[Nursing of patients with acute infectious psychoses].
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The question if there are "symptomatic schizophrenias" has been discussed since the 20s. Schizophrenic psychoses caused be definable and well known brain diseases are presented. All schizophrenic symptoms and syndromes, the first rank symptoms (K. Schneider) too, occur in somatically founded psychoses. The group of paroxysmal transition syndromes in the sense of aura prolongata (continua) and the episodic schizophrenic psychoses in psychomotor epilepsy may be a model for the schizophrenia research. Vital threatening, so-called pernicious catatonic schizophrenias are found on the basis of infectious brain diseases, sometimes only diagnosed in autopsy. Beside acute and reversible symptomatic schizophrenic psychoses there are, even if rarely, recurrent and chronic courses of symptomatic schizophrenias. That certain conditions for the developing of symptomatic schizophrenias are rarely realised, could be an explanation for their rarity. Some findings indicate that the limbic system is significant for symptomatic (and idiopathic) schizophrenic psychoses and the pre- and postpsychotic basic stages determined by dynamic and cognitive basic symptoms, which are phenomenologically very similar to aura symptoms released by stereoelectroencephalographic depth recordings (Wieser). The characteristic features of marked fluctuation, discontinuity and insteadiness of the cognitive thought, perception, psychomotor and cenesthetic phenomena do not speak against an organic brain disorder provided that the traditional process hypothesis is abandoned in favor of a neurobiochemic disorder, fluctuating on its part depending on endogenous as well as psychic-reactive factors.
Alcohol use is directly responsible for hospitalizations resulting from chronic conditions, such as alcoholic liver disease and alcoholic psychoses; in addition, alcohol use can be a contributing factor in other conditions, such as infectious diseases and injuries, that require hospital admission. Based on discharge data from Indian Health Service (IHS) facilities and CDC's National Hospital Discharge Survey (1), the proportion of alcohol-related hospitalizations (ARHs) among American Indians/Alaskan Natives has been reported as 2.5 times that for the total U.S. population. However, these estimates rely on a limited set of alcohol-defined diagnoses that are primarily associated with chronic alcoholism. To characterize more accurately the relation of alcohol use to inpatient admissions to IHS and tribally operated hospitals in the United States, IHS conducted a 1-day survey of ARHs in these facilities on Monday, May 18, 1992. This report summarizes preliminary results from the survey.
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The clinical notes of the 146 patients who died during a five year period in the psychiatric ward at the Muhimbili Hospital were studied and analysed to identify gender, age, duration of hospital stay, psychiatric diagnosis and primary cause of mortality. There were 99 (67.8%) males and 47 (32.2%) females. The mean age, which could be established in only 105 (71.9%) instances, was 31.1 years. The average hospital stay was 21.6 days. The main psychiatric morbidity consisted of functional psychoses (52.7%), organic psychoses (37.6%), epilepsy (6.2%) and puerperal psychosis (2.1%). Mortality was primarily attributed to infectious diseases in at least half of the cases. Pyrexia of unknown origin was associated with death in 11.0% of cases and the cause of death could not be established in 17.1%. Clinical notes need to be improved and greater efforts made to diagnose and treat concomitant physical illnesses effectively.
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