Search PubMed⌕ Search

Biomedical subjects

M J Steinhart

Publications and source records attributed to M J Steinhart.

11 recordsLinked to original sources
PubMed1992

Irritable bowel syndrome. How to relieve symptoms enough to improve daily function.

Irritable bowel syndrome is a symptom complex that appears to have multiple causes. In those patients with diagnosable psychiatric illness, treating the psychiatric illness often leads to considerable improvement of the symptoms of irritable bowel syndrome. For almost all symptomatic patients, a caring, thoughtful physician can be very therapeutic by educating the patient, being supportive, offering realistic reassurance and adequate time, and prescribing a minimum of medication judiciously. As in many areas of medicine, a physician can succeed in "taking the hurt out of the pain," thereby vastly improving the patient's quality of life.

Colonic Diseases, Functional↗
PubMed1991

Depression and chronic fatigue in the patient with heart disease.

Depression and chronic fatigue are frequently associated with heart disease. They may precede the onset of myocardial infarction, singly or together, and increase the morbidity and mortality of patients with a history of MI. Virtually all such patients have a transient depression, usually accompanied by anxiety, with onset soon after hospitalization. Although this depression is transient and usually abates spontaneously, it frequently warrants therapeutic intervention. Psychosocial and personality factors play a significant role in the recovery of a patient with a cardiac condition. The clinician must be alert for the effects of changing roles within the family and behaviors that may lead to chronic invalidism. Anxiety disorders, often combined with depression, may mimic cardiac disease and may result from it, leading to chronic fatigue and weakness. Proper diagnosis usually leads to considerable improvement. Cardiac drugs, in addition to many others, may produce depression and fatigue that may be misdiagnosed. Often, discontinuing or changing a medication will lead to marked diminution of such symptoms. Observational and listening skills are key ingredients of the "art" of medicine; they can lead to interventions that are not only therapeutic, but which improve the "quality" of life.

Depression↗
PubMed1982

Demographic, cognitive and experiential predictors of presurgical anxiety.

A heterogeneous sample completed a demographic survey, a measure of internal-external locus of control (I-E), the Hospital Stress Rating Scale (HSRS), and a state anxiety measure on the eve of major surgery. Three sets of variables (demographic, cognitive, and experiential) together significantly accounted for one-quarter of the variance in state anxiety. However, only the cognitive set (I-E and the HSRS) was uniquely significant, supporting the view of presurgical anxiety as a patient's response to interpretation of a life-threatening event. Higher levels of anxiety were associated with more anticipated stressful experiences, stronger beliefs that powerful others and chance influence events, and weaker beliefs that events are caused by one's own efforts. Implications are presented for identifying patients at risk for presurgical anxiety and for designing interventions to enhance the patient's sense of control.

Adult↗
PubMed1981

A survey of attitudes on the use of electroconvulsive therapy.

Electroconvulsive therapy in recent years has received extensive coverage in the mass media, much of it negative. However, little can be found in either the professional literature or the popular press on the attitudes of professionals, patients, and the general public toward ECT. A questionnaire study of 587 individuals drawn from these three categories shows an over-all favorable response to the use of ECT, despite the presence of significant differences in response among members of each category. The implications of the findings for current practice and research are discussed.

Attitude of Health Personnel↗
PubMed1980

Ganser state: a case of hysterical pseudodementia.

This case history shows the clinical features of a Ganser-like syndrome, in which two basic dilemmas readily present themselves to the clinician. First, careful neurologic, psychiatric, and psychosocial investigation is essential for differential diagnosis. And second, criteria must be established to distinguish a true Ganser syndrome from Ganser symptoms. Ultimately, one must ask where this "syndrome" or constellation of symptoms belongs on the spectrum of psychosis and hysteria.

Diagnosis, Differential↗
PubMed1980

Conversion hysteria.

Conversion hysteria differs from hysteria in that it arises suddenly, rather than being a lifelong disorder. It is monosymptomatic rather than polysymptomatic, and is seen in men almost as frequently as in women. La belle indifférence, when present, is a useful clue to diagnosis. Other clues are ambiguity in reporting of the symptoms, medically inconsistent symptoms and hysterical personality features. Treatment may include removing the patient from a stressful environment and removing the "payoff" yielded by the illness. A confrontation with the patient is generally to be avoided.

Affect↗
PubMedDate not supplied

Treatment of delirium--a reappraisal.

Delirium is a frequently encountered clinical syndrome which can pose serious problems for the physician and patient. Numerous etiological possibilities exist, and each case is usually associated with multiple causal factors. Although the pathophysiology is poorly understood, the clinical presentation is marked either by stupor and hypoarousal or agitation and hyperarousal. Both types of delirium must be treated by searching for and correcting reversible causative factors. In addition, medication may be quite efficacious in managing the clinical aspects of agitated delirium. Most cases of agitated delirium are either of the "sensory overload" or "sensory deprivation" type. The drug treatment of each is discussed with reference to their respective central nervous system physiological correlates.

Antipsychotic Agents↗
PubMedDate not supplied

Therapeutic usefulness of amitriptyline in spastic colon syndrome.

The therapeutic efficacy of amitriptyline in irritable bowel was studied in a cross-over double-blind trial, employing fourteen patients whose symptoms were rated as Class II or worse on an arbitrarily-defined interval scale and who had not benefited from previous trials of anticholinergics, anticholinergic-sedative combinations, and bulk-forming agents. During the study, patients rated their own symptoms and the interviewer rated their symptoms using the same scale. Average scores for the patients while on drug showed significant improvement compared to pre-test level. No placebo or drug carry-over effects could be demonstrated. Inasmuch as amitriptyline is effective in this context at dosages subtherapeutic with regard to depression, the authors suggest that a central (perhaps anticholinergic) mechanism of action is responsible.

Adult↗