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Biomedical subjects

T A Stern

Publications and source records attributed to T A Stern.

At least 55 records · Page 3Linked to original sources
PubMed1985

The effects of electroconvulsive therapy on serial electrocardiograms and serum cardiac enzyme values. A prospective study of depressed hospitalized inpatients.

Electroconvulsive therapy (ECT) is an effective, safe, and controversial treatment of severe depression. In order to further evaluate its safety, the effect of ECT on serial electrocardiograms and serum cardiac enzyme values was studied prospectively in 29 patients. Neither persistent electrocardiographic changes nor elevations in creatine phosphokinase or serum glutamic oxalaminase transaminase levels were observed following 85 treatments. Twenty-four percent of our patients had stable, preexisting cardiovascular disease, which included conduction system disease, recent myocardial infarction, and depressed ventricular function. Electroconvulsive therapy was well tolerated by all of these patients. The proposed mechanisms for transient or persistent electrocardiographic changes and cardiovascular complications of ECT are reviewed.

Adult↗
PubMed1985

Complications after overdose with tricyclic antidepressants.

We reviewed 72 consecutive cases of tricyclic antidepressant (TCA) overdose (OD) admitted from the emergency ward (EW) to the ICU between 1977 and 1982. Most patients were seriously ill before ICU admission: 70% were comatose; 68% were intubated, including 61% in need of mechanical ventilation; and 30% were hypothermic. One patient died after ICU admission. ECG abnormalities were present in 37 (51%) patients in the EW. These abnormalities were associated with higher TCA plasma levels, but not with either acidosis or hypoxemia. Of 14 patients without ECG abnormalities or the need for intubation in the EW, none developed new ECG abnormalities or required ventilatory support. No patient had a late complication after transfer from the ICU, after a mean stay of 2.1 days. Late, unexpected complications in TCA OD are very rare. Our study suggests that TCA OD patients who do not have an abnormal ECG and do not require ventilatory support at the time of initial evaluation may not need ICU admission simply for intensive observation.

Adolescent↗
PubMed1985

Osteoporosis and pathologic fractures in anorexia nervosa.

Osteoporosis with pathologic fractures occurred in three patients with chronic anorexia nervosa. The authors discuss the pathophysiology of this rarely reported complication and advise clinicians to thoroughly investigate complaints of bone or back pain from this high-risk population.

Adolescent↗
PubMed1985

Non-lithium-induced renal failure with secondary lithium toxicity: case reports.

Two manic-depressive patients are described who presented with acute renal failure and concurrent lithium toxicity. In both cases the etiology of the renal failure was not a direct result of the use of lithium. Controversy concerning the nephrotoxicity of lithium is discussed, and recommendations for the evaluation of renal failure during lithium therapy are provided.

Acute Kidney Injury↗
PubMed1984

Life-threatening drug overdose. Precipitants and prognosis.

During a four-year period, 255 persons were admitted to a medical intensive care unit 283 times (5% of all admissions) for treatment of drug overdose. Because of the high personal and social costs associated with overdose and the high rate of repeated overdose admissions, we prospectively studied 104 patients who had taken an overdose admitted during a 20-month period to define better the precipitants of overdose and the prognosis after intensive care unit admission for overdose. Of 103 hospital survivors, 88 consented to and could be reached for follow-up (mean duration, ten months). During that time, 8% died (5% by overdose) and 42% had been readmitted for another nonfatal overdose or for psychiatric illness. Prior psychiatric treatment was associated with subsequent readmission; 61% with a history of suicide attempt were readmitted during the follow-up period. Demographic characteristics, psychiatric evaluation, and medical history were not associated with subsequent hospitalization or death from overdose.

Adolescent↗
PubMed1984

Patient-generated dysphoria in house officers.

Patients can induce intense emotions in physicians. Such feelings can become a source of stress for the physician and interfere adversely with patient care. The authors investigated patient illnesses and conditions that caused dysphoria among three specialty groups of house officers. Tragic, horrifying, or difficult patients produced intense dysphoria in all three groups. The characteristics of the patients producing the greatest dysphoria for each specialty group fell outside the traditional expertise of that group.

Emotions↗
PubMed1984

Complex partial seizures presenting as a psychiatric illness.

A 36-year-old woman was treated for a wide variety of psychiatric illnesses over a span of two decades before a diagnosis of complex partial seizures was made. Her history included poor impulse control, rage attacks, multiple suicide attempts, rapid mood swings, depression, and psychotic episodes. Bulimia, panic attacks, severe obsessive-compulsive symptoms, and multiple somatic complaints were also present. In retrospect, these symptoms could be attributed to complex partial seizures with cognitive and affective symptomatology, automatisms, and psychosensory symptoms, and were controlled by anticonvulsant medications. Therefore, so-called "purely" psychiatric disorders should not be diagnosed before a diagnosis of limbic epilepsy (however, this might be labeled, e.g., complex partial seizure, psychomotor seizure, psychical seizure, or temporal lobe epilepsy) has been considered.

Adult↗
PubMed1984

Trazodone-digoxin interaction in an animal model.

Serum digoxin concentrations have been reported to increase in two patients taking daily doses of trazodone. However, in a canine model, no elevation in serum digoxin concentration was found with combined trazodone-digoxin administration. The authors suggest that serum digoxin concentrations should be monitored in patients receiving trazodone and digoxin concomitantly.

Animals↗
PubMed1982

Identification of patient-generated feelings in security personnel.

Several authors have pointed out that the recognition of feelings aroused by patients in health professionals can be useful in the delivery of patient care. The general hospital setting provides an in vivo research laboratory for studying the awareness of patient-generated feelings. A questionnaire designed to help categorize and quantify the feelings experienced by security personnel (N = 28 males) while working with patients at the Massachusetts General Hospital indicated that security personnel experience a wide variety of emotions as a result of their contact with patients. Fear, anxiety, and helplessness were reported by the majority. The preponderance of negative affects identified confirms the stressful nature of their work.

Adult↗
PubMed1979

Benztropine prophylaxis of dystonic reactions.

The effectiveness of antiparkinson medication for the prevention of drug induced dystonias has remained a question. Forty patients with acute psychosis who received high potency oral antipsychotic drugs were interviewed to determine the incidence of acute dystonia. An eleven-fold increase in dystonia was found in patients who received no prophylactic medication. Such prophylaxis appears effective in preventing acute dystonia.

Adult↗
PubMed1979

Killer phenomenon in pathogenic yeast.

Potentially pathogenic yeast strains from four genera, Candida, Cryptococcus, Torulopsis, and Trichosporon, were examined for killer activity and sensitivity using Saccharomyces and Torulopsis strains of known killer status. Tests were performed by using a streak method and by concentration of culture fluid by lyophilization. Of 236 strains examined, killers were found with low prevalence among Torulopsis and Cryptococcus strains; Candida and Trichosporon isolates showed no killing activity. Different specificities of killing activity were observed among strains of a single species. Sensitive strains were found with varying frequencies in all genera but Trichosporon.

Candida↗