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Biomedical subjects

J W Paulley

Publications and source records attributed to J W Paulley.

At least 19 recordsLinked to original sources
PubMed1991

Specificity revisited and updated.

Typicality is probably a better representation of Alexander, Dunbar and others' conclusions than specificity, which was always too absolute a term. As such it became a valid cause of objection by opponents. No genuine attempts to repeat the original studies have been made and most of the original opposition to the concept is now acknowledged as invalid. Typicality (specificity) in psychosomatic disorders appears to be conferred by coping mechanisms acquired through interaction with mother and early surrogates in infancy and childhood as a means of reducing tensions and restoration of homeostatic emotional equilibrium. Psychosomatic medicine patients share one such mechanism, notably superstability/alexythymia, but contained within it are coping mechanisms typical for differing disorders. Examples are listed, and also mention of typicality of recurrently provocative life events/situations. Until typicality is appreciated, taught, learned and practised, success in management of psychosomatic disorders will be limited. The current bio-psycho-social approach is too imprecise.

Adaptation, Psychological↗
PubMed1990

Giant cell (temporal) arteritis-polymyalgia rheumatica: a critical review.

Giant cell (temporal) arteritis G.C.(T) A. is common disorder and affects medium sized and large arteries in people over the age of fifty. Many series show that up to 50% of people with the clinical syndrome of polymyalgia rheumatica (PMR) go on to develop manifestations of G.C.(T) A. within a year; others may do so later. A critical review is offered of aspects of the subject which despite much study and research remain controversial or neglected. This includes epidemiology: statistics from routine autopsy suggests that the disease affects more people than are diagnosed clinically. The need to resolve uncertainty whether intracerebral vessels are involved or not, is now urgent, particularly in view of the wide spread use of short courses of Dexamethasone in the treatment of stroke. All clinicians should recognise the implications of the fact that they are dealing with a disease which may be active and yet symptomatically silent.

Adrenal Cortex Hormones↗
PubMed1990

Hyperventilation.

Physicians' and specialists' continued failure to recognise, diagnose and treat adequately the majority of hyperventilators is a disgrace. Hyperventilation Syndrome (H.V.S.), incorrectly labelled myalgic encephalomyelitis (M.E.), is the latest example of the profession's incompetence. Reasons for failure to teach doctors about H.V. are discussed followed by its incidence, and the tendency for patients to gravitate to Specialist Departments where general history and a complete physical examination have become more perfunctory as sophisticated tests have multiplied. Signs which should alert a clinician's suspicion are listed, which if present should lead to a series of suggested facilitating questions. Controversial aspects of tests to confirm diagnosis are discussed, and also recent work on the relationship of panic attacks to hyperventilation and vice versa. The need for understanding and how to elicit the typical psychopathogenesis is stressed. Lastly, a form of management is described which requires combined competent physiotherapy and competent psychological management. The latter involves uncovering the underlying psychopathology and then helping the patient resolve early loss or alienation which when reawakened by further losses or anticipated loss or surrogates, precipitate symptomatic H.V.

Adult↗
PubMed1979

The potential use of videotape in teaching psychosomatics.

Psychosomatists should admit that so far they have largely failed in communicating their knowledge and skills to those outside a limited circle. As a result many sick people suffer more than they need. Students of animal behaviour have made better use of sound and videotape to illustrate the normal and abnormal than students of human behaviour. Some of the reasons for this are examined. In teaching and learning psychosomatics the potential of videotape has yet to be realised. The article presents some such possibilities and is illustrated by edited versions of the author's experience over four years in a busy outpatient clinic of (1) characteristic life situations and attitudes in three disorders: Multiple Sclerosis, Migraine and auto immune disease, (2) the psychological management of an intractable case of Asthma over two years (approx. 32h of therapy).

Adolescent↗
PubMed1978

If I were a dean.

Explore the source record for details and available documents.

Education, Medical, Undergraduate↗
PubMed1978

Amoebic hepatic abscess--potential causes of delay in diagnosis.

Delay in diagnosis can be serious in amoebic hepatic abscess, which is readily treatable. Two cases are presented to illustrate potential causes of delay. The first case had never been to an endemic area, apparently contracting the infection from his wife. The second case had negative serological tests.

Adult↗