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N D Zasler

Publications and source records attributed to N D Zasler.

At least 19 recordsLinked to original sources
PubMed1995

AMA guides.

Explore the source record for details and available documents.

American Medical Association↗
PubMed1994

Role change after traumatic brain injury in adults.

OBJECTIVES: The purpose of this study was to gather information regarding changes in adult life roles following severe traumatic brain injury. METHOD: The Role Checklist and a semistructured interview were administered to 28 adults with traumatic brain injury who had been in the community for at least 8 months prior to the study. All 28 subjects reported role changes in their lives. RESULTS: The majority of the role changes were losses (71%). More than 64% percent of the subjects reported three or four role losses. The losses were in major organizing roles such as worker, hobbyist, and friend. Most role gains were seen in the roles of home maintainer, family member, and religious participant. Almost 40% of all roles were reported as changed (loss or gain), while more than 60% of roles were reported as unchanged (continuous or absent). The participants' subjective impressions concerning the role changes and why they occurred were elicited. CONCLUSION: With a better understanding of possible role change after traumatic brain injury, rehabilitation professionals can target the development of specific skills necessary for the continuation of valued roles.

Adult↗
PubMed1990

The effect of vacuum devices on penile hemodynamics.

External vacuum devices are being used increasingly for the management of erectile dysfunction. There is limited information regarding the effect of vacuum devices on penile blood flow and potential for ischemic penile injury. The penile xenon washout rate was measured before and after application of 2 vacuum systems in 15 subjects. Compared to flaccid state measurements the xenon washout rate did not change significantly with the Synergist Erection System but it was significantly reduced with the Osbon ErecAid System. However, the degree and duration of decrease in penile blood flow that may result in ischemic changes are unknown.

Adult↗
PubMed1990

Return to work for persons with traumatic brain injury: a supported employment approach.

Supported employment was used to place 41 persons into competitive employment during 30 months. All individuals had experienced severe head injuries; almost 70% of injuries were due to motor vehicle accidents. A mean of seven years had passed since injury for all referred clients, who had been unconscious a mean of 53 days. Only 36% of referred clients had achieved any competitive postinjury employment, compared with 91% of the same group who were competitively employed before injury. A job retention rate of 71% was reported, with most jobs in warehouse, clerical, and service-related occupations. A mean of 291 hours of job coaching was required to place and maintain all clients in supported employment.

Adolescent↗
PubMed1989

Penile blood flow by xenon-133 washout.

Penile erectile failure is often attributed to abnormalities of vascular supply or drainage, but few direct measurements of penile blood flow have been made. We describe the xenon washout method for measurement of penile blood flow, and present the results obtained in a group of normal and impotent subjects. The procedure was performed with standard nuclear imaging equipment. Flaccid-state penile blood flow in the impotent patients studied was not significantly different from the normal group, suggesting that flaccid-state measurements may not be helpful in evaluation of erectile failure. However, this method can be used to measure penile venous outflow with stimulated or induced erection, and may provide a method for detecting abnormal venous leakage.

Adult↗
PubMed1989

Synergist erection system in the management of impotence secondary to spinal cord injury.

The Synergist erection system is a silicone sheath vacuum device for management of erectile dysfunction. The efficacy of this device was assessed in the spinal cord injured population. All patients were referred through a spinal cord injury center at a major medical facility. Twenty patients with neurogenic impotence, who were injured at least one year previously and who had a regular sexual partner, were evaluated. Erectile function was assessed by neurologic examination, patient and partner questionnaires, and snap-gauge evaluations. Overall, patient and partner assessments of device efficacy and sex life satisfaction with the device were very good to excellent. The device was simple to use and without significant side effects. In our initial experience, the Synergist system was an effective, safe, noninvasive alternative for the management of impotence secondary to cord injury.

Adult↗
PubMedDate not supplied

Psychosexual consequences of traumatic brain injury: methodology and preliminary findings.

A methodology to systematically assess the psychosexual consequences of traumatic brain injury was developed and applied to a group of 21 male patients. A majority of the sample reported negative changes in sexual behaviour, including decreased sex drive, erectile function and frequency of intercourse. Common personality changes included depression, reduced self-esteem and a perceived decline in personal sex appeal. However, despite these changes in sexual behaviour, there was evidence that the quality of their marital relationships was preserved. Furthermore, there was no evidence of a relationship between the level of affect and sexual behaviour.

Adaptation, Psychological↗
PubMedDate not supplied

Psychogenic seizures in brain injury: diagnosis, treatment and case study.

Psychogenic seizures are a functional phenomena in which a person experiences a paroxysmal event that may be interpreted as epileptiform in nature. By definition, psychogenic seizures imply a sudden episode of change in behaviour or psychic state that is not associated with an identifiable process, either vasculogenic or neurogenic, and during which there is an absence of characteristic epileptiform changes on the electroencephalogram. Prevalence rates range from 5% to 50% in outpatient populations seen in epilepsy clinics. However, approximately 20% of true seizure patients also have psychogenic seizures. As psychogenic seizures are not a pathophysiological phenomena, pharmacological interventions do not alter their aetiology and can cloud the cognitive skills necessary to ameliorate the psychogenic seizure behaviour. In non-aphasic true seizure patients, as well as psychogenic seizure patients, self-control relaxation paradigms have been successful where pharmacological intervention has failed. This case involved an aphasic brain-injured patient who had both psychogenic and true seizures. For this patient, the self-control paradigm was modified to include use of gesture and prosody to achieve similar psychotherapeutic effects. Additionally, family therapy was instituted to provide a constructive means for the patient's family to participate in the reduction of psychogenic seizures. As seizures are a common sequelae of brain injury, the differential diagnosis of seizures and knowledge of standard and alternative treatment is essential for rehabilitation professionals.

Adult↗
PubMedDate not supplied

Advances in neuropharmacological rehabilitation for brain dysfunction.

The use of pharmacological agents as rehabilitative tools following brain injury remains to some degree both a science and an art. Recent work in the area of the neural sciences has shed new light on the workings of basic CNS neurochemical systems and the use of pharmacologic agents in altering central neurophysiologic processes. The major central neurochemical systems are reviewed both anatomically and physiologically. An overview is provided of basic neuropharmacologic agents by class. Lastly, some of the newer neuropharmacological options for treatment of post-acute brain injury deficits are examined.

Brain↗
PubMedDate not supplied

Post-traumatic seizures: a critical review.

Post-traumatic seizures are a well-recognized complication of head injury; however, the issue of seizure risk assessment remains controversial. The authors present a critical review of the literature pertaining to post-traumatic seizures, with particular emphasis on current concepts of definitions, incidence and risk factors. Different methods of risk assessment are reviewed and the possibility of utilizing functional imaging techniques for seizure risk assessment is also explored.

Anticonvulsants↗
PubMedDate not supplied

Survey of case manager training needs in traumatic brain injury.

The results of 138 surveys assessing the training needs of case managers in the area of traumatic brain injury were analysed. Sixty-six per cent of the respondents were case managers working primarily with adults in a variety of work settings. Respondents rated working with families, vocational rehabilitation, and community re-entry as the top three areas for training. Mild traumatic brain injury, paediatric traumatic brain injury, neuropsychological assessment, and medicolegal aspects received the highest rankings by case managers with more than 8 years experience. The need for certification of case managers in specialty areas was supported by 83% of all respondents.

Accreditation↗
PubMedDate not supplied

Oral hygiene following traumatic brain injury: a programme to promote dental health.

Dental care and oral hygiene programmes for persons with traumatic brain injury (TBI) have been relatively ignored areas of clinical care and research. Data regarding the need for structured oral hygiene programmes with this population are sorely lacking. Further, evidence to support or contraindicate the efficacy of such interventions is negligible. The purpose of the present study was to address the need for ongoing dental follow-up and oral hygiene programmes in the post-acute phase of rehabilitation care. A group of 20 TBI patients (10 experimental, 10 control) who were at least 1 month post-injury and had Rancho Los Amigos Scale scores of 6 or greater, were randomly selected for participation in the study. Oral hygiene status was assessed by a dental hygienist using a plaque index score developed by Silness and Loe. The experimental group received individualized oral hygiene instruction along with dental supplies for their personal use, including a dental mirror and red disclosing tablets. The control group received no such instructions or supplies. At 5-6 weeks following initial evaluation, 18 patients (nine from each group) were reassessed via the plaque index score. Comparisons between the control and experimental groups revealed significant differences on follow-up plaque scores with a lower mean score for the experimental group only on baseline and follow-up data yielding a significant decrease in plaque scores over time. These results suggest that dental hygiene interventions for patients following TBI can effectively promote dental plaque control.

Adult↗