Liver injury in abdominal trauma. Review of the literature and personal observations

The association of infantile diarrhoea with the occurrence of Candida species and their different morphological cell forms (pseudohyphae and/or blastospores) in faeces was studied in children of 0-15 months in a developing community (Lahore, Pakistan) where malnutrition is prevalent. Stool samples from 119 patients admitted to the Diarrhoea Treatment Unit, Department of Pediatrics, King Edward Medical College, and 46 healthy children were investigated for yeasts, bacteria, viruses and parasites. Salmonella and enteropathogenic Escherichia coli were seen in 13 (11%) each of the cases while Candida was the most frequent micro-organism, grown in cultures from 38 (32%) of the diarrhoea cases. C. tropicalis dominated (19%) over C. albicans (6%) and C. parapsilosis (3%). However, in a great number of cases (23, equals 19%), Candida did not grow in cultures but blastospores and/or pseudohyphae were seen on microscopical examination. Other Candida species and yeasts were relatively more common in the control group. Candida albicans, C. tropicalis and C. parapsilosis were the only identified agents in 23 of the cases (19%). The characteristic clinical findings in children with Candida as the only identified pathogen were malnutrition (69%), age less than 8 months (90%), and microscopically identified pseudohyphae in faecal smears (71%).     

Pharmacologic therapy of cranio-cervico-mandibular disorders. Review of the literature

Enzymes are essential to life and catalyze various metabolic activities. They find application in a number of diseased conditions, and their scope is being widened as knowledge develops.     

Hypothalamic-pituitary-adrenal axis suppression and inhaled corticosteroid therapy. 2. Review of the literature

In order to overcome the need for secondary intervention to remove metallic osteosynthesis devices after fracture healing, endeavours have been directed towards developing resorbable osteosynthesis materials during the last decade. The resorbable material must fulfil a number of basic demands. For example, an adequate holding strength of these materials is essential for undisturbed fracture union, complete resorption after bone healing, good histocompatibility without any damage to the surrounding tissues and without detrimental distant effects within the organism. Suggested materials are primarily high-polymerlactic acid or glycolic acid compounds. In particular, research was concentrated on the enhancement of the mechanical properties and biodegradation of polylactides. Debris high in crystallin was found to be responsible for late soft tissue reactions. To achieve disintegration products with lower crystallin content stereocopolymeres of lactic acids are preferred nowadays. Based on our experimental work, another osteosynthesis system manufactured from autoclaved allogenic bone tissue was developed as an alternative. This has osteoconductive properties and converts by creeping substitution into bone. In contrast to metallic plates and screws, the modulus of elasticity is quite similar to vital bone tissue. The initial strength enables its use in the field of maxillofacial surgery.     

Therapists' personal therapy and professional self-awareness.

Surveyed 185 doctoral-level psychologists, averaging 16 yrs of experience, who responded to questions about their personal therapy histories and provided their professional reactions to 25 hypothetical psychotherapy situations. Results suggest that awareness of countertransference issues was highly significantly and positively related to the amount of personal therapy a therapist had received. Data also suggest a relationship between countertransference and the therapist claiming a psychoanalytic orientation, receiving personal therapy from a psychoanalytically oriented therapist, and having attended a psychoanalytically oriented training program. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychotherapists view their personal therapy.

Studied the long-term effects of intensive psychotherapy or psychoanalysis on a sophisticated group of patients—practicing psychotherapists who had previously been in treatment. A comprehensive questionnaire was distributed to 97 30–60 yr old psychotherapists preselected by having completed personal psychotherapy or psychoanalysis. The items focused on subjective experiences in psychotherapy, the elucidation of intrapsychic effects, and Ss' perception of outcome. Positive benefits of treatment involved improvements in self-esteem as well as interpersonal relations. Symptom alleviation was ranked as the least important benefit. Improvement in all areas (including self-esteem, work function, sex life, social relations, character change, and alleviation of symptoms) positively correlated with the feeling of being liked by and liking the therapist. The emotional "tone" of the treatment situation as exemplified by aspects of the patient–therapist relationship appeared to be critical to a positive outcome. 21% of the Ss reported that their treatment was also harmful in some fashion. Data suggested that unresolved transference issues were central to a negative effect. (11 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prolonged pregnancy. Review of the literature

There have been various estimations of the frequency of postdate pregnancies. On the average, 10% of all pregnancies exceed 42 weeks amenorrhoea with a range from 4 to 14% according to the authors. Rates vary with use of ultrasound examinations early, avoiding false dating and induced labour. A pregnancy becomes a pregnancy at risk at the end of the 41st week of amenorrhoea. Fetal maturity may be affected by a disease process or due to individual or ethnic variations. The potential danger of prolonged pregnancy is inhalation of meconium prepartum. Expulsion of meconium is both a frequent consequence of fetal distress and the result of increased intestinal reactivity. There does not appear to be agreement on the degree of risk of sudden death at the end of pregnancy, although the risk does appear to exist. Surveillance should include recording fetal heart rate under basal conditions and an assessment of the amniotic fluid volume with ultrasounds. The Doppler technique is currently under study. When the status of the cervix is favourable, labour may be induced by rupturing the membranes of with a perfusion of Syntocinon. When the status of the cervix is unfavourable, prostaglandin E2 is applied intravaginally or intracervically with a gel. Therapeutic trial published to date do not demonstrate any advantage over cesarean section or fetal morbidity. The safety of the procedure has not been proven. Randomized trials comparing systematic induction of labour with a wait-and-see attitude have not given a definitive answer. Only two trial have shown a significant advantage of systematic induction of labour. The others have shown that the rate of cesarean section and neonatal morbidity are comparable in the two groups.     

Coffin-Siris syndrome. Review of the literature

A great deal of new information has become available in the field of hypertension since the JNC report of 1988. The JNC V report has changed the categorization of blood pressure, modified suggested drugs for initial therapy, and recommended that diuretics or beta blockers be considered the first-line drugs of choice. Information concerning the J curve and end-stage renal disease has made therapeutic goals more challenging. One of the most important additions to this report is the new information on treating elderly patients, which had been lacking until last year. The report calls on pharmacists to assist with detecting, evaluating, and referring hypertensive patients. Pharmacists must take a leadership role in promoting compliance with antihypertensive therapy and can assist other health-care professionals by suggesting therapeutic alternatives to improve efficacy, reduce the frequency of administration, and lower costs. The complete JNC V report is an essential reference for the files of any pharmacist who is responsible for the care of hypertensive patients.     

Diagnostic imaging in the detection of parotid adenoma. Review of the literature and personal experience with the combined use of computerized tomography and MRI

In this report we reviewed the role of Ultrasonography, Computed Tomography, Magnetic Resonance and 99Tc-Sestamibi Scintigraphy for the detection of abnormal parathyroid glands in patients with biochemical evidence of hyperparathyroidism. We also report our personal experience with CT and RM.     

Sepsis--generalized infection. The treatment of adults based on personal observations

Basing on the own experience, the authors discuss causative treatment of sepsis, mainly of unknown etiology. Emphasis is on the depression of immunological system in the acute phase of the disease. Therefore, a combined treatment with 2, often 3 or even 4 bacterial antibiotics is recommended, together with passive immunotherapy, and in certain cases surgical removal of the infection foci.     

Review of The personal life of the psychotherapist.

Reviews the book, The personal life of the psychotherapist by James D. Guy (see record 1987-97783-000). This book is a broad-ranging discussion of the psychotherapist as a person. It is a book about the development of the psychotherapist from the time he or she enters the field through his or her life stages and significant events, including burnout, therapist impairment, and death. Guy's book is a thoroughly researched and annotated work. He certainly has done a comprehensive review of the literature. His last two sections on career satisfaction and future trends are interesting. The book has one problem which is inherent in any attempt to encompass all of the theoretical orientations in the field. That is, at times it seems too encompassing and not definitive enough. All in all, however, this is a fine book which should be of interest to beginning psychotherapists as well as therapists in the field for some time. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Acute and chronic sphenoid sinusitis. Review of the literature

Isolated involvement of the sphenoid sinus is a relatively uncommon entity. We present a review of the most important series. Acute and chronic diseases are separated. Acute sphenoid sinusitis is a potentially catastrophic infectious disease. It is frequently initially misdiagnosed, and, due to the severe intracranial complications, a genuine medical and surgical treatment is recommended. Chronic sphenoid lesions may pose a problem of etiologic diagnosis. It may be difficult to differentiate between benign and malignant lesions. The most common presenting symptom is headache, followed by visual symptoms and cranial nerves palsies. Radiographically, computed tomography is the gold standard. Treatment includes antibiotic therapy and surgical drainage. This drainage is now done through an endoscopic approach.     

Melanoma of the oral cavity. Review of the literature

The location of melanoma in the oral cavity is extremely rare: its frequency varies between 0.2 and 8%. Oral melanoma strikes mainly male subjects and is more frequently seen at the level of the hard palate and gingiva. Today the clinicopathological classification of oral melanoma is not yet clearly outlined, and that is why the skin form is often taken as a reference. The acral lentiginous subtype proves to be the most common in this seat. In many cases (up to 50%) the diagnosis of melanoma is made on lesions which have evolved from the pre-existing pigmented lesions: as a consequence, every pigmented lesion of undetermined origin must be biopsied as a routine. The prognosis often proves poor and the surgical approach, combined with the chemotherapeutic one, is the first choice treatment. Lymph node dissection is not routinely practiced.     

Home rehabilitation after stroke. Review of the literature

To find an answer to the question whether domiciliary rehabilitation after stroke is better or cheaper than alternative forms of rehabilitation, a systematic literature review of controlled trials was performed. Three large and two smaller, more preliminary studies of all together a thousand patients were found and regarded methodologically acceptable. Efficacy as regards functional, emotional and qualitative outcome of patients was equivalent for various modes of care. So was the degree of stress, social function and quality of life for the main carers. Home treatment costed less than regular day care but more than routine care including a mixture of outpatient and day care, as considered required. Domiciliary rehabilitation seems to be a good and cost effective alternative for stroke patients who need and cannot manage frequent out-patients visits without ambulance or other exhausting and expensive transports.     

Review of Applications of personal construct theory.

Reviews the book, Applications of personal construct theory edited by J. Adams-Webber and J. C. Mancuso (1983). The 24 chapters of this volume are a selection from papers presented at the Fourth International Congress on Personal Construct Psychology (PCP) held in 1981. The title of the volume is perhaps misleading, as there are three discernible motifs in this varied assortment of offerings. These can be identified as those papers dealing primarily with theoretical issues, those concerned with the history of the theory and the man who developed it (George Kelly), and those that focus on applications of the theory. It is clear that ten chapters are theoretical, including the first nine and Bannister's concluding chapter on the self. If I were to assume that these efforts are representative of the development of PCP, my judgment would be that little important change in Kelly's ideas has occurred over the years. It is not easy to say why this is so, although the fact that Kelly died before he might have revised aspects of his theory has to be considered. Overall, however, the conceptual advances have a pallid quality and the occasional adulatory echoing of the master is disconcerting. Of the 11 or so empirical and applied chapters, a number point in useful and interesting directions. Several papers deal with PCP in relation to schizophrenic thought disorder, depression, chronic illness, anorexia nervosa, and obsessive neurosis. Neimeyer's chapter on sociohistorical influences in the development of PCP affords an opportunity to reflect upon the past, present, and future of Kelly's ideas--including the trend toward integration with other schools of thought despite Kelly's well-known resistance to direct comparison with other kindred theories. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Applications of personal construct theory.

Reviews the book, Applications of personal construct theory edited by Jack Adams-Webber and James C. Mancuso (1983). Jack Adams-Webber and James Mancuso have edited a book well worth studying. Almost any psychologist will derive some benefit from the research methods used and the results reported. Most psychologists will also be encouraged to discover that there is renewed hope for a successful experimental approach to a number of research questions in personality and abnormal psychology. Applications of personal construct theory is a collection of papers presented at the Fourth International Congress on Personal Construct Psychology held at Brock University in St. Catharines, Ontario, in the summer of 1981. For this volume the editors have chosen all five invited addresses and nineteen selected papers from the more than eighty items of the complete Congress programme. The selection that they have made is varied and contains some excellent chapters. The book's title is somewhat misleading, however, in that there are chapters dealing with theoretical questions and historical material, as well as those that can properly be regarded as applications of personal construct theory. Apart from its general interest, this book would be a possible text for a senior undergraduate course. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Saliva: clinical and diagnostic usefulness. Review of the literature

Modern clinical pathology is mainly based on the analysis of blood samples, carried out through more and more sophisticated techniques. Being the blood test an invasive technique, it certainly reduces the possibility of carrying out blood analysis, especially in patients such as children, old people, handicapped people and every person who needs continuous biochemical or pharmacological monitoring. In these cases it is very important to find other body fluids that can be easily obtained and that can offer the same reliable data as blood. Due to some of its characteristics, sometime saliva may be a good alternative to venous blood, as it presents the same features of plasma or urine. The chemical analysis of saliva provides some information that are useful for metabolic, inflammatory, neoplastic and genetic diseases; furthermore radioimmunological dosages allow to assess small concentrations of active substances. On the basis of an accurate review of literature, the aim of this study is to analyse the importance of saliva in diagnosing and monitoring certain systemic diseases, the utilization of saliva in hormonal and pharmacological dosages and the use of saliva in some epidemiological studies. Finally, it is emphasized that saliva in monitoring may help to manage several clinical conditions.     

Counseling and psychotherapy with Asian-Americans: Review of the literature.

Reviews the existing literature on counseling and psychotherapy with Asian-Americans and discusses research needs and recommendations for future research. Diagnosis and assessment issues include symptom expression, therapist bias, problems with the use of interpreters, and problems with the use of clinical and personality tests. Client variables in counseling and psychotherapy involve the personality of Asian-Americans, language problems, the acculturation process, and counseling expectations. Therapist variables involve therapist bias, training bias, lack of intercultural skills, and culture-specific knowledge. In a discussion of process and outcome, the author reviews empirical studies, clinical case studies, and articles with treatment strategies and recommendations. Research recommendations for each of the areas reviewed are identified. (3 p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)