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The authors reviewed 21 studies dealing with the rate of diagnosed and undiagnosed physical illnesses in the psychiatric patient population. These studies performed by different authors in variable clinical settings with diverse methodology in different locations over a period of 45 years yielded a close concordance. Approximately half of the patients (50.1%) suffered from significant physical illnesses, of these 58.2% were previously undiagnosed. A substantial portion of the physical illnesses (27.1%) produced symptoms showing direct relation to the psychopathology of the patient. These numbers are quite close to those found by authors in earlier research.

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Symptoms of significant medical illnesses, in this case subdural hematoma, is easily overlooked in midst of alcohol withdrawal. Unusual symptoms must be regarded with caution.

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A striking accumulation of new technologies and recent diverse research developments open new insight into the nature of primary dementias. The gene of the familial form of Alzheimer's disease was located in the chromosome 21. By further study of the amyloid protein precursor gene, laboratory diagnosis and eventual treatment of Alzheimer's disease may become a reality. This paper reviews and adds perspective to old and new data on the cortical dementias: Alzheimer's disease and Pick's disease.

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This article reviews the medical aspects of mental retardation with a focus on classification, types of retardations, evaluation and therapies, and etiology.

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A case of altered kinetics of amitriptyline in a patient with porto-caval anastomosis and liver cirrhosis who showed an unusually strong sedative response to the drug, is presented. Therapy with tricyclic antidepressants should be initiated with lower doses and adjusted by plasma level monitoring in patients with liver by-pass.

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A case of renal echinococcosis, most uncommon in Hungary, is reported. The problems of diagnosis and therapy are discussed. It is emphasized that difficulties of diagnosis, particularly differential diagnosis, arise mainly in countries where the incidence of echinococcosis is low. It is with the aid of the new diagnostic methods that an echinococcus cyst has been identified preoperatively in an occluded kidney which had been out of function for years.

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In 37 of the 258 patients with pelvic fractures rather severe urological complications were diagnosed. It seems that the majority of polytraumatized patients can be considered as potential urologic cases. The characteristic urological complications associated with the various types of fractures are described. The importance of urgent urological examination is stressed in order to detect urological injuries requiring acute care and to determine the need for operation or for conservative treatment. Co-operation between the traumatologist, the urologist and the radiologist will ensure the definitive care of the polytraumatized patient and the best chances for recovery.

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After a brief review of renal tumours diagnosed on the basis of metastases, two cases are described in which subcutaneous formations believed to be lipomas were metastases of symptomless hypernephromas. One case was diagnosed early on basis of the histological finding. The primary tumour could be localized only by angiography. After nephrectomy and resection of the contralateral rib and pleura, the patient was free of symptoms for one year. In the subsequent year a pathologic subtrochanteric fracture called attention to a new metastasis. After laminar osteosynthesis function of the hip and knee joints was satisfactory and so has been the general condition ever since the first operation now for three years. In the second case, the knot assumed to be a lipoma was removed but no histological examination was carried out. These experiences have induced the authors to call attention to the importance of histological examination of apparently banal lesions and to the considerable survival which can be achieved in these patients.

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Major medical illnesses remain undiagnosed and patients' ailments are being labeled "psychosomatic" at an alarming rate. A careful screening of 2,090 psychiatric clinic patients showed that 43% of this population suffered from one or several physical illnesses. Almost half of the physical illnesses (46%), remained undiagnosed by the referring source. Morbidity in the psychiatric clinic patients far surpassed the expected rate found in the general population. Among others, diabetes mellitus was a frequently overlooked diagnosis and proved, particularly, to produce emotional disturbances. Physicians other than psychiatrists missed one third and psychiatrists one half of the major medical illnesses in patients they referred. Self-referred and social agency--referred patients almost always had undiagnosed physical illnesses. The causes for failing to recognize medical illnesses are discussed. Based on the obtained data, the necessity for a medical orientation on the part of psychiatrist in evaluating all patients is stressed.

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The favourable experience gained with the so-called modified Denis-type method is described. It is stressed that the method has all the advantages which are ensured by the Hencz-type haemostatic thread. In addition, the patient is spared many unpleasantness and post-operative complaints. Post-operative treatment is easier since a separate flow from the loge and from the bladder is provided for. The results of different methods are compared on the basis of 150 prostatectomies performed in the Department of the authors.

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