[Nutrition for psychiatry. The inner person in psychiatry].
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Biomedical subjects
Publications and source records attributed to H A Oomen.
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An enquiry of the Dutch Lupus Patients Society revealed that 49% of the members had experienced psychiatric symptoms before systemic lupus erythematosus (SLE) was diagnosed and 33% had sought professional psychiatric help at that stage. To determine the frequency of SLE on psychiatric admission 2,121 patients were tested for the presence of SLE-specific antinuclear and anti-DNA autoantibodies. The results suggest that SLE is a cause of admission in psychiatric hospitals at the rate of 0.1-0.2% and routine screening of antinuclear and anti-DNA antibodies on admission is not an effective diagnostic approach.
The need for the taking of a medical history when dealing with dental patients, is discussed from two different points of view. The medically compromised patient, according to article 9 part 3 of the regulation 'Special dentistry' in The Netherlands must be recognized by a medical history so adequate preventive treatment will avoid unnecessary medical intervention. As part of the EC proposals on the education of dental practitioners, the prevention of medical emergencies in the dental practice is important as well. A structured medical history based on risk classification and preventive measures meets both options.
Hundred-and-ten dentists, both practitioners and teachers, attending a postgraduate course in medical emergencies, were unanimous in their choice of anaesthetics and medical anamnesis, the importance of avoiding toxicity and also in the unpredictability and infrequency of allergic reactions. There was no consensus on the importance of the aspiration test to avoid intravascular injection.
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Sixty-two patients presenting with upper abdominal pain of the non-ulcer dyspepsia type, and radiological signs of duodenitis, were investigated for parasites; biopsies of the duodenum were performed, both by capsule and by endoscopy. The findings were compared with a group of 18 healthy controls with and without parasites. The group of 36 patients with parasites showed a significant degree of inflammatory infiltrate compared to the non-parasitized patients and to the control group.
Between June 1974 and February 1977, in one eighth sample of the Machakos Project area, weight and height were determined in all 1-60 months-olds. This resulted in 568 subjects producing averagely 9.3 monthly growth data over an average period of 22.2 months. Only subjects examined five times or over were considered. Weighing and measuring were done by home visiting fieldworkers. Growth in the first six months closely followed the Harvard Standards of weight-for-age (W/A) and height-for-age (H/A). In the course of the next six months this dropped until about 83% for W/A and 92% for H/A, to stay at these levels until the sixth year. In the group which persistently grew over 88% for W/A these values were 91.5% for W/A and 94.8% for H/A. This group is thought to represent the local standard for optimum growth. In the group which persisted at levels below 75% of W/A a distinction was made between normal slow growers and PEM cases. In both W/A was more compromitted than H/A. Children persistently or episodically under W/A 70% were considered malnourished; their incidence in the 1-5 year group was between 4.5 and 6.5%. There was no reason to put the PEM level above 70% of W/A; This should be used as a cut-off level for screening PEM cases. A diagram is presented to visualize the successive age cohorts simultaneously for W/A, H/A and W/H as regards their position to the respective Harvard Standards, indicating percentages of positive and negative deviators.
Sixty two cases of sickling haemoglobinopathy have been admitted and specially studied between 1973 and 1977 in the Bugando Hospital, Mwanza, Tanzania. Presenting symptoms are described. The problems of recognition in the medical diaspora and of management are considered. It is expected that with improving regional health facilities more cases will survive childhood but also will cause special difficulties in adequate care. It is pleaded that because of the ubiquity of the HbS gene in Tanzania sufficient priority is given to the affected in planning health services in Tanzania.
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