Dissociation Revealed in a Therapeutic Consultation

The Collected Works of D. W. Winnicott ◽

10.1093/med:psych/9780190271398.003.0039 ◽

2016 ◽

pp. 245-272

Author(s):

Donald W. Winnicott

Keyword(s):

Clinical Picture ◽

Antisocial Behaviour ◽

Case Histories

Winnicott discusses one detail of the antisocial clinical picture to illustrate the feature of dissociation, which recurs regularly in case histories. He illustrates this using a psychotherapeutic interview with a girl of eight years, which led to a cessation of stealing and which Winnicott believes was therefore significant. He writes that the child who does not acknowledge the antisocial act is the child who is in distress and who wants help and who can be helped. Another example concerns a deprived child who craved friendship but could not achieve it and did not make friends easily. The child was aware that he was suffering from a compulsion, but could not believe in what he had done under this compulsion, showing the dissociation in his psyche. Winnicott maintains that antisocial behaviour in a child is linked to a loss of hope—disillusionment—which needs to be returned to in order to recover the capacity for hope.

Download Full-text

Peculiarities of clinical diagnosis of retroperitoneal hemorrhages in closed abdominal trauma

Kazan medical journal ◽

10.17816/kazmj81113 ◽

1997 ◽

Vol 78 (1) ◽

pp. 53-53

Author(s):

S. V. Dobrokvashin ◽

A. Kh. Davletshin

Keyword(s):

Clinical Diagnosis ◽

Abdominal Trauma ◽

Clinical Picture ◽

Emergency Surgery ◽

Case Histories ◽

Emergency Hospital ◽

Decisive Importance ◽

Surgery Department ◽

Instrumental Methods ◽

Further Development

Closed abdominal and retroperitoneal injuries occur in 1.5-4% of peacetime injuries. Many issues of their diagnostics require further development. In this article we describe only clinical diagnosis of this pathology, without focusing on the use of instrumental methods (invasive and noninvasive). In our opinion, the clinical picture is of decisive importance in the diagnosis of any urgent abdominal pathology. Our observations are based on the analysis of 100 case histories of patients treated in the emergency surgery department of Kazan Emergency Hospital, as well as on the literature data.

Download Full-text

EXPERIENCE IN TREATING ACUTE APPENDICITIS IN TASHKENT

Russian Journal of Pediatric Surgery ◽

10.18821/1560-9510-2019-23-3-157-160 ◽

2019 ◽

Vol 23 (3) ◽

pp. 157-160

Author(s):

Kh. A. Akilov ◽

N. T. Urmanov ◽

F. Sh. Primov ◽

Jurat A. Djurayev ◽

N. R. Xadjayarov

Keyword(s):

Acute Appendicitis ◽

Clinical Picture ◽

Pediatric Patients ◽

Laparoscopic Technique ◽

Anatomical Location ◽

Case Histories ◽

Scientific Center ◽

Surgical Practice ◽

Widespread Implementation ◽

Made In

75% of all emergency surgeries are surgeries for acute appendicitis. Annually, only in the Republican Scientific Center 700 appendectomies in children are made, in average. The article summarizes data obtained in the retrospective analysis of case histories of 6 256 patients with acute appendicitis and its complications who were hospitalized in the pediatric department of emergency surgery for 12 years. The following incidence of acute appendicitis in children is reported: from 1 to 3 years of age - 0.6 per 1 000; from 4 to 7-1.4-2.6 per 1 000; 13 years of age - 8 per 1 000. The authors discuss specific features in the clinical picture of acute appendicitis in children depending on patient’s age and anatomical location of the appendix. The clinical picture in children of older age and of the first three years of life is discussed separately. Out of 6 256 pediatric patients with acute appendicitis 72 (1.15%) were children younger than 3. The authors have substantiated a complex of diagnostic and therapeutic manipulations as well as tactic options to the treatment of this category of patients. Widespread implementation of the laparoscopic technique into surgical practice has significantly changed the tactics of treatment. The number of surgeries for simple appendicitis in children has decreased up to 3.9-7%.

Download Full-text

Traumatic Panniculitis-the Spectrum

International Journal of Clinical Case Reports and Reviews ◽

10.31579/2690-4861/106 ◽

2021 ◽

Vol 6 (5) ◽

pp. 01-04

Author(s):

Jochanan Naschitz

Keyword(s):

Adipose Tissue ◽

Clinical Picture ◽

Symptomatic Treatment ◽

The Other ◽

Tissue Necrosis ◽

Case Histories ◽

Physical Trauma ◽

Subcutaneous Nodules ◽

Chemical Agents ◽

Subcutaneous Mass

Panniculitis, when induced by physical trauma or by chemical agents at injection sites, presents as indurated subcutaneous nodules or plaques. The clinical picture may vary, but the context makes usually the diagnosis easy. Three case histories from our department illustrate the spectrum of traumatic panniculitis: subcutaneous nodules at injection sites, a large subcutaneous mass disproportionate to mild trauma, and, at the other end of the spectrum, severe adipose tissue necrosis with liquefied fat discharging through surface wounds. Traumatic panniculitis is self-limiting and only requires symptomatic treatment.

Download Full-text

On the diagnosis and coding of reactive arthropathies

Modern Rheumatology Journal ◽

10.14412/1996-7012-2020-2-41-44 ◽

2020 ◽

Vol 14 (2) ◽

pp. 41-44

Author(s):

R. M. Balabanova

Keyword(s):

Retrospective Analysis ◽

Clinical Picture ◽

Reactive Arthritis ◽

Case Histories ◽

Ministry Of Health ◽

Rheumatology Clinic ◽

Insufficient Attention ◽

Number Of Patients ◽

Icd 10 ◽

Made In

According to statistics from the Ministry of Health of Russia, the incidence of reactive arthropathies varies significantly by region and year. In ICD-10, reactive arthropathies include reactive urogenic arthritis (M02.3), other reactive arthropathies (M02.8), and reactive arthropathies, unspecified (M02.9). Information on reactive arthritis (ReA) cannot be extracted from these data.Objective: to specify the number of patients with ReA among inpatients with reactive arthropathies.Patients and methods. A retrospective analysis of 224 case histories was made in the patients treated at the V.A. Nasonova Research Institute of Rheumatology Clinic in 2009–2018 and discharged with Codes M02.3, M02.8, and M02.9.Results and discussion. Nineteen out of the 224 patients were diagnosed with reactive urogenic arthritis (M02.3), 128 had reactive arthropathies (M02.8), and 77 had reactive arthropathies, unspecified (M02.9). All the 19 patients with this diagnosis met the criteria for reactive urogenic arthritis. Among the 128 patients with reactive arthropathies, 77 met the ReA criteria, 8 of them were found to have reactive urogenic arthritis, since the clinical picture had a triad consisting of arthritis, urogenic or enterocolitic infection, and conjunctivitis. Twenty-five out of the 77 patients discharged with Code M02.9 met the criteria for certain ReA and 6 did those for possible ReA. Thus, the diagnosis fitted the criteria for ReA in only half (56.7%) of the patients with reactive arthropathies.Conclusion. The performed investigation revealed that clinicians paid insufficient attention to the diagnosis of ReA and that statisticians did this to the coding of reactive arthropathies.

Download Full-text

Jansky-Bielschowsky syndrome, a lysosomal disease: First diagnosed cash in Oman

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100123568 ◽

1992 ◽

Vol 50 (1) ◽

pp. 632-633

Author(s):

Line Buhl ◽

David Muirhead

Keyword(s):

Mental Retardation ◽

Clinical Picture ◽

Neurological Disorder ◽

Clinical Presentation ◽

Neuronal Ceroid Lipofuscinosis ◽

Infantile Form ◽

Lysosomal Disease ◽

Juvenile Form ◽

Progressive Encephalopathy ◽

Lysosomal Diseases

There are four lysosomal diseases of which the neuronal ceroid lipofuscinosis is the rarest. The clinical presentation and their characteric abnormal ultrastructure subdivide them into four types. These are known as the Infantile form (Santavuori-Haltia), Late infantile form (Jansky-Bielschowsky), Juvenile form (Batten-Spielmeyer-Voght) and the Adult form (Kuph's).An 8 year old Omani girl presented wth myclonic jerks since the age of 4 years, with progressive encephalopathy, mental retardation, ataxia and loss of vision. An ophthalmoscopy was performed followed by rectal suction biopsies (fig. 1). A previous sibling had died of an undiagnosed neurological disorder with a similar clinical picture.

Download Full-text