General hospital psychiatry
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Gen Hosp Psychiatry · Sep 2006
Multicenter StudyInfluence of patient preference and primary care clinician proclivity for watchful waiting on receipt of depression treatment.
We examined whether patients' preference for watchful waiting and their primary care clinician's proclivity for watchful waiting were associated with decreased likelihood of receiving depression treatment. ⋯ Patient preference for watchful waiting is associated with lower rates of some depression treatments, especially among patients with subsyndromal depression. Addressing patient preference for watchful waiting in primary care may include active symptom monitoring and patient education.
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This study aimed to determine a marker that predicts delirium using preoperative oxidative processes in patients undergoing cardiopulmonary bypass surgery. ⋯ Patients with low preoperative CAT levels appeared to be more susceptible to delirium than patients with higher CAT levels.
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Gen Hosp Psychiatry · Sep 2006
Case ReportsElectroconvulsive therapy complicated by life-threatening hyperkalemia in a catatonic patient.
Electroconvulsive therapy (ECT) requires brief general anesthesia, and succinylcholine is a depolarizing neuromuscular blocking agent that is frequently used for this procedure. Its use leads to intracellular potassium release into the extracellular space, usually increasing the serum potassium level by 0.5-1 mEq/L, with little clinical significance. ⋯ Resumption of normal physical activity reverses these neuromuscular junctional changes, allowing subsequent safe succinylcholine administration. Current drug development may eliminate the need for succinylcholine use during ECT.
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This study investigated the characteristics of suicide attempters referred to psychiatric hospitals and the factors affecting such referral. ⋯ Although the clinical characteristics of patients attempting suicide are a major determinant of whether they are subsequently referred to psychiatric hospitals, the treatment practices of emergency room hospitals also influence treatment decisions.