Psychologische Diagnostik bei chronischer Erkrankung

Psychological assessment in chronic conditions refers to the examination both of the coping to the disease (specific adaptation) and of the primarily disease-independent behavioural development and psychopathological status in the child (general adaptation). Instruments applied comprise history and exploration, structured psychological tests and questionnaires, and semi-structured clinical checklists, interviews and observations. Assessment of the specific adaptation to the chronic condition comprises identification of the secondary psychosocial stressors and demands, of the patterns and efficacy of coping and the self-management strategies applied, and of the health-related quality of life using disease-specific or generic questionnaires. Assessment of general psychological adaptation involves the identification of psychopathological vulnerability or the manifest disorder, which may occur as a comorbid condition or result from cumulative coping failure.     

Wegener-Granulomatose im Kindes- und Jugendalter

Wegener’s granulomatosis (WG) is a necrotising granulomatous small vessel vasculitis with a clinical predilection for the involvement of the upper airways, lungs and kidneys. It occurs at all ages. The pathogenesis of WG is determined by the pathological activation of phagocytes during transmigration through the vessel. Whereas most aspects of WG are similar at all ages, some features appear to be significantly different. WG in childhood is more frequently complicated by subglottic stenosis and nasal deformity, while treatment related morbidity is less common compared to adults. The introduction of combined treatment with cyclophosphamide and glucocorticoids has resulted in a dramatic improvement in patient outcome; however, commonly occurring disease relapses and the risk of chronic organ damage at all ages make long-term follow-up of all patients necessary.     

Nachstarbildung nach Intraokularlinsenimplantation

Zusammenfassung Der Nachstar ist die häufigste Komplikation nach Kataraktoperation. Seine Rate wurde durch die gründliche Entfernung der Rindenreste und die Einführung scharfkantiger Optiken drastisch gesenkt. Der Einfluss von Linsendesign und Optikmaterial im Detail wurde in Wien in prospektiv randomisierten intraindividuellen Vergleichstudien unter Einsatz objektiver Graduierungsmethoden systematisch untersucht. Die zirkuläre Überlappung der Optik erwies sich als Voraussetzung für die dauerhafte Wirksamkeit der scharfen Hinterkante. Durch kapselsackgerechte Haptiken mit schlanker Optikanbindung und Fibrose induzierende Optikmaterialen konnte der regeneratorische Nachstar weiter verringert werden, während sich die Politur des vorderen Kapselblatts als kontraproduktiv herausstellte. Eine wichtige Erkenntnis war, dass der Nachstar in seiner Häufigkeit und Ausprägung durch diese konventionellen Maßnahmen zwar drastisch gesenkt, jedoch nicht gänzlich vermieden werden kann.     

Identification of Alcohol Abuse and Alcoholism with Biological Parameters

The prevalence and incidence of heavy alcohol consumption are major problems which have been increasing in many countries in recent years. It is crucial for physicians to consistently identify early drinking problems as well as the various end disease states in order to minimize suffering and maximize recovery. This paper reviews the evolutionary development of clinical tools for detection of alcohol abuse. The focus is primarily on clinical/biochemical indicators of alcohol abuse, emphasizing but not limited to changes in hematological characteristics, liver enzyme activity, lipids, immune function factors, hormones, neurological factors, and some physically based tests. Use of test combinations and sophisticated statistical analysis of pattern changes in test batteries evidence increased diagnostic efficiency.     

The narcissistically vulnerable system: A case study of the public mental hospital

The present paper introduces the concept of the narcissistically vulnerable system by suggesting that organizations may manifest some of the same pathological characteristics as narcissistic individuals. The public mental hospital was chosen as an example of such a system. Reasons for its vulnerability were suggested and specific defenses, employed at the system level, were discussed. Finally, remedies for the repair of the narcissistically vulnerable system were considered.     

Schwankungen im Nahrungsverzehr

Ohne Zusammenfassung     

Levels of alkaline phosphatase isozymes in human seminoma tissue

The three human isozymes of alkaline phosphatases were quantitatively determined in normal testis and seminoma tissues. The highly selective assays were based on isozyme specific monoclonal antibodies. In the normal testis approximately 90% of the catalytic activity originates from the tissue unspecific alkaline phosphatase, and the remaining activity was due to trace expression of both intestinal (approximately 5%) and placental alkaline phosphatase (PLAP) or PLAP-like isozyme (approximately 5%). In homogenates of seminoma tissues, highly increased levels of all three isozymes were identified. Both the tissue unspecific alkaline phosphatase and PLAP-like enzymes displayed relative increases of 10- to 100-fold and intestinal alkaline phosphatase 2- to 10-fold compared with normal testis. This finding indicates that the entire genome coding for alkaline phosphatases may be activated in seminomas. The PLAP-like enzyme from seminoma cells comprises a heterogenous population of molecules demonstrating partial heat sensitivity and microheterogeneity upon starch gel electrophoresis in contrast to the pregnancy related PLAP. These findings have implications for the different PLAP assays used in the clinical monitoring of seminoma patients.