The abduction of disorder in psychiatry.

The evolutionary cornerstone of J. C. Wakefield's (see record 1999-03409-002) harmful dysfunction thesis is a faulty assumption of comparability between mental and biological processes that overlooks the unique plasticity and openness of the brain's functioning design. This omission leads Wakefield to an idealized concept of natural mental functions, illusory interpretations of mental disorders as harmful dysfunctions, and exaggerated claims for the validity of his explanatory and stipulative proposals. The authors argue that there are numerous ways in which evolutionarily intact mental and psychological processes, combined with striking discontinuities within and between evolutionary and contemporary social/cultural environments, may cause nondysfunction variants of many widely accepted major mental disorders. These examples undermine many of Wakefield's arguments for adopting a harmful dysfunction concept of mental disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The diagnosis and treatment of leprosy

Leprosy is a complex disease, but recent research and the Ridley-Jopling classification which emphasize its immunologic aspects have greatly aided our understanding of and approach to the problem. The diagnosis should be considered whenever skin lesions and sensory loss occur. Dapsone remains the treatment of choice, but several newer drugs show great promise, especially in those cases whose bacilli have become sulfone resistant. Immunotherapy may play an increasingly prominent role in the future. Reactive episodes continue to be a serious complication, but the availability of thalidomide to control erythema nodosum leprosum has markedly improved the prognosis. Physicians of the US Public Health Service Hospital at Carville, Louisiana, are available at all times for consultation on these and other matters related to leprosy.     

The diagnosis and treatment of neck wounds

The largest in Russia experience of diagnostics and treatment victims with side-arms' wounds of the neck (492 patients) is represented. The authors subdivide allo wounds into superficial (170 cases without mortal outcomes) and profound ones (322 cases with total mortality rate as 6.8%). Classification of the injuries, their features, depending of the causes and the king of the weapon, are represented. Complex of diagnostic methods, which application depends on severity of the patients condition, is substantiated. The standard surgical approach in profound injuries of the neck is considered to be an anterior colotomy.     

The diagnosis and treatment of liver abscesses

An analysis of results of treatment of 15 patients with abscesses of the liver of different genesis is given in the article. The ultrasonic method of examination was shown to be highly efficient for diagnosis of liver abscesses. The authors stress the necessity of differential approach to treatment of such patients based on etiopathogenesis of the disease. In most cases the method of choice for treatment of liver abscesses was found to be the percutaneous puncture and drainage under control of echography.     

The diagnosis and treatment of bladder cancer metastases

Central hemodynamics was studied by thermodilution in 16 patients with acquired mitral defect during surgery under conditions of hypothermia without perfusion. Cooling and surgical correction were carried out under superficial ether anesthesia with morphine and droperidol. A 28% decrease of the minute circulation volume is observed as early as under general anesthesia and at the very beginning of cooling (10.8% more); this decrease is caused by rarer heart contractions and increase of the total peripheral vascular resistance as a result of body response to cool exposure. An almost 10 degrees C drop of body temperature (to 27.2 +/- 0.2 degrees C) involves a just 13% decrease of the cardiac index in comparison with the value at the beginning of cooling. Injection of droperidol before cooling blocks the increase of the total peripheral resistance in a dose-dependent mode (about 0.13 mg/kg of droperidol is needed for sufficiently complete prevention of the increase of total peripheral resistance), and thus maintains the stroke and cardiac indexes at a sufficiently high level. Morphine (in doses of up to 2.3 mg/kg) did not bring about such an effect.     

The diagnosis and treatment of the gummy smile

The diagnosis and treatment of the "gummy smile" (altered passive eruption, excessive gingival display) help the periodontist to provide the most beautiful smiles possible for patients. This article describes diagnosis, surgical planning, and case reports that show the benefits of treatment of this common clinical problem for the patient and restorative dentist who can now provide ideal cosmetic results for their patients.     

The diagnosis and treatment of blunt renal trauma

225 patient with blunt renal trauma were treated from 1955 to 1994. Coexistent injuries of other organs were noted in 79 patients (35.11%). The extent of renal trauma was not demonstrated by hematuria. B-ultrasonography seemed to be best for the diagnosis of renal trauma. Abdominal incision was helpful to explore injuries of other organs and manage renal trauma. Early treatment of renal trauma was necessary for the treatment of shock and prevention of serious complication.     

The diagnosis and treatment of malaria in Australia

The number of reported malaria cases is increasing each year with several deaths reported recently. This article reviews the types of malarias, including their incidence, prevention, presentation and the standard treatment protocols.     

Enzyme deficiencies detected on cultured fibroblasts and amniotic cells. Application to prenatal diagnosis

The detection of enzumatic deficiencies on cultured cells is reviewed from the literature and the authors personal experience. The application to the antenatal diagnosis of enzymatic genetic diseases is discussed, with special reference to lysosomal enzymes, of which the deficiency is most frequent. The authors insist on the importance of such detections and the problems which they may have to meet.     

The diagnosis and treatment procedure in periodic disease

The main forms of periodic disease are presented, clinical cases with the different forms are described. A special attention is paid to the problems of diagnosis and treatment in the emergency surgery of the abdominal organs is abdominal form of the disease.     

The nature, diagnosis and treatment of post-concussion syndrome

INTRODUCTION: The relationship between brief loss of consciousness, subsequent cognitive and emotional complaints, and impact on daily functioning continues to be hotly debated. DEVELOPMENT: In this paper the strong variability about prevalence of the postconcussional syndrome found in several studies is outstanding and the main issues of this disagreement are suggested. Recent neuroimaging techniques are discussed and some neuropsychological measures are suggested. CONCLUSIONS: Currents models (organic/psychogenic) of postconcussional symptoms are reviewed, and a multifactorial model which integrates biological factors with the relevance of neuropsychological deficits--attention, memory, speed of information processing--and coping process is proposed. Finally, according with this model, we conclude with some suggestions to improve neuropsychological intervention and medical treatment of these patients.     

The specifics of diagnosis and surgical treatment of traumatic pneumocephalus

Traumatic pneumocefalus (TPC)--complication of severe craniocerebral injury--occurs, as a rule, in fractures, line of which is coming across the air-containing sinuses of the skull base. Depending on the air localization subarachnoidal, subdural, epidural, ventricular, clinically asymptomatic and strained forms of TPC are discerned. TPC diagnosis is based on taking into account the clinico-neurological and radiological examination peculiarities. In the acute craniocerebral injury period surgical treatment for parabasal injuries is directed on the skull cavity hermetization and for TPC--the valve mechanism abolition, liquorous fistula closure, the air tumor emptying and intracranial space hermetization. Presence of strained progressing TPC constitutes the life perilous indication for surgical intervention.     

The effect of cancer diagnosis and treatment on hand function

Cancer diagnosis and treatment can have a profound effect upon hand function, presenting a challenge to the occupational therapist. The therapist who specializes in oncology or hand therapy must have knowledge of the medical treatment model in regard to cancer conditions and must be able to set realistic goals that consider the patient's medical prognosis as well as the effect the disease or medical treatment has on the patient's physical and emotional functioning. The challenge to therapists in this area of practice will be to conduct research to verify or validate the effectiveness of the occupational therapy interventions currently provided. As cancer is diagnosed at earlier stages of the disease and survival improves after cancer treatment, hand therapy may improve the functional outcomes of persons with cancer. This judgment of rehabilitation oncology practice will need to be confirmed by research.     

The modern approach to diagnosis and treatment of pollen allergy

Pollinosis is a seasonal multisytemic allergic disease the incidence of which is rising in the second half of the 20th century worldwide as well and also in the Czech Republic. The most frequent clinical manifestation of pollinosis is allergic rhinoconjunctivitis, less frequent are asthmatic complaints, there are however also other manifestations depending on the affected target organ. The diagnosis is based on a carefully recorded case-history, more accurate information and confirmation of the diagnosis is obtained from skin tests, in some cases assessment of specific IgE antibodies. The most important therapeutic procedure is prevention or at least restricted contact with pollen. Causal therapy involves properly indicated and performed specific immunotherapy by high quality standardized allergens. Pharmacotherapy of pollinosis, includes general treatment, in particular using second generation antihistaminic substances, and local treatment of nasal symptoms of pollinosis, the use of nasal steroids mastocyte stabilizers and topical antihistamines. In the treatment of ocular symptoms dominates the use of mastocyte stabilizers and topical antihistamines. For rapid control of acute nasal and ocular manifestations preparations containing decongestants are useful. An integral part of treatment is always systematic education of patients.     

The diagnosis and treatment of hormonally inactive adrenal formations]

Under analysis are results of an examination of 56 patients with hormonally non-active tumors of the adrenals, 48 of them were operated upon. In 20 patients (35%) they had clinical manifestations, 16 patients (28%) had an elevated level of the 17-HCS and 17-CS excretion in the 24-hours urine. Morphological investigations of the tumors in 20 patients have revealed clear cell adenomas of the cortical layer of the adrenal, in 19 patients--tumoral cysts, in 3 patients--true cysts, in 1 case-myelolipoma, in 1 case--ganglioneuromyelolipoma, in 4 cases--hormonally non-active carcinomas of the adrenal cortex. The authors propose to designate the new formations described as hormonally non-active tumors of the adrenals. In view of the absence of absolute methods for the identification of malignancy of the tumors the operative treatment of them is proposed.