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Biomedical subjects

D M Kaplan

Publications and source records attributed to D M Kaplan.

At least 19 recordsLinked to original sources
PubMed1995

Acute Salmonella mastoiditis in an infant.

During the last few decades antibiotics have played an extremely important role in the management of otitis media (OM). Nowadays there are only sporadic reports of its sequelae and complications in the developed countries. Nevertheless, complications of OM still arise and the potential seriousness of this problem emphasizes the need for a high degree of monitoring. We report herewith a case of acute mastoiditis in an 18-month-old infant with chronic suppurative otitis media (CSOM). Repeated cultures from the middle ear and mastoid cavity yielded Salmonella type C. The treatment modality and the pathophysiologic aspects are discussed.

Acute Disease↗
PubMed1995

The unfinished manuscript in the drawer: observations on the analysis of a type of symptom.

The interminable project, such as an unfinished manuscript in the drawer, is a familiar affliction in populations of writers, artists and intellectuals. An unrelenting absorption in such a project consuming whole decades of one's life distinguishes this plight from more benign varieties of work inhibition. The interminable project lends itself to a real dilemma of a double life. A case of a female writer and lecturer is presented, in which a longstanding unfinished manuscript figures as a principal complaint. In addition to familiar developmental conflicts, which psychoanalysis finds in psychopathologies of ambition and achievement, the analysis of this patient called for particular attention to various gains of the symptom itself; for example, its lending feasibility to the patient's alternative career by making of it something less ideal and therefore less crucial than it otherwise would have been. Moreover, the harrowing consumption of time that characterises such symptoms was also maintaining a state of moral masochism that gratified the patient's subdued ambivalence towards the analyst and the analysis. A literary project that exists principally to serve such ends as these expires as something feasible when the analysis has subtracted from it its extra-literary aims and devices.

Adult↗
PubMed1991

Heparin skin necrosis: delayed occurrence in a patient on hemodialysis.

A case of skin necrosis in a patient receiving intravenous (IV) heparin during routine intermittent hemodialysis is reported. Multiple erythematous, tender lesions developed over the abdomen and thighs and rapidly became necrotic. Biopsies showed fibrin thrombi in the dermal venules and capillaries, but no cellular infiltrate. The patient was in her third month of regular hemodialysis. Skin necrosis associated with the use of heparin usually occurs within 2 weeks of beginning heparin therapy and has not been reported in patients receiving heparin with hemodialysis. Possible mechanisms, including acquired antithrombin III deficiency leading to heparin-induced skin necrosis, are discussed.

Abdomen↗
PubMed1990

Some theoretical and technical aspects of gender and social reality in clinical psychoanalysis.

Since the social order embodies and authorizes ideals of femininity and masculinity, a psychoanalysis of gender entails decisions as to how social reality figures in the clinical situation. This paper approaches social reality as part of a general problem of neurosis, in which all versions of normality are analyzed as aspects of resistance. What such an approach emphasizes about social ideals is their role in a psychopathology of conformity, which constitutes a stage in the development of neurosis.

Adult↗
PubMed1989

The place of the dream in psychotherapy.

The dream assumed an exceptional place in clinical practice beginning with Freud's extraordinary use of dream interpretation in his early presentations of psychoanalytic theory. Early students of analysis misconstrued this emphasis on the dream in theoretical exposition to apply to clinical practice as well. Eventually this difference was clarified, but there is still something exceptional about the dream in clinical practice that survives clarifications of this early misapprehension. The author reviews the historical issues, identifies the exceptional aspects of the dream in psychoanalytic practice, discusses some problems this phenomenon creates for the analyst, and describes several stereotypical attitudes toward the practice of dream interpretation.

Dreams↗
PubMed1988

The psychoanalysis of art: some ends, some means.

The psychoanalysis of art has been a lively activity for virtually a century, ever since Freud first likened certain findings of his self-analysis to certain turns of plot in Oedipus Rex and Hamlet. Yet over this time a lack of clarity has persisted with respect to the kind of knowledge applied psychoanalysis achieves and its means of justification. Starting with the observation that clinical and applied psychoanalysis are, in every respect, radically different endeavors, this paper goes on to identify some ends and means of the psychoanalytic study of art and to suggest a few criteria of adequacy for the outcomes of such study.

Art↗
PubMed1986

Low back pain and x-ray films of the lumbar spine: a prospective study in primary care.

We prospectively studied 96 men with low back pain to evaluate the association of x-ray findings with clinical diagnosis, treatment, functional outcome, and satisfaction with care. Degenerative joint disease (DJD) was the most common radiologic finding (70%). Making the diagnosis of spinal DJD has little effect on patient management, but patients with x-ray evidence of DJD were three times more likely than those with normal films to receive nonsteroidal anti-inflammatory drugs other than aspirin. Furthermore, patients given a "diagnostic label" of DJD were more likely to express satisfaction with medical care and less likely to seek care elsewhere than patients with similar x-ray results who were given nonspecific diagnoses. These factors will need to be considered in arriving at an estimate of the net benefits of x-ray examination of the lumbar spine.

Adult↗
PubMed1984

History of implants.

In summary, implants are highly successful because encapsulation occurs around the implant without rejection and no other fixation is necessary. There is relatively no shortening or instability of the toe, such as a floppy toe. This seems to prevent painful stiff pseudoarthrosis or arthritis because it acts as a spacer to prevent narrowing of the joint and allows for movement. It prevents a short first toe and prevents any undesired cosmetic results, as it provides the joint with a pain-free range of motion, allowing it to become more mobile and stable. Also, ulnar implants have been used with the same indications and contraindications. The most important consideration about implant surgery is that these implants, that is, the Silastic and the Swanson design, are nonabsorbable. They will not cause tissue reaction and the fibrous encapsulation forms all that is necessary to encapsulate the implant itself; therefore, there is very little bony rejection. From recent literature and through professional experience, it has been proved that implants act primarily as a spacer. They provide a pain-free range of motion but not as well as desired. Implants provide stability to the joint, which is of the utmost importance. The Silastic implants have stood the test of time in most cases. However, the search for better biomaterials, better results, and better functions is never ending. There is a great need for continued research into this field. Podiatry must continue to maintain, contribute, and improve this research.

Biocompatible Materials↗
PubMed1984

Some conceptual and technical aspects of the actual neurosis.

The idea of the actual neurosis is approached as a problem of the transformation of the meaning of terminology by developments in psychoanalytic thought. However, unlike most concepts, the transformation of the meaning of the actual neurosis presents a special problem because this concept refers to issues at the boundaries of psychoanalysis. Three meanings of the actual neurosis are discussed: the actual neurosis as a diagnostic entity, as an infantile core of the psychoneurosis and as observable states in the clinical situation. Certain controversies having to do with technical points of view on the various meanings of the concepts are reviewed. The danger of over-technologizing the clinical situation in deference to actual-neurotic states is stressed.

Humans↗
PubMed1984

Reflections on the idea of personal fate and its psychopathology: Helene Deutsch's "Hysterical Fate Neurosis" revisited.

The idea of a psychopathology of fate or what had come to be called a fate neurosis has failed to retain any established place in the structure of psychoanalytic thought. The clinical observations and theoretical formulations, to which the idea of a fate neurosis answered, have been subsumed in the course of things by more fundamental and systematic conceptualizations. A review of Helene Deutsch's (1930) paper, "Hysterical Fate Neurosis," is therefore bound to be largely an excursion into an area of intellectual history. However, such history never fails to shed light on certain ongoing clinical and theoretical problems that may have lost too much to current developments in psychoanalytic thought. It is with this historical purpose that the present study of Deutsch's classic paper on a fate neurosis is undertaken.

Acting Out↗
PubMed1976

Predicting the impact of severe illness in families.

The goals of this survey of families with a leukemic child were (1) to develop simple, objective methods of describing the overwhelming impact of this serious illness on families, and (2) to test the value of family coping responses that manifested themselves immediately after the diagnosis in predicting stress outcome as measured a few months after the death of the child. The findings indicate that most of the families with a seriously ill child were still overwhelmed by this crisis three months postmortem. The effectiveness of these families appeared, at that time, to have been substantially reduced in that their members suffered from multiple problems affecting their health and normal functioning. The evidence indicates substantial differences in the impact of the illness on the survey families, in accord with the effectiveness of their initial coping response to the diagnosis. Adaptive coping families were far superior in outcome than were maladaptive coping families in the follow-up survey. The study findings support the view that the optimal period for intervention is during the early, acute stage of the crisis, immediately following the confirmation of the diagnosis, when the family is making those decisions associated with maladaptive coping and poor stress outcome.

Adaptation, Psychological↗