The illnesses of Elizabeth Barrett Browning.
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Biomedical subjects
Publications and source records attributed to P Dally.
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The authors report three cases of a palpable abdominal mass without clinical evidence of obstruction. In each case, ultrasound diagnosed a solid tumor. Computer tomography examination measured the density of the tumor and the extension of the disease. In each case, the colonic origin was established owing to surgery. Histological examination of the three cases diagnosed a fibroma of the caecum, an enterogenic cyst of the caecum and a T-lymphosarcoma developed from the wall of the left colon.
Isolated pulmonary valvular stenosis shows a typical radiological pattern in 70% of the cases, including bulging of the left middle and the right inferior segments, a convex left inferior segment and an upwards shift of the apex. In quite a lot of cases (28%), only one of the four above mentioned criteria, are found, mainly the bulging of the left middle segment. There is a small percentage (6%) of cases with an atypical radiological pattern or showing total normality (5%). There is a clear connection between the cardio-thoracic index and the degree of the stenosis but there is no connection between the severity of the stenosis and the degree of bulging of the left middle segment. However the plain chest film has no value for prognosis (evaluation of the degree of the stenosis) nor to follow the post operative course of this frequent congenital abnormality.
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A case of the Capras phenomenon in a man of 58, arising during the course of a depressive illness, is described. Physical, electroencephalographic and psychometric investigations gave no sign of organic disease, and recovery was complete. Factors leading to the development of a depressive psychosis and its particular manifestation in the Capgras delusion are traced in detail. The psychopathology of the condition and the implications for treatment are discussed.
Ninety-six patients complaining of recurrent or persistent abdominal pain were referred consecutively to a surgical clinic and a medical clinic, respectively. They were examined psychiatrically after their initial physical investigation. The psychiatric examination included rating scales for depression and anxiety, a personality inventory, life-events schedule, scale of verbal expressivity, and family and personal patterns of pain and invalidism. Only 15 patients (15-6%) had organic disorders that could be responsible for their symptoms. In the remainder, psychiatric factors were considered primarily responsible for their abdominal pain: 31 were depressed; 21 had chronic tension; in 17 hysterical mechanisms were prominent; and 12 were found to be unrecognised alcoholics. Follow-up at three and six months and recognition by 80% of the psychogenic group that a psychological explanation was plausible, confirmed the diagnoses, and over half responded favourably to psychiatric management. Features distinguishing the organic and psychogenic groups were delineated. Psychiatric assessment has a place among the investigations of non-acute abdominal pain; certainly it should not be condisered simply as "a last resort."
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Forty depressed in-patients for whom electro-convulsive therapy had been prescribed were rated before treatment on depression and anxiety scales. Side effects, post-operative agitation and retrograde memory impairment were assessed in each patient after each of several treatments. Results were compared when no tranquillizer was given and when either diazepam or haloperidol was administered intravenously immediately before the anaesthetic. It was found than when ECT was given without tranquillization, the incidence and severity of post-operative agitation and of side effects were significantly greater in those patients with a high level of anxiety before treatment. Both diazepam and haloperidol were found to be effective in subduing agitation and side effects in anxious, depressed patients, but with diazepam recovery time was longer.
An arteriovenous fistula, created for hemodialysis access, may on occasion produce ischemia or even gangrene of the extremity distal to the fistula. This article describes a simple plethysmographic test which will accurately differentiate a steal syndrome from other causes of ischemia, pain, or necrosis and will allow the surgeon to remedy the problem in a specific way.