ABSTRACT
PURPOSE: Our study examines the frequency and further characteristics of psychiatric emergencies in the ambulance service of doctors on call in the city of Hamm. METHODS/PATIENTS: All emergency documentations of the year 2000 were retrospectively examined and evaluated with regard to psychiatric disorders according to the ICD-10. In Hamm (181, 197 inhabitants) there were 3812 emergency calls for doctors on call in the examined period. RESULTS: Due to internal emergencies, psychiatric diseases were diagnosed twice as often. Alcoholic intoxications (32.8 %), suicide attempts (16.8 %) and alcoholic withdrawal-syndromes were mostly diagnosed in psychiatric emergencies. Most patients were male. The average age was 41.7 years. CONCLUSIONS: In the education for doctors on call, the training in the subject psychiatry is very low. Therefore the education and training of the diagnostic and therapy of psychiatric disorders must be intensified in the acquiring of the certification for ambulance service. acquiring
Subject(s)
Emergency Medical Services , Mental Disorders/therapy , Adolescent , Adult , Aged , Aged, 80 and over , Alcohol Withdrawal Delirium/epidemiology , Alcohol Withdrawal Delirium/therapy , Alcoholic Intoxication/epidemiology , Alcoholic Intoxication/therapy , Ambulances/statistics & numerical data , Documentation , Female , Germany/epidemiology , Humans , Male , Mental Disorders/epidemiology , Middle Aged , Retrospective Studies , Suicide, Attempted/statistics & numerical dataABSTRACT
We report a case of an 18 year old female Turkish patient, who was suffering from psychogenic seizures. The family did not accept the disease, prohibited treatment by a medical doctor, preferred to bring her to a Hoca. She was maltreated by her father und sexually abused at the age of eight years by her brother. In this article we describe the problems of a psychiatric ill female patient within a family of Turkish origin.
Subject(s)
Epilepsy/psychology , Islam , Medicine, Traditional , Mental Healing , Psychophysiologic Disorders/psychology , Religion and Psychology , Adolescent , Child , Epilepsy/therapy , Female , Germany , Humans , Incest/psychology , Psychophysiologic Disorders/therapy , Turkey/ethnologyABSTRACT
BACKGROUND: To evaluate failures and to investigate the need for prophylactic inclusion of the inguinal lymph nodes in case of whole abdominal irradiation in gastrointestinal lymphoma. PATIENTS AND METHOD: In October 1992 a prospective study on primary gastrointestinal lymphoma was initiated to evaluate management strategies. Treatment consisted either of conservative management comprehending radiotherapy +/- chemotherapy or radio-/chemotherapy sequential to primary surgery, depending on the physician's decision. Until November 1996, 382 patients were enrolled. Out of them we analyzed 92 patients who received a whole abdominal irradiation, in 21 cases with prophylactic inclusion, in 71 cases without inclusion of inguinal lymph nodes. RESULTS: After a median follow-up time of 36 months in 92 patients with whole abdominal irradiation 9 patients developed relapse of gastrointestinal lymphoma (8 local failures, 1 distant failure). In these cases the analysis of radiation therapy shows low tumor doses or small field sizes. No significant difference in the relapse rates is shown between the 21 patients with inclusion of the inguinal lymph nodes in the abdominal radiation fields (3 recurrences approximately equal to 14.3%) and the 71 patients without enclosure of the inguinal lymph nodes (6 recurrences approximately equal to 8.5%). CONCLUSION: General prophylactic enclosure of the inguinal lymph nodes in the case of whole abdominal irradiation in gastrointestinal lymphoma seems to be unnecessary.
