Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0392674 (exhaustion)
 13,658 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An examination of the social concerns of the elderly reinforces the importance of a thorough social assessment and the availability of skilled staff in an Emergency Department to make appropriate community referrals. The resolution of disposition problems brought about through caregiver exhaustion, patients no longer able to care for themselves in the community, and abandonment by individuals and institutions require a complex array of skills. The serious problem of drug and alcohol abuse among the elderly must be recognized by Emergency Department staff. Physical problems often disguise the existence of a problem of substance abuse. Clinicians in the Emergency Department should evaluate elderly patients using social and family history information in addition to a thorough physical assessment. Elder abuse manifests as physical abuse, psychological abuse, material abuse, and active and passive neglect. The problem is growing, and there is a need for skilled observation and detection of elderly patients presenting for emergency care. As the proportion of the elderly population in this country increases, social policies and program development must reflect these changes. Experts in fields such as gerontology, geriatric medicine, psychiatry, nursing, and social work must make recommendations for changes in the medical and social service delivery systems. The availability of coordinated, comprehensive services for the elderly will expand as the movement toward geriatric treatment centers grows. These centers will provide medical, psychiatric, social, and residential care through the concept of a continuum of care. They will employ a multidisciplinary team of geriatric specialists and include outreach as well as treatment services. Communities with a geriatric treatment center provide a valuable resource for patients identified through Emergency Department visits. The Emergency Department must play an active role in assisting hospitals, area agencies on aging, and other concerned members of the community plan programs for elderly patients with physical and social concerns. While these changes are implemented, the Emergency Department will continue to remain responsive to the social concerns of the elderly through deliberate organizational efforts designed to maintain a high quality of care for elderly patients.
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PMID:Social emergencies in the elderly. 218 93

We assessed cocaine abstinence symptomatology in a sample of 100 cocaine-abusing, methadone-maintained patients who completed an anonymous questionnaire retrospectively rating the intensity of 18 symptoms at six time points, from 30 minutes to 2 weeks, post-cocaine use. We found that a majority of patients endorsed symptoms related to dysphoria 24 hours post-binge. However, these symptoms tended to be mild to moderate in intensity and relatively short-lived. Principal components analyses extracted four factors accounting for 64% of the variance: psychoticism, exhaustion, agitation, recovery. Early post-binge period was dominated by psychoticism and agitation, followed by recovery for the duration of the period assessed.
Am J Drug Alcohol Abuse 1996 Aug
PMID:Abstinence symptomatology associated with cessation of chronic cocaine abuse among methadone-maintained patients. 884 86

The definition of burn-out the most often cited and proposed by Maslach and Jackson, clarifies the three cardinal symptoms affecting doctors, namely, emotional exhaustion, with depersonalization of their patients and reduction of the feeling of personal accomplishment. The causes of this phenomenon are relatively well-known: individual psychological factors, stressful factors intrinsic to the medical practice and finally extrinsic factors related to the professional environment and its organization. The purpose of this review is to estimate the prevalence of burnout within the population of Belgian family physicians and to understand both individual and societal consequences. About the method. This is a literature review using databases Medline, Cochrane Library, and the American Psychological Association from 2000 to 2011 with the keywords: primary health care, family practice, burnout, emotional exhaustion, psychological stressors, distress, fatigue, depersonalization, substance and alcohol abuse, depression, well-being, quality of life, job satisfaction, professional efficiency, patient care, physician-patient relations, medical errors, quality of health care, pharmaceutical/health expenditure/statistics-numerical data, obstacles to prevention, health system assessment, medical demography. Selecting of the most relevant articles through the reading of abstracts and then full text reading of 49 selected articles. In conclusion, the exact prevalence of burn-out amongst Belgian general practitioners is not known. From some works, it is estimated that about half of them would be achieved at least in terms of emotional exhaustion. The symptoms related to burn-out are potentially serious: ea depression, alcohol and tobacco abuse and cardiovascular complications. There are also arguments demonstrating the fact that this disorder amongst general practitioners influences negatively the quality of care, their cost, but also medical demography of primary care with as a corollary a questioning of the viability of the health care system as we know it. At the time of writing this article, the Belgian Health Care Knowledge Centre (KCE) is completing, at the request of the Belgian Ministry (SPF) of Health a study entitled "Burn Out of General Practitioners: which prevention, which solutions" whose goal is to make recommendations for the prevention and support of this issue. To measure the real impact of the solutions eventually implemented, we need to create a tool for a regular assessment of the prevalence of this problem in our country.
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PMID:[Burnout of general practitioners in Belgium: societal consequences and paths to solutions]. 2203 74

Salivary lactoferrin is a glycoprotein involved in the elimination of pathogens and the prevention of massive overgrowth of microorganisms that affect oral and general health. A high concentration of lactoferrin in saliva is often considered to be a marker of damage to the salivary glands, gingivitis, or leakage through inflamed or damaged oral mucosa, infiltrated particularly by neutrophils. We conducted a study to determine the effect of chronic alcohol intoxication on salivary lactoferrin concentration and output. The study included 30 volunteers consisting of ten non-smoking male patients after chronic alcohol intoxication (group A), and 20 control nonsmoking male social drinkers (group C) with no history of alcohol abuse. Resting whole saliva was collected 24 to 48 hours after a chronic alcohol intoxication period. Lactoferrin was assessed by enzyme-linked immunosorbent assay. For all participants, the DMFT index (decayed, missing, or filled teeth), gingival index (GI) and papilla bleeding index (PBI) were assessed. The differences between groups were evaluated using the Mann-Whitney U test. We noticed significantly decreased salivary flow (SF) in alcohol dependent patients after chronic alcohol intoxication (A), compared to the control group (C). Although there was no significant difference in salivary lactoferrin concentration between the alcohol dependent group A and the control group C, we found significantly decreased lactoferrin output in group A compared to group C. We found a significant correlation between the amount of daily alcohol use and a decrease in lactoferrin output. There was a significant increase in GI and a tendency of PBI to increase in group A compared to group C. We demonstrated that chronic alcohol intoxication decreases SF and lactoferrin output. The decreased lactoferrin output in persons chronically intoxicated by alcohol may be the result of lactoferrin exhaustion during drinking (due to its alcohol-related lower biosynthesis or higher catabolism) or to decreased function of neutrophils affected by the ethanol. The poorer periodontal state in alcohol dependent persons compared to controls may be a result of lower salivary flow and decreased protection of the oral cavity by lactoferrin.
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PMID:Decrease in salivary lactoferrin output in chronically intoxicated alcohol-dependent patients. 2276 72

Combat stress cases were traced in historical texts and military manuals on warfare from the Middle Byzantine period; they were mainly labelled as cowardice. Soldiers suffered from nostalgia or exhaustion; officers looked stunned, or could not speak during the battle. Cruel punishments were often enforced. Suicide and alcohol abuse were rarely mentioned. The Byzantines' evacuation system for battle casualties was well organized. Psychological operations were conducted and prisoners-of-war were usually part of them. The Byzantine army had 'parakletores', officers assigned to encourage soldiers before combat. The leaders dealt with combat stress by using their rhetoric skills and emphasizing religious faith in eternal life. The treatment of the 'cowards' was rather similar to modern war psychiatry principles of treatment. No description of PTSD was found.
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PMID:A war psychiatry approach to warfare in the Middle Byzantine period. 2751 Jul 8

Medical students are thought to have increased pressures in study life beyond that of their peers. This could impact their psychological wellbeing, burnout and substance use, impeding a smooth transition into the health workforce. A cross-sectional electronic survey of one of New Zealand's two medical schools was undertaken, and students in all years were invited to participate through email. Two hundred and twenty students completed the survey. Forty-six students (21%) reported that they were currently seeing a GP or Allied Healthcare Professional (AHP) for their mental ill-health. Seventy-seven students (35%) reported having taken cannabis during medical school. The number of respondents reaching the threshold for CAGE, and thus demonstrating problem drinking, was 40 (18%). Additionally, burnout levels were scored, with 150 students (68%) classifying as disengaged and 169 (77%) as suffering from exhaustion on the Oldenburg burnout measure. Going forwards, organizational bodies including governments and medical schools should place emphasis on the importance of optimizing medical student wellbeing, including resilience training and improved workforce wellbeing planning, to positively impact not just medical students as they progress to doctors, but for patients, and the healthcare system as a whole.
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PMID:Psychological wellbeing, burnout and substance use amongst medical students in New Zealand. 3170 92