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Query: UMLS:C0042571 (vertigo)
 7,148 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Anxiety is the fifth most common clinical diagnosis in the primary care setting. Panic disorder, a severe episodic form of anxiety, has been found to occur in approximately 6% of primary care patients. These patients often selectively focus on one of the frightening autonomic symptoms and are frequently misdiagnosed. The three most common presentations of panic disorder in the medical setting are cardiac symptoms (chest pain, tachycardia), neurologic symptoms (headache, dizziness/vertigo, syncope), and gastrointestinal symptoms, especially epigastric distress. The presentation of cardiac symptoms by patients with panic disorder is especially likely to lead to expensive and potentially iatrogenic medical testing. Hypertension and peptic ulcer are the most commonly associated medical diagnoses in patients with panic disorder. Major depression, alcohol abuse, simple phobias, and posttraumatic stress disorder are the most frequently associated psychiatric diagnoses. Psychopharmacologic treatment of panic disorder has been demonstrated to be highly effective in double-blind, placebo-controlled studies. Effective psychopharmacologic agents include the tricyclic antidepressants (notably imipramine and desipramine), the monoamine oxidase inhibitors (phenelzine), and the high-potency benzodiazepines (alprazolam).
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PMID:Panic disorder: epidemiology, diagnosis, and treatment in primary care. 353 Nov 89

The consequences of the severe head injuries should be estimated 1-2 years following the injury. The evaluation must be based upon certain postulates which are to be obligatory for the team of experts (neuropsychiatrist, otologist, ophthalmologist, neuro-radiologist, clinical psychologist). They must work simultaneously as a team for it is the only way to establish the precise qualification of the damage in question. The clinical work up to now has shown many weak points. The first postulate is the information on the state of health prior to the injury: previous injuries and their sequelae, psychopathological manifestations, alcohol abuse, disturbances of the consciousness, vertigo, disturbances of the sight and hearing etc. The second postulate is the review of the case history regarding the acute period of the injury: the qualification of the injury, the duration of the state of unconsciousness and post-traumatic amnesia, focal neurological signs, psychological disturbances, EEG, CT etc. The third postulate is a detailed clinical examination including paraclinical parameters neurological examination (focal neurological signs, hemicerebral syndrome and very seldom-parkinsonism) with consultation of otologist (vestibularis, audiogram) and ophthalmologist (visus, fundus, campus, intraocular pressure), EEG (longitudinal follow-up), possible evoked cerebral potentials. The epilepsy syndrome must be based upon clinical and EEG criteria, while the selection must be very strict. In there are structural brain changes the collaboration with the neuroradiologist is important. Psychological disorders: neurasthenic neurosis, personality disorders, and rarely dementia. It should be clinically confirmed accompanied by psychological tests.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A doctrinaire approach to evaluation of sequelae of craniocerebral injuries]. 796 91

Bleeding pseudocysts respectively pseudoaneurysms represents a seldom complication of chronic pancreatitis in owing to erosion of pancreatic or peripancreatic arteries. The potential rupture into neighbouring organs or in the peritoneal cavity is accompanied with paramount life-threatening risks. During the last years we observed 3 patients with acute intestinal bleeding caused by pseudocysts converted to pseudoaneurysms. The goal of our report is to analyze the diagnostic tools and the management of patients with bleeding pancreatic pseudocysts, also well establish the clinical constellation, which is typical for this complication, the best diagnostic tool and the modalities to immediate control of the acute bleeding situation. All three patients suffered from chronic pancreatitis and alcohol abuse. The first patient had a known pancreatic pseudocyst, which penetrated through the gastric wall and caused a life-threatening bleeding. The second patient was admitted in owing to melena. The examinations yielded a pancreatic pseudocyst with hematosuccus pancreatis. The third patient suffered from abdominal pain and vertigo caused by anemia. With endoscopy, Cat and celiacography a pancreatic pseudocyst with cysto-colic fistula has been identified. The color-doppler ultrasound revealed a pseudoaneurysm supplied from a splenic artery branch. With management of these patients with hemorrhagic complications of pancreatic pseudocysts we acquired the following findings: 1. Patients with known chronic pancreatitis and abdominal tumor, especially when accompanied by epigastric pain and anemia, are highly suspicious for pancreatic pseudoaneurysms. 2. The color-doppler ultrasound is the best diagnostic tool, since this investigation can establish the pseudoaneurysm and identify the source.
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PMID:[Hemorrhage from pseudocysts caused by pseudoaneurysms in chronic pancreatitis. Diagnosis and management]. 837 41

This study examined the reasons for referral of patients from general practice to health centre hospitals in central and northern Finland during one week in 1994. Participants were 806 general practitioners (GPs) from public health centres. Outcome measures were reasons for referral by ICPC codes, with respect to characteristics of patients, GPs, and practices. A total of 723 patients (1.4%) were referred from 53,633 consultations. Most referrals (532, 74%) were from out of hours consultations. The most commonly reported reasons for referral in the age group under 65 years were alcohol abuse for males and vertigo for females. For patients aged 65 or over, angina pectoris was the most common reason for referral for both male and female patients. Our results will be useful in developing primary healthcare and the training of GPs. Future research should focus on alcohol-related diseases in those patients referred to health centre hospitals.
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PMID:Drinking problems load health centre hospitals in Finland. 1042 24