Management Of Functional Disorders Research Articles

Role of Gamma Knife Radiosurgery in the Management of Functional Disorders - A Literature Review.

Role of radiosurgical lesioning in functional disorders has been restricted because of development of deep brain stimulation (DBS) techniques. However, many elderly patients with comorbidities and coagulation abnormalities may not be eligible for DBS. Radiosurgical lesioning may be a good alternative in such cases. The objective of the study was to review the role of radiosurgical lesioning for functional targets in common functional disorders. Literature reports pertaining to common disorders were reviewed. Disorders included are tremors (essential tremors, tremor-dominant Parkinson's disease [PD], multiple sclerosis [MS] related refractory tremors), Parkinson's disease (for rigidity, bradykinesia, drug-induced dyskinesias), dystonia, and obsessive-compulsive disorder (OCD). The most commonly performed procedure was ventral intermediate nucleus (VIM) lesioning for essential tremors and tremor-dominant PD, with about 90% patients demonstrating improvement. Intractable OCD with 60% responders is a promising indication. Other disorders are less commonly treated, with dystonia being the least commonly treated entity. Subthalamic nucleus (STN) and globus pallidus interna/posteroventral pallidum (GPi) lesioning are very rarely reported, and the available literature suggests caution due to high rates of adverse effects. Outcomes for radiosurgical lesioning for essential tremors (VIM) and OCD (anterior limb of internal capsule [ALIC]) are encouraging. Radiosurgical lesioning offers a lower immediate risk profile in patient population with several comorbidities; however, long-term adverse effects due to radiation are a concern, especially for STN and GPi lesioning.

A Wearable Wideband Analog Bio-Impedance Analyzer for Real-Time Monitoring of Human Physiology.

Continuous monitoring of electrophysiological activities of the human body is a significant step toward the effective prognosis, diagnosis, and management of functional disorders and cardiovascular diseases. This paper presents the development of a wireless system for the real-time acquisition of hemodynamics data and ambulatory monitoring of body composition based on electrical bio-impedance (Bio-Z) analysis. The developed system is composed of a low-power wearable unit and a stationary unit connected to a computer. The system conducts the non-radiative non-invasive Bio-Z analysis over a wide bandwidth of 1 MHz through four independent channels. The proposed analog approach detects the physiological activity by extracting the magnitude of the mixed Bio-Z signal, in real-time. A graphical user interface was designed for monitoring, analysis, and storage of the processed data. Moreover, the amplitude and frequency of the electrical excitation signals can be instructed through the user interface, wirelessly. Bench-top validation of the system demonstrated the delivery of current signals over a wide frequency range of 1 kHz - 1 MHz and peak-to-peak amplitude of up to 20 mA. Besides, the system was able to detect the magnitude of the envelope of the mixed signal with amplitude modulation depths as low as 0.1 %. Clinical Relevance- The system provides the real-time monitoring of cardiac activity and blood pulsation in human arteries. In addition, due to the configurability of the frequency and amplitude of the current injection circuit, the system is an excellent candidate to be utilized for real-time medical imaging through electrical bio-impedance tomography as well as electrical bio-impedance spectroscopy.

Practical recommendations for screening and management of functional disorders of the adrenal cortex in cases of SARS-CoV-2 infections

Erkrankungen der Nebennierenrinde erfordern im Rahmen der Severe-acute-respiratory-syndrome-coronavirus-2(SARS-CoV-2)-Pandemie eine besondere Aufmerksamkeit. Zum einen können SARS-CoV-2-Infektionen sich auch extrapulmonal manifestieren und endokrine Störungen – insbesondere im Bereich der Nebennierenrinde – verursachen. Zum anderen sind Patienten mit einer vorbestehenden Nebennierenrindeninsuffizienz oder einem Hyperkortisolismus durch eine schwerwiegende Infektion wie etwa mit SARS-CoV‑2 besonders gefährdet, zusätzliche Komplikationen oder einen schwerwiegenderen Verlauf einer akuten SARS-CoV-2-Infektion mit erhöhter Mortalität zu erleiden. Insbesondere bei hämodynamisch instabilen Patienten mit SARS-CoV-2-Infektion müssen deshalb auch Erkrankungen der Nebennieren differenzialdiagnostisch erwogen und gegebenenfalls abgeklärt werden, falls diese nicht bereits anamnestisch bekannt sind. Weiterhin kann auch die Therapie einer SARS-CoV-2-Infektion mit hohen Glukokortikoiddosen über einen längeren Zeitraum eine sekundäre Nebennierenrindeninsuffizienz verursachen. Wir stellen hier deshalb eine Praxisempfehlung zur Erkennung und Therapie von Nebennierenfunktionsstörungen bei Patient*innen mit SARS-CoV-2-Infektion vor.

Functional visual loss.

Functional visual loss (FVL) is a syndrome in which subjective visual parameters are inconsistent with objective measures. Recent advances in understanding the pathophysiology and management of functional disorders and FVL will be explored. FVL requires a positive diagnosis of normal function through clinical examination or visual electrophysiology. A substantial proportion of patients have an underlying organic illness that needs to be identified and treated. Recent updates in Diagnostic and Statistical Manual of Mental Disorders-5 reflect the observation that many patients with FVL do not have a recognizable psychological association. A small number of functional neuroimaging studies suggest that there may be a stress-mediated prefrontal suppression of visual awareness. There is limited evidence to guide the treatment of FVL; education and reassurance remain first line, followed by cognitive behavioral therapy and pharmacotherapy for psychiatric comorbidities. FVL remains a poorly studied and understood condition. Recent advances in the understanding and management of functional symptoms more generally may aid in advancing the understanding of this condition.

Коррекция функциональных нарушений моторики органов пищеварения при атопическом дерматите у детей

Коррекция функциональных нарушений моторики органов пищеварения при атопическом дерматите у детей

Consultation

On the theme of Linus Geisler's nine steps for a successful consultation between doctor and patient, the ability for self-criticism, the ability to be able to listen to oneself and the value of the doctor-patient relationship in the context of medical practice will be discussed. Subsequently, the framework of the consultation, the consulting room atmosphere and the complete setting of the consultation will be dealt with. The importance of active listening and the recognition of all messages, both verbal and from body language, will be particularly emphasized. The capability for empathy is presented as the necessary bridge to recognition of the feelings and inner world of the patient. Because one only sees what one is looking for and only recognizes what one knows, the recognition of typical complaints presented by patients in a consultation represents the "something" which must be specifically elucidated. The problems and symptoms which the patient brings to the doctor are surrounded by a ring of fears and apprehensions. For this reason it is decisive to uncover the accompanying cloud of fears and apprehensions with appropriate questions, to correctly assign the unsettling symptoms of the patient and to be able to correctly interpret them. As illustrated by the language of nature - the translation of deoxyribonucleic acid (DNA) triplets into amino acids - the translation of biological, psychological and social aspects of the complaints symptomatic into the level of diagnosis and the translation of the referential, social and affective meaning of the expressions used by the patient, into the level of the significance will be discussed. The role of the doctor here is that of a producer of context and a skilled translator. In the management of functional disorders and chronic diseases the construction of a shared reality is important. The therapeutic function of consultations is due to an introduction of metaphors as bridges - bridges to an improved understanding of the body, the self and the world. The role of the physician here is that of a moderator, motivator an accompanying person. Finally, Jaspers levels of good doctoring (natural science or causal level, nursing level, communicative-existential level) are stressed and the importance of a good patient-physician relationship for a patient-centered medicine is underlined.

Botulinum toxin injection therapy in the management of lower urinary tract dysfunction

We have great pleasure in introducing this supplement containing a collection of articles reviewing the contemporary clinical management of functional disorders of the lower urinary tract (LUT) with particular emphasis on the potential role of botulinum toxin injection therapy. Detrusor sphincter dyssynergia (DSD), detrusor overactivity (DO), painful bladder syndrome (PBS) and LUT symptoms consequent on bladder outflow obstruction (LUTS/BPH) have all been treated by the injection of botulinum toxin. This treatment can be administered as a minimally invasive, outpatient procedure which on the initial trials for DO (particularly of neurogenic aetiology) shows a remarkable efficacy with effects lasting up to a year after a single treatment with few significant side effects. Success has been reported with the management of detrusor sphincter dyssynergia and preliminary series report positive outcomes in the management of PBS and LUTS/BPH. However, most of the studies to date include small numbers and have a recruitment bias with few randomised controlled trials having been reported. The answers to some of the key questions are addressed with reference to our contemporary knowledge. It is clear that considerable work both clinical and basic science still needs to be performed to answer the many remaining questions with regard to this treatment modality but undoubtedly it will be a major future treatment option in those with intractable symptoms or those unable to tolerate medications. Currently, all botulinum toxin use for urological conditions is off-label and unlicensed, therefore caution should be exercised until future large randomised studies are reported.

Efficacy of cerebroprotective substances in the management of functional disorders induced by the cytotoxic brain oedema-producing substance hexachlorophene

The hexachlorophene-induced cytotoxic brain oedema is used as experimental model of brain damage, suitable for testing cerebroprotective substances. It has clinical importance since many brain injuries are accompanied by an oedema. The primary target of the neurotoxin, hexachlorophene, is the neuronal cell membrane, but it also causes secondary effects including a disruption of myelin lamellae, increases in water and sodium content, decreases of potassium content, and vacuolation in the white matter. Rats received orally hexachlorophene 240 mg/kg a day for three weeks by liquid diet. The disruption of coordinative motor response, observed in a specially developed test, was used to characterise hexachlorophene-induced injuries in studies designed to evaluate the potential of cerebroprotective substances. Because of their membranotropic efficacy some nootropic substances with different modes of action were examined. The disturbance of coordinative motor response was restored significantly earlier than in spontaneous remission following administration of piracetam, pyritinol, methyl glucamine orotate, naftidrofuryl, and also under the influence of the calcium antagonists cinnarizine, flunarizine and nifedipine. These results support the therapeutic use of nootropic substances in the management of neurotoxic injuries and brain oedema.

The Neuroses. Diagnosis and Management of Functional Disorders and Minor Psychoses. Walter C. Alvarez

Previous articleNext article No AccessNew Biological BooksThe Neuroses. Diagnosis and Management of Functional Disorders and Minor Psychoses. Walter C. Alvarez Harold RosenHarold Rosen Search for more articles by this author PDFPDF PLUS Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by The Quarterly Review of Biology Volume 28, Number 2Jun., 1953 Published in association with Stony Brook University Article DOIhttps://doi.org/10.1086/399668 PDF download Crossref reports no articles citing this article.

Book ReviewThe Neuroses: Diagnosis and management of functional disorders and minor psychoses.

Book ReviewThe Neuroses: Diagnosis and management of functional disorders and minor psychoses.

The Neuroses: Diagnosis and Management of Functional Disorders and Minor Psychoses

The Neuroses: Diagnosis and Management of Functional Disorders and Minor Psychoses

The Neuroses. Diagnosis and Management of Functional Disorders and Minor Psychoses

The Neuroses. Diagnosis and Management of Functional Disorders and Minor Psychoses

The Neuroses—Diagnosis and Management of Functional Disorders and Minor Psychoses

The Neuroses—Diagnosis and Management of Functional Disorders and Minor Psychoses