1/4. Psychosomatic disorders in pediatrics.Psychosomatic symptoms are by definition clinical symptoms with no underlying organic pathology. Common symptoms seen in pediatric age group include abdominal pain, headaches, chest pain, fatigue, limb pain, back pain, worry about health and difficulty breathing. These, more frequently seen symptoms should be differentiated from somatoform or neurotic disorders seen mainly in adults. The prevalence of psychosomatic complaints in children and adolescents has been reported to be between 10 and 25%. These symptoms are theorized to be a response to stress. Potential sources of stress in children and adolescents include schoolwork, family problems, peer pressure, chronic disease or disability in parents, family moves, psychiatric disorder in parents and poor coping abilities. Characteristics that favour psychosomatic basis for symptoms include vagueness of symptoms, varying intensity, inconsistent nature and pattern of symptoms, presence of multiple symptoms at the same time, chronic course with apparent good health, delay in seeking medical care, and lack of concern on the part of the patient. A thorough medical and psychosocial history and physical examination are the most valuable aspects of diagnostic evaluation. Organic etiology for the symptoms must be ruled out. Appropriate mental health consultation should be considered for further evaluation and treatment.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/4. Group therapy in the management of epilepsy.A pilot project using group therapy with patients from an epilepsy clinic is described. Observations of the group show that members were able to discuss their feelings about having epilepsy, and the difficulties the disorder caused in all areas of their lives, and to tolerate and learn from seizures which took place during group meetings. The greatest benefit was meeting others with epilepsy and sharing experiences in an environment that was not overprotective or overanxious, in contrast to their usual surroundings. The author suggests that groups of a similar nature could be a useful addition to the management of people with epilepsy.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/4. hyperventilation and myocardial infarction.chest pain that is associated with hyperventilation is often considered to be benign and noncardiac in nature. While not commonly recognized, hyperventilation can provoke coronary vasospasm. We report a man who presented with hyperventilation and developed myocardial infarction. In the setting of hyperventilation, chest pain and ST segment elevation, coronary vasospasm must be considered.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/4. When a sigh is just a sigh . . . and not asthma.Sighing is a normal physiologic response, expanding the lungs to vital capacity, usually followed by a prolonged expiratory phase. Sighing dyspnea is a condition that may be mistaken for asthma, and should be considered in the atypical cases. Recognizing sighing dyspnea at the onset may save patients from having to undergo extensive diagnostic evaluations and treatments. This condition, once identified, can often be easily treated by explaining the benign nature and giving reassurance to the patient.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |