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Migratory Exploratory Laparotomy

100%

Marszałek M., Kozłowicz G., Jurgielaniec D.

Polish Journal of Surgery

2008

vol. 80

issue 2

86-88

Migratory exploratory laparotomy is one of the four types of psychosomatic disorders referred to as Münchhausen's Syndrome. Patients manifest symptoms of acute abdominal cavity disease. Thus, numerous diagnostic examinations are required, the results of which rarely produce a clear diagnosis. The surgeon, who during the course of his practice comes across patients suffering from the above-mentioned type of disorder, is often faced with the difficult decision of whether or not a exploratory laparotomy should be performed. The reasons behind the development of Münchhausen's Syndrome, which may be clarified by following a detailed patient history, will perhaps help to avoid unnecessary laparotomy.

Stroke mimics: a psychogenic stroke patient treated with alteplase

88%

Kotlęga D., Peda B., Trochanowski T., Gołąb-Janowska M., Ciećwież S., Nowacki P.

vol. 17(1)

97-102

For rtPA treatment to be effective it should be initiated within the first 4.5 hours following the onset of a stroke. Such a short therapeutic window demands a rapid diagnosis and decision making on the part of the physician. There are patients with stroke-like symptoms and an initial diagnosis of a stroke, but who are finally diagnosed as suffering from another condition. According to the subject literature, stroke mimics are diagnosed in about 1.4 – 3.5% of patients initially diagnosed as having had an ischemic stroke. Psychogenic strokes (conversion disorders) may be found in as many as 8.2% of stroke patients. Proper diagnosis is especially important in patients eligible for thrombolytic treatment when there is usually not enough time to establish the diagnosis of a stroke mimic, especially one of psychogenic origin. A patient with an initial diagnosis of an ischemic stroke who was treated with intravenous alteplase infusion. The previous two ischemic strokes treated in the same manner had been diagnosed one and two years earlier. In all hospitalizations no rtPA treatment complications had been observed. In our patient a proper neuropsychological examination was performed and a conversion disorder diagnosed. We would like to underline the importance of cooperation between the neuropsychologist and neurology physician within clinical practice.

Psychologiczne aspekty chorób alergicznych: trudności dorosłych pacjentów z astmą oskrzelową i atopowym zapaleniem skóry

63%

Albińska P.

Psychiatria i Psychologia Kliniczna

2014

vol. 14

issue 4

296-303

The aim of this article is to present a theoretical review of studies on psychological functioning of adult individuals who suffer from allergic disorders. This article focuses on adults because of a small number of scientific research dealing with a change in manifestation of symptoms in patients with the above-mentioned diseases which can be treated as the first and the last stage of the allergic march, because its symptomatic manifestation in children usually takes the form of atopic dermatitis, while in adults it is known as bronchial asthma. This analysis answers the question whether the common allergic and inflammatory aetiology of these disorders reflects the similarities of experienced psychological difficulties. The discussion refers to Polish and foreign literature from the last decade and takes into account the most common aspects of psychosomatic diseases such as asthma and atopic dermatitis, i.e. sleep disorders, depression, anxiety, other affective disorders, behavioural disorders and cognitive difficulties. The co-occurrence of mental and somatic disorders in patients suffering from allergy is the conclusive evidence on the integrity of the human psyche and soma, which is scarcely noticed by health-care decision makers. Thereby they ignore the important element of diagnostic and therapeutic process which is crucial for the recovery of patients with asthma and atopic dermatitis.

Celem pracy jest zaprezentowanie przeglądu badań na temat psychologicznego funkcjonowania dorosłych cierpiących na choroby alergiczne. Artykuł koncentruje się na dorosłych ze względu na istnienie małej liczby prac naukowych dotyczących zmiany manifestacji symptomów u pacjentów z wyżej wymienionymi chorobami, która może być traktowana jako pierwsze i ostatnie stadium marszu alergicznego, ponieważ jego objawowa manifestacja u dzieci zwykle przybiera postać atopowego zapalenia skóry, podczas gdy u dorosłych jest znana jako astma oskrzelowa. Analiza odpowiada na pytanie, czy wspólnej, alergiczno-zapalnej etiologii tych schorzeń odpowiadają podobieństwa doświadczanych trudności psychologicznych. Omówienie odwołuje się do polskiej i zagranicznej literatury przedmiotu i uwzględnia kluczowe aspekty chorób psychosomatycznych – astmy i atopowego zapalenia skóry – czyli trudności ze snem, depresję, lęk, inne zaburzenia afektywne, zaburzenia zachowania i trudności poznawcze. Współwystępowanie zaburzeń psychicznych i somatycznych u chorych na alergię to niepodważalny dowód integralności somy i psyche, co rzadko dostrzegają osoby odpowiedzialne za system opieki zdrowotnej. Ignorują one tym samym ważny element procesu diagnostyczno-terapeutycznego, istotny dla wyzdrowienia pacjentów z astmą i atopowym zapaleniem skóry.

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1 Acta Neuropsychologica

1 Polish Journal of Surgery

1 Psychiatria i Psychologia Kliniczna

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1 Albińska P.

1 Ciećwież S.

1 Gołąb-Janowska M.

1 Jurgielaniec D.

1 Kotlęga D.

1 Kozłowicz G.

1 Marszałek M.

1 Nowacki P.

1 Peda B.

1 Trochanowski T.

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Migratory Exploratory Laparotomy

Stroke mimics: a psychogenic stroke patient treated with alteplase

Psychologiczne aspekty chorób alergicznych: trudności dorosłych pacjentów z astmą oskrzelową i atopowym zapaleniem skóry