A literature review and pilot investigations reveal that (ward-) management consultation-liaison (C/L) psychiatry recommendations are infrequent and unsystematically used. Furthermore, the communication with the operational group as defined by Meyer and Mendelson is not sufficiently activated. The major focus of the consultation is the first contact, but follow-up is infrequent. With the exception of biologic recommendations and disposition, chart notes by psychiatric consultants do not sufficiently specify the actions to be taken by the ward staff in a general hospital. A schema for the systematic organization of the intervention was developed. A checklist of operationalized C/L interventions is reported. This combination provides a tool for the systematic use of strategic ward management and discharge recommendations. Its basic structure is currently integrated in MICRO CARES [Hammer et al, SCAMC]. The impact on clinical care, education, and research is described.

Adjustment Disorders↗
PubMed1988

A reassessment of diet and osteoporosis--possible role for copper.

Much emphasis has centred on the role of dietary calcium and calcium supplementation in the pathophysiology and prevention of osteoporosis. Yet there is accumulating evidence that current recommendations on preventive measures are at best of little value and are inconsistent with the available epidemiological data. It is proposed that more attention should be given to dietary trace elements, especially copper, in the aetiology of post-menopausal osteoporosis. Osteoporotic lesions attributable to copper deficiency have been described in both man and animals and the hypothesis that a mild dietary copper deficiency may be implicated in the onset and progression of osteoporosis is also consistent with the epidemiological evidence. Many western diets are low in copper but in addition milk and milk products are amongst the poorest sources of copper and lactose may interfere with copper metabolism. Current recommendations, therefore, for the prevention of osteoporosis may actually be detrimental to health.

Animals↗
PubMed1988

Milk consumption, lactose and copper in the aetiology of ischaemic heart disease.

Milk is a poor source of copper--a nutrient which is known to be limiting or marginal in many western diets. Lactose (a major nutritional constituent of milk) may interfere with copper utilization in milk and in the overall diet. It is postulated that the strong association between the consumption of milk and dairy products (especially fresh milk and non-fermented milk products) and the incidence of ischaemic heart disease (IHD) indicates a central role for a dietary copper deficiency in the aetiology of this disease.

Animals↗
PubMed1988

Treatment opportunities on a consultation/liaison service.

The amount of time consultation psychiatrists in a large metropolitan teaching hospital spent providing direct services was studied over 1,104 consecutive consultation cases. Although the majority of cases required less than 5 hours of psychiatric time apiece, more than 10% of these cases each received more than 10 hours of direct services. This finding has important implications for understanding the types of psychiatric services provided to hospitalized medical/surgical patients.

Humans↗
PubMed1988

The effect of a low copper diet on blood cholesterol and enzymic antioxidant defense mechanisms in male and female rats.

The effect of copper deficiency on blood cholesterol and antioxidant defense mechanisms was investigated in male and female rats. Diets low in copper (Cu, 0.3 mg/kg) were given to a group of male (n = 5) and a group of female (n = 5), weanling Wistar rats for ten weeks. Diets containing adequate copper (Cu, 3.7 mg/kg) fed to another group of males (n = 5) and another group of females (n = 5) served as controls. Serum cholesterol levels and erythrocyte, granulocyte, lymphocyte and macrophage antioxidant enzyme activities were compared. Only copper deficient males showed increased serum cholesterol levels compared to controls. There were no significantly differences in erythrocyte measurements due to copper status, but males had significantly (P less than 0.05) higher haemoglobin levels, and erythrocyte catalase (CAT) and superoxide dismutase (SOD) activities than females. Low copper diets significantly decreased granulocyte SOD (P less than 0.01) in males, peritoneal macrophage SOD in females and lymphocyte SOD (P less than 0.05) in both sexes. Female controls had significantly (P less than 0.01) higher macrophage SOD than male controls and lymphocyte SOD was significantly higher in females. Results demonstrate sex differentiated effects of low copper diets on blood cholesterol and antioxidant defence mechanisms.

Animals↗
PubMed1988

Chronic occupational exposure to asbestos: more than medical effects?

One hundred and twenty-nine workers chronically exposed to asbestos were interviewed regarding their perceived health status and concerns, their health behaviors, particularly their smoking behavior, and their psychologic well-being. In contrast to a non-exposed comparison group of postal workers, asbestos workers exhibited significantly elevated levels of somatic concern (P less than .03), and significantly lower levels of mental health functioning only when experiencing high levels of stress (P less than .01). Despite feeling significantly more susceptible to developing cancer (P less than .0001), 34% of asbestos workers were cigarette smokers (compared to 32% of the postal group) and long-term mask usage was minimal. Asbestos workers' increased sensitivity to stress and changes in health status along with the lack of adaptation of health-promotive behaviors indicate the need for interventions to attend to the psychologic effects of increased risk status.

Asbestos↗
PubMed1987

Appraisal of marketing approaches for consultation-liaison psychiatry.

The high prevalence of undetected and undertreated mental disorders in the general health care sector suggests that the active "marketing" strategies proposed in these articles are overdue. However, a more extensive data base that documents the need for psychiatric involvement in the medical setting and assesses the capacities of other mental health professionals to substitute for consultation-liaison (C-L) psychiatrists in clinical care, teaching, and research is urgently needed and will prove to be the most potent marketing tool available to the specialty.

Cost Control↗
PubMed1987

Ombudsman Rounds on the otolaryngology service.

An attempt to enhance psychiatric teaching on the Otolaryngology Service was undertaken by employing the vehicle of Ombudsman Rounds. The structure of these rounds is dictated by its major goal of maximizing the relationship of the surgeon and liaison psychiatrist as coteachers among the staff of the ENT surgical unit. Surgical residents, surgical clerks, nurses, and the social worker meet with the Chairman of the ENT Department and the liaison psychiatrist in a scheduled weekly conference, which addresses both staff and patient needs on the in-patient surgical service. Through patient interviews, multidiscipline staff presentations, chief of service surgical and prognostic summaries, and liaison psychiatrists' formulations, group discussions are undertaken. Through such an experience the staff become aware of the patient's feelings and understandings about their illness and care. The goal of Ombudsman Rounds is to enhance patient care, advance psychiatric knowledge of the multidiscipline staff, and provide an ongoing vehicle to change attitudes so that they incorporate a biopsychosocial approach to patient management on the ENT Service.

Adaptation, Psychological↗
PubMed1987

Impact of psychiatric comorbidity on length of hospital stay for medical/surgical patients: a preliminary report.

The impact of psychiatric comorbidity on the length of hospital stay was addressed in a study of all medical/surgical patients discharged in 1984 from the Mount Sinai Hospital in New York City (N = 37,370) and Northwestern Memorial Hospital in Chicago (N = 21,889). At both hospitals the mean +/- SD length of stay of the patients with psychiatric comorbidity was significantly longer than that of the other patients: 19.8 +/- 33.3 versus 9.2 +/- 15.3 days at Mount Sinai Hospital and 13.7 +/- 27.7 versus 8.3 +/- 13.2 days at Northwestern Memorial Hospital. Early identification of patients with psychiatric comorbidity would permit appropriate psychosocial intervention, which might shorten their hospital stays.

Adult↗