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Biomedical subjects

T A Stern

Publications and source records attributed to T A Stern.

67 records · Page 4Linked to original sources
PubMedDate not supplied

Autognosis rounds for medical house staff.

The authors describe the autognosis countertransference rounds for medical house staff at the Massachusetts General Hospital. At these rounds, which have been held weekly for more than a decade in the intensive care unit, countertransference phenomena and their relationship to medical practice are discussed. Methods that have facilitated the autognostic process are provided and highlighted by brief case examples. Participants at these rounds report that their self-awareness increases and the clinical care they provide often improves.

Adult↗
PubMedDate not supplied

The association between intravenous haloperidol and Torsades de Pointes. Three cases and a literature review.

Torsades de Pointes (TDP) is a potentially malignant ventricular arrhythmia that often has a drug-induced origin. Oral, but not intravenous, haloperidol has been generally associated with this arrhythmia. The authors detail three patient cases of TDP that occurred while the patients were receiving intravenous haloperidol. The authors discuss the known risk factors for the development of TDP and review the literature on ventricular arrhythmias associated with haloperidol use.

Aged↗
PubMedDate not supplied

Neuropsychiatric manifestations of systemic lupus erythematosus.

The authors critically review the literature describing the varied neuropsychiatric syndromes associated with systemic lupus erythematosus (SLE). Factors that have complicated the identification and treatment of affective, behavioral, and cognitive disturbances in these patents are identified, and the utility of various diagnostic interventions is examined. Finally, the authors outline the role of the consultation-liaison psychiatrist in the clinical management of the SLE patient with neuropsychiatric disturbances.

Brain↗
PubMedDate not supplied

The Massachusetts General Hospital annotated bibliography. For residents training in consultation-liaison psychiatry.

The annotated bibliography for the resident's division of the Avery D. Weisman Psychiatry Consultation Service at the Massachusetts General Hospital (MGH) equips the residents with a practical knowledge in consultation-liaison (C-L) psychiatry for their forays onto the floors of the general hospital. As an annotated bibliography, it is not intended to be a comprehensive source for C-L training. However, the basic fund of knowledge prepares MGH's psychiatric residents in a practical way for the variety of questions posed to the C-L service. The authors present this annotated bibliography as a guide for future efforts to establish a core content of knowledge for residents training in C-L psychiatry.

Hospitals, General↗
PubMedDate not supplied

The Academy of Psychosomatic Medicine practice guidelines for psychiatric consultation in the general medical setting. The Academy of Psychosomatic Medicine.

This practice guideline seeks to provide guidance to psychiatrists who regularly evaluate and manage patients with medical illnesses. The guideline is intended to delineate the knowledge base, professional expertise, and integrated clinical approach necessary to effectively manage this complex and diverse patient population. This guideline was drafted by a work group consisting of psychiatrists with clinical and research expertise in the field, who undertook a comprehensive review of the literature. The guideline was reviewed by the executive council of the Academy of Psychosomatic Medicine and revised prior to final approval. Some of the topics discussed include qualifications of C-L consultants, patient assessment, psychiatric interventions (e.g., psychotherapy, pharmacotherapy), medicolegal issues, and child and adolescent consultations.

Adolescent↗
PubMedDate not supplied

A prospective multicenter study of competency evaluations by psychiatric consultation services.

Psychiatric consultation for assessment of competency is common but infrequently studied. Past studies have used chart reviews. The authors prospectively studied 88 consecutive psychiatric consultations at 3 centers. Competency evaluation was performed to determine whether the patient could 1) sign out of the hospital against medical advice (AMA) (N = 16); 2) give informed consent (N = 16); 3) take care of him-/herself (N = 33); 4) refuse medical care (N = 24); or 5) deal with other matters (N = 12). Patients with a favorable risk-benefit ratio were more likely to be seen in consultation compared with those with an unfavorable ratio. Patients in whom there was concordance in the assessment of the psychiatric consultant and the referring physician (N = 61) were more likely to be male, single, to have psychotropics recommended, to sign out AMA, and to be discharged from the hospital. Patients in whom there was disagreement between the consultee and the consultant merits further study.

Adult↗
PubMedDate not supplied

Patient generated dysphoria in psychiatric residents.

Caring for patients can induce intense emotions in psychiatrists. Although clinical experience suggests that such feeling can become a source of stress for the psychiatrists, particularly the first year resident, and interfere adversely with patient care, research in this area has been lacking. We studied a group of psychiatric residents in order to identify what patient conditions or characteristics induce the greatest dysphoria and adversely affect the quality of patient care. Serious medical illnesses induced the greatest dysphoria.

Adult↗