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Biomedical subjects

J S Simon

Publications and source records attributed to J S Simon.

36 records · Page 2Linked to original sources
PubMed1991

The detection of depression by patient self-report in women with gynecologic cancer.

We examined the utility of patient self-report forms in identifying those gynecologic oncology patients who would be diagnosed by an experienced consultation-liaison psychiatrist as suffering from major depression. Sixty-five women with gynecologic tumors were evaluated by a consultation-liaison psychiatrist, using standardized (DSM-III) criteria. Each patient also completed a Carroll Rating Scale for Depression (CRS). The CRS demonstrated sensitivity and specificity of 87 percent and 58 percent, respectively. Used as a screening instrument to rule out depression, the CRS yielded a negative predictive value of 94 percent. We identified a priori forty items from the CRS which should not be influenced by the non-psychiatric biologic effects of gynecologic tumors, and compared the performance of this non-cancer related symptoms subscale (NCSG) to that of the CRS. The NCSG did not significantly outperform the CRS; its sensitivity and specificity were 87 percent and 62 percent, respectively. Because our study population was relatively homogeneous (i.e., non-ovarian gynecologic oncology patients without severe debilitation who were not receiving chemotherapy, radiation therapy, or other invasive procedures), the findings should not be generalized to other oncologic populations at this time. Our results suggest that patient self-report forms can be effective screening devices for identifying those non-ovarian, gynecologic oncology patients who should then be carefully evaluated for coexisting clinical depression.

Adult↗
PubMed1990

The presence of antithyroid antibodies in patients with affective and nonaffective psychiatric disorders.

We determined the frequency of antithyroglobulin and antimicrosomal antibodies in 173 consecutively admitted psychiatric inpatients. (We found antithyroid antibodies in 8% (5/65) of patients with DSM-III major depression, 13% (4/31) with biploar disorder, and in 0% (0/4) of those with schizoaffective disorder.) The rate of antibody occurrence was unrelated to lithium exposure either within individual diagnostic categories or for the sample as a whole. The overall frequency of positive antithyroid antibody titers in patients with DSM-III affective disorder, 9% (9/99), did not differ from that in patients with nonaffective disorders, 10% (7/68). However, patients with bipolar affective disorder-mixed or bipolar affective disorder-depressed had a higher rate of positive antithyroid antibody titers than other patients. Our findings confirm earlier reports that thyroid disorders may be particularly common in patients with bipolar affective disorder, even in the absence of lithium exposure. However, as antithyroid antibodies also occurred at a relatively high rate in nonaffective disorders, the possible psychiatric effects of autoimmune thyroiditis do not appear to be limited to affective dysregulation.

Adolescent↗
PubMed1990

Subclinical hypothyroidism: a review of neuropsychiatric aspects.

The authors review current information about the prevalence, causes, course, and consequences of subclinical hypothyroidism. There is evidence that subclinical hypothyroidism may be associated with cognitive dysfunction, mood disturbance, and diminished response to standard psychiatric treatments. Recommendations are presented for the screening, evaluation and treatment of patients in whom subclinical hypothyroidism may be contributing to neuropsychiatric dysfunction.

Humans↗
PubMed1987

The dexamethasone suppression test and antidepressant response in major depression.

UNLABELLED: We conducted a prospective open pilot study of 34 consecutively admitted patients with the DSM-III diagnosis of MD who were admitted to a general psychiatric unit. Patients underwent a 1 mg DST and were randomly assigned to treatment with either maprotiline or trazodone. Antidepressant dosages were increased as tolerated clinically and according to treatment response. RESULTS: mean final oral doses were 193 mg for maprotiline and 328 mg for trazodone. The mean treatment duration was 4.5 weeks for maprotiline and 5.9 weeks for the trazodone group. Of these 34 patients 44% showed DST nonsuppression (41% maprotiline, 45% trazodone). Seventy-six per cent of the patients responded to treatment (76% for both drugs) as defined by GAS. Eighty-seven per cent of the nonsuppressors responded to treatment (86% maprotiline, 88% trazodone) and 68% of the suppressors responded (70% maprotiline, 67% trazodone). Of the eight treatment nonresponders six showed DST suppression. The implications of these findings are discussed.

Adolescent↗
PubMed1987

An outbreak of recurrent acute and chronic hypersensitivity pneumonitis in office workers.

Three episodes of an acute, flu-like illness, one studied in detail, were associated with manipulations on the central air handling system of an office building in Tennessee in the summer and early fall of 1981. Symptoms were compatible with acute hypersensitivity pneumonitis, although the time of onset revealed a biphasic epidemic curve. Breathing air not supplied through the central air handling system protected against disease. Ill persons had significantly more precipitins to agents cultured from the building than did controls. Symptoms suggestive of chronic hypersensitivity pneumonitis were also found. Chronic disease was associated with the presence of humidifiers at home, asthma, and longer work in the building. Acute disease occurred less frequently in smokers and persons who had previously worked in the building before 1976. Persons with acute disease were more likely to have chronic disease. No single etiologic agent could be identified. Because of difficulties with demonstrating safety for reoccupancy, the building was vacated and remains empty at this time.

Acute Disease↗
PubMed1987

Abdominal surgery in patients undergoing chronic hemodialysis.

The reports on surgical techniques that specifically focus on the management and outcome of patients on chronic hemodialysis (CHD) who undergo major intra-abdominal procedures--particularly of an emergency nature--are few. It is hoped that by analysis of our experience the nature of the problem can be further clarified and guidelines for clinical care can be formulated. Thirty-two cases which encompass a 7-year period (1978 to 1985), were reviewed. Seventeen patients underwent elective surgery and fifteen underwent emergency intervention. There was a wide range of cases that were similar to those most generally seen in an acute-care teaching hospital. The morbidity and mortality rates in elective surgery patients were 12% and 6%, respectively, while in the emergency cases, these rates were 62% and 47%. Patients with diabetes had the highest morbidity and mortality. These results were analyzed, and we conclude that CHD patients at risk with a surgically correctable condition should be considered for elective intervention, even if they are currently free of symptoms. This may be particularly true for CHD patients with diabetes.

Abdomen↗
PubMed1986

Depression in women treated for gynecological cancer: clinical and neuroendocrine assessment.

To determine the prevalence of major depression in cancer patients and assess the usefulness of the dexamethasone suppression test (DST) and the thyrotropin-releasing hormone (TRH) stimulation test for diagnosing major depression in these patients, the authors studied 83 women hospitalized for gynecological cancer. Nineteen (23%) had major depression according to DSM-III criteria. The sensitivity and specificity of the DST were 40% and 88%, respectively. No relationship between DST and TRH test results was found. These findings indicate a high prevalence of depression in cancer patients, but further research on these tests in cancer patients is needed; their routine use with cancer patients is premature at this time.

Adult↗
PubMed1985

Antithyroid antibodies in depressed patients.

The presence of antithyroid (antimicrosomal and antithyroglobulin) antibodies was assessed in 45 psychiatric inpatients with prominent depressive symptoms (28 with DSM-III major depression). Nine patients (20%) had detectable titers of antithyroid antibodies, a rate considerably higher than the 5%-10% observed in the normal population. Each of these nine patients with symptomless autoimmune thyroiditis had normal baseline serum thyrotropin concentrations and normal thyroid function (as assessed by T4, T3 uptake, and free thyroxine index). These findings support the hypothesis of subtle thyroid dysfunction in a sizable sample of psychiatric inpatients with prominent depressive symptoms.

Adolescent↗
PubMed1985

Nuclear magnetic resonance imaging of liver hemangiomas.

Nine patients with cavernous hemangioma of the liver were examined by nuclear magnetic resonance imaging (MRI) with a 0.5 T superconductive magnet. Spin-echo technique was used with varying time to echo (TE) and repetition times (TR). Results were compared with 99mTc red blood cell (RBC) scintigraphy, computed tomography (CT), echography, and arteriography. Four illustrated cases are reported. It was possible to establish a pattern for MRI characteristics of cavernous hemangiomas; rounded or smooth lobulated shape, marked increase in T1 and T2 values as compared with normal liver values. It is concluded that, although more experience is necessary to compare the specificity with that of ultrasound and CT, MRI proved to be very sensitive for the diagnosis of liver hemangioma, especially in the case of small ones which may be missed by 99mTc-labeled RBC scintigraphy.

Adolescent↗
PubMed1976

Changes in occupation after aortocoronary vein-bypass operation.

The effect of aortocoronary vein-bypass operation on changes in occupational status was investigated in a cohort of 893 men. The median period of time between the operation and follow-up evaluation of postoperative occupational status was 14 months. The patients were divided into two age groups, with 55 years as the dividing point. The results showed that 11% of the younger men and 26% of the older group who were employed before the operation retired following the operation. In addition, 30% of the patients changed their occupational status following the operation. When occupational changes also resulted in changes in physical demands, 49% of the patients took new jobs that were less demanding physically, while 40% took jobs that were more demanding. Close to 9% of the patients were retired prior to the operation; about one fifth of them came out of retirement following the operation.

Adult↗
PubMed1976

Constrictive pericarditis.

A patient with constrictive pericarditis following an open-heart operation without sepsis is discussed. In the absence of sepsis, it has been widely held that this complication does not develop following an open-heart procedure. The fatal outcome in this patient could have been avoided had such an association been known.

Aortic Valve↗
PubMedDate not supplied

MR imaging in myelofibrosis.

Two patients with myelofibrosis demonstrated decreased signal intensity from the bone marrow due to replacement of marrow fat with fibrosis and cellular elements.

Aged↗