Fortschritte der Neurologie-Psychiatrie
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Fortschr Neurol Psychiatr · Sep 1991
Review[Prognostic factors in rehabilitation after severe craniocerebral injuries].
Even with modern standards of intensive care management and rehabilitation services, severe head injury often results in permanent disability. A review of the literature concerning predictors of outcome after severe head injury is presented. The early identification of those factors which are of greatest significance in determining outcome is of essential value in the appropriate management of rehabilitation therapy. ⋯ The presence of previous brain damage also seems extremely important. In contrast, the prognostic value of pretraumatic personality factors and of the psychosocial status of the head injured patient requires additional research. Comparison among studies is hindered by differences in patient samples, timing of assessments, and various outcome measures with respect to rehabilitation management.
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Fortschr Neurol Psychiatr · Sep 1991
Historical Article[Placebos: aspects in medical history and approaches to definition].
The historic roots of the term placebo, its development from religious to secular use and finally its establishment as a medical terminus at the end of the 18th century are described. After the first and rare placebo publications in the 30ties and 40ties a sudden increase in the number of published placebo articles took place since 1950. In the following decades the progress in experimental placebo investigations was overwhelming and placebo phenomena more and more became a subject of scientific inquiry in its own. ⋯ In particular the 'myth of the non-specificity of placebos' will be critical reviewed and reconsidered. Finally, after a short retrospective view to placebo definitions in medical dictionaries since the 19th century the actual controversy between pharmacological and general placebo definitions is outlined. Two modern definitory propositions of Shapiro and Morris, 1978, and Brody, 1980, are presented and discussed in detail.