Cases reported "Alcoholism"

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1/8. Intrasplenic pancreatic pseudocyst: a case report.

    An intrasplenic pseudocyst associated with the acute relapsing phase of chronic pancreatitis in a 51-year-old woman is reported, with a review of the Japanese literature. The patient was admitted with a complaint of left lateral and back pain. Abdominal US and CT revealed communicating cysts at the pancreatic tail and the subcapsule of the spleen. A repeat US and CT 1 month after admission demonstrated enlargement of the cyst at the pancreatic tail. ERCP revealed a dilated main pancreatic duct without any definite evidence of stenosis, and direct communication with the cyst at the pancreatic tail. Percutaneous cystography revealed that the subcapsular cyst of the spleen, the cyst of the pancreatic tail, and the main pancreatic duct communicated with each other. The cyst contained serous fluid with an amylase content of 57,500 IU/I. Distal pancreatectomy and splenectomy was performed. Histologically, there was a nonepithelial lining on the inner surface of the cysts at the pancreatic tail and the subcapsule of the spleen. Severe chronic inflammatory changes were present in the resected tail of the pancreas. Timely surgical treatment is advocated to reduce the mortality and morbidity associated with complications of intrasplenic pseudocysts.
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2/8. Mediastinal pancreatic pseudocyst with recurrent pleural effusion. Demonstration by endoscopic retrograde cholangiopancreatogram and subsequent computed tomography scan.

    Mediastinal pseudocysts of internal pancreatic fistulas are rare as a cause of bilateral pleural effusions even in relapsing pancreatitis. We describe a 38-year-old man with recurrent bilateral pleural effusion as a complication of a pancreatic pseudocyst. Extension of a pancreatic pseudocyst into the posterior mediastinum was clearly identified by endoscopic retrograde cholangiopancreatogram and subsequent computed tomography scan of the abdomen and chest, and the complication was successfully treated by surgical management. We stress the importance of definite assessment of the communication of pancreatic pseudocyst with mediastinum in patients with pancreatitis who develop recurrent pleural effusions.
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3/8. Spontaneous internal drainage of pancreatic pseudocysts.

    Six cases are reported in which spontaneous internal drainage between a pancreatic pseudocyst and the alimentary tract became established. In each instance the communication was demonstrated radiologically. The clinical circumstances and radiographic features of these cases are described, and the existing literature pertaining to this phenomenon is reviewed.
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4/8. Cerebellar hemorrhage: unusual ventriculographic findings.

    A case of a cerebellar (vermian) hematoma that communicated with the fourth ventricle as seen on air study is presented. Although vertebral angiography appears to be the first diagnostic procedure of choice, the angiographic study may not be definitive diagnostically because it may be difficult to distinguish fourth ventricular enlargement from a cystic hematoma cavity in communication with the fourth ventricle. An air study may then be required to differentiate between such diagnostic possibilities.
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5/8. Psychosocial aspects of head and neck cancer.

    The major psychosocial issues in managing the patient with a head and neck tumor are dealing with the emotional reactions to structural and functional deficits, recognizing and treating preexisting personality problems, especially those related to alcohol and tobacco abuse, which frequently complicate their treatment course. These factors influence the rehabilitation process which should begin in the preoperative period with careful attention to psychologic and social assessment and psychiatric evaluation; if an alcoholic history is elicited. Important continuity in rehabilitation can be accomplished by contact with the rehabilitative team members before surgery, preoperative chemotherapy or radiation. attention to appropriate adaptation to facial prostheses and dealing early with communication disorders requires a specialized staff and a rehabilitative team which can call on a range of skills including a psychiatric consultant. While the ordeal of the head and neck cancer patient is psychologically difficult and challenging, most patients are able, with the proper help, to resume full and productive lives.
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6/8. Applying behavioral contracting to alcohol abuse in a spinal cord injured patient.

    While there have been studies of the use of contingency contracting with several populations of alcohol abusers, the application of alcohol-related contracting to non-psychiatric environments and patients without primary alcohol diagnoses has not been illustrated. A behavioral contract, which included the use of a time out detoxification room, scheduled communication sessions, and a drinking checklist was employed to reduce the inappropriate drinking, verbal and physical abuse of a spinal cord injured patient during a 12-month intervention/follow-up period. The contract's features and methods for improving its effectiveness are discussed.
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7/8. parenting groups for recovering addicts in a day treatment center.

    This article describes parenting groups that were conducted at a day treatment center in new york city from 1989 to 1992. The population consisted of parents who were recovering from substance and alcohol addiction with backgrounds of poverty, educational deficits, and intergenerational addiction. The approach combined brief dynamic group therapy with the learning of child development, communication skills, and family management concepts in a psychoeducational model. empathy and respect for the struggle of the recovering addict characterized the group culture and the stance of the group leader. The methodology included creative writing through group process, role playing, and values clarification activities. The high number of parenting group graduates who also completed the day treatment program suggests that parenting groups were a significant component in the recovery process. Clients in the groups reported feeling better about themselves as parents and were able to express more positive feelings toward their children.
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8/8. A model approach to care of a patient with alcohol problems.

    This paper looks at how theory can be related to nursing practice. The author describes the care of a patient with chronic alcohol misuse problems and shows how Peplau's model of nursing was used to help build trusting relationships and to identify and resolve the patient's problems. The nurses were also able to resolve any difficulties in nursing this patient by developing peer support and improving communication.
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