Theodore A Stern

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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.(More)
BACKGROUND Delirium is a serious postoperative condition for which few pharmacologic prevention trials have been conducted. OBJECTIVE The authors tested the efficacy of perioperative olanzapine administration to prevent postoperative delirium in elderly patients after joint-replacement surgery. METHOD The authors conducted a randomized, double-blind,(More)
BACKGROUND Falls and delirium in general-hospital inpatients are related to increases in morbidity, mortality, and healthcare costs. Patients fall despite safeguards and programs to reduce falling. OBJECTIVE The authors sought to determine the prevalence of diagnosed and undiagnosed delirium in patients who fell during their hospital stay. METHOD The(More)
Patients with Munchausen's syndrome--a syndrome characterized by the intentional production of physical symptoms to gain the sick role-present a variety of challenges to health care providers. Their treaters quickly become frustrated by their demanding interpersonal styles, by deception and manipulation, and by multiple unrevealing diagnostic procedures.(More)
CONTEXT Major depressive disorder (MDD) can be challenging to diagnose in patients with congestive heart failure, who often suffer from fatigue, insomnia, weight changes, and other neurovegetative symptoms that overlap with those of depression. Pathophysiologic mechanisms (eg, inflammation, autonomic nervous system dysfunction, cardiac arrhythmias, and(More)
Lithium carbonate is a highly effective and commonly prescribed treatment for bipolar illness, but its use— owing to a narrow therapeutic index—risks iatrogenic (and sometimes irreversible) neurotoxicity.We present a case of “acute-on-chronic” lithiumneurotoxicity and use it to highlight the clinical features, pathophysiology, and treatment of(More)
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(More)