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Biomedical subjects

M A Silverman

Publications and source records attributed to M A Silverman.

At least 37 records · Page 2Linked to original sources
PubMed1998

Medical readiness training exercise in El Salvador, Central America, 1996.

Medical Readiness Training Exercises (MEDRETEs) can be a valuable training tool for U.S. Army personnel in remote areas of deployment. We report our experience of the MEDRETE in El Salvador in 1996. Working with foreign physicians of the host country was a positive experience in which we learned local customs and mutual cooperation. Evaluation and treatment of nearly 6,000 patients increased goodwill in the community and provided an opportunity for teamwork for Army Reserve medical units, including increased discussions of public health issues. We also report on the field applicability of the advanced laboratory and pharmacy equipment we included in our training.

Adolescent↗
PubMed1996

A case presentation of Sweet's syndrome and discussion of life-threatening dermatoses.

Sweet first described acute febrile neutrophilic dermatosis in 1964. Since then, more than 425 cases of this typically benign, steroid-responsive disease have been recorded. Although often associated with myelodysplasic syndromes or hematologic malignancies, Sweet's syndrome has also been related to pregnancy, autoimmune disorders, and many drug therapies. Although it is not typically an acutely life-threatening illness, there is a potential for significant pulmonary involvement and respiratory compromise. Additionally, emergency physicians should be aware of this unusual disease and its frequent association with systemic illnesses. We report the first case of Sweet's syndrome in the emergency medicine literature and present a review and discussion of several common life-threatening dermatoses.

Diabetic Ketoacidosis↗
PubMed1996

Pseudoaneurysm of the superficial temporal artery.

Ours is the first report of pseudoaneurysm of the superficial temporal in a 90-year-old woman. Although falls with associated head and scalp injuries in the geriatric population are common, pseudoaneurysm of the superficial temporal artery is rarely reported, probably due to the generally protected course of the superficial temporal artery across the skull. Clinicians' familiarity with this entity is important for early diagnosis and intervention.

Accidental Falls↗
PubMed1995

Lessons learned from Hurricane Andrew: recommendations for care of the elderly in long-term care facilities.

We report on the experience of a 500-bed, long-term care facility in Miami, Fla, which provides housing and nursing care units for patients--ranging from those who are independently ambulatory to those who are acutely ill and feeble--in preparing for, during, and in the immediate aftermath of Hurricane Andrew, which struck on August 24, 1992. The problems encountered included a massive influx of evacuated elderly to the facility, facility isolation, loss of electrical power, loss of running water, special dietary needs, and limited professional staffing due to personal property losses or loss of transportation. Overwhelmed county emergency medical services, limited access to hospitals and patient care, and difficulty in procuring supplies exacerbated the already complicated situation resulting from the storm. As a result of these catastrophic conditions, a number of challenges specific to the care of the elderly were identified. In conjunction with the Florida Department of Elder Affairs, we drafted a comprehensive blueprint that could serve as a disaster plan for other long-term care facilities facing a similar threat during the hurricane season.

Aged↗
PubMed1993

The role of serum amylase in the diagnosis of acute pelvic inflammatory disease.

The use of serum amylase levels in the diagnosis of acute pelvic inflammatory disease (PID) was investigated prospectively. Eighty-five women presenting with the chief complaint of lower abdominal pain were entered into the study; all patients were examined by one of the principal investigators. In addition to the usual laboratory studies, a serum amylase level was obtained on all patients; the investigators were blinded to the results. Patients were diagnosed with PID if they fulfilled previously published clinical criteria. Forty-eight patients met the criteria for the diagnosis of PID (PID group); 37 patients were diagnosed with other disease processes (non-PID group). The average serum amylase level for the PID group was 62 U/L, with a standard deviation (STD) of 24; for the non-PID group, the average was 76 U/L with an STD of 32. Although there was a statistical difference between the two groups (P < .05), there was no clinically significant difference because both values fell within the normal range of serum amylase. The routine use of serum amylase in the diagnosis of acute PID seems to be of no value.

Acute Disease↗
PubMed1992

Angiotensin-converting enzyme inhibitor-induced angioedema: still unrecognized.

Angiotensin-converting enzyme inhibitors are a widely used antihypertensive modality. While they have a favorable side effect profile, there is a .1% to .2% incidence of potentially life threatening angioedema. The edema usually presents in the head and neck, especially the face, lips, tongue, and glottis. Patients may initially be treated with standard anti-allergic therapy; however, the situation may dictate a more aggressive therapeutic approach. The authors present the case of a patient who presented with angioedema 18 times over a 3-year period to qualified emergency physicians before the correct diagnosis of angiotensin-converting enzyme inhibitor-induced angioedema was made. Despite recent literature on the subject, there appears to be a lack of familiarization among emergency department physicians regarding this relatively common adverse effect.

Adult↗
PubMed1992

Characterization of Caenorhabditis elegans lectin-binding mutants.

We have identified 45 mutants of Caenorhabditis elegans that show ectopic surface binding of the lectins wheat germ agglutinin (WGA) and soybean agglutinin (SBA). These mutations are all recessive and define six genes: srf-2, srf-3, srf-4, srf-5, srf-8 and srf-9. Mutations in these genes fall into two phenotypic classes: srf-2, -3, -5 mutants are grossly wild-type, except for their lectin-binding phenotype; srf-4, -8, -9 mutants have a suite of defects, including uncoordinated movement, abnormal egg laying, and defective copulatory bursae morphogenesis. Characterization of these pleiotropic mutants at the cellular level reveals defects in the migration of the gonadal distal tip cell and in axon morphology. Unexpectedly, the pleiotropic mutations also interact with mutations in the lin-12 gene, which encodes a putative cell surface receptor involved in the control of cell fate. We propose that the underlying defect in the pleiotropic mutations may be in the general processing or secretion of extracellular proteins.

Animals↗
PubMed1992

Cancer in the elderly patient. Unique aspects of presentation, management and screening.

The high incidence of cancer in the rapidly expanding geriatric population presents a major challenge to the health care field. Since most cancers present and behave similarly in both older and younger persons, similar approaches to management must be considered in both. The elderly, however, are a heterogeneous group with individuals demonstrating varying degrees of comorbidity and physiologic change. Decisions, therefore, should be based on a sound knowledge of geriatric assessment and the factors important for "successful" aging rather than on chronological age alone.

Age Factors↗
PubMed1990

Evaluation of Army field sanitation during Blazing Trails '87.

US medical personnel serving in Ecuador analyzed how the field sanitation procedures of troops employed in Blazing Trails '87 had impact on living conditions and overall health of the troops. Such a situation allowed evaluation of USAR troop training and preparedness in field sanitation. Results indicate that field sanitation training needs to be improved at the unit level.

Ecuador↗
PubMed1986

The male superego.

Explore the source record for details and available documents.

Freudian Theory↗
PubMed1986

Identification in healthy and pathological character formation.

The character of the ego is built up via a series of identifications carried out in the course of development. As infants are forced by experience to give up the 'internal illusion' of primal identification with the powerful mother, the sense of helplessness that ensues leads to secondary identification to create an 'external illusion' of oneness with the mother during heightened stress or tension. Adequate experiences, leading to increasing trust and tolerance of frustration and tension, promote ego structuralization, self-object differentiation, and oedipal, triadic object relations. Inadequate experiences lead to pathological identifications that interfere with ego development. Oedipal conflicts produce new problems, which are dealt with in part by complex identifications that contribute extensively to the child's personality structure. Superego crystallization derives largely from these later identifications. In optimal circumstances, the identifications out of which the child's character is built become reworked and modified so that it becomes increasingly unique and independent of its sources in others. Stability is never absolute, however. Under stress, reversion is possible to dependence on powerful, charismatic leaders that offers return to the illusion of identificatory union with a powerful, protective, parental 'other'. This can be exploited by potentially dangerous, destructive leaders.

Character↗
PubMed1986

Sylvia Plath and the failure of emotional self-repair through poetry.

Creativity serves not only an aesthetic function but also psychological self-repair for the creative artist. The authors examine the failure of Sylvia Plath's efforts to control her suicidal violence and to bridge her isolation from others via the shared affective experience of poetry. At first, she used traditional forms and mediated images, but when she abandoned them for a more personal expressive art, she lost the shaping, controlling devices she had been using for self-containment and self-repair. They were no longer available to her when she underwent a sweeping narcissistic regression following some very stressful life events. Her emotional deterioration ultimately cost her her life.

Adaptation, Psychological↗
PubMed1985

Progression, regression, and child analytic technique.

A detailed example is presented of analytic work with a latency age youngster. The technical problems encountered in the analysis of such a child are discussed in order to consider how child analysis can help to elucidate what is involved in the psychoanalytic process.

Assertiveness↗
PubMed1985

Countertransference and the myth of the perfectly analyzed analyst.

Countertransference is an inevitable feature of every psychoanalysis. Psychoanalysts are (and need to be) only human; psychoanalytic work is arduous and replete with stresses, strains, and deprivations; analysands tend to probe for vulnerabilities in their analysts that can be exploited in the interest of acting out neurotic wishes instead of analyzing them; and a training analysis cannot completely immunize a psychoanalyst against countertransferential reactions that impede analytic progress. Psychoanalysts must be vigilant to the emergence of countertransference reactions so that they can analyze and overcome them. Two illustrative clinical examples are provided.

Adult↗