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Biomedical subjects

P Solomon

Publications and source records attributed to P Solomon.

At least 91 records · Page 5Linked to original sources
PubMed1991

The role of litigation in predicting disability outcomes in chronic pain patients.

This study examined the extent to which being involved in civil and industrial litigation predicted outcome in an population of chronic pain patients. Data were collected in a structured telephone interview for a litigant group of 80 patients and a nonlitigant group of 47 patients. There were no significant differences in the amount of medication used, the number of hours spent resting per day, or the number of individuals who were able to return to work. Litigants showed significantly higher levels of depression. Multiple regression analyses indicated that litigation was not the primary predictor of downtime or medication use. Litigation was found to be the primary predictor of Zung depression scores. Discriminant function analyses indicated that litigation was not the most important variable in distinguishing between those working and not working. Results lend support to previous studies that suggest that the suspicion and disbelief with which litigating patients are often treated is unfounded.

Adult↗
PubMed1991

Experience with colposcopy in a family practice center.

The experience of a family practice center that performed colposcopy for one year was reviewed to provide insight into the appropriateness of this procedure to a family practice clinic. Almost three thousand Papanicolaou smears were performed, which prompted 97 colposcopy clinic appointments involving 68 patients. Dysplastic Pap smears accounted for 1.82% of the total. Atypical Pap smears occurred in 3.91% of the tests, and 16.1% of a sample of these demonstrated dysplasia. Controversy concerning the atypical Pap smear is discussed. The colposcopy service was convenient for the patients and was at least revenue neutral while providing a new professional opportunity for selected family practitioners. A referral base of at least 1,000 Pap smears might justify a colposcopy program, depending on referral strategies.

Ambulatory Care↗
PubMed1991

Advanced actinomycotic pelvic inflammatory disease simulating gynecologic malignancy. A report of two cases.

Two women had large, solid, fixed pelvic masses simulating advanced ovarian cancer in one case and advanced cervical cancer in the other. Both patients had had plastic intrauterine contraceptive devices in situ for 7 and 17 years, respectively. Both patients required laparotomy to make the diagnosis. In both the surgery was markedly difficult because of the total absence of tissue planes. Both had obvious actinomycotic disease on routine histologic examination of the ovary and were treated with prolonged penicillin, with some, but not total, resolution of the pelvic fibrosis. The diagnosis of advanced actinomycotic pelvic inflammatory disease should be entertained in patients with a large, solid pelvic mass and an intrauterine device in situ or a recent history of intrauterine device use.

Actinomycosis↗
PubMed1990

Effect of station examination item sampling on generalizability of student performance.

This article may be of interest to physical therapy educators who are responsible for structuring station or practical examinations used to evaluate physical therapy students. The global intent of the article is to provide information that may be useful in selecting test items. Specifically, the purposes of this study were 1) to examine how two item-sampling strategies (one based on different diagnostic concepts, or diagnostic probes, and the other based on different anatomical sites) influenced the generalizability of a station examination, 2) to determine the interrater reliability during the station examination, and 3) to determine whether the status of the rater (that of observer or simulated patient) influenced the rating. Using a nested study design, 24 physical therapy students were assessed by eight raters. The raters were randomly and equally assigned to four teams. Each team assessed six students. One rater acted as the simulated patient for the first three students in each group, and the other rater acted as observer. This order was reversed for the last three students. Each student performed nine mini-diagnostic patient cases consisting of three diagnostic probes reproduced at three different anatomical sites. The results demonstrate that 1) similar diagnostic concepts can be generalized across anatomical sites, although different concepts or skills cannot be generalized at a given anatomical site or across sites; 2) interrater reliability was excellent; and 3) the status of the raters (ie, simulated patient or observer) did not bias the ratings.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical Competence↗
PubMed1989

Patients' perceived service needs when seen in a psychiatric emergency room.

Patients who came to a psychiatric emergency room and were assessed as not needing psychiatric hospitalization were interviewed regarding their service needs for the month prior to their index visit. The highest expressed needs were for information and advice, financial assistance, counseling and assistance in controlling emotions, while leisure-time activities, meeting people, budgeting, medications, and getting along with others were the lowest areas of expressed need. Those who sought help generally went to appropriate community resources rather than informal supports. For some, coming to the psychiatric emergency room was their way of addressing their needs. For a number, their methods of coping were to escape from their problems through the use of drugs and alcohol or sleep. Implications for programming in the psychiatric emergency room are discussed.

Adolescent↗
PubMed1989

Research as an impetus for change in a state psychiatric hospital.

This article presents recommendations resulting from a study of barriers to discharge from a state psychiatric hospital. The results of this study became the impetus and basis for this particular hospital's definition of its mission within a community support system and for the development of a hospital plan responding to the study recommendations. The programmatic and policy changes initiated by the hospital have demonstrated that a traditional state psychiatric hospital can become more responsive to the needs and desires of consumers and families by utilizing the entire mental health delivery system and other community resources. It is evident that the hospital need not be bound by the physical limits and facility-based resources that have historically restricted its responsiveness.

Community Mental Health Centers↗
PubMed1989

Treatment of recurrent and metastatic endometrial cancer with cisplatin, doxorubicin, cyclophosphamide, and megestrol acetate.

The combination of cisplatin, doxorubicin, cyclophosphamide, and megestrol acetate was used to treat 15 patients with recurrent and metastatic endometrial cancer. Four patients had a complete response and one patient had a partial response, yielding a total response rate of 33%. Five patients had stable disease. The median survival for the whole group was 38 weeks. The median survival for responders was 60 weeks, and that for nonresponders was 21 weeks. The median progression-free survival for the whole group was 17 weeks. The median progression-free survival for responders was 32 weeks, and that for patients with stable disease was 25 weeks. The toxic reactions noted were primarily nausea, vomiting, and myelosuppression. The combination of cisplatin, doxorubicin, cyclophosphamide, and megestrol acetate has modest effectiveness in the treatment of metastatic or recurrent carcinoma of the endometrium.

Aclarubicin↗
PubMed1988

Family members' perspectives on psychiatric hospitalization and discharge.

Families of currently hospitalized patients in an extended-care psychiatric facility were interviewed concerning their views of hospitalization and discharge. Although most were sad that their relative was hospitalized, only a third felt that they would rather be caring for their relative at home. Families felt communication with hospital staff was poor and many of their needs were unmet. Families indicated a number of concerns around discharge. If clients were to be discharged soon, most families felt the clients needed a highly structured supervised living arrangement.

Adult↗
PubMed1988

Comparison of outpatient care of discharged state hospital and non-hospitalized psychiatric emergency room patients.

The present article compares a cohort discharged from two state hospitals in a large urban area with a cohort referred for outpatient services from a psychiatric emergency room. Both cohorts were referred into the same community mental health system of services. The two cohorts are examined in terms of clinical and social demographic characteristics, in part to consider how distinct the two populations appear to be. In addition, patterns of initial contact and the nature and amounts of community services received by each group are compared. Based on these comparisons, some conclusions are drawn regarding the way in which these two groups are served by the community system.

Adolescent↗
PubMed1988

Outpatient compliance of psychiatric emergency room patients by presenting problems.

In the present study, a cohort of patients who came to a psychiatric emergency room in a general hospital, and were not referred for hospitalization, were analyzed in regard to the amount and rate of subsequent contact with community mental health and substance abuse agencies. Patterns of service receipt and the differential impact of service use on hospitalization and/or return visits were analyzed by three major problem types: (1) psychiatric; (2) psychiatric/substance abuse; and (3) substance abuse. The analysis of these subgroups yielded valuable information about how the service system and/or different groups of patients in crisis respond to the system.

Adolescent↗
PubMed1987

Follow-up of outpatient referrals from a psychiatric emergency room.

This article reports on the findings of a follow-up study of a cohort of 114 patients who were evaluated at a psychiatric emergency room and were referred to community mental health and substance abuse agencies. Two-thirds subsequently made contact with these agencies, but fewer made contact with the agency to which they were specifically referred. Few kept their scheduled appointment. Prior experience with an agency, as was a client's diagnosis, were related to agency contact. Considerations for social workers to increase patients' ability to complete referrals for treatment are addressed.

Adult↗
PubMed1987

Response of tardive and L-dopa-induced dyskinesias to antidepressants.

We report two patients with dyskinesia responding to antidepressants. The first is a 70-year-old man with depression, Parkinsonism and neuroleptic-induced tardive dyskinesia who presented with hysterical mutism. After recovery from the mutism, he was started on desipramine for depression. One week later the dyskinesia improved markedly. The second patient is a 61-year-old man with Parkinson's disease, dementia, depression and L-dopa-induced oro-lingual-facial dyskinesias. He was taking levodopa, trihexyphenydil and bromocriptine. The depression was treated first with desipramine and later with trazodone. The dyskinesia improved significantly on both drugs. The response of the dyskinesias to antidepressant medication may be due to the fact that antidepressants decrease beta-adrenoreceptor sensitivity and density which in turn may result in a diminished release of dopamine since beta-adrenoceptors mediate the noradrenaline-stimulated release of dopamine.

Aged↗
PubMed1986

Reconceptualizing assumptions about community mental health.

Beliefs that patients fall between the cracks in the transition from hospital to community services, that the aftercare population is shut out of community mental health agencies, and that services are duplicated to a high degree continue to be widely accepted. Using data from a study of a publicly funded mental health aftercare system in a major urban county, the authors reconceptualize these and similar assumptions about mental health aftercare. It appears that the primary focus of concern should be on the nature and quantity of the services being delivered rather than on increasing the proportion of patients connecting with them. Current services appear to be largely oriented toward helping the patient maintain a borderline existence in the community. Instead, much more emphasis is needed on meaningfully rehabilitating patients and reducing their chronic need for professional support.

Attitude↗
PubMed1986

The effects of alcohol abuse among the new chronically mentally ill.

In recent years, there has been a growing recognition of the high incidence of alcohol abuse among the new generation of chronically mentally ill. This article reports on a study that tracked a subgroup of the chronically mentally ill, those discharged from state psychiatric hospitals, through an entire community mental health aftercare system and its major auxiliary human service agencies. Those who were assessed by hospital discharge social workers as having a need for alcoholism services were found to be less likely to be referred for aftercare and to make contact with aftercare agencies post discharge; and for those with an alcoholism problem who do make contact, they generally received less service than those who did not have a need for alcoholism services. The professionals in both the mental health and alcoholism fields need to work together to better meet the needs of the chronically mentally ill with an alcohol problem.

Adult↗
PubMed1985

Meeting community service needs of discharged psychiatric patients.

There is a growing recognition that the chronically mentally ill are a heterogeneous population with a multiplicity and diversity of needs. But inadequate information concerning the extent of the population service needs and the degree to which aftercare services meets these needs has contributed to the minimization of the problem. This article reports on the extent to which aftercare services meets the needs of discharged patients. Most discharged patients had a need for basic maintenance aftercare services such as individual counseling, chemotherapy, and financial assistance. However, there was also a high need for more rehabilitative services such as socialization services, social and vocational rehabilitation, and supportive residential services. Although almost half had their basic service needs met by aftercare services, few had their rehabilitative ones met.

Adolescent↗
PubMed1985

A longitudinal study of children exposed to sulfur oxides.

This study is a longitudinal comparison of the health of children exposed to markedly different concentrations of sulfur dioxide (SO2) and moderately different concentrations of particulate sulfate (SO4=). The four groups of subjects lived in two areas of one smelter town and in two other towns, one of which was also a smelter town. In the area of highest pollution, children were intermittently exposed to high SO2 levels (peak three-hour average concentration exceeded 2,500 micrograms/m3) and moderate particulate SO4= levels (average concentration was 10.1 micrograms/m3). When the children were grouped by the four gradients of pollution observed, the prevalence of cough (measured by questionnaire) correlated significantly with pollution levels (trend chi-square = 5.6, p = 0.02). No significant differences in the incidence of cough or other symptoms occurred among the groups of subjects over three years, and pulmonary function and lung function growth over the study were roughly equal among all the groups. These results suggest that intermittent elevations in SO2 concentration, in the presence of moderate particulate SO4= concentration, produced evidence of bronchial irritation in the subjects, but no chronic effect on lung function or lung function growth was detected.

Air Pollutants↗
PubMed1984

Discharged state hospital patients' characteristics and use of aftercare: effect on community tenure.

A study of a publicly funded mental health system determined that the use of aftercare services by discharged patients had the effect of extending community tenure. Patients' clinical characteristics, particularly number of previous hospitalizations, had only minimal effect and patients' demographic characteristics had essentially no impact on community tenure. Increasing the variety and intensity of rehabilitation-oriented types of service rather than increasing the frequency of supportive contacts through individual therapy and case management appears to hold the greatest promise for extending community tenure.

Adolescent↗