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Biomedical subjects

R A Munoz

Publications and source records attributed to R A Munoz.

At least 19 recordsLinked to original sources
PubMed2000

A new quantitative method for the diagnosis of right ventricular hypertensive disorders in 3 dimensions.

UNLABELLED: A new 3-dimensional (3D) method is described for the diagnosis of normal and hypertensive right ventricular (RV) conditions on the basis of similarity of RV structure to models of normal average shape or hypertensive average shape. Right ventricular quantification in multiple views (coronal, sagittal, and transverse) was obtained by measuring tangent angle differences (TADs) between RV tracings and average shapes at 128 points around the ventricular contour in each view. The TAD measurements of all views were then combined to quantify the closest 3D fit of the ventricle to a normal or hypertensive model. RESULTS: In 24 lamb casts measured in vitro, an accurate diagnosis was obtained in 11 of 12 normotensive casts (specificity 92%) and 11 of 12 hypertensive casts (sensitivity 92%). CONCLUSION: Accurate 3D diagnosis of in vitro normotensive and hypertensive RV conditions can be realized by measuring the TADs between the ventricle and average-shaped models.

Animals↗
PubMed1992

Pseudocyesis in organic mood disorders. Six cases.

Pseudocyesis, the delusion of pregnancy, has had an uncertain nosology, primarily because of the concentration on the content of the beliefs and lack of interest in the underlying phenomenology. Six patients with a major mood disorder caused by cerebral dysfunction are presented in this article. The delusion is reviewed with respect to the entities it overlaps, and the clinical manifestations are related to the mood disorders. Although no clear neuroanatomic localization was possible with this group of patients, there may be some association with desomatization caused by parietal lobe dysfunction.

Adult↗
PubMed1987

Brief reactive psychosis.

A careful reevaluation of 24 patients diagnosed as suffering brief reactive psychosis failed to validate this diagnosis according to DSM-III criteria. Fourteen of the patients had other psychiatric disorders that could explain their symptoms, and 8 had psychosis lasting longer than 2 weeks; the precipitating events were unclear or had uncertain relationships to the psychoses. The criteria proposed for the DSM-III-R do not facilitate the diagnosis of brief reactive psychosis but perhaps make it even more confusing.

Adolescent↗
PubMed1986

Graduates of foreign medical schools in American psychiatry.

Members of the American Psychiatric Association who graduated from foreign medical schools, currently 25 percent of APA membership, are increasingly integrating themselves into the mainstream of American psychiatry. Nevertheless, an APA survey of members who are foreign medical graduates (FMGs) conducted in 1984 indicates that FMGs continue to pass the American Board of Psychiatry and Neurology examination and to be awarded APA fellowships at a significantly lower rate than their U.S.-trained counterparts. Solutions to these disparities have been increasingly sought by the leaders of APA, especially those of the association's areas II, IV, and V, where FMGs are concentrated. The higher percentage of women among FMGs than among U.S.-trained psychiatrists and the increasing presence of Americans and Canadians among FMGs are likely to enhance pressure to solve the problems of FMGs.

Certification↗
PubMed1985

Postpartum psychosis as a discrete entity.

Twelve patients with postpartum psychosis treated over a period of 18 years by 11 different psychiatrists appeared to suffer from a homogeneous disorder, with similar onset, clinical picture, course, and immediate prognosis. This observation, together with reports by other authors, suggests that postpartum psychosis deserves a place in the psychiatric nomenclature other than as "atypical psychosis."

Adolescent↗
PubMed1981

The psychiatric physical examination - Part I: methodology.

The frequency of medical findings in psychiatric patients is quite high. Regardless, none of the responding psychiatrists in a recent survey do routine physical examinations. In response to this survey, the authors describe a method of rapid physical examination specifically designed for the psychiatric patient. The average duration of the examination in 75 patients was 16.9 minutes. There was no evidence of negative transference or countertransference. The level of competency required was that of a medical student, yet there were 8.2 physical findings per patient with 5.3 physical findings per patient being unknown previously.

Humans↗
PubMed1981

The psychiatric physical examination - Part II: findings in 75 unselected psychiatric patients.

The psychiatric physical examination described in the previous paper was done on 75 new psychiatric inpatients. The examiners were one psychiatrist and two psychiatrist-internists. Results confirmed the high frequency of known and unsuspected medical illnesses previously reported in the literature. Additionally, the specific "psychiatric physical examination" confirmed the known psychiatric diagnoses in 76% of the patients and led to consideration of a second or other psychiatric diagnoses in 43% of the patients.

Adolescent↗
PubMed1979

Hospitalization of the elderly patient for acute illness.

There is a paucity of studies on the characteristics of elderly patients who are admitted for treatment of acute disorders, even though their utilization of hospitals is high. This study involved 828 older persons admitted to a general hospital during a period of six months, for the treatment of acute illness. The typical patient appeared to be a woman in her 70's who entered the medical department because of a cardiovascular or a gastrointestinal disturbance, stayed no longer than 10 days, and returned home to live with her spouse. Though such a person apparently needed minimal assistance in readjusting successfully to the community, there were some exceptions, especially among those who had been living alone or with persons other than a spouse. There was minimal utilization of professional services that might help to assure an optimal post-hospital readjustment.

Acute Disease↗
PubMed1979

650 private psychiatric patients.

650 psychiatric patients seen for the first time in San Diego on a private basis received a research interview that allowed a study of demographic and clinical characteristics. They were compared with 100 psychiatric patients seen in similar circumstances in Wisconsin. The 2 populations were remarkably similar in several respects.

Adult↗
PubMed1977

A contrast of the three more common illnesses with the ten less common in a study and 18-month follow-up of 314 psychiatric emergency room patients.

The present study combines four factors: an initial research interview, a blind follow-up of the patients seen initially, the use of specified diagnostic criteria, and the application of these techniques to a psychiatric emergency room population of 314 patients. Follow-up studies were done in 299 patients (95%) a mean of 18.2 months after the initial interview. The patients were described diagnostically and demographically. There were three more common diagnoses: affective disorder, alcoholism, and antisocial personality. There were ten additional less common diagnoses, as well as an undiagnosed group and a group without diagnosis. There were single diagnoses in 190 patients and multiple diagnoses in the remaining 124 patients. Three diagnoses or less per patient were not uncommon; more than three diagnoses per patient were uncommon. Diagnoses of affective disorder, alcoholism, and antisocial personality occurred in 64% of the total number of diagnoses. The remainder of the diagnoses occurred in 36%. Prompt hospitalization occurred in 14% of the total sample.

Adult↗
PubMed1977

A contrast of the three more common illnesses with the ten less common in a study and 18-month follow-up of 314 psychiatric emergency room patients. II. Characteristics of patients with the three more common illnesses.

The three more common illnesses diagnosed in the sample of 314 emergency room patients were (in order of frequency) affective disorder (N = 135), alcoholism (N = 112), and antisocial personality (N = 57). This study describes the occurrence and frequency of affective disorders and evaluates the relative usefulness of three separate sets of diagnostic criteria for the depressive phase of the illness, which are considered in three self-evident, mutually exclusive groups, the definition of which depends on chronology of onset in relation to other diagnoses. Findings show a 3:2 ratio of primary affective disorder to secondary affective disorder. The 112 diagnoses of alcoholism were based on defined criteria that separated "definite" (N = 102) from probable (N = 10) alcoholism. A high incidence of secondary affective disorder (38%) in patients with a first diagnosis of alcoholism is noted. The third most common diagnosis, antisocial personality, was based on defined criteria requiring a specified number of manifestations both before and after age 15 years. Only 11% of the antisocial personality patients received a single diagnosis of antisocial personality. An additional diagnosis of alcoholism occurred in 61%. Besides antisocial symptoms, the 57 patients reported 74 different nonantisocial symptoms, supporting the conclusion that antisocial personality patients may be as susceptible to neurotic and psychotic symptoms as other patients.

Adolescent↗
PubMed1977

A contrast of the three more common illnesses with the ten less common in a study and 18-month follow-up of 314 psychiatric emergency room patients.

An 18-month follow-up of 314 randomly selected psychiatric emergency room patients showed that, although there were 15 possible diagnostic groups the diagnoses made at initial interviews proved to be largely accurate. Follow-up results showed the prediction based on those initial diagnoses was 84% correct in the 299 patients (95%) that could be followed up. Follow-up results also showed that 88% of the individual diagnoses (as opposed to diagnosed patients) were correct. The kappa coefficients were high, all of them being above 0.60, some between 0.80 and 0.90. In addition to the relatively high diagnostic validity, the results also demonstrated a high item reliability for the more than 400 separate items for which kappa coefficients were calculated. Less than 15% of these items had a kappa coefficient of less than 0.60. This study thus demonstrated a high diagnostic reliability and a high diagnostic validity The basis of these diagnoses in a heterogeneous psychiatric population was the application of precisely defined and applied diagnostic criteria. The diagnostic process was blind in that the follow-up diagnosis was made in the absence of knowledge of the initial diagnosis. The use of precisely defined and systematically applied criteria may prove to be superior to multivariate analysis, cluster analysis, or other statistical techniques.

Adult↗