Panic disorder. Recognizing and managing the 'real thing'.

Panic disorder is a severe anxiety disease frequently encountered in primary care. Although it is associated with potentially serious medical and psychiatric complications and is often difficult to diagnose, the condition is highly treatable. Initial pharmacotherapy may include alprazolam (Xanax), imipramine hydrochloride (Janimine, Tofranil), or phenelzine (Nardil). Correct diagnosis and treatment can alleviate much suffering and expense and promote both mental and physical health.     

Aspiration pneumonia. Recognizing and managing a potentially growing disorder

Gross aspiration of liquid or particulate matter into the lung can result in severe hypoxemia, pulmonary infiltrates in dependent lung regions, fever, and leukocytosis. The initial lung injury is primarily due to inflammatory mediators rather than infection. The responsible bacterial pathogens differ between community-acquired and nosocomial aspiration pneumonia. Many aspiration pneumonias are mixed aerobic-anaerobic infections. Enteric gram-negative bacilli and S aureus are more common in nosocomial aspiration pneumonia. Current treatment guidelines support initial empirical antibiotic therapy in patients with severe aspiration pneumonia pending culture results. Appropriate initial treatment improves outcome. Antimicrobial therapy for aspiration pneumonia is often empirical and should be based on patient characteristics, the setting in which aspiration occurred, the severity of pneumonia, and available information regarding local pathogens and resistance patterns.     

Recognizing the child with obsessive defiant disorder

Nurses may find themselves in a home situation where a child demonstrates characteristics of a child with ODD. While the nurse is not in the home to provide therapy for the child, it may be evident that the parents need help in determining an appropriate plan of action. While it is not the role of the nurse to diagnose the child, the nurse who is aware of the symptoms of ODD may play a very significant role in assisting the parents in dealing therapeutically with the child.     

Recognizing borderline personality disorder in the primary care client

The nurse practitioner is responsible for the diagnosis and treatment of a great variety of physical and psychological disorders in the ambulatory client. Frequently the diagnosis of personality disorder is missed, ignored or not even considered. This article will introduce the nurse practitioner to the various personality disorders. The main focus, borderline personality disorder, is estimated to affect 5 to 15 percent of the general population. A picture of the borderline client from etiology to treatment as well as recent research findings and suggestions for history taking and physical exam are covered. Borderline has been a difficult and confusing diagnosis to make because in the past the term has had several different meanings. This article will clarify what this diagnosis means, and will assist the nurse practitioner in the recognition, diagnosis and management of all clients with personality disorders.     

Transient involuntary movement disorder after spinal anesthesia: A case report

BACKGROUNDSpinal anesthesia is commonly used for various surgeries. While many complications occur after induction of spinal anesthesia, involuntary movement is an extremely rare complication.CASE SUMMARYHerein, we report the case of a 54-year-old healthy male patient who experienced involuntary movements after intrathecal injection of local anesthetics. This patient had undergone metal implant removal surgery in both the lower extremities; 7 h after intrathecal hyperbaric bupivacaine administration, involuntary raising of the left leg began to occur every 2 min. When the movement disorder appeared, the patient was conscious and cooperative. No other specific symptoms were noted in the physical examination conducted immediately after the involuntary leg raising started; moreover, the patient''s motor and sensory assessments were normal. The symptom gradually subsided. Twelve hours after the symptom first occurred, its frequency decreased to approximately once every three hours. Two days postoperatively, the symptoms had completely disappeared without intervention.CONCLUSIONAnesthesiologists should be aware that movement disorders can occur after spinal anesthesia and be able to identify the cause, such as electrolyte imbalance or epilepsy, since immediate action may be required for treatment. Furthermore, it is crucial to know that involuntary movement that develop following spinal anesthesia is mostly self-limiting and may not require additional costly examinations.     

大学生的情绪障碍特征

目的:探讨学生的情绪障碍及影响因素。方法:采用Zung抑郁自评量表(SDS)、Zung焦虑自评量表(SAS)和自编大学生心理健康状况调查表对463名学生进行情绪障碍调查研究,其中一年级120人,二年级105人,三年级120人,四年级118人;通过SDS,SAS量表测定具有焦虑和抑郁倾向的阳性人数,同时具体分析阳性学生在各因素上的得分。结果:大学生中抑郁发生率为26.57%,焦虑的发生率为15.55%,均随年级升高而升高;在抑郁的学生中,感觉学习压力大、自尊心受伤害、学校不理解的比例随年级的升高而增大,具有显著性差异(F=3.547,P<0.05);由大学生自己列出3项使自己最感苦恼的问题,发现排在前5位的问题依次为学习考试压力大,经济拮据,恋爱苦恼,人际交往困难,分配担忧,其中分配担忧随年级的升高而升高。结论:有少部分大学生存在情绪障碍;大学生的情绪障碍受到学习压力大、自尊心受到伤害、校方不理解等因素影响,。     

伴有情绪障碍的功能性排空障碍

功能性便秘、功能性排便障碍是功能性胃肠道疾病(FGIDs)的一些常见疾病。但在如何定义功能性便秘,以及如何对功能性便秘、功能性排便障碍进行归类,无论是"罗马Ⅲ标准",还是国内的"慢性便秘的诊治指南(2013年,武汉)",均存在值得商榷的地方。功能性便秘的主要障碍在于结肠转运时间(CTT)的延长,而功能性排便障碍即功能性出口梗阻,则是直肠肛门抑制反射的异常。尽管这是两种不同的疾病,但均能引起粪便排空障碍。因此建议将功能性便秘与功能性出口梗阻合并在功能性排空障碍(FED)名称下,功能性便秘和功能性出口梗阻既可单独存在,也可合并存在。功能性排空障碍常常伴有情绪障碍,有情绪障碍背景的功能性排空障碍需要做情绪和躯体两方面症状的联合治疗。     

ICU病人情绪障碍的心理护理

ICU是危重病人和先进监护抢救设备集中的科室[1].由于病人病情危重,不仅身体上陷于危机状态,精神上也承受很大刺激.对有些病人来说,ICU的特殊环境和管理制度以及在治疗护理过程中所承受的种种痛苦体验,导致了病人异常情绪的出现.为了使病人积极配合医务人员的抢救治疗,提高抢救成功率,促进病人转危为安,因此,心理护理在ICU病房尤为重要[2].……     

Recognizing Horner's syndrome.

Horner's syndrome is a dramatic finding identified by perianesthesia nurses after regional anesthesia. This article describes the relationship between Horner's syndrome and regional anesthesia while explaining the signs and symptoms as they relate to blockade of the sympathetic nervous system.     

团体咨询在产后情绪障碍病人中的应用

产后情绪障碍是分娩后发生的各类情绪障碍的集合体,可持续至整个产褥期甚至更长,在产妇中的发生率较高,直接影响母体及婴儿身心健康。为此,对本市两家医院一年来收住的46例产后情绪障碍病人进行调查分析,探讨病人的人格特点,并应用团体咨询针对性的进行干预,取得了满意的效果。     

乙醇依赖患者情绪障碍的护理

目的 分析乙醇依赖患者情绪障碍的护理效果.方法 将我院2009年1月至2010年2月收治的乙醇依赖患者81例,随机分为观察组41例和对照组40例.对照组给予常规护理,而观察组在对照组的基础上加强对情绪障碍的护理,比较2组的护理效果.结果 观察组的复饮率、再住院率分别为19.5％、7.3％,明显低于对照组的40.0％、27.5％,且观察组的复饮间隔时间明显长于对照组;观察组护理后的焦虑、抑郁评分均明显优于对照组.结论 对乙醇依赖患者在常规护理的基础上加强情绪障碍护理可以取得更好的临床效果,有利于患者的康复.     

团体咨询在产后情绪障碍病人中的应用

产后情绪障碍是分娩后发生的各类情绪障碍的集合体，可持续至整个产褥期甚至更长，在产妇中的发生率较高，直接影响母体及婴儿身心健康。为此，对本市两家医院一年来收住的46例产后情绪障碍病人进行调查分析，探讨病人的人格特点，并应用团体咨询针对性的进行干预，取得了满意的效果。现介绍如下。     

Cognitive processing of emotional information in posttraumatic stress disorder

Vietnam combat veterans either with or without posttraumatic stress disorder (PTSD) participated in a computerized Stroop color-naming experiment in which they named the colors of neutral, positive, negative, and combat words. Idiographic stimulus selection established the personal emotional significance of the stimuli. Words appeared either randomly or blocked by type. Results indicated that PTSD patients exhibited more interference for combat words than for other words, whereas control subjects exhibited similar, but less pronounced, patterns of interference. Positive words produced no more interference than neutral words, and much less than combat words. This paradigm may provide a nonintrospective index of intrusive cognition in traumatized people.Preparation of this article was supported, in part, by a grant from the Henry and Ramsey Pevsner Fund in Neuropsychology and Behavioral Medicine awarded to Susan P. Kaspi, and by National Institute of Mental Health grant MH43809 awarded to Richard J. McNally. We thank Howard J. Lipke, Roger C. Metz, Robert J. O'Brien, and Austin Staunton for their invaluable assistance in subject recruitment. Finally, we appreciate the superb comments made by an anonymous reviewer.This experiment was conducted when the authors were at the Department of Psychology, University of Health Sciences/The Chicago Medical School.