RESUMEN
Corneal calcification is a vision-threatening manifestation of calcium containing agents in ocular burn. As we previously reported, our interest was sparked by a particular discrepancy of a case: A patient treated for a non-calcium containing agent in eye burn from exposure to an alkaline mixture of NaOH and KOH, who unexpectedly developed corneal calcification. This current study aims to elucidate whether the 2min lasting irrigation with a phosphate-buffered saline itself, regardless of rinsing regimen, triggers corneal calcification. The Ex Vivo Eye Irritation Test (EVEIT) system was used on rabbit corneas to replicate the very same phosphate-buffered saline solution the patient was treated with. The rabbit corneas were first burned with 1 M NaOH, rinsed with 4.9% phosphate-buffered saline for 2 min, and were then moisturized with an artificial tear solution for 48 h. All corneas were fluorescein-stained for photo documentation, snap-frozen, lyophilizated, and the electrolyte content was analyzed by Energy-Dispersive X-ray spectroscopy (EDX). The EDX analysis revealed pathological phosphorous in corneal stroma after a single rinsing with phosphate-buffered saline. Ongoing application of artificial tears containing physiological 14.581 mmol Ca2+ /l led to macroscopically visible calcification, but only in areas of induced corneal erosion. Regardless of the rinsing protocol neither 2 or 15 min of eye rinsing with phosphate containing rinsing solutions, we have given proof that corneal calcification is a foreseeable effect of the phosphate-buffered saline rinsing of mechanically epithelial damaged and chemically burnt eyes. Thus, it is crucial to legally restrict the formulations of phosphate-buffered salines in the medical treatment of eye burns, corneal erosions or chemical splashes of the eye.
Asunto(s)
Quemaduras Químicas/terapia , Calcinosis/inducido químicamente , Córnea/efectos de los fármacos , Quemaduras Oculares/terapia , Fosfatos/farmacología , Solución Salina/química , Irrigación Terapéutica/métodos , Adulto , Animales , Tampones (Química) , Quemaduras Químicas/etiología , Calcinosis/patología , Córnea/diagnóstico por imagen , Quemaduras Oculares/inducido químicamente , Primeros Auxilios , Humanos , Técnicas In Vitro , Masculino , Fosfatos/efectos adversos , Conejos , Hidróxido de Sodio/toxicidad , Espectrometría por Rayos XAsunto(s)
Mamografía , Tamizaje Masivo/organización & administración , Área sin Atención Médica , Unidades Móviles de Salud , Adulto , Anciano , Neoplasias de la Mama/prevención & control , Centros Comunitarios de Salud , Análisis Costo-Beneficio , Estudios de Factibilidad , Femenino , Florida , Promoción de la Salud , Accesibilidad a los Servicios de Salud/economía , Humanos , Mamografía/economía , Persona de Mediana Edad , PobrezaRESUMEN
In the course of collecting historical material about the first psychoanalytic in-patient clinic ("Sanatorium Schloss Tegel") in the years 1927-1931, the authors discovered an unpublished typescript by Ernst Simmel entitled "Neurotic criminality and lust murder". On the basis of clinic records, excerpts from letters, and personal information, the authors supplement Simmel's treatment report of a lust murderess with a historical, documentary text, which is followed by Simmel's paper.
Asunto(s)
Trastorno de Personalidad Antisocial/historia , Homicidio/historia , Trastornos Parafílicos/historia , Pedofilia/historia , Psicoanálisis/historia , Femenino , Alemania , Historia del Siglo XX , HumanosRESUMEN
UNLABELLED: In 54 patients with excessive obesity a silicone balloon was implanted endoscopically into the stomach. The overweight amounted to 76% (median) by Broca's formula. The therapeutical plan included balloon-implantation, dietary treatment, psychotherapeutical guidance, kineto-therapy and balloon-extraction. According to their therapeutical compliance there were three different groups of patients: G1 - maintenance of therapy; G2 - discontinuation of therapy; G3 - no additional therapy at all after balloon implantation. Up to the sixth week a weight reduction of 9.5-20.5 kg could be demonstrated in all groups. Only in the first group a further weight reduction by a mean of 20 kg after 20 weeks was noted. Patients in group 2 and 3 - in some the balloon was still implanted - had a renewed weight increase sometimes surmounting the original weight. COMPLICATIONS: 3 gastric respectively duodenal ulcers, one subileus. The long-term success can only be obtained by a multi-component therapy plan.
Asunto(s)
Obesidad Mórbida/terapia , Prótesis e Implantes , Adulto , Terapia Combinada , Dieta Reductora , Femenino , Estudios de Seguimiento , Mucosa Gástrica/patología , Humanos , Intubación Gastrointestinal , Masculino , Cooperación del PacienteRESUMEN
Under the conditions of persecution and repression imposed by Nazi Germany there was no productive contribution to psycho-analytical science. The limitations responsible for this are outlined. After classing the psycho-analytical writings of these years into groups, the production and publication practice of the period is examined through the works of Alexander Mette. Even when the clinical problems of applied psycho-analysis were set aside, as in the analytico-biographical study of Novalis, made jointly with Edmund Bergler in 1935, this was insufficient to guarantee the possibility of completing the study. Novalis was among that group of German poets and thinkers who were lauded as discoverers of the unconscious in order to diminish the importance of Freud's pioneer work. In spite of the failure of the Novalis project, Mette's effort to preserve publishing autonomy, through his publishing house (Dion-Verlag) must be considered a noteworthy attempt to oppose official regimentation (Gleichschaltung). Mette's personal development after the war, when he replaced Freud by a new idol, Pavlov, is treated briefly.