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Biomedical subjects

T J Silber

Publications and source records attributed to T J Silber.

At least 73 records · Page 4Linked to original sources
PubMed1983

Pseudocyesis in adolescent females.

Three adolescent patients were diagnosed as having pseudocyesis based on an assessment including pelvic examination, pregnancy tests, and pelvic ultrasound scanning. Their psychosocial evaluation demonstrate a conversion reaction in already deprived and depressed adolescents. They responded to psychotherapeutic counseling. Pseudocyesis merits consideration in the differential diagnosis of secondary amenorrhea. It occurs psychologically in vulnerable adolescents who exhibit rather primitive defense mechanisms. Once a patient acknowledges that she is not pregnant, severe depression is a possible complication. A review is presented of the current medical literature on this subject.

Adolescent↗
PubMed1983

Clinical spectrum of pharyngeal gonorrhea in children and adolescents: a report of sixteen patients.

Pharyngeal gonorrhea in children and adolescents is probably increasing. During a 1-year period, 16 patients were diagnosed and treated for pharyngeal gonorrhea. This was the result of a search among a high-risk group, consisting of victims of sex abuse, patients suspected of homosexual practices, and adolescents with symptoms or signs suggestive of sexually transmitted diseases. Of the 16 positive throat cultures, 75% represented pharyngeal colonization while only 25% had clinical symptoms. Pharyngeal gonorrhea was found to be a marker in screening for psychosocial pathology, leading in two-thirds of the cases to the discovery of instances of incest, sexual abuse, chaotic family situations, or severe depression, all of which had been previously denied, ignored, or neglected. The purpose of this article is to alert health care providers to the clinical spectrum of pharyngeal gonorrhea in children and adolescents.

Adolescent↗
PubMed1983

Chronic illness in adolescents: a sociological perspective.

This article relates chronic illness in adolescents to a sociological model of deviance. This is an area of controversy: the views of Freidson, Lorber and Robinson are presented as being representative of the dispute. Four situations are discussed in which the issues of prognosis, responsibility and stigma elicit societal response. The usefulness of a sociological model consists in making vague societal perception and rules explicit. The concept of the chronically ill adolescent as deviant is descriptive and devoid of value judgment. Only through such rigorous assessment is it possible to gain a realistic understanding of the societal role in the life of the chronically ill adolescent.

Adolescent↗
PubMed1983

Pediatrician and psychiatrist as co-therapists.

Co-therapy is a neglected method of learning and integrating important concepts of behavioral pediatrics. This report describes a unique enterprise: pediatrician and psychiatrist as co-therapists. This is a situation in which the responsibility for patient care is shared to its maximum extent because the interaction involves diagnostic technique, interpretation and therapeutic management.

Adolescent↗
PubMed1982

Diagnosis of adolescent pregnancy--1965 vs 1980.

The study compares changes in the accuracy of the diagnosis of pregnancy in adolescents between 1965 and 1980. We compared 44 records of adolescents evaluated in 1965 to those of 44 who were evaluated 15 years later in 1980. The following data were examined: (1) reason for consultation, (2) amount of time prior to making the correct diagnosis, and (3) the most common diagnostic errors. The results showed that (1) the initial diagnosis was correct only 75 per cent of the time in 1965 and 86 per cent in 1980, (2) both in 1965 and 1980 most patients initially consulted for "vague complaints," (3) in 1965 and 1980 the most common diagnostic errors were "gastrointestinal disorder" and "functional symptoms," and (4) pregnancy was diagnosed earlier in 1980 than in 1965. Improvement in diagnostic accuracy should be possible if clinicians screen for pregnancy in adolescent girls consulting for vague symptoms such as nausea, weight gain, urticaria, and somnolence.

Adolescent↗
PubMed1982

Ethical considerations concerning adolescents consulting for contraceptive services.

Adolescents increasingly come to physicians' offices for contraceptive care. This raises the issue of parental involvement, often formulated in terms of conflict around the issues of consent and confidentiality. In the past two decades, a new philosophy has emerged that deals with the issues from a perspective of the "civil rights" of adolescents. This concept, referred to as the "mature minor doctrine," allows for parents or the state to represent the minors' interest only as long as the adolescent is not able to do so. The ethical justification for this position is based on the principles of autonomy and beneficence. The legal implications are being developed in state laws which recognize that teenagers should have access to confidential medical care in order to facilitate contraceptive knowledge and prevention of pregnancy.

Adolescent↗
PubMed1982

The differential diagnosis of functional symptoms in adolescence.

Functional complaints constitute the major reason why adolescents visit the physician's office. These complaints may co-exist with organic illness of minor or major significance. Distinguishing between the organic and functional component is the physician's first task. But, just as each organic condition requires a different medical workup and treatment plan, each functional disorder also requires a variety of approaches. The physician therefore must be aware of the need for a further differential diagnosis among functional symptoms in adolescence. This article proposes a definition of functional disorders, sets forth a classification of the differential diagnosis of these disorders and suggests techniques for their management.

Adolescent↗
PubMed1981

Adolescent pregnancy testing: which test to use.

In order to study the sensitivity and efficiency of five pregnancy tests, we evaluated four types of urine tests in 162 adolescent girls in whom pregnancy was suspected; a serum test was performed in 46 of them. We found that (1) an increase in sensitivity occurred at the expense of specificity, (2) the quantitation of the beta-subunit of human chorionic gonadotropin in serum proved to be the most reliable test for pregnancy, and (3) the latex agglutination inhibition tube test (Placentex) was the most accurate of the four types of urine tests evaluated. We concluded that for adolescents, the serum pregnancy test is the preferred test, but when it is not available, the urine latex agglutination inhibition tube test offers the most reliable alternative.

Adolescent↗