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Biomedical subjects

J Yager

Publications and source records attributed to J Yager.

At least 91 records · Page 5Linked to original sources
PubMed1985

Anorexia nervosa and sudden death.

Necropsy findings and electrocardiograms from three women with anorexia nervosa were reviewed. Necropsy examination failed to establish an anatomic cause of death. Electrocardiograms recorded days or less before death showed various degrees of Q-T interval prolongation: Q-T intervals corrected for heart rate measured 0.61 s, 0.47 s, and 0.46 s, respectively. Terminal ventricular tachyarrhythmias were documented in two patients, including torsade de pointes in one. The necropsy and clinical findings in these three cases provide evidence that sudden death in anorexia nervosa, like sudden death in liquid-protein dieting, may result from ventricular tachyarrhythmias related to Q-T interval prolongation. For such patients, electrocardiographic monitoring should be routine.

Adult↗
PubMed1984

The quality of deans' letters from medical schools.

Residency training directors have noted considerable variability in the quality of deans' letters sent by medical schools on behalf of graduating students. A total of 212 deans' letters from 103 U.S. medical schools received by a large psychiatric residency program were rated by two of the authors. Of these, 26.9 percent were judged excellent, 49.5 percent average, and 23.6 percent poor. Excellent letters were characterized by detailed personal and academic comments; verbatim statements for each clinical clerkship; tactful , yet explicit, remarks about problems; and internal consistency. Poor letters were generally short regardless of content, offered global impressions about clerkship performance by fusing remarks from several different clerkships without identifying sources, or omitted important information that was quickly evident to the discriminating interviewer. Recommendations are offered for authors and readers of deans' letters and to medical students.

Administrative Personnel↗
PubMed1984

Interaction of life events and symptoms in psychiatric patient and nonpatient married couples.

Many studies have related life events to various symptoms, but there has been little effort to examine how life events and symptoms experienced by a spouse might contribute to health change in the partner. On 3 bimonthly occasions, 115 husbands and wives completed the Schedule of Recent Experiences and a Symptom Checklist. In 40 of the couples, husbands were psychiatric outpatients, and in 75 they were nonpatients. Among nonpatient couples, symptoms in either partner were significantly predicted by the level of each one's own life events (especially undesirable events) and by the levels of symptoms in the spouse during the preceding 2 months. Among couples in which the husband was a patient, the most important predictor of symptoms in either spouse was that person's self-report of life events. Future research on the social origins of psychiatric symptoms should consider the possible contributions of a spouse's symptom state to the health of the individual under study.

Adult↗
PubMed1984

The cutting edge in psychiatry.

The authors sampled the views of 138 "experts" in psychiatry in relation to three questions: 1) What were the major accomplishments of 1970-1980? 2) What were the important publications of the decade? 3) What important questions will be answerable in the next decade? Advances in basic sciences and in psychopharmacology led the list for the past decade. Fourteen publications were mentioned four or more times; DSM-III headed the list. The experts predicted that we can anticipate advances in understanding the causes and in the treatment of major disorders. Despite methodological constraints, these results have implications for training medical students and house staff, for continuing education, and for the allocation of research resources.

Attitude of Health Personnel↗
PubMed1984

A comparison of national and in-house examinations of psychiatric knowledge.

The search continues for the optimum method of assessing psychiatric residents' knowledge. In 1982, 72% of the U.S. residency programs gave the Psychiatry Resident In-Training Examination ( PRITE ). The authors compared the PRITE with an examination developed by their program. The two tests yielded highly correlated percentages of correct responses and resident rank orders for advanced residents, detected similar areas of weakness, had comparable dollar costs, and elicited similar, moderately high resident satisfaction. Important differences were the amount of information and feedback provided to residents and to the residency program and the time between the test and the feedback.

Clinical Competence↗
PubMed1984

Dental sequelae to the binge-purge syndrome (bulimia): report of cases.

The "thin-is-in" syndrome that obsesses many young people today leads to many severe medical and dental complications. Dental damage that follows the binge-purge episodes is reduced by strict management of oral hygiene; the damage is not totally correctable until the habit is well controlled through proper psychotherapy.

Adolescent↗
PubMed1984

Differences in the numbers and costs of tests ordered by internists, family physicians, and psychiatrists.

One hundred forty-six physicians responded to two written patient vignettes by recording problem lists, diagnostic impressions, and the tests and procedures they would have ordered after the initial encounter with the hypothetical patient described in each vignette. Wide variations within medical specialty were found in the number and types of tests or procedures ordered and their costs. We conclude that little consensus exists among physicians as to types of tests and procedures to order, and that private habits or rituals may account for much of the variation in ordering patterns. These findings point to the need for intensive study of how physicians respond to clinical ambiguity as well as how test-ordering habits and rituals arise and persist in different practice settings even within the same specialty. The health care cost implications are substantial.

Adult↗
PubMed1984

Bulimia in men: report of three cases with neuroendocrine findings.

Bulimia, like anorexia nervosa, primarily affects women. Although survey reports have shown that as many as 10%-13% of students meeting DSM-III criteria for bulimia are male, 1,2 detailed clinical descriptions of male bulimic patients are rare. The following case reports describe three men seen for evaluation of bulimia at the UCLA Eating Disorders Clinic.

Adult↗
PubMed1984

On transferring certain patients from medicine to psychiatry: a biopsychosocial analysis of turfing.

Turfing is a process by which unwanted patients are transferred from one hospital service to another for a variety of biopsychosocial reasons. Turfing results from a complex cost-benefit analysis conducted by physicians who are influenced by personal and institutional pressures, as well as by the patients' specific clinical problems, illness behaviors, and personality. A set of interventions that deal comprehensively with such phenomena must take all these influences into account.

Hospital Departments↗
PubMed1983

Neuroendocrine abnormalities in bulimia.

The authors examined the relationship of clinical variables, family history, and neuroendocrine function in 18 bulimic patients. Twelve of 18 patients (67%) showed abnormalities of cortisol suppression, and 8 of 10 (80%) showed blunted thyrotropin-releasing hormone (TRH) tests. These findings suggest that neuroendocrine abnormalities identified previously in anorexia nervosa are not solely an artifact of low weight and, further, that eating disorders and affective disorders may share neurochemical similarities.

Adolescent↗
PubMed1983

Flashbacks among soldiers discharged as unfit who abused more than one drug.

Of 280 soldiers discharged from military service in 1971 as unfit, 207 reported the heavy use of at least one drug (most of these abused more than one drug) and 146 (52%) reported having flashbacks. Most flashbacks were of a simple visual nature, but repeat "trips," complex subjective experiences, and persistent difficulties in concentration were often reported. The prevalence and severity of flashbacks increased with drug use, particularly with hallucinogens and marijuana. Because psychological, social, and physiological factors may all contribute to flashback phenomena, other populations need to be studied to determine the extent to which these findings can be generalized.

Adolescent↗
PubMed1982

Life events and symptoms: Fourier analysis of time series from a three-year prospective inquiry.

In a three-year prospective study in which life events and psychiatric symptoms were assessed every two months, Fourier analyses led to the classification of event-symptom relationships into five typologies. Only one event-symptom typology, representing 9% of subjects, was consistent with the commonly held causal model. The results indicate that further progress in life-events research will require prospective designs, more sophisticated methods for gathering life-events data than the Schedule of Recent Experiences, focus on qualitative features of events (eg, undesirability or threat), and identification of personal characteristics and coping styles that might augment or attenuate the health impacts of life happenings.

Adult↗