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At least 1,315 records · Page 73Linked to original sources
PubMed1991

Legal regulation of terminal care: options and obstacles.

The law regulates some aspects of medical practice and facilitates other aspects. Two laws in Texas that both facilitate and regulate medical care are the Texas Natural Death Act (TNDA) and the Durable Power of Attorney for Health Care (DPOAHC). The TNDA implements the treatment wishes of the patient who is terminally ill. The DPOAHC designates a proxy to make medical decisions for patients when they become incompetent. Because these laws can provide considerable help in caring for terminally ill or incompetent patients, physicians in Texas should understand these laws and use them in their practices.

Federal Government↗
PubMed1991

[Obstacle removal syndrome in the postoperative period of obstructive uropathy].

Eighty patients to operated upon secondary hidronephrosis to pieloureteral or ureterovesical stenosis are studied. Diary diuresis and excretion of sodium of the operated kidney and the healthy kidney are valorated. We analyse the differences between age groups, grade of parenquima afectation or kind of pathology that cause the obstruction. Results show that the desobstruction of the urinary tract is accompanied by a increase of diuresis (p less than 0.001) and by a lost of sodium (p less than 0.001) in the operated kidney. Poliury is bigger in neonatal period than in other age groups.

Child, Preschool↗
PubMed1990

[Progress and obstacles in chemotherapy and combined modality treatment of small cell lung cancer].

In order to assess the development of treatment of small cell lung cancer (SCLC), we analyzed a total of 183 patients who had been entered into our protocol studies since 1976. Between 1976 and 1981, 39 patients (20 LD and 19 ED) received COMP, a 4-drug combination of cyclophosphamide (CTX), vincristine (VCR), methotrexate and procarbazine. During the period, chest irradiation (RT) was optimal for those with LD. Between 1981 and 1986, 112 patients (56 each of LD and ED) were treated with a cyclic alternating chemotherapy (CT) of COMP and VAN, a 3-drug combination of etoposide (VP-16), adriamycin (ADM) and nimustine. In this study, we randomized patients with LD either to receive CT alone or CT plus RT of 40 Gy to assess the role of RT in the treatment of LD. Thereafter, a pilot study of CAV-PVP hybrid CT has been conducted in 32 patients (16 each of LD and ED), in which CTX, ADM and VCR were given on day 1 (CAV), and cisplatin on day 8 and VP-16 on days 8 and 9 (PVP). RT was administered mandatory to LD in this study.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Obstacles to the routine use of magnetic resonance imaging--results of a multicenter study for evaluating nuclear magnetic resonance tomography].

Within the framework of this study, the factors that impair the value of MR scans were also investigated and analysed. It was found that artifacts occurred in a large number of examinations that exercised a negative effect on the results. Artifacts are particularly seen in the thorax (54%) and upper abdomen (57%), but they have also been reported in 23% of the CNS examinations. The sources of such artifacts were mainly movements in the investigated layer, whereas other causes were negligible. In the 21,633 examined patients no undesirable effects caused by the examination were noted that would have impaired the patient or the course of the study. On an average, 88% of the examinations were performed with normal tolerance of the examination. In the remaining cases there was motor unrest or claustrophobia requiring special measures, thus hampering the course of the examination.

Diagnosis, Differential↗
PubMed1990

The psychoanalytic process: motives and obstacles in the search for clarification.

One motive for regarding psychoanalysis as a "process," and for attempting to define its exact nature, is to enable analysts to clarify their criteria for distinguishing authentic psychoanalysis from other therapies that resemble it or are derived from it. In the present climate of theoretical pluralism, any list of defining qualities that could win wide acceptance would of necessity be cast in terms of such general quality as to limit its utility as a precise template. Another motive for holding on to the "process" concept arises from the unpredictable nature of analytic progress in even the most satisfactory cases.

Defense Mechanisms↗
PubMed1990

Pathological organizations as obstacles to mourning: the role of unbearable guilt.

A patient is described who made moves to face his internal and external reality only to find that this put him in touch with an internal world in a horrific state. The horror resulted from his view of damaged and imprisoned objects which arose from the way his defences were organized into a pathological organization of the personality which controlled his objects with ruthlessness and cruelty. As he began to loosen his dependence on the organization and to face his internal situation, depressive anxieties became prominent and of these he found guilt particularly unbearable. In order to escape from guilt he retreated once more to the protection of the organization and it is this which prevented him mourning his lost objects. It is argued that it is in the process of mourning that lost parts of the self are regained and it is specifically this process which was interfered with by the pathological organization.

Defense Mechanisms↗
PubMed1990

[Social and personal obstacles in the fight against smoking at group and at individual level].

Is it fair to expect the individual to bear alone the responsibility of whether to smoke or not? What are the responsibilities of the community, the environment and of the groups like industry and political figures which influence him? That is the issue addressed by the author in describing (1) the factors determining an individual decision (health danger, personal threat, other disadvantages or advantages) and (2) those factors establishing within a community an environment favorable to smoking (tobacco cultivation and processing, legislation, publicity, media, etc.). In the planning of any educational programme against smoking this author stresses the need to consider above all the social factors which militate for or against smoking (family setting, friends as role models, self-image and the image of the smoker in publicity and the media) rather than the risk factors which often seem remote to the young who have more immediate concerns than imagining themselves ill from tobacco use by age forty. What instructional methods are recommended? Grade school education, which could contribute to instilling an early resistance to smoking, is far from the only or even the principal means of combatting tobacco use. Too much is made of what teachers can accomplish here. School curricula are overloaded and teachers must develop many different abilities among their students. They can still do a great deal to encourage a child to know and respect himself and to trust his instructor. Every academic programme must be incorporated within a wider community programme like those in Norway and Iceland which link legislation and education.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗