Statistical association criteria in forensic psychiatry-a criminological evaluation of casuistry.

PURPOSE: Identification of potential shared primary psychoprophylaxis and crime prevention is measured by analyzing the rate of commitments for patients-subjects to forensic examination. MATERIAL AND METHOD: The statistic trial is a retrospective, document-based study. The statistical lot consists of 770 initial examination reports performed and completed during the whole year 2007, primarily analyzed in order to summarize the data within the National Institute of Forensic Medicine, Bucharest, Romania (INML), with one of the group variables being 'particularities of the psychiatric patient history', containing the items 'forensic onset', 'commitments within the last year prior to the examination' and 'absence of commitments within the last year prior to the examination'. The method used was the Kendall bivariate correlation. For this study, the authors separately analyze only the two items regarding commitments by other correlation alternatives and by modern, elaborate statistical analyses, i.e. recording of the standard case study variables, Kendall bivariate correlation, cross tabulation, factor analysis and hierarchical cluster analysis. RESULTS: The results are varied, from theoretically presumed clinical nosography (such as schizophrenia or manic depression), to non-presumed (conduct disorders) or unexpected behavioral acts, and therefore difficult to interpret. CONCLUSIONS: One took into consideration the features of the batch as well as the results of the previous standard correlation of the whole statistical lot. The authors emphasize the role of medical security measures that are actually applied in the therapeutic management in general and in risk and second offence management in particular, as well as the role of forensic psychiatric examinations in the detection of certain aspects related to the monitoring of mental patients.

[New developments in the diagnosis of benign prostatic hyperplasia]. / Actualitati în diagnosticul hiperplaziei benigne a prostatei.

The first phase in the diagnosis of patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia is to exclude another disease. This initial evaluation consist of anamnesis, including the quantification of symptoms according to the International Prostatic Symptom Score, physical examination--with digital rectal examination playing a central role, urinalysis, and renal function assessment; the prostate-specific antigen may suggest prostate cancer or may predict the volume of the prostate and the natural evolution of the disease. If, after the initial evaluation, the diagnosis is still uncertain, further investigations are necessary: imagistic exploration of the urinary tract, urodynamic tests or urethro-cystoscopy. The authors review current knowledge.

[Our experience in diagnostic and treatment of the upper urothelial tract tumours]. / Experienta noastra în diagnosticul si tratamentul tumorilor uroteliale înalte.

UNLABELLED: The aim of the study was to analyse methods of diagnostic and treatment used in our clinic in patients with upper urothelial tract tumors in recent years. MATERIAL AND METHODS: We studied retrospectively 117 files of patients diagnosed with upper tract tumors between 1996-2002. RESULTS AND DISCUSSIONS: The diagnostic was based in 99 cases by urography, retrograde pyelography or both, in 10 cases by cystoscopy (for intramural ureteral tumors), in 8 cases by ureteroscopy and one case was diagnosed by antegrade pyelography. Ultrasound didn't diagnosed solely any tumor. Computerized tomography was also be helpful for staging. Radical treatment was realised in 73 patients (total nephroureterectomy), in 4 patients ureterectomy of the ileo-pelvic segment were realised by stripping. In 20 patients, we performed subtotal nephroureterectomy, in 9 patients transurethral resection, in 2 cases terminal ureterectomy, and in one case we done endoscopic electrocauterization after cold biopsy. CONCLUSION: The most important paraclinical investigation in diagnostic of upper urothelial tract tumors are radiological investigations, urography and retrograde pyelography. Best way to cure such tumors are total nephroureterectomy. In select cases we can perform terminal ureterectomy and transurethral electroresections.

[Ureterolithotomy versus retrograde ureteroscopy for lumbar ureteral stone. A cost analysis]. / Ureterolitotomia versus ureteroscopia retrograda pentru calcul ureteral lombar o analiza a costurilor.

Ureterolithotomy is considered to be the last option for treating a lumbar ureteric stone. The authors reviewed two cases with lumbar ureteric stones treated in january 2003, one by ureterolithotomy and one by retrograde ureteroscopy regarding the costs for hospitalisation, investigations and medication. Among the certain clinical advantages for the patients, including a smaller rate of complications, ureteroscopy is considerably cheaper than open surgery. We consider that these costs criteria should be taken into consideration when the necessary equipment for-urological departments are set.

[Internal urethrotomy, a modern method in the treatment of urethral strictures]. / Uretrotomia optica: metoda moderna de tratament în stricturile uretrale.

The aim of this study was to evaluate the internal urethrotomy in the treatment of urethral strictures, by the retrospective analysis of 54 cases. The patients' age ranged between 18-92. 35 patients (64.8%) had iatrogenic strictures and 10 (18.5%) had traumatic ones. 35 patients presented with urinary infections before the procedure. Following internal urethrotomy, the medium hospital stay was 3.15 days. There were only 7 patients with postoperative fever and no death was recorded. The follow-up period was between 1-12 months with a medium of 9 months and only 2 patients required recurrent internal urethrotomy. Out of the 54 patients, 8 had recurrent urethral stricture disease and 6 of them had posttraumatic membranous urethral strictures. Optical internal urethrotomy appears to be the ideal therapeutic method of urethral strictures, because it has a low morbidity, it is safe to perform and the postoperative results are good. The hospitalization and the recovery periods are short, allowing a quick socio-professional reintegration. Most of the recurrencies occur with posttraumatic strictures.

[The contribution of cystography in the diagnosis of bladder trauma]. / Aportul cistografiei în diagnosticul unor traumatisme vezicale.

With the aim of the evaluation of cystography as a diagnostic method, this study has retrospectively analysed 22 cases of bladder rupture (19) or perforation (3). When performed, the retrograde cystography has made the accurate diagnosis immediately in all the 15 cases (100%). The adequate filling and the x-rays made after the bladder evacuation are the main conditions, that allow the visualisation of the contrast material extravasation. Out of the remaining 7 cases, the urographic cystography has made the correct diagnosis in 6 of them (86%) and the method should be indicated in cases with concomitant rupture of the membranous urethra.

[The role of intravenous urography in the diagnosis of urinary tract lithiasis in the era of new therapeutical methods]. / Rolul urografiei intravenoase în diagnosticul litiazei reno-ureterale în epoca noilor metode terapeutice.

Urinary stones continue to be an interesting and major problem for both urologists and radiologists. The authors try to present the imaging diagnosis possibilities for this pathology according to the expectations of the urologists who have to deal with urinary tract lithiasis with the new methods (extracorporeal shock wave lithotripsy, percutaneous nephrolithotomy, and ureteroscopy). Helical CT has certain advantages and in different centers in Europe appear to be less expensive than intravenous urography (IVU), but unfortunately, is not available in our medical center. So, for us, IVU remains the basic investigation for urinary stones. Echography helps a lot for correct strategy, but together with KUB cannot replace IVU if we want to avoid mistakes.

[Is partial cystectomy a justified intervention in the treatment of bladder tumors?]. / Este cistectomia partiala o interventie justificata în tratamentul tumorilor vezicale?

The authors present their experience of 122 partial cystectomy cases made on a number of 288 vesical tumors in our clinic, during 5 years (1986-1991) from which 23 are superficial tumors and 99 are infiltrative ones. The treatment of vesical tumors can be done in many ways; this partial cystectomy must be completed with an other therapeutic method: irradiation on chemotherapy in conformity with the anatomo-pathological form, the steady and tumoral grading.

[A procedure for assessment "relaxed state" with reference to basic exercises in autogenic training]. / Ein Verfahren zur Erfassung der "Entspannbarkeit" in Anlehnung an die Grundübungen des Autogenen Trainings.

The starting point of the present article was the fact that there is practically never a baseline-testing of "relaxability" before a relaxation training starts. This article presents such a procedure, which has been adapted from the "Autogenic Training". The procedure is suitable for application to groups, and consists of an instruction text for 11 exercises and a questionnaire. The psychometric properties of the questionnaire were checked with data of an accidental sample (n = 106) of an orthopedic rehabilitation clinic. In order to check for the stability over time, the procedure was repeated after an interval of two to three weeks. Cronbach's coefficient alpha was .96 and .97 for the first and second testing, respectively. The corrected item-total-correlation varied between .56 and .87 for both testings. The retest-reliability of the score was .75. Factor-analysis yielded two factors for each testing, respectively. For one factor, items mainly referring to the heaviness- and warmthexercises had highest loadings. Items referring to the gerenal relaxation predominantly belonged to the other factor. Consequently, all the analyses point to the stability of the results over time.

[The therapeutic approach in superficial epithelial tumors of the bladder. Apropos 98 cases]. / Atitudinea terapeutica în tumorile epiteliale superficiale ale vezicii urinare. Consideratii pe marginea a 98 de cazuri.

Between 1985 and 1990, superficial epithelial tumors of gallbladder were found in 98 patients. Peculiar aspects such as age, sex, symptoms, clinical and laboratory diagnosis, surgical treatment, additional interventions, postoperative treatment, anatomo-pathological examination, pTNM classification and tumoral grading, postoperative recurrences, occurring after the primary and adjuvant treatment, were analysed. After some general comments, the authors point out that in their experience the lowest rate of postoperative recurrences was obtained by a multimodal treatment, that is surgery and vesical instillations with cytostatics or B.C.G. vaccine, according to EORCT scheme.

[Tumors of the upper urinary tract. Apropos 35 cases]. / Tumorile cailor urinare superioare. Consideratii pe marginea a 35 cazuri.

Thirty-five cases of upper urinary tract tumors treated by the authors in an interval of 10 years (1979-1988) are presented. After a detailed analysis of the cases some general considerations on the anatomopathologic forms of upper urinary tract tumors, stage classification, symptoms and clinical and laboratory diagnosis, therapeutical indications are made.

[The present-day aspects of urogenital tuberculosis. Comments on 113 cases]. / Aspecte actuale ale tuberculozei urogenitale. Consideratii pe marginea a 113 cazuri.

One hundred and thirteen new cases of urogenital tuberculosis, admitted and treated in the interval 1980-1986 (an average number of 16 cases yearly) are reported. The analysis of these patients includes age, sex, bacillary history, symptoms, clinical forms, diagnostic methods, therapeutical management and late results. Seven cases are detailed. It is concluded that the treatment with the actual tuberculostatic drugs is efficient provided the urogenital tuberculosis is early detected. In case this disease is late detected the treatment is associated, drug and surgical.

[Malignant infiltrating bladder tumors. Comments on 157 cases]. / Tumorile vezicale maligne infiltrante. Consideratii pe marginea a 157 de cazuri.

157 cases of malignant infiltrative tumors of urinary bladder admitted and treated in a 5-year interval (1983-1988) are presented. Considerations on age, sex, urological history, associated urological disorders, symptoms and clinical examination, diagnostic methods, surgical procedures and their association with other non-surgical procedures, postoperative evolution, pathological examination of the resection sample, tumoral stage, recurrences are made. Five cases treated by various methods are presented in detail. The clinical and laboratory diagnosis, therapeutical methods and the staged therapeutical indications are also commented upon. In the malignant infiltrative tumors of urinary bladder the authors recommend the partial cystectomy which, when correctly indicated and performed, gave similar results as total cystectomy. It is also underlined that in case of an urographically silent kidney the attitude should be conservative and the treatment of the malignant infiltrative tumors of urinary bladder should be multimodal.

[Objective and simulated stimulation: an empirical study of the effect of indirect suggestion on motor behavior]. / Objektive und vorgetäuschte Stimulation: Eine empirische Untersuchung zur Wirkung indirekter Suggestion auf die Motorik.

In an experimental investigation it is demonstrated that motor behavior-in contrast to the opinion forwarded in the literature-is not only elicitable by means of direct persuasion, but also to a great extend by mere indirect suggestion, (feigning of stimuli). A differential investigation of these effects provided evidence that reactions to feigned stimuli are highly person specific and relatively homogenous concerning the respective instruments whereas objective stimuli lead to reactions relatively specific for the respective instrument applied. The findings are interpreted as an analog on to placebo-effects in the area of motor behavior. Their extend may be seen as an argument for a stronger concern with subjective reaction tendencies in this field.