Casework Treatment of an Alcoholic Woman with Severe Underlying Pathology

1957 ◽  
Vol 18 (3) ◽  
pp. 475-491 ◽  
Author(s):  
Jean Markham ◽  
Leonard M. Lasser
Keyword(s):  
Underlying Pathology ◽  
Alcoholic Woman

Quick Reference: Chapter 1: The Musculoskeletal System: The Hand and Upper Extremity

2000 ◽  
Vol 5 (5) ◽  
pp. 4-5
Keyword(s):  
Dorsal Column ◽  
Persistent Pain ◽  
Illness Behavior ◽  
Abnormal Illness Behavior ◽  
Organ Systems ◽  
Spinal Cord Dorsal ◽  
Objective Basis ◽  
Dorsal Column Stimulation ◽  
Underlying Pathology

Abstract Spinal cord (dorsal column) stimulation (SCS) and intraspinal opioids (ISO) are treatments for patients in whom abnormal illness behavior is absent but who have an objective basis for severe, persistent pain that has not been adequately relieved by other interventions. Usually, physicians prescribe these treatments in cancer pain or noncancer-related neuropathic pain settings. A survey of academic centers showed that 87% of responding centers use SCS and 84% use ISO. These treatments are performed frequently in nonacademic settings, so evaluators likely will encounter patients who were treated with SCS and ISO. Does SCS or ISO change the impairment associated with the underlying conditions for which these treatments are performed? Although the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) does not specifically address this question, the answer follows directly from the principles on which the AMA Guides impairment rating methodology is based. Specifically, “the impairment percents shown in the chapters that consider the various organ systems make allowance for the pain that may accompany the impairing condition.” Thus, impairment is neither increased due to persistent pain nor is it decreased in the absence of pain. In summary, in the absence of complications, the evaluator should rate the underlying pathology or injury without making an adjustment in the impairment for SCS or ISO.

Cognitive Functioning and Other Discriminatory Variables in Anorexic Patients

2005 ◽  
Vol 27 (1) ◽  
pp. 191-210 ◽  
Author(s):  
Carmen García-Alba
Keyword(s):  
Cognitive Functioning ◽  
Research Study ◽  
Early Stage ◽  
Developmental Period ◽  
The Other ◽  
Model Synthesis ◽  
Consistent Function ◽  
Current Article ◽  
Rorschach Variables ◽  
Underlying Pathology

This study is part of a larger research study (doctoral dissertation), in which a comparative study with adolescent samples is done: 50 anorexic restricting patients (ANP), 50 patients diagnosed with depression (DP) and 50 non patients (NP). The proposed objective is two-fold: 1) To try to clarify the existing relationship between Anorexia (AN) and Depression (D), investigated from diverse disciplines but without conclusive results. 2) To detect in the ANP personality different traits from those of other groups, which should, if possible, allow to detect them at an early stage for an adequate prognosis. The current article presents the Rorschach findings in relation to the cognitive functioning of the ANP. In them, the following has been detected: (1) An information processing similar to that of the other groups, even with a more complete (L ≤ .99), more complex (DQ+↑) and better discriminated (Zd↑) grasp of the stimulus; (2) Mediating processes very similar to those of the other groups, sharing with them the perceptive maladjustments (X–%↑) and an excessive individualism (Xu%↑); (3) A clearly differentiating ideation disorder. Definitely, the ANP use predominantly ideation (M↑), but their thought, usually well-adjusted (MQo↑), presents eventual operations of delusional type (MQnone↑). Above that, their thinking is marked by a great passivity (Mp↑), which makes them more vulnerable to accept ideas without criticizing them and it results in a very inefficient thinking, which spins around these concepts without finding solutions, entering into a sort of ruminating which is completely unproductive. The differences toward the obsessive pathology are established. The discriminant analysis conducted with all the Rorschach variables that resulted as significant throughout the research, provides quite a consistent function which discriminates the ANP: MQnone↑, Mp↑, FD↓, Ma↑, MQo↑, AdjD↑, Sum H↑, (H)↑. Based on this we can understand that these adolescents, being in a developmental period of big changes and disorientations in relation with their own image, confronted with life events, and possibly starting off with some biologic vulnerability: (1) Due to the alterations of their ideation, accept without criticism (Mp) irrational ideas dominating in our culture, in which slimness appears as the only model, synthesis of intelligence, beauty and success; remaining captured in this type of mental activity (MQnone), which they cannot escape nor criticize (Mp), despite they reason adequately on other topics (MQo); (2) Their alterations of self-perception [(H)] make them hide themselves in a fantasized image, which is the axis of their interests and the only thing that really matters to them; (3) The resources they have to decide on behaviors and to finish these deliberately (AdjD), and their scarce tendency to the introspection (FD) lead to their decision of not eating, based on distorted and passively accepted thinking, which has great power and thus, so difficult to modify. Finally, based on the Rorschach data obtained, the hypothesis of a personality disorder as underlying pathology is pointed out.

Pancytopenia: A Challenging Problem for Treating Physician

2018 ◽  
Vol 2 (01) ◽  
pp. 22-28
Author(s):  
Md. Rezaul Karim Chowdhury ◽  
Amina Begum ◽  
Md. Haroon Ur Rashid ◽  
Md. Kamrul Hasan
Keyword(s):  
Bone Marrow ◽  
Physical Examination ◽  
Blood Smear ◽  
Peripheral Blood Smear ◽  
Bone Marrow Examination ◽  
Challenging Problem ◽  
Trephine Biopsy ◽  
Life Threatening ◽  
Underlying Pathology ◽  
Careful History

Pancytopenia is an important clinico-haematological entity and striking feature of many serious and life-threatening illnesses. Many haematological and non-haematological diseases involve the bone marrow primarily or secondarily and cause pancytopenia. Decrease in haemopoietic cell production, ineffective haemopoiesis and peripheral sequestration or destruction of the cells are the main pathophysiology of pancytopenia. The cause of pancytopenia thus may be lying in the bone marrow or in the periphery or both. Careful history, physical examination, simple blood work, review of the peripheral blood smear, sometimes bone marrow examination and trephine biopsy are required for diagnosis. Treatment and prognosis depend on the severity of pancytopenia and underlying pathology.

scholarly journals NUMERICAL RATING SCALE AS A PREDICTOR OF AN UNDERLYING PATHOLOGY IN PEDIATRIC BACK PAIN USING MAGNETIC RESONANCE IMAGE AS DIAGNOSTIC TOOL

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0004
Author(s):  
Eduardo A. Lindsay ◽  
Gerardo Olivella ◽  
Manuel Rodríguez ◽  
Edwin Burgos-Rossy ◽  
Natalia Torres-Acevedo ◽  
...  
Keyword(s):  
Back Pain ◽  
Magnetic Resonance Image ◽  
Rating Scale ◽  
Chronic Back Pain ◽  
Numerical Rating Scale ◽  
Children And Adolescent ◽  
Constant Pain ◽  
Neurological Exam ◽  
Numerical Rating ◽  
Underlying Pathology

Background & Objectives: Recently, constant and night pain has been discarded as adequate clinical markers to predict the presence of an underlying pathology in pediatric back pain. The pain intensity has been recognized as an important domain in the pain assessment. Numerical Rating Scale (NRS) is one of the most common validated tools to assess pediatric pain intensity in children above 8 years of age. The aim of this study is to assess NRS as a predictor of underlying pathologies found by magnetic resonance image (MRI) in pediatric back pain. We hypothesize that a higher NRS score is associated with a high sensitivity, specificity and likelihood ratio to identify the present of organic pathology in pediatric chronic back pain. Methodology: After obtaining Institutional Review Board approval, a retrospective electronical medical record review was conducted. All pediatric patients who reported back pain lasting > 4 weeks between 2009 to 2018 were enrolled in the study. As per regular protocol, a pediatric orthopedic surgeon evaluated all patients who presented with back pain. After a non-diagnostic history, physical examination and spinal x-ray; spine MRI was order. Pain was graded with the use of NRS from 0 to 10. Patients were divided in two groups: NRS (1-5) & NRS (6-10). Variables such as gender, age, pain frequency, night pain, neurological exam, and the presence of an underlying pathology were compared between both groups. Patients that presented with injury due to trauma, previous diagnosis of back pain or cervical pain were excluded. Results: A total of 467 patients were evaluated in the study. Mean age of subjects was 15 years; 69% being female. An underlying pathology was identified in 131/315 (41.6%) patients with NRS (6-10), and 55/152 (36.2%) patients with NRS (1-5) (P=0.27). Patients with NRS (6-10) had two times more probability of suffering constant pain (P<0.03) and three times more likely of having an abnormal neurological examination (P<0.05). See table 1. Conclusion: Evaluation and treatment of children and adolescent with chronic back pain is challenging. Our study shows a strong association between NRS high (6-10) and constant pain and/or abnormal neurological exam. However, the use of NRS of (6-10) was not found as adequate predictor for the presence of an underlying organic pathology in children and adolescent patients. Therefore, physicians should not rely only high NRS score to recommend advance imaging study to assess chronic back pain in children and adolescent patients. Summary [Table: see text]

scholarly journals Estimated Burden of Fungal Infections in Oman

2020 ◽  
Vol 7 (1) ◽  
pp. 5
Author(s):  
Abdullah M. S. Al-Hatmi ◽  
Mohammed A. Al-Shuhoumi ◽  
David W. Denning
Keyword(s):  
Fungal Infection ◽  
Fungal Infections ◽  
Epidemiological Studies ◽  
Vaginal Candidiasis ◽  
Skin Infections ◽  
Opportunistic Pathogens ◽  
Fungal Rhinosinusitis ◽  
Populations At Risk ◽  
Different Populations ◽  
Underlying Pathology

For many years, fungi have emerged as significant and frequent opportunistic pathogens and nosocomial infections in many different populations at risk. Fungal infections include disease that varies from superficial to disseminated infections which are often fatal. No fungal disease is reportable in Oman. Many cases are admitted with underlying pathology, and fungal infection is often not documented. The burden of fungal infections in Oman is still unknown. Using disease frequencies from heterogeneous and robust data sources, we provide an estimation of the incidence and prevalence of Oman’s fungal diseases. An estimated 79,520 people in Oman are affected by a serious fungal infection each year, 1.7% of the population, not including fungal skin infections, chronic fungal rhinosinusitis or otitis externa. These figures are dominated by vaginal candidiasis, followed by allergic respiratory disease (fungal asthma). An estimated 244 patients develop invasive aspergillosis and at least 230 candidemia annually (5.4 and 5.0 per 100,000). Only culture and microscopy are currently available for diagnosis, so case detection is suboptimal. Uncertainty surrounds these figures that trigger the need for urgent local epidemiological studies with more sensitive diagnostics.

scholarly journals Sertoli-Leydig Cell Tumour and DICER1 Mutation: A Case Report and Review of the Literature

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
B. Wormald ◽  
S. Elorbany ◽  
H. Hanson ◽  
J. W. Williams ◽  
S. Heenan ◽  
...  
Keyword(s):  
Case Report ◽  
Gene Mutation ◽  
Leydig Cell ◽  
Autosomal Dominant ◽  
Review Of The Literature ◽  
Autosomal Dominant Fashion ◽  
Rare Tumours ◽  
Leydig Cell Tumour ◽  
Underlying Pathology ◽  
Leydig Cell Tumours

Sertoli-Leydig cell tumours of the ovary (SLCT) are rare tumours predominantly caused by mutations in the DICER1 gene. We present a patient with a unilateral SLCT who had an underlying germline DICER1 gene mutation. We discuss the underlying pathology, risks, and screening opportunities available to those with a mutation in this gene as SLCT is only one of a multitude of other tumours encompassing DICER1 syndrome. The condition is inherited in an autosomal dominant fashion. As such, genetic counselling is a key component of the management of women with SLCT.

Echocardiography Evaluation of a Novel Stable Ovine Heart Failure Model Suitable for Cardiovascular Device Testing

2011 ◽  
Author(s):  
Peter W. Walsh ◽  
Craig S. McLachlan ◽  
Leigh Ladd ◽  
Arie Blitz ◽  
R. Mark Gillies ◽  
...  
Keyword(s):  
Heart Failure ◽  
Animal Models ◽  
Large Animal ◽  
Failure Model ◽  
Large Animal Models ◽  
Surgical Model ◽  
Coronary Ligation ◽  
Rapid Ventricular Pacing ◽  
Heart Failure Model ◽  
Underlying Pathology

Numerous large animal models of chronic cardiac ischemia have been developed to explore either pathological mechanisms and or device interventions in developed heart failure models. Traditionally chronic heart failure in large animal models such as sheep or pigs has been induced by either coronary ligation with or without reperfusion. Coronary ligation is often attempted in the open chest surgical model or more recently in the closed chest animal via angiography [1]. Both techniques can be challenging and also induce high mortality with the risk of myocardial stunning and resultant shock and or lethal arrhythmias. There is also difficulty in developing stable heart failure across cases where infarct sizes can be variable. One strategy to over come this variability has been via rapid ventricular pacing, however inducing heart failure does not induce sustained heart failure in many cases if the pacing is switched off, and additionally pacing does not induce some of the underlying pathology seen in the development of heart failure [1].

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