Telephone Associated Pathology: Clinical Case Studies and Discussion

The advancement of modern technology shapes and develops new expressions of psychopathology and accompanying treatments. This is most apparent with the telephone, an instrument of contact and communication for the patient, and assessment and intervention for the therapist. The telephone both constrains and creates unique constellations of patient symptomatology. This paper will examine one such telephone symptom complex-the habitual over use of the telephone by non-bipolar patients. The frequent monopolization of the phone seen in some bipolar patients will not be considered, though the elements of intrusion and aggression discussed in this paper are probably shared by manic patients. A review of the psychiatric literature reveals a surprising paucity of writing about the psychodynamic significance of patient\u27s use of the telephone, even in the area of sexual paraphilias and sexually obscene phone calls. Freud describes the telephone as a representation of the body, and as a metaphor for psychoanalysis (1,2). Stekel (3) discusses the telephone as a sexual symbol, and Harris (4) relates phobic anxiety of the telephone to castration anxiety. Fliess (5) is the first to write of telephoning as a symbol for masturbation, an idea elaborated by Shengold in his paper The Symbol of Telephoning (6). Alman si, Socarides, and others have written of the use of the telephone in sexual paraphilias (7,8) . The bulk of writing in the mental health literature, however, focuses on the use of the telephone in counseling services and suicide hotlines. With the ever increasing utilization of the telephone by patient and therapist alike, this limited analysis of the meaning and uses of the telephone in the psychiatric literature is an intriguing deficiency in the understanding of patient behavior

Potential Drug Interactions with Coumadin (Warfarin) and Prozac (Fluoxetine): A Brief Report and Review of the Literature

We were asked to see a woman with recurrent depression and a history of deep vein thrombosis. (Consultation and Liaison Service). She had been started initially on Prozac (fluoxetine) and was secondarily started on Coumadin (warfarin). The patient presented with severe bruising of both lower extremities. We were asked to investigate the case to determine if a drug interaction with Prozac had produced the problem. A review of the world\u27s literature failed to produce a report of a drug interaction between Prozac and Coumadin producing a bleeding disorder. Scrutiny of this case could not produce evidence that this occurred. A retrospective analysis of 4 additional cases was performed. None of these patients required adjustment of their Coumadin while on Prozac

Laparoscopic surgery for large hydatide liver cyst after two previous laparotomies [Laparoskopska operacija velike ehinokokne ciste jetre nakon prethodno učinjene dvije laparotomije]

Laparoscopic surgery for hepatic echinococcosis is a technically difficult and demanding surgical procedure even for the most experienced abdominal surgeon. Surgery is performed after the conservative treatment with albendazole for 28 days. We report a case of laparoscopic partial pericystectomy with biliostasis and omentoplasty in a patient with two previously open surgeries (laparotomies)--right subcostal laparotomy for acute inflammation of the gallbladder and right pararectal laparotomy for perforated gangrenous appendix. The patient underwent extensive laparoscopic adhesiolysis due to pronounced intra-abdominal adhesions to gain access to a large hydatid cyst with the diameter of 11 cm. Laparoscopic surgery is much less traumatic to the patient with a better cosmetic effect

Laparoscopic Repair of Perforated Peptic Duodenal Ulcer

Although prevalence of peptic ulcer is decreasing, the number of peptic ulcer perforations appears to be unchanged. This complication of peptic ulcer is traditionally surgically treated. In recent years, a number of papers have been published where the authors managed perforated duodenal peptic ulcer in selected patients using laparoscopic approach. Laparoscopic treatment of perforated duodenal ulcer has been described as safe and advantageous compared to open technique but advantages are still not clear due to small number of cases in published studies. Based on these recommendations we decided to establish our own protocol for laparoscopic treatment of perforated peptic duodenal ulcer. In this prospective study we evaluated the first 10 patients in whom we performed laparoscopic repair of perforated duodenal ulcer. There were no conversions to open procedure and no early postoperative complications. The patients were contacted by phone a year after the operation, and all were satisfied with the operation and the appearance of postoperative scars. We regard laparoscopic repair of selected patients with perforated duodenal ulcer as a safe and preferable treatment

Isolated Splenic Metastasis from Colon Cancer – Case Report and Literature Review

Solitary splenic metastases are very rare and sporadic. There are several explanations for this low incidence of splenic metastasis including anatomical, histological and immunological features of the spleen. In this paper we present a case of 70-year-old man with no history of previous diseases who was first operated under the diagnosis of acute abdomen revealing perforated colon tumor of splenic flexure with no metastases at that time. Left hemicolectomy was performed followed by postoperative complications demanding a subtotal colectomy and ileostomy. Primary tumor was classified as Dukes (Astler-Coller)-C2, T4N1M0. Patient was referred to oncologist and received chemotherapy (5FU, Leucovorin). 5 months later continuity of the gut was performed by ileosygmoanastomosis. 2 years after first surgical procedure, a CT scan and abdominal ultrasound, followed by needle biopsy, showed isolated metastasis in spleen, so splenectomy was performed. Pathological findings revealed sharply bordered, partially necrotic tumor inside of spleen tissue, spreading to, but not reaching splenic hilum. Histology showed low to medium differentiated adenocarcinoma tissue with desmoplastic stromal reaction. There were no protrusions of tumor cells through spleen surface. In splenic hilum 4 tumor free lymph nodes were harvested. No additional chemotherapy was conducted. The latest follow up, a year after diagnosis of metastasis showed no signs of cancer disease. Review of the literature showed that long term survival and prognosis of isolated splenic colorectal metastasis after splenectomy are rather optimistic, although these are the cases of distant metastasis. Due to small number of cases reported in literature, definitive conclusions and/or guidelines for the treatment of isolated splenic metastasis cannot be given, but splenectomy and chemotherapy are preferable in the treatment, promising long term survival at least for metachronous metastasis

I Rode Six Miles to Zion : The Experiences of a Circuit Rider in Virginia

HistoryMaster of Arts (M.A.

A comparison study on teacher-centered and inquiry-based instruction in science education of middle school students with learning disabilities: what is effective?

The purposes of the study are to examine the effects of inquiry-based and teacher-centered instruction methods when teaching science for middle school students with learning disabilities. These two instructional methods were provided to 81 students in two middle schools located in southern New Jersey. Of those, 30 students with learning disabilities, 15 in each school participated in the study. Both groups were given a pre and post test prior to and after the three weeks of science instruction to evaluate student performance. In addition, a student and teacher survey was provided to examine their satisfaction. The results show that students with learning disabilities receiving teacher-centered instruction gained 11% higher on the posttest than those taught by inquiry-based instruction. However, students receiving inquiry-based instruction reported that they enjoyed their learning and would have a career in science

Actual and Future Perspectives of Isothermal NSC-Engines

It is doubtless that the world population, energy consumption and worldwide environment and biosphere pollution are growing almost synchronously and exponentially and this fact is causing enormous environmental problems and will continue to do so (CO2, NOX and the consequences; global earth warming, global earth dimming, ozone hole, global climate changes etc. The energy reserves of the planet will be approx. until the end of the actual century well exhausted). One can deduce that the solutions for a number of mentioned problems are in the improvement of some of the primary causal factors, especially the current thermal engines. This can satisfactorily be achieved only: A) By developing new high efficiency thermal engine concepts, e.g. the newly-developed “NSC-Concept” (NSC=New Stirling engine Concept [1]), and on this concept based “Isothermal NSC-engines [4]”, geared for consequent use of actual conventional and alternative energy sources (e.g. all combustible gases - especially hydrogen, solar energy sources, geothermal and other energy sources and waste heat or waste cold sources). B) By invention and application of new energy sources and technologies, especially the industrial hydrogen production and in this way to start the “Hydrogen energy age” [3]. This topic and NSC-concept was thoroughly analysed by the first author (PhD Thesis [1]). Both authors reported about it several times and recently in [5], [6] and [12]. The research results show that new isothermal NSC-engines are and will be suitable for nearly all application fields of the actual thermal engines. The paper presents an overview of the latest results of the above-mentioned research and presents actual and possible future application perspectives of isothermal process based thermal NSC-engines