A Rare Case of Acquired Segmental Megacolon with Unknown Cause in a Young Woman

Abstract: Acquired Megacolon is a rare disease that usually presents in elderly people and there have been only few reported cases in literature. In this article we report a 24-year-old woman who had referred with chronic intermittent epigastric pain from 4-5 years ago and also chronic constipation and distension of upper abdominal part. Clinical examinations and imaging studies (chest x-ray, barium enema) showed dilatation of colon with unknown border. She underwent laparatomy surgery with primary diagnosis of partial colon obstruction. Several biopsies were taken from dilated and collapsed parts. Microscopic findings showed destruction of ganglion cells in dilated areas and normal ganglion cells in collapsed parts. At the second operation dilated parts were resected and end to end anastomosis of collapsed parts were done. The patient was discharged in good general condition. About 77 days after operation, the patient was examined again in order to following up. She was in a very good physical condition and had a weight gain about 20 pounds. Keywords: Megacolon, Intestinal obstructio

A report on the potentialities of restoration and revitalization of the historical village of Meymand, Iran

Considering the importance of conservation and in recognition of historical places this paper explains the potential of revitalization of Meymand, while presenting its architecture in generalities. These potentials will be examined in a rural and single-unit architecture scale through applying models. This case study has been made as a field study report. Using previous studies available in Meymand’s cultural heritage base archive, interviewing different people, taking photographs, collecting related information from the village, and processing and gathering them, have been done in order to conduct this study. The whole fabric of Meymand has been examined with regard to general characteristics, understanding different periods of development, and components and elements of the units. The only way to revitalize this village in a correct way is to recover its proper economy and to restore all of its residential units and its past culture in a new form. Reorganizing the fabric of Meymand depends on solving the problems related to its fabric with the least intervention

Evaluation of Injuries Caused by Penetrating Chest Traumas in Patients Referred to the Emergency Room

The aim of the study was to determine the frequency of different injuries caused by penetrating chest traumas, and also the cause and type of trauma and its accompanying injuries. This is a cross-sectional descriptive study, carried out on all patients referred to the emergency room of Shahid Bahonar Hospital, Kerman, from March 2000 to September 2008, due to penetrating chest trauma. The required information including age, sex, cause of trauma, type and site of injury, and accompanying injury was obtained and used to fill out a questionnaire and then was analyzed. 828 patients were included in the study; most of them were in the age range of 20-29. Of the patients, 97.6 % were males. The most frequent cause of trauma was stabbing, and the most frequent injuries following the trauma were pneumothorax and hemothorax. Orthopedic trauma was the most frequent accompanying injury. The most commonly used diagnostic method was plain chest radiography. In 93 % of the patients, the chest tube was placed and thoracotomy was performed for 97 % of the patients. Shahid Bahonar Hospital is a referral Trauma Centre and treats large number of chest trauma patients. Most patients need only chest tube placement as a definitive treatment

The Cardiac Rehabilitation Psychodynamic Group Intervention (CR-PGI): an explorative study

Objective: An explorative study focusing on the process of a Cardiac Rehabilitation Psychodynamic Group Intervention (CR-PGI) addressed to myocardial infarction (MI) patients is discussed. The study aimed at analyzing whether the treatment based on CR-PGI serves as a communicational context within which MI patients are enabled to explore new interpretations of their post-infarction condition. Methods: The intervention, divided into 12 weekly one-hour group sessions, was addressed to MI patients recruited within a Public Hospital of southern Italy. Each session was audio-recorded and lexical correspondence analysis (LCA) was applied to the verbatim transcripts, in order to provide a map of the evolution of the communication exchange occurring over the 12 sessions. Results: The findings showed that the discourses associated to the first eight sessions differed from the discourses of the last four sessions. Two main transitions occurred. The first concerns the response to the infarction, first interpreted as a process of affective elaboration and afterwards as practical management of the functional aspects associated with the condition of MI patients. The second concerns the nature of the change and contrasts a lifestyle-oriented model with a social role approach, which refers to social, legal, and medical practices related to the acknowledgment of being an MI patient. Conclusion: The findings offer preliminary support to the capacity of CR-PGI to work as a context where new meanings for the biographical rupture of the MI can be explored. Consistently with the rationale of the model, the intervention seems to have promoted the emergence of new ways of feeling and understanding one’s condition

HEALTHCARE AND CULTURE: SUBJECTIVITY IN THE HEALTHCARE CONTEXTS.

The book deals with current issues, pertinent every healthcare relationship. Changes in medicine as well as some constant aspects over time arise within a cultural ground and generate new questions and issues that are not only purely medical, but also bioethical, social, political, economic and psychological of course. On the one hand, changes in medicine generate new questions for society, on the other hand, the society poses new questions to the medicine, new challenges, and in some cases they can conflict with consolidated models and practices. Never the progress of Western medicine and its therapeutic practices have been as significant as in the last decades but the increase of specific competence and effectiveness of medical treatments are not linearly translated into an increase of consensus, dialogue and alliance between medicine and society. How does psychology take on a position of interlocutor towards medicine and its transformations? How does Cultural Psychology, Health Psychology, Clinical Psychology confront themselves with the processes of meaning making generated by medicine? The interest of the book is aimed to grasp the construction of processes of cultural, relational and subjective meaning in the dialogical encounter between medicine and society, between doctor and patient. The book intends to focus in particular on two specific plans: on the one hand, to present a reflection and analysis on contemporary medicine and its on‐going transformations of the healthcare relationship; on the other hand, to present and discuss experiences of intervention and possible models of intervention addressed to healthcare and doctor‐patient relationships during its crucial steps (consultation, formulation and communication of diagnosis, therapy, conclusion). The book’s purposes are aimed to discuss crucial and current issues on the borders between medicine and psychology: consensus and sharing, decision‐making and autonomy, subjectivity and narration, emotions and affectivity, medical semeiotics and cultural semiotics, training of physicians, and epistemological, theoretical and methodological issues. CONTENTS Series Editor’s Preface: Caring for Health Care: Cultural Processes in Medicine, Jaan Valsiner. Introduction: The Meaning Making Processes of Healthcare Relationship in the Current Scenario, Maria Francesca Freda and Raffaele De Luca Picione. PART I: HEALTHCARE RELATIONSHIP AS ARENA OF MEANING. FROM CULTURAL ISSUE TO SUBJECTIVE CONSTRUCTION OF ILLNESS. Medicine as a Complex Set of Cultural Systems of Meanings, Raffaele De Luca Picione. The Border Into Wonderland: When Words Between Doctor and Patient Is Not Enough, Jensine Nedergaard. Autonomy: A Concept at the Crossroads of Medicine and Psychology, Giovanni Guerra. The Role of the Meaning‐Making Process in the Management of Hereditary Angioedema, Livia Savarese, Maria Bova, Raffaella Falco, Maria Domenica Guarino, Gerarda Siani, Paolo Valerio, and Maria Francesca Freda. PART II: HEALTHCARE RELATIONSHIP AS ARENA OF TRANSFORMATION: FROM COMMUNICATION TO DIALOGUE. Psychological Scaffolding in the Healthcare Relationship: A Methodological Proposal, Maria Francesca Freda, Raffaele De Luca Picione, and Francesca Dicè. Breaking Bad News: Theory and Practice for Healthcare Professionals’ Training, Giulia Lamiani, Daniela Leone, Elaine C. Meyer, and Elena Vegni. Psychologists and Family Physicians in an Experience of Collaborative Care in Italy: An Effort Towards Integration and Against Stigma, Luigi Solano, Barbara Cordella, Michela Di Trani, Rosa Ferri, and Alessia Renzi. Clinical Psychology in Hospital Setting, Renzo Carli, Rosa Maria Paniccia, Silvia Policelli, and Andrea Caputo. PART III: MENTAL HEALTHCARE AS PARADIGMATIC ARENA TO UNDERSTAND THE COMPLEXITY OF HUMAN RELATION. From Psychopathology to Service. A New View of the Clinical Psychology Intervention, Sergio Salvatore, Claudia Venuleo, Valeria Pace, Marianna Puglisi, Mari Tandoi, Annalisa Venezia, Rossano Grassi, and Gianna Mangeli. Recovery, Paternalism and Narrative Understanding in Mental Healthcare, Tim Thornton. “Why Do You Then Not Shit?” Diagnosis and the Semiotic Sphere, Yair Neuman. PART IV: PREGNANCY AND MOTHERHOOD: A CHALLENGING ARENA FOR DIALOGUE BETWEEN MEDICINE AND PSYCHOLOGY. Birth Experience as Socially and Culturally Regulated Event, Kristiina Uriko. The Generative Function of a Healthcare System: Linking Meanings Between Chronic Illness and Motherhood, Giorgia Margherita, Maria Carlino, and Francesca Tessitore.Doctor‐Patient Relationship in Face of Grief/Mourning: The Case of Gestational Losses, Vivian Volkmer Pontes and Ana Cecília Bastos.Conclusion: Healthcare Relationship: An Open Space Dialogue in Search of Its Own Forms, Maria Francesca Freda and Raffaele De Luca Picione. About the Authors